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Sample records for acute atropine intoxication

  1. Efficacy of Biperiden and Atropine as Anticonvulsant Treatment for Organophosphorus Nerve Agent Intoxication

    DTIC Science & Technology

    2000-01-01

    3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE Efficacy of biperiden and atropine as anticonvulsant treatment For organophosphorus nerve agent...inhibitors, soman, sarin, tabun, GF, VX, anticonvulsants, atropine, biperiden , anticholinergic compounds, convulsions, EEG activity 16. SECURITY... biperiden and atropine as anticonvulsant treatment for organophosphorus nerve agent intoxication Received: 16 November 1999 /Accepted: 9 February

  2. [Acute intoxication by cosmetics].

    PubMed

    Larcan, A; Lambert, H; Laprevote-Heully, M C; Nida, F

    1975-01-01

    Intoxications due to cosmetics are of various types, but certain substances may be particularly harmful, especially when the constituants include acetone, boric acid and borates, ethyl alcohol, bromates, formol, methyl alcohol, propylene glycol, thallium, thioglycolate.. Every cosmetic substance may induce accidental intoxications. Most often, fluid cosmetics are absorbed either by children or by feeble-minded subjects. In all intoxication, one must take account of the age and weight of the patient, of the quantity absorbed, of the toxicity and of the constituants of the substance.

  3. Acute cyanide intoxication and central transmitter systems.

    PubMed

    Persson, S A; Cassel, G; Sellström, A

    1985-12-01

    In rats treated with sodium cyanide (5-20 mg/kg, ip) dopamine was dose dependently decreased in the striatum within 60 sec. One of the main metabolites of dopamine in the central nervous system, 3-methoxy-4-hydroxyphenylacetic acid (HVA), was decreased in striatum, olfactory tubercle, and hippocampus. However, the oxidatively deaminated metabolite, 3,4-dihydroxyphenylacetic acid (DOPAC), was not significantly altered in any of the brain regions studied. Naturally occurring levels of 3,4-dihydroxy-L-phenylalanine (L-dopa), as well as L-dopa accumulated after inhibition of the neuronal L-aromatic amino acid decarboxylase, increased in cyanide-treated rats. The dopamine receptor antagonist spiperone (0.05 mg/kg, ip) slightly increased the survival in acute cyanide intoxication. Sodium cyanide increased the levels of glutamine in frontal cortex and striatum at all doses studied. Glutamic acid was increased in the cerebellum, striatum, and hippocampus after sodium cyanide (5-10 mg/kg, ip). Higher doses decreased glutamic acid in the cerebellum, the frontal cortex, and the striatum. gamma-Aminobutyric acid (GABA) concentrations were diminished at high doses in all regions studied. Cyanide increased the levels of cyclic GMP in the cerebellum. In the striatum cyclic GMP was decreased after sodium cyanide (10 and 20 mg/kg). No significant alterations in the concentrations of acetylcholine or choline were seen in the striatum of cyanide-treated rats. The acetylcholinesterase inhibitor physostigmine and the muscarinic receptor antagonist atropine decreased the survival of mice given sodium cyanide. Acute cyanide intoxication thus produces rapid and fairly specific changes in central dopaminergic and GABA-ergic pathways.

  4. Fenmetozole in acute alcholol intoxication in man.

    PubMed

    McNamee, H B; Mendelson, J H; Korn, J

    1975-06-01

    Forty healthy adult male volunteers were studied to determine the efficacy of fenmetozole to antagonize the effects of acute alcholol intoxication. Twenty subjects receive placebo and 20 fenmetozole in dosage of 100 mg and 200 mg in a double-blind paradigm. Pretreatment with fenmetozole failed to antogonize or attenuate cognitive, perceptual, motor and affective changes associated with acute alchol intoxication.

  5. Mad honey intoxication mimicking acute coronary syndrome.

    PubMed

    Dur, Ali; Sonmez, Ertan; Civelek, Cemil; AhmetTurkdogan, Kenan; AkifVatankulu, Mehmet; Sogut, Ozgur

    2014-09-01

    Mad honey intoxication or grayanotoxin poisoning is caused by consumption of grayanotoxin-containing toxic honey produced from leaves and flowers of the Rhododendron family. Despite the rarity of intoxication cases, the correct diagnosis and treatment are required because of the significance of haemodynamic disturbance and confounding of symptoms for disease identification. We report herein a case of a patient with mad honey intoxication mimicking acute non-ST segment elevation myocardial infarction and review the pathophysiology and diagnostic considerations.

  6. Atropine intoxication from the ingestion and smoking of jimson weed (Datura stramonium).

    PubMed

    Guharoy, S R; Barajas, M

    1991-12-01

    Anticholinergic effects occur due to jimson weed intoxication. The most common intoxication involves teenagers desiring mind-altering properties from the plant. We report 4 cases of jimson weed intoxication due to ingestion and inhalation (smoking) of jimson weed. Clinicians should be aware of the potential abuse of botanicals such as jimson weed.

  7. Acute psychological stress-induced water intoxication.

    PubMed

    Mukherjee, Sagarika; Antonarakis, Emmanuel S; Asaduzzaman, S; Peters, John R

    2005-01-01

    Excessive water drinking is a recognised feature of schizophrenia. We present here a case of excessive water drinking precipitated by acute psychological stress. A 52-year-old woman, with no previous mental health problems, was found in a state of altered consciousness and was profoundly hyponatraemic. She had consumed excess amount of water due to severe mental stress. She was treated with hypertonic saline followed by fluid restrictions. The water intoxication had caused brain damage which led to behavioural changes and impaired cognition. We describe the pathophysiology of water intoxication.

  8. Acute intoxication with guaifenesin, diphenhydramine, and chlorpheniramine.

    PubMed

    Wogoman, H; Steinberg, M; Jenkins, A J

    1999-06-01

    Mixed drug reactions are frequently encountered in emergency department overdose cases and also in fatal intoxications. Assessment of the relative contribution of each drug in producing adverse effects is often compounded by lack of case history and the paucity of cases reported in the literature. This report describes a fatal intoxication with three common over-the-counter medications: guaifenesin, diphenhydramine, and chlorpheniramine. A 48-year-old woman was found dead in the attic bedroom of her residence. Specimens obtained at autopsy for toxicologic analysis included heart blood, urine, bile, gastric contents, vitreous humor, and cerebrospinal fluid. The over-the-counter drugs were identified and quantitated by acid/neutral or basic liquid-liquid extraction followed by gas chromatographic analysis with nitrogen phosphorus detection. Concentrations of guaifenesin, diphenhydramine, and chlorpheniramine detected in the heart blood were 27.4, 8.8, and 0.2 mg/L, respectively. The cause of death was determined to be acute intoxication by the combined effects of guaifenesin, diphenhydramine, and chlorpheniramine, and the manner of death was determined to be suicide. To our knowledge, the blood guaifenesin concentration in this case is the highest reported concentration to date associated with an acute intoxication.

