![]() Sorbitol has not been proven effective in enhancing drug removal and has side effects that can be significant in a poisoned patient. The addition of sorbitol did not enhance the efficacy of activated charcoal but did increase the side effects noted. Both interventions significantly reduced the area under the curve versus control (P less than. Serial acetaminophen levels were determined at intervals over eight hours and side effects noted. Subjects ingested 3 g of acetaminophen followed by either no intervention, 50 g of plain activated charcoal at one hour, or 50 g activated charcoal-sorbitol solution at one hour. Eight healthy volunteers participated in a randomized, crossover trial. An investigation was undertaken to determine if sorbitol catharsis enhanced the antidotal efficacy of activated charcoal. This results in rapid and profuse catharsis that could possibly cause fluid and electrolyte imbalance. The use of a 70% sorbitol solution has recently been advocated as an adjunct to activated charcoal. ![]() We describe successful treat- ment of a thallium overdose with prussian blue that was rapidly obtained from within the US and further discuss methods for obtaining prussian blue in the US. Furthermore, methods for obtaining prussian blue are not well known to physicians, pharmacists, and poison center personnel. Prussian blue (Radiogardase), a useful antidote for treating thallium poisoning, was FDA approved in 2003 but is still difficult to obtain for pharmaceutical use in the US. Therefore, thallium is still available in certain workplaces, and poisonings in the US still occur. nuclear medicine studies and gamma radiation detection equipment it is also being researched for development of high-temperature superconducting materials for applica- tions such as magnetic resonance imaging (MRI) and magnetic energy storage. Thallium is still used in certain commercial and research areas such as. Thallium poisoning in the US has become uncom- mon, as its household uses have vanished. Thallium has been used medici- nally to treat ringworm (tinea), as a rodenticide, and is found naturally in many varieties of rock. Thallium is a metal that throughout the past century has been found useful in a wide variety of ways. For cases of CCB poisoning where cardiotoxicity is evident, a combination of calcium and epinephrine should be used initially, reserving HDIDK for refractory cases. For cases of beta-blocker poisoning where symptomatic bradycardia and hypotension are present, high-dose glucagon is considered the first-line antidote. Poisoning by beta-blockers or CCBs usually produces hypotension and bradycardia, which may be refractory to standard resuscitation measures. Health-system pharmacists should be aware that when these drugs are used as antidotes, higher than normal dosing is needed. For cases of CCB poisoning where cardiotoxicity is evident, first-line therapy is a combination of calcium and epinephrine high-dose insulin with supplemental dextrose and potassium therapy (HDIDK) is reserved for refractory cases. Traditionally, antidotes for CCB overdose have included calcium, glucagon, adrenergic drugs, and amrinone. However, in beta-blocker poisoning where symptomatic bradycardia and hypotension are present, high-dose glucagon is considered the first-line antidote. ![]() Therapies include beta-agonists, glucagon, and phosphodiesterase inhibitors. Poisoning by CCBs is characterized by cardiovascular toxicity with hypotension and conduction disturbances, including sinus bradycardia and varying degrees of atrioventricular block. The common feature of beta-blocker toxicity is excessive blockade of the beta-receptors resulting in bradycardia and hypotension. In overdose, beta-blockers and CCBs have similar presentation and treatment overlaps and are often refractory to standard resuscitation measures. Beta-blockers and CCBs represent the most important classes of cardiovascular drugs. Overdoses with cardiovascular drugs are associated with significant morbidity and mortality. The toxic effects and treatment of beta-adrenergic blocker and calcium-channel blocker (CCB) overdose are reviewed.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |