Journal of toxicology. Clinical toxicology
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J. Toxicol. Clin. Toxicol. · Jan 1994
Elevated serum creatine kinase (CK-MM) in petrol sniffers using leaded or unleaded fuel.
This study examined blood lead and creatine kinase levels in a group of 24 Australian Aboriginal males admitted to the hospital for treatment of severe petrol sniffing related illness after using only leaded petrol and 27 sniffers, 16 ex-sniffers and 13 non-sniffers from an isolated Aboriginal community using only unleaded petrol. Creatine kinase levels (which were nearly all creatine kinase-skeletal muscle isoenzyme indicating skeletal muscle damage) were correlated with blood lead levels and were elevated in active sniffers of leaded petrol on admission to hospital but were also increased in those sniffing unleaded petrol in the remote community. ⋯ The data suggest that elevated creatine kinase associated with petrol sniffing may be due to compounds in petrol other than the lead additives, possibly volatile hydrocarbon components. Elevated creatine kinase may be useful in detecting current petrol sniffing activity, particularly in locations using unleaded petrol.
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J. Toxicol. Clin. Toxicol. · Jan 1993
Hydroxocobalamin as a cyanide antidote: safety, efficacy and pharmacokinetics in heavily smoking normal volunteers.
The safety, efficacy and pharmacokinetic parameters of 5 g of hydroxocobalamin given intravenously, alone or in combination with 12.5 g of sodium thiosulfate, were evaluated in healthy adult men who were heavy smokers. Sodium thiosulfate caused nausea, vomiting, and localized burning, muscle cramping, or twitching at the infusion site. Hydroxocobalamin was associated with a transient reddish discoloration of the skin, mucous membranes, and urine, and when administered alone produced mean elevations of 13.6% in systolic and 25.9% in diastolic blood pressure, with a concomitant 16.3% decrease in heart rate. ⋯ Hydroxocobalamin alone decreased whole blood cyanide levels by 59% and increased urinary cyanide excretion. Pharmacokinetic parameters of hydroxocobalamin were best defined in the group who received both antidotes: t1/2 (alpha), 0.52 h; t1/2 (beta), 2.83 h; Vd (beta), 0.24 L/kg; and mean peak serum concentration 753 mcg/mL (560 mumol/L) at 0-50 minutes after completion of infusion. Hydroxocobalamin is safe when administered in a 5 gram intravenous dose, and effectively decreases the low whole blood cyanide levels found in heavy smokers.
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J. Toxicol. Clin. Toxicol. · Jan 1992
Comparative StudyA comparison of amrinone and glucagon therapy for cardiovascular depression associated with propranolol toxicity in a canine model.
This study's objective is to evaluate the ability of glucagon and amrinone to reverse propranolol induced cardiovascular depression in a canine model, compared to a control of normal saline. The study design included 18 animals which received intravenous propranolol (10 mg/kg) resulting in significant depression in heart rate, cardiac output, mean arterial pressure, maximal ventricular dP/dt and stroke volume. Each canine was randomly assigned to one of three treatment groups; controls (normal saline only), glucagon (20 micrograms/kg bolus) and amrinone (4 mg/kg bolus). ⋯ Beta blocker induced bradycardia did not respond significantly to amrinone while glucagon induced a tachycardia which is unique to canines. It is concluded that in this canine model, amrinone appears to be an effective therapeutic alternative to glucagon for reversing depressed dP/dtmax, cardiac output and stoke volume induced by propranolol toxicity. Unlike glucagon, amrinone appears to lack positive chronotropic activity which may limit its clinical utility in the treatment of beta blocker overdose.
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J. Toxicol. Clin. Toxicol. · Jan 1991
Case ReportsTaiwan National Poison Center survey of glyphosate--surfactant herbicide ingestions.
Between January, 1986 and September, 1988, the Taiwan National Poison Center recorded 97 telephone consultations (49 male, 48 female) on cases of ingestion of glyphosate-surfactant herbicide concentrate containing the isopropylamine salt of glyphosate (N-phosphonomethyl glycine, CAS 1071-83-6) and a non-ionic tallow amine surfactant. Eleven of the cases resulted in fatalities, all among those attempting suicide. The average amount ingested by survivors was 120 +/- 112 mL and by nonsurvivors was 263 +/- 100 mL (p less than or equal to 0.0001). ⋯ Thirteen percent of patients received a urine test for paraquat or treatment customarily used for paraquat ingestion, possibly reflecting similar initial presentations following ingestion of these two herbicides. Laboratory differentiation is essential if any doubt exists about which herbicide was ingested. Patients ingesting large volumes of concentrated glyphosate-surfactant herbicide formulations require close observation and supportive treatment.