  9. Efficacy of biperiden and atropine as anticonvulsant treatment for organophosphorus nerve agent intoxication.

    PubMed

    Shih, T M; McDonough, J H

    2000-05-01

    The ability of the nerve agents tabun, sarin, soman, GF, VR, and VX to produce brain seizures and the effectiveness of the anticholinergics biperiden HCl or atropine SO4 as an anticonvulsant treatment were studied in a guinea-pig model. All animals were implanted a week prior to the experiment with cortical electrodes for electroencephalogram (EEG) recordings. On the day of exposure, the animals were pretreated with pyridostigmine (0.026 mg/kg, i.m.) 30 min prior to challenge with a 2 x LD50 dose (s.c.) of a given agent. In separate experiments, animals were challenged with 5 x LD50 (s.c.) of soman. One minute after agent challenge, the animals were treated intramuscularly (i.m.) with 2 mg/kg atropine SO4 admixed with 25 mg/kg 2-PAM Cl and then observed for the onset of seizure activity. Five minutes after the start of nerve agent-induced EEG seizures, animals were treated i.m. with different doses of biperiden HCl or atropine SO4 and observed for seizure termination. The anticonvulsant ED50 of biperiden HCl and atropine SO4 for termination of seizures induced by each nerve agent was calculated and compared. With equally toxic doses (2 x LD50) of these agents, continuous EEG seizures (status epilepticus) developed in all animals challenged with soman, tabun, or VR, and in more than 90% of the animals challenged with GF or sarin. In contrast, only 50% of the animals developed seizures when challenged with VX. The times to onset of seizures for soman, tabun, GF, and sarin were very similar (5-8 min) while for VR, it was about 10 min. In the case of VX, not only was the time to seizure development longer (20.7 min), but the seizure activity in 19% of the animals terminated spontaneously within 5 min after onset and did not return. Under these conditions, the anticonvulsant ED50s of biperiden HCl for soman, GF, VR, tabun, sarin, and VX were 0.57, 0.51, 0.41, 0.2, 0.1, and 0.09 mg/kg, respectively, while those of atropine SO4 for soman, VR, tabun, GF, sarin, and VX were

  10. Neuromuscular Functions on Experimental Acute Methanol Intoxication

    PubMed Central

    Moral, Ali Reşat; Çankayalı, İlkin; Sergin, Demet; Boyacılar, Özden

    2015-01-01

    Objective The incidence of accidental or suicidal ingestion of methyl alcohol is high and methyl alcohol intoxication has high mortality. Methyl alcohol intoxication causes severe neurological sequelae and appears to be a significant problem. Methyl alcohol causes acute metabolic acidosis, optic neuropathy leading to permanent blindness, respiratory failure, circulatory failure and death. It is metabolised in the liver, and its metabolite formic acid has direct toxic effects, causing oxidative stress, mitochondrial damage and increased lipid peroxidation associated with the mechanism of neurotoxicity. Methanol is known to cause acute toxicity of the central nervous system; however, the effects on peripheral neuromuscular transmission are unknown. In our study, we aimed to investigate the electrophysiological effects of experimentally induced acute methanol intoxication on neuromuscular transmission in the early period (first 24 h). Methods After approval by the Animal Experiment Ethics Committee of Ege University, the study was carried out on 10 Wistar rats, each weighing about 200 g. During electrophysiological recordings and orogastric tube insertion, the rats were anaesthetised using intra-peritoneal (IP) injection of ketamine 100 mg kg−1 and IP injection of xylazine 10 mg kg−1. The rats were given 3 g kg−1 methyl alcohol by the orogastric tube. Electrophysiological measurements from the gastrocnemius muscle were compared with baseline. Results Latency measurements before and 24 h after methanol injection were 0.81±0.11 ms and 0.76±0.12 ms, respectively. CMAP amplitude measurements before and 24 h after methanol injection were 9.85±0.98 mV and 9.99±0.40 mV, respectively. CMAP duration measurements before and 24 h after methanol injection were 9.86±0.03 ms and 9.86±0.045 ms, respectively. Conclusion It was concluded that experimental methanol intoxication in the acute phase (first 24 h) did not affect neuromuscular function. PMID:27366524

  11. Acute pancreatitis and acute renal failure complicating doxylamine succinate intoxication.

    PubMed

    Lee, Yang Deok; Lee, Soo Teik

    2002-06-01

    Doxylamine succinate is an antihistaminic drugwith additional hypnotic, anticholinergic and local anesthetic effects first described in 1948. In Korea and many other countries, it is a common-over-the counter medication frequently involved in overdoses. Clinical symtomatology of doxylamine succinate overdose includes somnolence, coma, seizures, mydriasis, tachycardia, psychosis, and rhabdomyolysis. A serious complication may be rhabdomyolysis with subsequent impairment of renal function and acute renal failure. We report a case of acute renal failure and acute pancreatitis complicating a doxylamine succinate intoxication.

  12. Treatment of acute cyanide intoxication with hemodialysis.

    PubMed

    Wesson, D E; Foley, R; Sabatini, S; Wharton, J; Kapusnik, J; Kurtzman, N A

    1985-01-01

    A dramatic response was noted in a patient at our hospital who received hemodialysis therapy for severe acidosis secondary to an unknown toxin, subsequently identified as cyanide. We were unable to find any information concerning the hemodialysis clearance and extraction ratio of cyanide; thus, we studied the effect of hemodialysis in dogs receiving a constant infusion of cyanide with and without a simultaneous infusion of thiosulfate. The hemodialysis clearance of cyanide in the presence of thiosulfate was 38.3 +/- 5.4 ml/min with an extraction ratio of 0.43 +/- 0.06 (n = 4). Hemodialysis was found to increase the lethal dose of cyanide without thiosulfate infusion, and a further increase was noted with the thiosulfate infusion. Thiosulfate promotes mitochondrial metabolism of cyanide to thiocyanate. The end product, thiocyanate, is quickly removed by hemodialysis. We believe that the demonstrated effectiveness of hemodialysis in the treatment of acute cyanide intoxication is related not only to the hemodialysis clearance of cyanide, but also to the removal of its metabolic end product, thiocyanate. Based on our observations, we feel that hemodialysis is an effective adjunct in the treatment of acute cyanide intoxication.

