Search PubMed⌕ Search

Biomedical subjects

S C Smolinske

Publications and source records attributed to S C Smolinske.

At least 19 recordsLinked to original sources
PubMed1992

Ibuprofen overdose in adults.

A prospective study of 63 ibuprofen overdose cases in adults (14 years or older) reported to the Rocky Mountain Poison and Drug Center between March 1987 and February 1988 was done to determine the incidence of renal injury and utility of timed plasma levels. No serious toxicity was noted. No CNS or other significant toxicity was seen with ingestion of less than 3 g. Two patients with normal serum creatinines had minor elevations of the blood urea nitrogen after ingesting 4 and 4.8 g. Timed plasma levels (125 total) from patients without coingestants from this study (48) and previously published reports (77) were compared with a previously described nomogram. The resulting nomogram revision may be useful in determining which initially asymptomatic patients are likely to remain so. Renal function tests are not routinely required for patients ingesting less than 6 g. Four h of observation is sufficient for asymptomatic patients not requiring psychiatric admission. Plasma ibuprofen levels are not required for proper patient management.

Acute Kidney Injury↗
PubMed1992

Review of parenteral sulfite reactions.

Sulfiting agents are commonly used in parenteral emergency drugs, including epinephrine, dexamethasone, dobutamine, dopamine, norepinephrine, phenylephrine, procainamide, and physostigmine. Published anaphylactic or asthmatic reactions have been associated with sulfited local anesthetics, gentamicin, metoclopramide, doxycycline, and vitamin B complex. The reactions differ from those caused by foods, in that they have a rapid onset, have no predilection for steroid-dependent asthmatics, and do not always coincide with a positive oral challenge. The mechanism is unknown, but may involve a dose-related reaction with disulfide bonds on sympathetic and parasympathetic receptor membranes. Patients with a history of positive oral challenge to 5-10 mg of sulfite may be at increased risk of developing a reaction to parenteral sulfites. Despite documentation of sensitivity, sulfites should not be withheld from patients experiencing a life-threatening emergency. Non-sulfited alternatives are often available, and should be used preferentially.

Drug Hypersensitivity↗
PubMed1992

Imprint coding on solid medication forms: problems in interpretation.

Currently, the FDA is planning to mandate imprinting on all solid medication forms. Regardless of the system it employs, identifying the manufacturer accurately and quickly is critical. Our data demonstrate that the current use of "logotypes" falls far short of minimally acceptable accuracy. We urge use of clear identifiers and that the proposed system be tested in the field prior to its implementation.

Capsules↗
PubMed1989

Superwarfarin poisoning in children: a prospective study.

This prospective study was undertaken to determine the incidence, severity, time of onset, and duration of coagulopathy in children following accidental ingestion of long-acting anticoagulant rodenticides, often called "superwarfarins." Of 110 children, who ingested superwarfarins and in whom one or more prothrombin time values were obtained, 8 had a prothrombin time ratio (patient to control) of greater than or equal to 1.2, indicative of anticoagulation. Prothrombin time values obtained 48 hours after ingestion were more likely to be prolonged (6/34, 17.6%) than values obtained 24 hours after ingestion (2/104, 1.9%) (P less than .005). The occurrence of an abnormal prothrombin time could not be predicted based on the history of amount ingested or on the presence of the characteristic green-blue product dye in or around the child's mouth. Acute toxicity was evidenced by transient abdominal pain, vomiting, and heme positive stools in 2 patients. The duration of prothrombin time prolongation could not be determined because of the few values obtained after 48 hours. To detect all possible abnormal prothrombin time values, 24- and 48-hour determinations are recommended after a child has ingested a superwarfarin.

4-Hydroxycoumarins↗
PubMed1988

Cigarette and nicotine chewing gum toxicity in children.

A prospective review of 51 cases of tobacco ingestion and 5 cases of nicotine resin chewing gum exposure was conducted to evaluate the incidence and degree of toxicity caused by these products in children. A dose-response relationship was observed for cigarette exposures. Nine of 10 children ingesting more than one cigarette or three cigarette butts developed signs or symptoms, while 12 of 24 ingesting lesser amounts became symptomatic (P less than 0.01). Severe symptoms (e.g. limb jerking and unresponsiveness) were only seen with the larger amounts. Nicotine resin gum produced toxicity in 4 of 5 children who chewed 1/2 to 4 pieces. Agitation, lethargy, tachycardia, hypotension, abdominal pain, and vomiting were seen within 30 min of exposure to the gum.

Chewing Gum↗
PubMed1988

Ibuprofen overdose--a prospective study.

