A 22-month-old, 10 kg child ingested 32 mg of chlorambucil and developed irritability, myoclonic-like muscle jerks, an exaggerated startle reflex, vomiting, and EEG changes within a few hours. The neurologic symptoms improved overnight, and the patient was discharged at about 28 hours postingestion. During the three weeks of follow-up, mild bone marrow suppression occurred and resolved. A normal EEG was reported at 33 weeks postingestion.

Accidents, Home↗

PubMedDate not supplied

Gastric lavage and acute poisoning.

Explore the source record for details and available documents.

Antidepressive Agents, Tricyclic↗

PubMedDate not supplied

Cocaine adsorption to activated charcoal in vitro.

Although activated charcoal (AC) is commonly used after ingestions of cocaine, the ability of AC to bind with this drug is unknown. We studied binding of cocaine to AC in vitro. Cocaine adsorption to charcoal for AC:drug ratios of 1:1, 2.5:1, and 5:1 at pH 1.2 was 40%, 92%, and 99%, respectively; at pH 8.0, it was 78%, 98%, and 99%, respectively. All means were significantly different (P less than 0.05) versus the control (no AC) at each pH. At the AC:drug ratio of 1:1, there was also significantly greater adsorption of cocaine at pH 8.0 than at pH 1.2. This study shows that AC strongly adsorbs cocaine under both acidic and alkaline conditions.

Adsorption↗

PubMedDate not supplied

All lithium overdoses deserve respect.

Explore the source record for details and available documents.

Delayed-Action Preparations↗

PubMedDate not supplied

Fluoxetine versus tricyclic antidepressants: a prospective multicenter study of antidepressant drug overdoses. The Antidepressant Study Group.

This study compares the clinical course of tricyclic antidepressant and fluoxetine overdose. The study was a prospective case series of 9 urban hospital systems. Consecutive sampling of overdose patients presenting to emergency departments provided the participants for the study. The therapy was determined by each institution. Clinical, laboratory, economic impact, and coroners' information was gathered. Of 622 patients, 482 were excluded because of significant coingestants or lack of laboratory confirmation, leaving 124 tricyclic antidepressant and 16 fluoxetine cases. Twenty-seven percent of tricyclic antidepressant patients were alert on arrival to the emergency department; only 12.9% remained alert. The following were significantly more frequent after tricyclic antidepressant overdose: agitation, tachycardia, QRS prolongation, terminal R-wave deviation, intubation, coma, and admission to the intensive care unit. The mean tricyclic plus metabolite level was 777.6 ng/mL (range = 20-5260 ng/ mL), and the mean fluoxetine plus metabolite level was 496.4 ng/mL (range = 120-1930 ng/mL). There were two tricyclic antidepressant deaths. Of 179 total drug-ingestion deaths from the coroners' records, 38 were from tricyclic antidepressants and none from fluoxetine. Thus, tricyclic antidepressant overdoses resulted in more toxicity and more frequent admissions to the intensive care unit than did fluoxetine overdoses.

Adolescent↗

PubMedDate not supplied

Soluble polymer supported synthesis of alpha-amino acid derivatives.

A Schiff base activated glycine supported on a soluble polymer (poly(ethylene glycol) (PEG)) was readily alkylated with a wide variety of electrophiles in the presence of a carbonate base in acetonitrile. The presence of the polymer provided a phase-transfer catalysis environment which accelerated the reaction. Effects of various carbonate bases and leaving groups have been also studied. Completion of the PEG-supported reaction was obtained without using a large excess of reagents or an extra phase-transfer catalyst, even in the case of unreactive or hindered electrophiles. After cleavage from the polymer, alpha-amino esters are obtained in good yields.

Alkylation↗

PubMedDate not supplied

Massive copper sulfate ingestion resulting in hepatotoxicity.

Intentional overdosage of copper salts is seen infrequently in the U.S., but is fairly common in other countries (1). Toxic blood levels can be seen after oral ingestion of as little as one gram of copper sulfate in an adult (2). We report a case of a patient who ingested 250 grams of copper sulfate, developed transient hepatic dysfunction, and recovered after the prompt administration of chelation therapy.

Adult↗

PubMedDate not supplied

Influence of the absolute configuration on pharmacological activity of antihypertensive and antiarrhythmic drugs.

Chirality is a fundamental property of biological systems and reflects the underlying asymmetry of matter. Interactions of drugs with receptors, enzymes or binding sites have long been known to be stereoselective, and it is increasingly recognized that both pharmacodynamic and pharmacokinetic events contribute to the overall clinically observed stereoselectivity. The pharmacological activity may reside only in one enantiomer, while the second one may be inactive or have desirable or undesirable activity. Two isomers may be nearly identical both in qualitative and quantitative aspects of pharmacological activity. The activity of particular enantiomers may differ only at the quantitative level. It is also possible that a particular enantiomer displays qualitatively different mode of action than the second one. This review describes the influence of the absolute configuration on pharmacological activity of the selected currently used or being under investigation drugs acting on cardiovascular system, especially as the antihypertensive and antiarrhythmic agents.

Animals↗

PubMedDate not supplied

Synthesis and anticonvulsant properties of new N-piperazinylalkyl imides of succinic acid.

A number of N-[(4-aryl)- or (4-methyl)-l-piperazinyl)alkyl]imides of 3-aryl or 3,3-pentamethylenesuccinic acid were synthesized and tested for anticonvulsant activity in the maximum electroshock seizure (MES) and pentylenetetrazole seizure threshold (scMet) tests. Structures of the novel compounds were confirmed by elemental and spectral analyses.

Animals↗