  13. Acute effects of lignocaine, procainamide, metoprolol, digoxin and atropine on human myocardial refractoriness.

    PubMed

    Edvardsson, N; Hirsch, I; Olsson, S B

    1984-08-01

    The acute intravenous effects of therapeutic doses of procainamide, lignocaine, metoprolol, digoxin and atropine on the monophasic action potentials (MAP) and effective refractory periods of the right ventricle (VERP) were studied in 48 healthy volunteers. Procainamide prolonged the VERP in the apex region. Lignocaine shortened the MAP duration at 90% repolarisation. Metoprolol did not affect any of the measured variables in spite of a significant decrease in heart rate. Digoxin produced a significant increase in the VERP at the outflow tract, but not in the apex region and the MAP variables did not change. Following atropine, the VERP at both recording sites decreased but the MAP signal was unaffected. In summary, the effects of procainamide, lignocaine, metoprolol and digoxin were in good agreement with previous studies in normal ventricular muscle cells in vitro. In addition, the findings following atropine, digoxin and procainamide are indicative of a parasympathetic innervation of the endocardial surface of the right ventricle.

  14. [Accidents in the home. Acute intoxication by household products].

    PubMed

    Amigó Tadín, Montserrat; Nogué Xarau, Santiago

    2010-09-01

    During a two month period, the authors gathered data from patients who visited an emergency ward due to acute intoxication by a household product, and they compared the care which those patients required with the other patients suffering from different intoxications. The variables were introduced and analyzed using a SPSS 75.0 statistics package. The emergency ward registered 281 intoxication incidents of which 22 or 8.7% were related to household products. Among the conclusions drawn from this study the authors emphasize that the majority of patients intoxicated by household products were women. Caustic products are involved in the greatest number of incidences, either accidentally swallowed, splashed into eyes or inhaled as gas. The amount of treatment those patients require is less than the treatment required for other intoxications. Their prognostic is good.

  15. Pulmonary oedema during treatment of acute water intoxication.

    PubMed Central

    Maclean, D.; Champion, M.; Trash, D. B.

    1976-01-01

    Acute water intoxication with deepening coma and uncontrolled epileptiform seizures in a 25-year-old previously fit male schizophrenic was treated with hypertonic (2 N) saline and a 20% mannitol solution. This improved his neurological state but precipitated severe pulmonary oedema. Intravenous frusemide increased his urinary output sufficiently to clear the pulmonary oedema. In acute water intoxication the use of hypertonic solutions may thus precipitate left heart failure by expanding the intra-pulmonary blood volume beyond the capacity of even a healthy left ventricle to compensate. Simple water restriction will produce a slower but perhaps safer improvement. Images Fig. 1 PMID:981097

  16. [Acute water intoxication as complication of intravenous urography].

    PubMed

    López Del Val, T; Del Olmo, D; Diago, J; Alcazar, V; Hernández, E; Vázquez, C

    2001-05-01

    Physiologically, two complementary mechanisms regulate plasma osmolality: antduretic hormone ADH) and thirst. ADH release s supressed, thirst s inhbted and renal water loss occurs when plasma osmolality below a threshold level. The rise in plasma osmolalty causes ADH release, stimulation of thirst and water intake. Acute water intoxication is exceptional in patients without a chronic psychiatric disease. Herein, we describe a case of acute water intoxication in a previously healthy patient, after making an intravenous urography. The excessive water intake and the impossibility of renal water loss because of streee-induced ADH release originated t. Only nine cases have been previously described; almost they all were women preparing for diagnostic procedures.

  17. [An unusual case of acute aminophylline intoxication].

    PubMed

    Manes, Massimo; Pellu, Valentina; Radin, Elisabetta; Molino, Andrea; Gabrielli, Danila; Caputo, Donatella; Paternoster, Giuseppe; Torti, Paola; Visetti, Enrico; Nebiolo, Pier Eugenio

    2015-01-01

    Theophylline/aminophylline use for asthma and chronic obstructive pulmonary disease has declined over time, as new and safer therapies developed. However, theophylline/aminophylline overdose can occur. Hereby it is described an unusual case of severe aminophylline intoxication due to mesodermic injections treated with CVVHDF session.

  18. Acute barium nitrate intoxication treated by hemodialysis.

    PubMed

    Bahlmann, H; Lindwall, R; Persson, H

    2005-01-01

    A 22-year-old male was admitted to hospital with diarrhea and vomiting, cardiac arrhythmias, severe hypokalemia and gradual onset of muscular weakness. A potassium infusion was started, but for several hours serum potassium remained low. Evidence of toxic ingestion was initially lacking. When it became clear -- after a considerable delay -- that the patient had ingested barium nitrate, hemodialysis was started. This resulted in rapid clinical improvement with correction of hypokalemia and restored muscular function. Intoxication with barium causes hypokalemia, arrhythmias, muscular weakness and paralysis, often requiring respiratory support. This patient presented with symptoms typical of severe barium intoxication, non-responsive to potassium supplementation. There are few published reports on the use of hemodialysis in barium poisoning. This case confirms the possible benefit of hemodialysis in severe cases, where potassium supplementation alone is insufficient.

  19. Acute water intoxication as another unusual manifestation of child abuse.

    PubMed Central

    Mortimer, J G

    1980-01-01

    A 4 1/2-year-old boy developed hyponatraemia with coma and convulsions as the result of acute water intoxication. Information subsequently obtained strongly suggested that the excessive water ingestion was enforced by a punitive foster father. PMID:7436477

  20. Acute water intoxication during military urine drug screening.

    PubMed

    Tilley, Molly A; Cotant, Casey L

    2011-04-01

    Random mandatory urine drug screening is a routine practice in the military. The pressure to produce a urine specimen creates a temptation to consume large volumes of water, putting those individuals at risk of acute water intoxication. This occurs when the amount of water consumed exceeds the kidney's ability to excrete it, resulting in hyponatremia owing to excess amount of water compared to serum solutes. The acute drop in serum osmolality leads to cerebral edema, causing headaches, confusion, seizures, and death. There has been increasing awareness of the danger of overhydration among performance athletes, but dangers in other groups can be underappreciated. We present the case of a 37-year-old male Air Force officer who developed acute water intoxication during urine drug screening. Our case demonstrates the need for a clear Air Force policy for mandatory drug testing to minimize the risk of developing this potentially fatal condition.

  1. Child abuse: acute water intoxication in a hyperactive child.

    PubMed

    Lin, Chih-Yang; Tsau, Yong-Kwei

    2005-01-01

    A 4-year-8-month-old boy was brought to our emergency department with coma and seizure. Initial physical examination showed evidence of physical child abuse and sudden body weight gain of 3.4 kg in one day. The laboratory results showed normal renal function with severe hyponatremia and the MRI study showed diffuse brain swelling. All of these findings were compatible with the diagnosis of acute water intoxication. Careful history taking from the boy and his parents separately confirmed the course of chronic polydipsia with acute compulsive water drinking. After clinical assessment and follow-up by psychiatrist, the patient was diagnosed with hyperactivity disorder. We present this case and show the possibility of correlation between compulsive water drinking, child abuse and hyperactivity disorder on acute water intoxication.