Of 61 cases of ibuprofen overdosage reported consecutively to the Rocky Mountain Poison and Drug Center from September 1985 through April 1986, 16 were excluded because of incomplete follow-up or concurrent medication ingestion. A toxic reaction developed in 7 (16%) of the remaining 45 patients. Nausea, vomiting, abdominal cramps, mild central nervous system depression, coma, tachycardia, apnea, metabolic acidosis with or without respiratory alkalosis, hematemesis, and oliguric renal failure were noted. Two of six adults had a toxic reaction, and one died. Among pediatric patients, 5/39 (13%) had a toxic reaction. Of patients whose ibuprofen ingestion was less than 104 mg per kg, none became ill. All patients in whom the time of ingestion was known (six of seven) and who had a toxic reaction did so within four hours of ingestion. An ibuprofen overdose, although usually benign, can occasionally produce serious toxicity.

Adolescent↗
PubMed1987

Clinical effects of accidental levothyroxine ingestion in children.

Forty-one children, aged 1 to 5 years, who accidentally ingested levothyroxine sodium were studied. Symptoms possibly associated with the ingestion occurred in 11 patients (27%). These symptoms (tachycardia, hyperactive behavior, fever, vomiting, diarrhea, diaphoresis, and flushing) were categorized as minor and all resolved without treatment. Because observed effects were generally mild and often unrelated to either estimated amounts of hormone consumed or serum thyroxine levels, a conservative approach to patient treatment is recommended in cases of levothyroxine ingestion in children.

Administration, Oral↗
PubMed1987

A case of MAO inhibitor/MDMA interaction: agony after ecstasy.

After ingesting 3,4-methylene-dioxy-methamphetamine (MDMA) and the monoamine oxidase (MAO) inhibitor phenelzine, a 50 year old male developed marked hypertension, diaphoresis, altered mental status, and hypertonicity lasting 5-6 hours. This clinical course is typical of interaction between MAO inhibitors and some sympathomimetics including amphetamines. Such interaction has not previously been described involving MDMA. Sympathomimetic-MAO inhibitor interactions can cause excessive release of endogenous bioactive amines (e.g. norepinephrine, serotonin). Hypertensive crisis, intracranial hemorrhage, hypertonicity, and severe hyperthermia have occurred due to sympathomimetic-MAO inhibitor interactions. MDMA shares structural and pharmacologic features with other agents capable of causing this interaction, and this case suggests that MDMA can cause significant toxicity in patients taking MAO inhibitors.

3,4-Methylenedioxyamphetamine↗
PubMed1986

Ibuprofen overdose: 126 cases.

In this study of ibuprofen overdose, symptoms developed in 19% of patients (24 of 126)--in 7% of children (6 of 88) and in 47% of adults (18 of 38). Central nervous system depression, seizures, gastrointestinal disturbances, bradycardia, hypotension, apnea, abnormal renal functions, hematuria, nystagmus, and blurred vision were observed. No patients became symptomatic more than four hours after ingestion. There was no significant difference (P greater than .05) between symptomatic and asymptomatic adult groups in either total milligrams or milligram-per-kilogram amounts ingested by history. Pediatric patients who became symptomatic had a mean ingestion by history of 440 mg/kg; those who remained asymptomatic had a mean ingestion by history of 114 mg/kg (P less than .001). No patients ingesting less than 99 mg/kg by history developed any symptoms. Two children had seizures or apnea and one died. Ibuprofen occasionally may cause serious toxicity in overdose.

Adolescent↗
PubMed1982

Consultations with attorneys as a funding source for drug information centers.

The provision of legal consultations to attorneys as a method of generating income for a drug information center is described. The center established a formal, fee-based consultation service for lawyers after receiving several calls a month on a regular basis. During a six-month trial period, approximately 60% of the calls from lawyers were simple requests for information, such as the identification of a drug, drug dosage, or product availability. The remainder of the calls required formal written consultations, which had to be individualized to meet the attorneys' needs. The average length of these consultations was 2-3 pages including patient data, the request, response, conclusions, and 10-15 citations from the medical/pharmaceutical literature. No fees were charged for the requests that could be handled on the phone. For the preparation of a written consultation with references, the lawyers were billed +100/hr. Conferences with attorneys before preparing a request were also billed at +100/hr. If a deposition was required after the consultation services in the state's law journals and various legal publications. The majority of the attorneys who used the service indicated that they would probably use it again. The center found the provision of legal consultations to attorneys to be an effective mechanism for generating additional revenue.

Drug Information Services↗