South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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The effect of suxamethonium on serum potassium levels was studied in 20 black patients undergoing emergency surgery. All patients were resuscitated pre-operatively to achieve a normal pH (range 7.35-7.45), normal electrolyte values (potassium range 3.5-4.5 mmol/l), and an adequate circulating blood volume using the criteria of systolic blood pressure in excess of 100 mmHg and a central venous pressure maintained at more than 2 cm H2O. Suxamethonium (approximately 0.8 mg/kg) was administered during a standard rapid intubation sequence for the induction of anaesthesia. In the adequately resuscitated emergency patient an induced respiratory alkalosis may prevent the rise in serum potassium previously reported with the use of suxamethonium.
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Analgesics containing dipyrone continue to be available throughout Africa, including South Africa and Zimbabwe. Although an effective analgesic and antipyretic, dipyrone may cause severe side-effects, including agranulocytosis. The mechanism of this hypersensitivity reaction has been well documented, and many reports of agranulocytosis associated with dipyrone use have been published. ⋯ Dipyrone is known by a variety of official names, which may contribute to confusion in deciding whether a particular preparation contains this drug. The prescribing information contained in the Monthly Index of Medical Specialities (MIMS) (South Africa) and the MIMS Desk Reference is inadequate for some of the products available, although the package inserts do provide more detailed information. The continued use of these products is difficult to justify when safer alternatives are available.