  2. Acute intoxication of lidocaine and chlorpheniramine: report of one case.

    PubMed

    Hua, Yi-Ming; Hung, Chih-Hsing; Yuh, Yeong-Seng

    2005-01-01

    A case of acute intoxication involving lidocaine and chlorpheniramine (an antihistamine) in a 13-month-old child after ingestion of a commercial topical agent is presented. The major toxic reaction consisted of convulsion, coma, tachycardia, fever, and fatigue. This report shows that parents and physicians should be made aware of the hazards of lidocaine and overdose of other topical agents in infants and children.

  3. Antagonists for acute oral cadmium chloride intoxication

    SciTech Connect

    Basinger, M.A.; Jones, M.M.; Holscher, M.A.; Vaughn, W.K.

    1988-01-01

    An examination has been carried out on the relative efficacy of a number of chelating agents when acting as antagonists for oral cadmium chloride intoxication in mice. The compounds were administered orally after the oral administration of cadmium chloride at 1 mmol/kg. Of the compounds examined, several were useful in terms of enhancing survival, but by far the most effective in both enhancing survival and leaving minimal residual levels of cadmium in the liver and the kidney, was meso-2,3-dimercaptosuccinic acid (DMSA). Several polyaminocarboxylic acids also enhanced survival. The most effective of these in reducing liver and kidney levels of cadmium were diethylenetriaminepentaacetic acid (DTPA), trans-1,2-diaminocyclohexane-N,N,N'N'-tetraacetic acid (CDTA), and triethylenetetraminehexaacetic acid (TTHA). D-Penicillamine (DPA) was found to promote survival but also led to kidney cadmium levels higher than those found in the controls. Sodium 2,3-dimercaptopropane-1-sulfonate (DMPS) was as effective in promoting survival as DMSA but left levels of cadmium in the kidney and liver that were approximately four times greater than those found with DMSA.

  4. [Acute ethanol intoxication among children and adolescents in Hamburg, Germany].

    PubMed

    Stolle, M; Sack, P-M; Spieles, H; Thomasius, R

    2010-09-01

    By using an anonymous postcard reporting system, data of n=358 children, adolescents, and young adults who were treated in 26 emergency departments because of acute alcohol intoxication were collected. The aim of this study was to estimate the prevalence of acute alcohol intoxications in Hamburg, compare these data with the official hospital diagnosis register, and analyze the circumstances that led to the intoxication. A total of 358 cases were reported by the postcard system. Age ranged from 11-21 years, with 64.5% being 14-17 years old. Data were collected in the municipal area of Hamburg during the calendar year of 2008. The percentage of female patients was 65.6% in the age group from 11-17 years and decreased in the age group of patients being 18 years and older. A vast majority of patients were admitted by ambulance and were reported as being a"first offender". On average, male patients showed a higher level of blood alcohol when being admitted (2.02 ‰) than female patients (1.76 ‰). The older the age group, the higher the blood alcohol level. Among drinking circumstances, the situation"drank together with friends" was most frequently reported. In comparison with the official hospital diagnosis register, prevalence was 31.6% higher. This could mean that the prevalence reported in the official hospital diagnosis register is an underestimation of the actual case numbers.

  5. Comparison of two commonly practiced atropinization regimens in acute organophosphorus and carbamate poisoning, doubling doses vs. ad hoc: a prospective observational study.

    PubMed

    Perera, P M S; Shahmy, S; Gawarammana, I; Dawson, A H

    2008-06-01

    There is a wide variation and lack of evidence in current recommendations for atropine dosing schedules leading to subsequent variation in clinical practice. Therefore, we sought to examine the safety and effectiveness of a titrated vs. ad hoc atropine treatment regimen in a cohort of patients with acute cholinesterase inhibitor pesticide poisoning. A prospective cohort study was conducted in three district secondary referral hospitals in Sri Lanka using a structured data collection form that collected details of clinical symptoms and outcomes of cholinesterase inhibitor pesticide poisoning, atropine doses, and signs of atropinization. We compared two hospitals that used a titrated dosing protocol based on a structured monitoring sheet for atropine infusion with another hospital using an ad hoc regime. During the study, 272 symptomatic patients with anticholinesterase poisoning requiring atropine were admitted to the three hospitals. Outcomes of death and ventilation were analyzed for all patients, 226 patients were prospectively assessed for atropine toxicity. At baseline, patients in the titrated dose cohort had clinical signs consistent with greater toxicity. This in part may be due to ingestion of more toxic organophosphates. They received less pralidoxime and atropine, and were less likely to develop features of atropine toxicity, such as delirium (1% vs. 17%), hallucinations (1% vs. 35%), or either (1% vs. 35%) and need for patient restraint (3% vs. 48%) compared with the ad hoc dose regime. After adjusting for the pesticides ingested, there was no difference in mortality and ventilatory rates between protocols. Ad hoc high dose atropine regimens are associated with more frequent atropine toxicity without any obvious improvement in patient outcome compared with doses titrated to clinical effect. Atropine doses should be titrated against response and toxicity. Further education and the use of a structured monitoring sheet may assist in more appropriate

  6. Obstructive acute renal failure related to amantadine intoxication.

    PubMed

    Nakai, Kentaro; Takeda, Kazuhito; Kimura, Hiroshi; Miura, Shuhei; Maeda, Atsuhiro

    2009-03-01

    We report the case of a 69-year-old woman with seizures and acute renal failure with hyperkalemia. She presented with bladder turgescence and hydronephrosis on admission and was diagnosed as obstructive acute renal failure. Urethral catheterization was performed after a single-session hemodialysis. It resulted in immediate improvement of renal function and consciousness, and subsequent disappearance of seizures. Improvement of serum creatinine level to 0.7 from 10.6 mg/dL was associated with a fall in blood level of amantadine hydrochloride from 4.40 to 0.47 microg/mL. Physicians should be aware of urinary retention in patients treated with amantadine as a first sign of intoxication that could lead if untreated to obstructive acute renal failure. And we recommend to check the overdose symptoms, even those with normal renal function, treated with amantadine.

  7. Death due to acute tetrachloroethylene intoxication in a chronic abuser.

    PubMed

    Amadasi, Alberto; Mastroluca, Lavinia; Marasciuolo, Laura; Caligara, Marina; Sironi, Luca; Gentile, Guendalina; Zoja, Riccardo

    2015-05-01

    Volatile substances are used widespread, especially among young people, as a cheap and easily accessible drug. Tetrachloroethylene is one of the solvents exerting effects on the central nervous system with experiences of disinhibition and euphoria. The case presented is that of a 27-year-old female, found dead by her father at home with cotton swabs dipped in the nostrils. She was already known for this type of abuse and previously admitted twice to the hospital for nonfatal acute poisonings. The swabs were still soaked in tetrachloroethylene. Toxicological and histological investigations demonstrated the presence of an overlap between chronic intake of the substance (with high concentrations in sites of accumulation, e.g., the adipose tissue, and contemporary tissue damage, as histologically highlighted) and acute intoxication as final cause of death, with a concentration of 158 mg/L in cardiac blood and 4915 mg/kg in the adipose tissue. No other drugs or medicines were detected in body fluids or tissues, and to our knowledge, this is the highest concentration ever detected in forensic cases. This peculiar case confirms the toxicity of this substance and focuses on the importance of complete histological and toxicological investigations in the distinction between chronic abuse and acute intoxication.

