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At least 451 records · Page 25Linked to original sources
PubMed1998

5-HT3 receptors are not involved in conditioned taste aversions induced by 5-hydroxytryptamine, ipecacuanha or cisplatin.

We have used the rat to examine the involvement of the 5-HT3 receptor in the mechanism(s) of conditioned taste aversion induced by 5-hydroxytryptamine (5-HT) and selected emetic drugs. 5-HT, ipecacuanha and cisplatin all induced conditioned taste aversion at doses known to induce emesis in other species but the responses were resistant to treatment with the 5-HT3 receptor antagonists ondansetron and granisetron. Further, m-chlorophenylbiguanide, a selective and potent 5-HT3 receptor agonist, failed to induce a conditioned taste aversion. The data provide strong evidence that the 5-HT3 receptor is not involved in conditioned taste aversion mechanisms in the rat. Results are discussed in terms of the usefulness of the rat conditioned taste aversion paradigm to anti-emetic research.

Animals↗
PubMed1990

Clonidine poisoning in young children.

We reviewed 47 consecutive inpatient records to determine the clinical course, role of supportive measures, and response to naloxone in children with clonidine poisoning. Severity of illness was assigned by means of the "pediatric risk of mortality" (PRISM) score. The children's ages ranged from 9 to 84 months. Central nervous system effects were noted in 44 patients; bradycardia occurred in 25, and apnea or depressed respiration was seen in 18. Thirty-four patients had symptoms within 1 hour of presentation, but no patient had further clinical deterioration more than 4 hours after presentation. Six patients required endotracheal intubation and mechanical ventilation. There was no difference in PRISM score or duration of symptoms between those patients who received naloxone and those who did not. More patients receiving naloxone required intubation, and only three patients had definite improvement after naloxone administration. We conclude that (1) young children who ingest clonidine have a wide spectrum of serious findings, (2) delayed progression of symptoms after clonidine poisoning is unlikely in a young child with normal renal function, and (3) naloxone is an inconsistent antidote for clonidine poisoning.

Atropine↗
PubMed1983

Management of clonidine ingestion in children.

Six cases of toxic ingestion of clonidine hydrochloride are reviewed. Apnea, respiratory depression, and rhythm disturbances were more frequent in our patients than in those previously reported; hypotension and bradycardia occurred at a similar frequency. Satisfactory management consisted of close attention to vital signs and judicious treatment of specific physiologic abnormalities. Atropine effectively corrected bradycardia. Tolazoline was found to be ineffective in reversing symptoms and signs of clonidine overdosage. Hypotension was managed by volume expansion, and if necessary, by a continuous infusion of dopamine. Naloxone, although not used in our patients, may be of both diagnostic and therapeutic value in treating clonidine overdosage.

Atropine↗
PubMed2004

[Efficacy and safety of gut decontamination in patients with acute therapeutic drug overdose].

BACKGROUND AND OBJECTIVE: Gut decontamination (GD) may be used as a treatment for acute therapeutic drug overdose (ATDO) to reduce the absorption of the drug and thereby avoid the presence or worsening of signs and symptoms of intoxication. The objective of this study was to assess the efficacy and safety of GD in ATDO patients. PATIENTS AND METHOD: A 4-month prospective observational study was designed to include all patients admitted to the emergency department due to an ATDO. On admission, epidemiological data, vital signs and physical examination results were all recorded and a blood sample was taken for toxicological analysis. An algorithm was used to determine the GD method to be applied. A clinical reassessment was made at 3-6 hours and a further sample was taken for toxicological analysis. Patients were followed until hospital discharge, with all possible adverse events due to GD being recorded. RESULTS: Ninety-four patients were included. GD was indicated in 60 patients (63.8%): 3.3% received ipecacuana syrup, 8.3% gastric lavage, 21.6% gastric lavage followed by activated charcoal and 71.6% oral activated charcoal alone. The clinical state worsened in 19.1% of patients, usually on the basis of a diminished consciousness. Adverse events attributable to GD were observed in 8.3% of patients. A toxicological analysis was made in 50 patients and in 42% of them, drug concentrations were higher at 3 or 6 hours than on admission. An analysis of the method of decontamination used showed that the procedure recommended by the algorithm was applied in 70 patients (group A) while in the remaining 24 (group B) another decontamination technique was used. Clinical deterioration was seen in 14.3% of patients in group A and 33.3% in group B (p = 0.041). There was a favourable evolution of the analytic curve in 63.9% patients in group A and 42.9% in group B (p = NS); severe adverse events attributable to GD were suffered by 2.4% patients in group A and 11.1% in group B (p = NS). CONCLUSIONS: The efficacy and safety of GD in ATDO increases in patients in whom the decision-making algorithm is applied. However, this does not prevent clinical deterioration or continued drug absorption in all cases and may be accompanied by adverse events.

