Search PubMed⌕ Search

Biomedical subjects

P Crome

Publications and source records attributed to P Crome.

At least 91 records · Page 5Linked to original sources
PubMed1979

The problem of tricyclic antidepressant poisoning.

In the year May 1976 to April 1977, 489 enquiries about the management of tricyclic antidepressant poisoning received at the London Centre of the National Poisons Information Service were followed-up. One hundred and sixty-four patients (33.5%) were unconscious, convulsions occurred in 62 (12.7%), hypotension in 31 (6.3%), respiratory depression in 28 (5.7%), tachydysrhythmias in 17 (3.5%) and cardiac arrest in 12 patients (2.5%). Sixteen patients died (3.3%). No statistically significant differences were found between individual antidepressants although poisoning with amitriptyline-like drugs resulted in a significantly higher proportion of unconscious patients than poisoning with imipramine-like drugs (P less than 0.01). There were more asymptomatic children than adults and more unconscious adults than children. Tricyclic antidepressant poisoning is a major clinical problem in general medical and paediatric practice.

Adolescent↗
PubMed1979

Further clinical observations on the pulmonary effects of paraquat ingestion.

Five patients are reported who developed evidence of acute lung damage after proved ingestion of paraquat. In two the lung changes resolved; in one an aspiration pneumonia occurred, which was successfully treated, while two developed fatal pulmonary oedema. These pulmonary complications after paraquat intoxication appear more common than the progressive pulmonary fibrosis previously described. It is suggested that acute pulmonary oedema is a response to large doses, usually of Gramoxone, that subclinical lung changes result from small doses, usually of Weedol, and that pulmonary fibrosis occurs after intermediate doses. Preliminary data on plasma paraquat concentrations suggest that these are of value in prognosis.

Adult↗
PubMed1979

The effects of physostigmine on amitriptyline induced cardiotoxicity in dogs.

When 0.5 mgs of physostigmine salicylate was injected intravenously into adult beagle dogs which had been severely poisoned with amitriptyline, a transient improvement in cardiac output, systolic blood pressure, intraventricular conduction and in the maximum rate of rise of arterial blood pressure (arterial dP/dT max.) was observed. These effects were maximal at 15-20 minutes after injection and had largely disappeared 30 to 35 minutes after the injection.

Amitriptyline↗
PubMed1978

Effect of delayed administration of activated charcoal on nortriptyline absorption.

Activated charcoal is known to reduce the absorption of therapeutic doses of nortriptyline in vivo when administered 30 min after drug ingestion. In a group of volunteers, one sachet (10 g) of a new activated charcoal preparation, 'Medicoal' was found to produce a highly significant reduction in nortriptyline absorption when given as long as four hours after nortriptyline dosing. Activated charcoal may therefore be useful in the treatment of tricyclic antidepressant poisoning even if a delay of several hours ensues before medical help is sought.

Adult↗
PubMed1978

Relationship between clinical features of tricyclic antidepressant poisoning and plasma concentrations in children.

Clinical features and drug plasma concentrations were studied in 13 children admitted to hospital with tricyclic antidepressant poisoning. Patients with plasma concentrations below 500 microgram/l had anticholinergic signs and increased reflexes but did not have convulsions or cardiac arrhythmias. Four patients with plasma concentrations above 1000 microgram/l suffered convulsions, cardiac arrhythmias, or prolonged coma. The diagnosis of poisoning in 2 of these cases was made only by toxicological analysis. Quantitative estimation of tricyclic antidepressants is useful in atypical or severe poisoning both to reach the diagnosis and to give an idea of the likely duration of symptoms.

Antidepressive Agents, Tricyclic↗
PubMed1978

A comparison of the effects of single doses of mianserin and amitriptyline on psychomotor tests in normal volunteers.

Eight healthy volunteers received single doses of either mianserin 10 mg, mianserin 20 mg, amitriptyline 25 mg or placebo. Critical flicker frequency, reaction time, digit substitution and addition times were tested up to six hours afterwards. Mianserin 20 mg and amitriptyline 25 mg significantly prolonged reaction time and mianserin 10 mg and 20 mg significantly reduced critical flicker frequency. No other significant effects were found. Patients should be warned of possible sedation when first starting treatment with mianserin.

Amitriptyline↗
PubMed1978

Partial lipodystrophy and insulin-resistant diabetes.

The coexistence of partial lipodystrophy of unusual distribution (limbs, back and head) with insulin-resistant diabetes and severe retinal, renal, neurological and arterial complications is reported. The lipodystrophy followed juvenile arthritis (Still's disease) and the diabetes, initially asymptomatic, became insulin dependent and technically insulin resistant (200 - 300 units insulin/day). Severe hyperlipidaemia has been a feature of this syndrome, probably contributing to the conspicuous peripheral arterial disease. The mother was diabetic but three sisters had normal glucose tolerance and there is no lipodystrophic member of the family. Underlying mechanisms of this syndrome remain obscure.

Adolescent↗
PubMed1977

Effect of activated charcoal on absorption of nortriptyline.

The ability of 'Medicoal', a new effervescent, activated charcoal preparation, to adsorb nortriptyline, has been investigated both in vitro and in vivo. A single dose of the effervescent charcoal 30 min after a dose of 75 mg nortriptyline produced a 60% mean reduction in both peak plasma levels and nortriptyline availability in healthy volunteers. Multiple doses of the effervescent charcoal produced 70% mean reduction in peak nortriptyline levels and availabiltiy. Activated charcoal is recommended for the treatment of tricyclic antidepressant poisoning. In in-vitro tests, a 10 g packet of the effervescent preparation containing 5 g activated charcoal) had an adsorptive capacity of approximately 3000 mg nortriptyline, a dose not usually exceeded in most cases of trycyclic antidepressant overdose.

Absorption↗