  8. [Cardioprotective effect of GABA derivatives in acute alcohol intoxication].

    PubMed

    Perfilova, V N; Tiurenkov, I N; Berestovitskaia, V M; Vasil'eva, O S

    2006-01-01

    Cardioprotective properties of GABA analogs under conditions of acute alcoholic intoxication have been studied using the following functional tests: volume loads, tests for adrenoreactivity, and maximum isometric load. The experiments showed that a 32% aqueous ethanol solution intraperitoneally injected in a dose of 8 g/kg produces a cardiotoxic action, which is manifested by a decrease in the inotropic reserve in load tests. Citrocard (50 mg/kg), phenibut (50 mg/kg), and piracetam (200 mg/kg) prevent the alcohol-induced myocardium injury, as shown by the heart contractility retained on a higher level in the test group than in the control group.

  9. Sustained low-efficiency dialysis (SLED) for acute lithium intoxication

    PubMed Central

    Fiaccadori, Enrico; Maggiore, Umberto; Parenti, Elisabetta; Greco, Paolo; Cabassi, Aderville

    2008-01-01

    Acute lithium intoxication may cause serious neurologic and cardiac manifestations, up to the patient's death. Owing to its low molecular weight, relatively small volume of distribution close to that of total body water, and its negligible protein binding, lithium can be efficiently removed by any extracorporeal modality of renal replacement therapy (RRT). However, the shift from the intracellular to the extracellular compartment, with the inherent rebound phenomenon after the end of RRT, might limit the efficacy of the conventional, short-lasting haemodialysis. There have been no published studies up to now concerning the use of sustained low-efficiency dialysis (SLED) in lithium intoxication. This report describes a woman with a voluntary acute lithium ingestion of 40 tablets of lithium carbonate (8.12 mEq lithium each). The lithium concentration increased up to 4.18 mEq/l about 24 h after admission, notwithstanding treatment with intravenous crystalloids and gastric lavage. She developed mental status changes, oliguria, hypotension and bradycardia. We started SLED (8 h) with a blood flow of 200 ml/min and countercurrent dialysate flow of 300 ml/min. Lithium serum levels decreased by 86% during treatment, and the patient fully awoke recovering a normal mental status within the first 4 h of treatment. SLED was completed safely within the prescribed time. After the end of treatment, the rebound of lithium concentration was unremarkable. Renal function fully recovered, and the patient was transferred into a psychiatric facility 3 days after admission. PMID:25983926

  10. Characteristic manifestations of acute paint thinner-intoxicated children.

    PubMed

    Agin, Khosrow; Hassanian-Moghaddam, Hossein; Shadnia, Shahin; Rahimi, Hamid Reza

    2016-07-01

    In this study, we evaluated the acute clinical and para-clinical abnormalities arising from paint thinner (PT) poisoning in children. Data were collected from 2008 to 2013, and sourced from the medical records of PT-intoxicated children and through questionnaires. A total of 42 children were enrolled in the study. The mean age was 37.2±2.4 months. The participants ranged from10 to 96 months of age; with a median age of 3 months; and a modal age of 24 months. The sex ratio in the study was 22 males (64.9%) to 20 females (35.1%). Clinical biochemistry results of participants revealed the significant presence of alkaline phosphatase (ALP, 569.25±151.58U/L), and lactate dehydrogenase (LDH, 576.14±164.97 IU/L). Arterial blood gas (ABG) analysis was also carried out. Chest X-ray predominantly revealed right side alveolar air space consolidation. These results confirmed hepatotoxicity and pneumonia in PT-intoxicated children. The study also revealed that positive outcomes were achieved in patients with early treatment and management. In addition, the current finding confirmed the timely transfer of the victim to the poisoning center.

  11. Acute alcohol intoxication in a child following ingestion of an ethyl-alcohol-based hand sanitizer.

    PubMed

    Hertzog, James H; Radwick, Allison

    2015-07-01

    While uncommon, ingestion of ethanol-based hand sanitizers by children may be associated with significant intoxication. We report the case of a 7-year-old with acute alcohol intoxication following hand sanitizer ingestion. Alcohol elimination in this patient followed zero-order kinetics with a clearance rate of 22.5 mg/kg/h, consistent with the limited pharmacokinetic information available for children who experience alcohol intoxication from more traditional sources.

  12. Acute care for alcohol intoxication. Be prepared to consider clinical dilemmas.

    PubMed

    Yost, David A

    2002-12-01

    The clinical assessment of an acutely intoxicated patient should be performed with meticulous care and include repetitive examinations to properly determine the patient's condition. Multiple factors, such as trauma and concomitant use of other drugs, can confuse the diagnostic picture and affect the choice of therapy. In this article, Dr Yost reviews the diagnostic considerations, appropriate treatment, and clinic discharge for the intoxicated patient.

  13. Diagnostic and therapeutic approach for acute paraquat intoxication.

    PubMed

    Gil, Hyo-wook; Hong, Jung-Rak; Jang, Si-Hyong; Hong, Sae-Yong

    2014-11-01

    Paraquat (PQ) has known negative human health effects, but continues to be commonly used worldwide as a herbicide. Our clinical data shows that the main prognostic factor is the time required to achieve a negative urine dithionite test. Patient survival is a 100% when the area affected by ground glass opacity is <20% of the total lung volume on high-resolution computed tomography imaging 7 days post-PQ ingestion. The incidence of acute kidney injury is approximately 50%. The average serum creatinine level reaches its peak around 5 days post-ingestion, and usually normalizes within 3 weeks. We obtain two connecting lines from the highest PQ level for the survivors and the lowest PQ level among the non-survivors at a given time. Patients with a PQ level between these two lines are considered treatable. The following treatment modalities are recommended to preserve kidney function: 1) extracorporeal elimination, 2) intravenous antioxidant administration, 3) diuresis with a fluid, and 4) cytotoxic drugs. In conclusion, this review provides a general overview on the diagnostic procedure and treatment modality of acute PQ intoxication, while focusing on our clinical experience.

