Veterinary and human toxicology
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Aeschynomene indica seeds cause a vestibulo-cerebellar syndrome in pigs. This experiment studied the toxicity of different plant chemical fractions in pigs to determine a susceptible laboratory species to search for the plant's toxic principle. Hexanic, ethanolic and acetonic extracts of A. indica seeds were administered to 1 pig each. ⋯ The residues were administered by gavage at 0.9 g/kg to groups of 6 mice; those dosed with the ethyl acetate residue developed nervous signs and died. Administrated to 4 pigs, the residue caused clinical signs and histologic lesions similar than those observed in experimental intoxication of swine with A. indica seeds. The active principle of these seeds was in the ethyl acetate residue and mice can be used as an experimental species to test toxicity of substances isolated from this plant.
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Overdose experience with the anti-epileptic agent zonisamide (Zonegran, ZNS) is limited. We present a case of suspected zonisamide overdose previously reported in abstract form, manifesting as seizures, dysrhythmias and death of an 18-y-o woman after single ingestion of 4.8 g ZNS in a suicide attempt. The patient experienced multiple generalized tonic-clonic seizures and copious airway secretions. ⋯ Serum ZNS was 44 mg/L, and the case was officially deemed death secondary to ZNS overdose. Subsequently, a comprehensive urine drug screen demonstrated mirtazepine, diphenhydramine metabolites, and caffeine. Due to confounding factors, a definitive causal role for ZNS in this overdose death cannot be made, despite the county coroner's ruling.
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Eye/skin chemical splashes are a significant problem. Diphoterine is an hypertonic, polyvalent, amphoteric compound developed in France as an eye/skin chemical splash water-based decontamination solution. In vitro and in vivo, it actively decontaminates approximately 600 chemicals, including acids, alkalis, oxidizing and reducing agents, irritants, lacrimators, solvents, alkylating agents, and radionuclides. ⋯ Diphoterine chemical reactions are not exothermic. Diphoterine and its acid/alkali decontamination residues are not irritating to the eyes or skin; it is essentially nontoxic. Diphoterine can prevent eye/skin burns following chemical splashes and results in nearly immediate pain relief.
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We used exchange transfusion as an alternative to hemodialysis in an infant with severe salicylism. A 4-mo old, 5 kg male was presented to a local hospital with acute vomiting, tachypnea, hyperpnea and intermittent agitation and lethargy. Shortly after a generalized tonic-clonic seizure he passed several tablets in his stool. ⋯ There were no complications. The patient recovered completely to his pre-morbid state. Double volume exchange transfusion was used safely as an effective alternative to hemodialysis in this case of severe infant salicylate poisoning.
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Previous reports of gabapentin overdose have described mild symptoms of somnolence, ataxia and slurred speech. Quetiapine has produced a false positive for cyclic antidepressants on immunoassay drugscreens. Quetiapine overdose is associated with coma, QTc prolongation and hypotension. We report a case of massive gabapentin and presumptive quetiapine overdose with the highest recorded serum gabapentin concentration (104.5 u/ml) associated with coma, respiratory depression requiring mechanical ventilation, and hypotension.