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Biomedical subjects

M Tenenbein

Publications and source records attributed to M Tenenbein.

103 records · Page 6Linked to original sources
PubMed1985

Severe cardiac dysrhythmia from barium acetate ingestion.

A 15-year-old girl presented with a severe cardiac dysrhythmia after having ingested an unknown chemical. Lidocaine therapy improved the dysrhythmia. Other clinical findings included arterial hypertension, vomiting, paresthesias, muscle weakness, and severe hypokalemia (1.8 mmol/L). Analysis of a portion of the noningested chemical and the finding of 130 mg/L of barium in the urine confirmed the identity of the ingestant. Barium poisoning is rare. Its presentation as a life-threatening cardiac dysrhythmia is previously unreported.

Acetates↗
PubMed1985

Whole bowel irrigation for toxic ingestions.

Eight children aged eleven months to sixteen years who ingested toxic substances were treated with whole bowel irrigation. This procedure involves the rapid infusion of fluids per nasogastric tube in order to flush the toxic substance out from the gastrointestinal tract thereby preventing its absorption into the bloodstream. The infusion is terminated when the rectal effluent takes on the characteristics of the infusate. The toxic substances included miniature disc batteries, iron, tricyclic antidepressant and paraquat. No significant changes in serum sodium, serum potassium or hematocrit were observed. Whole bowel irrigation was felt to be efficacious in this series. It requires additional study as a therapeutic approach to the patient who has ingested a toxic substance.

Adolescent↗
PubMed1984

Peripheral neuropathy following intentional inhalation of naphtha fumes.

Two adolescent native Canadians who presented with peripheral neuropathy secondary to the abuse of volatile hydrocarbons are described. They were initially thought to have been sniffing leaded gasoline fumes, but public health investigation revealed that they had been sniffing naphtha fumes. Naphtha contains a significant amount of n-hexane, a known inducer of neuropathy. Nerve conduction studies and nerve biopsy confirmed the diagnosis of naphtha abuse. These cases emphasize the need to specifically identify the formulation of hydrocarbons being abused.

Adolescent↗
PubMed1984

Continuous naloxone infusion for opiate poisoning in infancy.

I report the successful treatment of severe infantile opiate poisoning with continuous naloxone infusions. Two infants, one aged 12 months and the other 3 days, were intoxicated with 100 mg normethadone and 5 mg morphine, respectively. They were given constant infusions of 0.04 and 0.16 mg/kg/hr for 2 1/2 and 5 days, respectively. Continuous naloxone infusion should be considered in the management of severe opiate poisoning.

Humans↗
PubMed1984

Hypersensitivity-like reactions to N-acetylcysteine.

This report describes nine episodes of presumed allergic reactions occurring in seven patients who were treated for acetaminophen overdose with intravenous N-acetylcysteine. All of these reactions were confined to the skin and consisted of urticaria and/or angioedema. All patients were pruritic. There was no evidence of bronchospasm or hypotension. In four of these episodes the intravenous protocol was completed after the parenteral administration of an antihistamine. In all four of these instances there was no progression of the hypersensitivity-like symptoms or signs. Previous case reports of acute allergic reactions to intravenous N-acetylcysteine will be reviewed. The advantages and disadvantages of oral vs. intravenous N-acetylcysteine therapy for acetaminophen overdose will be discussed in light of the hypersensitivity-like reactions to intravenous N-acetylcysteine.

Acetaminophen↗
PubMedDate not supplied

Theophylline toxicity due to drug interaction.

Acute theophylline toxicity is usually due to overdose. However, it may also be brought about by interference of its metabolism secondary to the concurrent administration of other drugs. Erythromycin is important in this regard as illustrated in the following case of a 16-year-old girl who developed theophylline toxicity while on therapy with both of these drugs. As well as the potential for theophylline toxicity, coadministration of these two drugs may result in subtherapeutic serum erythromycin concentrations. Thus, if at all possible, this practice should be avoided. If unavoidable, then serial serum theophylline concentrations should be monitored. The occurrence of this interaction is unpredictable. Thus the previous recommendation of decreasing the theophylline dosage by 25% to prevent toxicity during erythromycin therapy is irrational and should be avoided. Drug interactions should be considered in the differential diagnosis of theophylline toxicity.

Adolescent↗
PubMedDate not supplied

Benign course after massive ingestion of yohimbine.

Yohimbine is an alpha 2 adrenoreceptor antagonist occasionally used in the treatment of impotence. Overdose of this drug is uncommon. We describe a 62-year-old male who ingested 100, 2.0 mg tablets whose only adverse effects were tachycardia, hypertension, and anxiety of brief duration. The limited experience to date suggests a benign course even after massive overdose. Observation would seem to be the management of choice.

Anxiety↗
PubMedDate not supplied

Cyanide overdose: survival with fatal blood concentration without antidotal therapy.

Cyanide poisoning is an uncommon emergency department problem. It has a high mortality, and specific antidotal therapy can be lifesaving. We describe a 23-year-old man who ingested potassium cyanide and survived without antidotal therapy. His blood cyanide concentration was 4.65 mg/L, which is within the lethal range. The arterial venous oxygen saturation gradient was considered in the decision regarding antidote administration. Our experience underscores the importance of supportive care.

Adult↗
PubMedDate not supplied

The neuroleptic malignant syndrome: occurrence in a 15-year-old boy and recovery with bromocriptine therapy.

The neuroleptic malignant syndrome (NMS) is an idiosyncratic reaction to neuroleptic medication not previously described in the pediatric literature. It is characterized by hyperthermia, extrapyramidal disorders, decreased level of consciousness and autonomic dysfunction. A 15-year-old boy with acute lymphoblastic leukemia developed the NMS after a brief exposure to chlorpromazine and promethazine. He responded favorably to the dopamine agonist bromocriptine. A review of the recent literature suggests bromocriptine as the most efficacious specific therapy. Management of the NMS includes immediate discontinuation of all neuroleptic agents, intense supportive care and prompt institution of bromocriptine therapy.

Adolescent↗