  14. NUTRITIONAL THERAPY IN THE TREATMENT OF ACUTE CORROSIVE INTOXICATION IN ADULTS

    PubMed Central

    Chibishev, Andon; Markoski, Velo; Smokovski, Ivica; Shikole, Emilija; Stevcevska, Aleksandra

    2016-01-01

    Introduction: Acute intoxications with corrosive substances can cause severe chemical injuries of the upper gastrointestinal tract, most often located in the mouth, pharynx, esophagus, stomach and duodenum. If a patient survives the acute phase of intoxication, regenerative response may result in esophageal and/or gastric stenosis, and increased risk of esophageal and gastric cancer. Such intoxication may be fatal due to perforation or tracheal necrosis. Enteral nutrition is a nutritional method when nutritional substances are administered through specially designed tubing placed through the nose or percutaneously, directly into the GIT. Aim: The aim of this study is to describe the methods of artificial nutrition in patients with acute corrosive intoxications and the importance of nutritional support in the treatment of these intoxications. Discussion: Nutrition in the treatment of acute corrosive intoxications is one of the most important therapeutic processes that largely contribute to faster recovery of the post-corrosive injuries of upper GIT, stabilization of biologic, immunologic and metabolic parameters, and reduction of length of stay in hospital Aim of the treatment of acute corrosive intoxications is to prevent perforation and progressive fibrosis, and esophageal and gastric stenosis. There are different and often conflicting positions, on the conservative treatment of acute corrosive intoxications in adults. Such treatment mainly consists of anti-secretory treatment, antibiotics and intensive hyper-alimentation, aiming to prevent late post-corrosive intoxications. Conclusion: It is considered that nutritional support plays a major role in maintenance of metabolic processes and prevention of severe metabolic complications that could additionally aggravate the condition and impair the treatment. PMID:27047272

  15. Nitrite as an antidote for acute hydrogen sulfide intoxication

    SciTech Connect

    Beck, J.F.; Bradbury, C.M.; Connors, A.J.; Donini, J.C.

    1981-11-01

    The detoxification of hydrogen sulfide (H/sub 2/S) by a heme catalyzed oxidation was examined as part of an on-going study of H/sub 2/S toxicity. Interlocking O/sub 2/ absorption and sulfide depletion data indicate that both oxyhemoglobin and methemoglobin are effective catalytic agents. Although the latter is more efficacious, the life time of excess sulfide in the presence of oxygen and either of the above is of the order of minutes. It has also been established that the formation of methemoglobin following nitrite administration occurs preferentially under oxygen poor conditions. Under an atmospheric or oxygen enriched environment, which favors sulfide depletion, the nitrite retards sulfide oxidation. Thus nitrite as an antidote for acute H/sub 2/S intoxication can only be effective within the first few minutes after the exposure, at which time resuscitation and/or ventilation of the victim is likely to produce conditions in which the nitrite actually slows sulfide removal.

  16. Bath salt intoxication causing acute kidney injury requiring hemodialysis.

    PubMed

    Regunath, Hariharan; Ariyamuthu, Venkatesh Kumar; Dalal, Pranavkumar; Misra, Madhukar

    2012-10-01

    Traditional bath salts contain a combination of inorganic salts like Epsom salts, table salt, baking soda, sodium metaphosphate, and borax that have cleansing properties. Since 2010, there have been rising concerns about a new type of substance abuse in the name of "bath salts." They are beta-ketone amphetamine analogs and are derivates of cathinone, a naturally occurring amphetamine analog found in the "khat" plant (Catha edulis). Effects reported with intake included increased energy, empathy, openness, and increased libido. Serious adverse effects reported with intoxication included cardiac, psychiatric, and neurological signs and symptoms. Not much is known about the toxicology and metabolism of these compounds. They inhibit monoamine reuptake (dopamine, nor epinephrine, etc.) and act as central nervous system stimulants with high additive and abuse potential because of their clinical and biochemical similarities to effects from use of cocaine, amphetamine, and 3,4-methylenedioxy-N-methylamphetamine. Deaths associated with use of these compounds have also been reported. We report a case of acute kidney injury associated with the use of "bath salt" pills that improved with hemodialysis.

  17. [Experimental rationale for the use of enterosorbents in acute ethanol intoxication].

    PubMed

    Orbidans, A G; Terekhin, G A; Vladimirskiĭ, E V; Terekhina, N A

    2009-01-01

    The experiment on 83 rats has provided a rationale for the use of enterosorbents in acute ethanol intoxication. Polysorb reduces the halflife of ethanol, recovers physical fitness in the animals with acute poisoning. The enterosorbents polysorb, litovit, and sapropel have been found to have a corrective effect on the level of the major plasma antioxidant ceruloplasmin in acute ethanol intoxication. Enterosorbents are an effective detoxifying agent in this condition. Examining the mechanisms of toxic action of ethanol allows the most expedient treatment policy to be substantiated in acute poisonings.

  18. Acute effects of a low-dose atropine/scopolamine mixture as a food contaminant in human volunteers.

    PubMed

    Perharič, Lucija; Juvan, Katja Ažman; Stanovnik, Lovro

    2013-09-01

    To verify the assumptions in our previous risk assessment of an atropine/scopolamine mixture in buckwheat flour, we performed a randomized, double-blind, placebo-controlled cross-over study in 20 healthy, adult volunteers. The volunteers ingested a traditional Slovenian buckwheat meal, made of boiled buckwheat flour to which alkaloids were added. In addition to the placebo they ingested 0.12/0.10, 0.37/0.29, 1.22/0.95, 3.58/2.81 and 12.10/9.50 µg kg(-1) body mass (BM) of the atropine/scopolamine mixture. The changes in body temperature, heart rate, salivary and sweat secretion, pupil size, near-point vision and subjective symptoms were recorded regularly for 4 h after the ingestion. Decreased salivary and sweat secretion, increased heart rate and pupil size and reduced near-point vision accompanied by characteristic subjective symptoms were observed at 12.10/9.50 µg kg(-1) BM. At doses of 0.37/0.29 and 1.22/0.95 µg kg(-1) BM, a significant decrease in the heart rate was noted, which we consider to be a critical effect of a low-dose exposure to the atropine/scopolamine mixture. Although this did not have any clinical relevance in our subjects, it may have serious implications if it occurred in people with pre-existent cardiac conditions or those on medications that may cause bradycardia. No significant changes in the observed end points were noted at 0.12/0.10 µg kg(-1) BM. We estimate that the NOAEL (No Observed Adverse Effect Level) for the atropine/scopolamine mixture lies between the lower two administered doses. Applying the uncertainty factor of 10, we propose a new provisional Acute Reference Doses (ARfDs) of the mixture, i.e. 0.01 µg kg(-1) BM for each alkaloid, and a further refinement using higher-tier approaches.

