Endogenous formate elimination and total body clearance during hemodialysis.
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Formates↗
Biomedical subjects
Dag Jacobsen
Publications and source records attributed to Dag Jacobsen.
[Severe ethylene glycol poisoning treated wtih fomepizole (4-methylpyrazole)].
BACKGROUND: Poisoning with ethylene glycol causes severe metabolic acidosis and renal failure, and is potentially lethal if not treated rapidly. Until recently the standard therapy for this poisoning has been bicarbonate to counteract the metabolic acidosis, inhibition of alcohol dehydrogenase (ADH) with ethanol to prevent the production of toxic metabolites and haemodialysis to remove ethylene glycol and its toxic metabolites. The new potent inhibitor of ADH, 4-methylpyrazole (fomepizole), has recently been approved for the treatment of methanol and ethylene glycol poisonings. MATERIAL AND METHODS: Three patients severely poisoned by ethylene glycol and treated with fomepizole are presented. RESULTS: Of our three patients treated with fomepizole two were managed without haemodialysis. One patient had an exceptionally high serum ethylene glycol concentration (90 mmol/l; 585 mg/dl) and was successfully treated with fomepizole without the need for haemodialysis despite pronounced metabolic acidosis. INTERPRETATION: Ethylene glycol poisonings may be treated effectively with fomepizole without haemodialysis.
Adult↗
[Antidote availability in Norway].
BACKGROUND: Antidotes are therapeutic substances that are used primarily to counteract the toxic action of poisonous agents and thus have an important role in the treatment of poisoning. Antidote availability is crucial for the poisoned patient; it is important that hospitals keep antidotes in stock to treat these patients. Most antidotes are expensive, infrequently used, and have short shelf-lives. This makes hospital stocking economically difficult. In Norway, there is no national antidote programme. MATERIAL AND METHODS: The National Poisons Information Centre recently made an inquiry about antidote stocking in Norwegian hospitals. RESULTS AND INTERPRETATION: This survey showed that the antidote availability is not satisfactory. The availability of antidotes in Norwegian hospitals is discussed and recommendations are given.
Antidotes↗
[Serious mushroom poisoning by Cortinarius and Amanita virosa].
BACKGROUND: Following a characteristic long latent period (3-17 days), the nephrotoxins of Cortinarius rubellus and Cortinarius orellanus can cause the orellanus syndrome, due to severe damage of the proximal tubular epithelium. Amanita virosa is known to produce serious toxic effects in the liver and the kidneys after an initial asymptomatic latent phase. MATERIAL AND METHODS: We discuss the toxicity, clinical features and treatment of the orellanus and the phalloides syndromes and present six case histories. RESULTS AND INTERPRETATION: Ingestion of Cortinarius rubellus and Cortinarius orellanus resulted in permanent renal failure in four out of five patients, following a latent period of about ten days. One patient who ingested Amanita virosa, developed hepatotoxicity. He was given silibinin and symptomatic treatment and recovered. After ingestion of Cortinarius rubellus and Cortinarius orellanus, no specific treatment is available. The therapy is directed toward the renal failure, including dialysis and possible transplantation. Poisoning by Amanita virosa is treated with the nonspecific antidote silibinin.
Adult↗