Adult↗
PubMed1999

Recent advancements in pediatric toxicology.

Ingestion of potentially poisonous agents is a common reason for children to present to an emergency department. The clinician must decide whether gastrointestinal decontamination is indicated for these patients. The controversy over the type of gastrointestinal decontamination is resolving and recent recommendations are reviewed. Also two new antidotes, fomepizole for toxic alcohols and octreotide for sulfonylureas, are reviewed.

Antidotes↗
PubMed1986

Phenothiazine and butyrophenone intoxication in children.

Antipsychotic agents are widely used for the treatment of psychotic disorders as well as for the acute treatment of nausea and vomiting, cough and cold treatments, and as supplementary agents for sedation for minor surgical or diagnostic procedures. There are many different circumstances in which the clinician may encounter a child who has experienced antipsychotic drug toxicity, such as from an acute accidental ingestion or as a side effect from therapeutic use. The phenothiazines and butyrophenone drugs have many pharmacologic actions. Thus, a wide range of clinical symptoms and signs may be encountered with their use. Treatment of antipsychotic drug toxicity includes general supportive care and monitoring, along with specific treatment of certain situations such as acute extrapyramidal syndromes and neuroleptic malignant syndrome. An awareness of the diverse and complex manifestations that may be associated with these agents will greatly aid in the evaluation of a child who presents with unusual behavioral or neurologic problems. Due to the unpredictable toxicity of these drugs, routine therapeutic use for such conditions as nausea and vomiting and as cough or cold aids is not recommended.

Absorption↗
PubMed1986

The alcohols: ethanol, methanol, isopropanol, ethylene glycol.

More than 6 per cent of poisonings involve alcohols and glycols, reflecting their availability in a wide range of household products, including aftershave, brake fluid, gas line antifreeze, model airplane fuel, mouthwash, rubbing alcohol, and windshield washing solution. Diagnosis involves recognition of an osmolal gap and variable degrees and delays in development of an anion gap metabolic acidosis. Therapeutic modalities are similar for methanol and ethylene glycol, both cases requiring ethanol-blocking of alcohol dehydrogenase and hemodialysis. More often, treatment of ethanol and isopropanol poisoning is limited to supportive care.

1-Propanol↗
PubMed1986

Boric acid toxicity.

Although boric acid was widely used therapeutically in the past and resulted in significant toxicity, the past few years have seen a decline in its usage. Ninety-nine per cent boric acid powder is now being used as a household pesticide. Physicians therefore should be aware of the potential for boric acid toxicity.

Absorption↗
PubMed1986

Iron poisoning.

Iron poisoning continues to be a major toxicologic problem, with major impact on the gastrointestinal and circulatory systems. Failure to recognize the severity of iron intoxication may result in an inappropriate level of intervention. By using estimates of the total body burden of iron, clinical symptoms, and the serum iron concentration, an appropriate decision can be made to initiate aggressive chelation therapy with deferoxamine. In severe intoxication, the use of intravenous deferoxamine is indicated, along with supportive care, with particular attention to maintaining the intravascular volume. Other important measures include correction of acidosis and disorders of coagulation and replacement of blood components when there is evidence of gastrointestinal hemorrhage. Under rare circumstances in which large numbers of iron tablets are present in the gastrointestinal tract, surgical removal may be indicated. In addition, measures such as hemodialysis and exchange transfusion should be reserved for those unusual poisonings in which more conservative therapy is unsuccessful. In rare cases of iron intoxication, late sequelae such as hepatic necrosis and gastrointestinal scarring with obstruction may occur. The prompt recognition and initiation of management of children with acute iron poisoning is the single most critical element in decreasing the morbidity and mortality associated with these products.

Absorption↗
PubMed1986

Hydrocarbon poisonings.

Many different compounds are classified as petroleum distillates. Most ingestions can be managed by careful observation and respiratory support.

Animals↗