  19. Early white matter injuries in patients with acute carbon monoxide intoxication

    PubMed Central

    Tsai, Ping-Huei; Chou, Ming-Chung; Chiang, Shih-Wei; Chung, Hsiao-Wen; Liu, Hua-Shan; Kao, Hung-Wen; Chen, Cheng-Yu

    2017-01-01

    Abstract Evaluation of acute white matter injuries caused by carbon monoxide (CO) poisoning can be limited by conventional magnetic resonance (MR) imaging. We aim to evaluate the feasibility of diffusion kurtosis imaging (DKI) for early detection of white matter alterations in patients with acute CO intoxication. A total of 30 subjects including 15 acute CO patients and 15 age- and sex-matched healthy volunteers were enrolled in this study. MR examinations were performed on a 3T MR scanner within 8 days after CO intoxication. DKI data were acquired to derive axial, radial, and mean kurtosis, as well as fractional anisotropy (FA), axial, radial, and mean diffusivity for tract-specific comparisons between the 2 groups. Significant decreases of mean kurtosis were shown in the genu of corpus callosum, cingulum, and motor-related tracts (corticospinal and corticobulbar tracts) in patients with acute CO intoxication as compared with controls. On the contrary, significant differences of FA values were merely shown in the regions of corticospinal tracts. DKI demonstrated comparably stronger potential than diffusion tensor imaging in terms of early detection of white matter changes in patients with acute CO intoxication. This may have implications in therapeutic strategy for managing acute CO intoxication patients. PMID:28151889

  20. Acute renal failure and metabolic acidosis due to oxalic acid intoxication: a case report.

    PubMed

    Yamamoto, Rie; Morita, Seiji; Aoki, Hiromichi; Nakagawa, Yoshihide; Yamamoto, Isotoshi; Inokuchi, Sadaki

    2011-12-20

    Most of the reports of oxalic acid intoxication are in cases of ethylene glycol intoxication. These symptoms are known to be central nerve system manifestations, cardiopulmonary manifestations and acute renal failure. There have been only a few reports of direct oxalic acid intoxication. However, there have been a few recent reports of oxalic acid intoxication due to the ingestion of star fruit and ascorbic acid. We herein report the case of a patient with acute renal failure and metabolic acidosis caused directly by consumption of oxalic acid. During the initial examination by the physician at our hospital, the patient presented with tachypnea, a precordinal burning sensation, nausea and metabolic acidosis. After admission, the patient developed renal failure and anion gap high metabolic acidosis, but did not develop any CNS or cardio-pulmonary manifestations in the clinical course. The patient benefitted symptomatically from hemodialysis.

  1. Acute isoniazid intoxication: an uncommon cause of convulsion, coma and acidosis.

    PubMed

    Uzman, Sinan; Uludağ Yanaral, Tümay; Toptaş, Mehmet; Koç, Alparslan; Taş, Aytül; Bican, Gülşen

    2013-01-01

    Despite the widespread use, suicidal ingestion of isoniazid is a rare condition in Turkey. We reported a case of acute isoniazid intoxication associated with alcohol intake presenting with convulsion, coma and metabolic acidosis. The patient was treated successfully with intravenous pyridoxine administration. Early recognation and appropriate treatment in the intensive care unit is very important to prevent mortality in patients with acute isoniazid toxicity.

  2. Spatiotemporal pattern of neuronal injury induced by DFP in rats: A model for delayed neuronal cell death following acute OP intoxication

    SciTech Connect

    Li Yonggang; Lein, Pamela J.; Liu Cuimei; Bruun, Donald A.; Tewolde, Teclemichael; Ford, Gregory; Ford, Byron D.

    2011-06-15

    Organophosphate (OP) neurotoxins cause acute cholinergic toxicity and seizures resulting in delayed brain damage and persistent neurological symptoms. Testing novel strategies for protecting against delayed effects of acute OP intoxication has been hampered by the lack of appropriate animal models. In this study, we characterize the spatiotemporal pattern of cellular injury after acute intoxication with the OP diisopropylfluorophosphate (DFP). Adult male Sprague-Dawley rats received pyridostigmine (0.1 mg/kg, im) and atropine methylnitrate (20 mg/kg, im) prior to DFP (9 mg/kg, ip) administration. All DFP-treated animals exhibited moderate to severe seizures within minutes after DFP injection but survived up to 72 h. AChE activity was significantly depressed in the cortex, hippocampus, subcortical brain tissue and cerebellum at 1 h post-DFP injection and this inhibition persisted for up to 72 h. Analysis of neuronal injury by Fluoro-Jade B (FJB) labeling revealed delayed neuronal cell death in the hippocampus, cortex, amygdala and thalamus, but not the cerebellum, starting at 4 h and persisting until 72 h after DFP treatment, although temporal profiles varied between brain regions. At 24 h post-DFP injection, the pattern of FJB labeling corresponded to TUNEL staining in most brain regions, and FJB-positive cells displayed reduced NeuN immunoreactivity but were not immunopositive for astrocytic (GFAP), oligodendroglial (O4) or macrophage/microglial (ED1) markers, demonstrating that DFP causes a region-specific delayed neuronal injury mediated in part by apoptosis. These findings indicate the feasibility of this model for testing neuroprotective strategies, and provide insight regarding therapeutic windows for effective pharmacological intervention following acute OP intoxication. - Research Highlights: > DFP induced neuronal FJB labeling starting at 4-8 h after treatment > The pattern of DFP-induced FJB labeling closely corresponded to TUNEL staining > FJB

  3. A case of survival after chlorfenapyr intoxication with acute pancreatitis

    PubMed Central

    Ku, Jae Eun; Joo, Young Seon; You, Je Sung; Chung, Sung Phil; Lee, Hahn Shick

    2015-01-01

    Chlorfenapyr is a moderately hazardous insecticide. There have been previous reports of chlorfenapyr intoxication, but none have reported patient survival or an association with pancreatitis. A 61-year-old woman was brought to the emergency department with vomiting after ingesting 10 mL chlorfenapyr in a suicide attempt 1 hour before. The patient was treated with gastric lavage and activated charcoal, then transferred to the intensive care unit. Initial laboratory data were unremarkable except for elevated amylase/lipase levels (134/222 U/L), which were even higher 7 days later and remained elevated for 2 weeks. Abdominal computed tomography showed diffuse pancreatic swelling. The patient improved with conservative care and was discharged to home 19 days after admission. This is the first reported case of survival after chlorfenapyr intoxication. We recommend early aggressive management in the emergency department and close monitoring in the intensive care unit to detect and treat potentially fatal deterioration after chlorfenapyr intoxication. PMID:27752575

  4. A case of survival after chlorfenapyr intoxication with acute pancreatitis.

    PubMed

    Ku, Jae Eun; Joo, Young Seon; You, Je Sung; Chung, Sung Phil; Lee, Hahn Shick

    2015-03-01

    Chlorfenapyr is a moderately hazardous insecticide. There have been previous reports of chlorfenapyr intoxication, but none have reported patient survival or an association with pancreatitis. A 61-year-old woman was brought to the emergency department with vomiting after ingesting 10 mL chlorfenapyr in a suicide attempt 1 hour before. The patient was treated with gastric lavage and activated charcoal, then transferred to the intensive care unit. Initial laboratory data were unremarkable except for elevated amylase/lipase levels (134/222 U/L), which were even higher 7 days later and remained elevated for 2 weeks. Abdominal computed tomography showed diffuse pancreatic swelling. The patient improved with conservative care and was discharged to home 19 days after admission. This is the first reported case of survival after chlorfenapyr intoxication. We recommend early aggressive management in the emergency department and close monitoring in the intensive care unit to detect and treat potentially fatal deterioration after chlorfenapyr intoxication.

