Veterinary and human toxicology
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Case Reports
Fentanyl patch abuse: naloxone complications and extracorporeal membrane oxygenation rescue.
Fentanyl patches offer a novel, but increasingly common method of drug abuse. We describe a patient who developed severe respiratory dysfunction after fentanyl patch abuse via insufflation, naloxone administration and aspiration. ⋯ To our knowledge, this is the 1st reported case of ECMO being used to correct severe pulmonary dysfunction associated with opioid abuse. The risks associated with naloxone administration are discussed.
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Paraquat is one of the few broad-spectrum herbicides available in the US; however, it is extremely toxic to companion animals when ingested. Despite its restricted use status, poisoning of dogs and cats remains relatively common. This clinical report documents a series of chronologically and geographically related cases of presumed malicious and fatal sub-acute paraquat poisoning in 7 dogs in Portland, OR. ⋯ Hyperlipasemia and moderate hypertension were notable featured in 5/7 cases. Trace levels of paraquat were demonstrated in the urine of 4/7 animals by gas-liquid chromatography/mass spectroscopy. Diagnosis in the remaining 3 cases was made through a combination of history or exposure, clinical signs and their progression, and pulmonary and renal histopathology.