  5. [Extended hemoperfusion in the treatment of acute carbamazepine intoxication].

    PubMed

    Peces, R; Azorín, S; Peces, C; Selgas, R

    2010-01-01

    Carbamazepine is used in the treatment of epilepsy, and also prescribed in neuralgic pain syndromes, and certain affective disorders. Carbamazepine intoxication with suicide attempt is a relatively common clinical problem that can result in coma, respiratory depression, arrhythmia, hemodynamic instability and death. The drug's relatively high molecular weight, elevated volume of distribution and intense protein-binding render it difficult to extracorporeal removal, but published experience with hemoperfusion or hemodialysis present variable results. We describe a case report involving carbamazepine intoxication who was successfully treated with charcoal hemoperfusion. With this treatment the half-life of carbamazepine was reduced with rapid lowering of carbamazepine levels and clinical improvement. Based on our experience in this patient and a review of previously reported cases, extended charcoal hemoperfusion should be considered for serious carbamazepine intoxication because free as well as bound drug fractions are eliminated via this technique.

  6. [Hemoperfusion in the treatment of acute valproic acid intoxication].

    PubMed

    Peces, R; Fernández, E J; Sánchez, R J; Peces, C; Montero, A; Selgas, R

    2007-01-01

    Valproic acid is increasingly used in the treatment of epilepsy, and also prescribed for bipolar affective disorders, schizoaffective disorders, schizophrenia and migraine prophylaxis. Valproic acid intoxication with suicide attempt is a relatively common clinical problem that can result in coma, respiratory depression, pancytopenia, hemodynamic instability and death. The drug's relatively low molecular weight, small volume of distribution and saturable protein-binding render it potentially amenable to exracorporeal removal (hemodialysis, hemoperfusion or hemofiltration ), but published experience is scarce. We describe a case report involving valproic acid intoxication with ingestion of ethanol, who was successfully treated with charcoal hemoperfusion. With this treatment the half-life of valproic acid was reduced with rapid lowering of valproic acid levels and clinical improvement. Based on our experience in this patient and a review of previously reported cases, charcoal hemoperfusion should be considered for serious valproic acid intoxication because free as well as bound drug fractions are eliminated via this technique.

  7. Acute respiratory distress syndrome after verapamil intoxication: case report and literature review.

    PubMed

    Izdes, S; Altintas, N D; Soykut, C

    2014-04-01

    Verapamil intoxication is a life-threatening condition that often presents with severe hemodynamic instability and requires vasopressor support. There are also documented case reports of the development of non-cardiogenic pulmonary oedema after verapamil overdose. However, the exact mechanisms responsible for pulmonary oedema remain unclear. Here, we describe a 36-year-old woman who was admitted to the intensive care unit after ingesting high-dose verapamil and subsequently developed acute respiratory distress syndrome soon after hemodynamic stabilization. Possible mechanisms are presented after taking into account findings in the current literature. Acute respiratory distress syndrome should be considered early during the evaluation of patients with verapamil intoxication.

  8. Acute alcohol intoxication suppresses the pulmonary ELR-negative CXC chemokine response to lipopolysaccharide.

    PubMed

    Happel, Kyle I; Rudner, Xiaowen; Quinton, Lee J; Movassaghi, Jennifer L; Clark, Charles; Odden, Anthony R; Zhang, Ping; Bagby, Gregory J; Nelson, Steve; Shellito, Judd E

    2007-08-01

    Alcohol abuse impairs the pulmonary immune response to infection and increases the morbidity and mortality of bacterial pneumonia. Acute alcohol intoxication suppresses lung expression of CXC chemokines bearing the Glu-Leu-Arg motif (ELR+) following lipopolysaccharide (LPS) challenge, but its effect on the structurally related ELR- CXC chemokines, which attract T cells, is unknown. We therefore investigated the effect of acute alcohol intoxication on the pulmonary response to intratracheal (i.t.) LPS challenge for the ELR- CXC chemokines monokine induced by gamma (MIG or CXCL9), interferon-inducible protein 10 (IP-10 or CXCL10), and interferon-inducible T cell alpha chemoattractant (I-TAC or CXCL11). Male C57BL/6 or C3H/HeN mice were given an intraperitoneal injection of ethanol (3.0 g/kg) or phosphate buffered saline 30 min before i.t. LPS challenge. Chemokine mRNA transcripts were measured at 0, 2, 6, and 16 h. Acute alcohol intoxication inhibited the lung's expression of all three chemokine genes in response to LPS. Lung IFN-gamma mRNA was also inhibited by acute intoxication over the same time course. The in vitro effect of ethanol on chemokine secretion was further studied in the MH-S alveolar macrophage cell line. IP-10, MIG, and I-TAC in response to LPS were enhanced by exogenous interferon (IFN)-gamma, and these responses were blunted by exposure to ethanol. Alcohol exposure did not affect MH-S cell nuclear factor kappa beta p65 nuclear localization during challenge, despite dose-dependent inhibition of Erk 1/2 phosphorylation. In addition, phospho-signal transduction and activator of transcription 1 was not decreased in the presence of acute ethanol, thereby indicating that acute intoxication does not affect IFN-gamma signaling in MH-S cells. Recruitment of CD3+ T cells into the alveolar space 4 days after LPS challenge was moderately impaired by acute ethanol intoxication. These results implicate acute ethanol intoxication as a significant inhibitor of

  9. Acute alcohol tolerance on subjective intoxication and simulated driving performance in binge drinkers.

    PubMed

    Marczinski, Cecile A; Fillmore, Mark T

    2009-06-01

    High rates of binge drinking and alcohol-related problems, including drinking and driving, occur among college students. Underlying reasons for the heightened impaired driving rates in this demographic group are not known. The authors hypothesized that acute tolerance to the interoceptive cues of intoxication may contribute to these maladaptive decisions to drive in binge drinkers. Groups of binge-drinking and non-binge-drinking college students (N = 28) attended sessions during which they received a moderate dose of alcohol (0.65 g/kg) or a placebo. The development of acute tolerance to subjective ratings of intoxication and simulated driving performance was assessed by comparing measures taken during the ascending phase and descending phases of the blood alcohol curve. Compared with placebo, alcohol increased ratings of intoxication and impaired multiple aspects of simulated driving performance in both binge and non-binge drinkers. During the descending phase of the blood alcohol curve, binge drinkers showed acute tolerance to alcohol's effect on subjective intoxication, and this effect was accompanied by an increased rating of willingness to drive. By contrast, non-binge drinkers showed no acute tolerance.

  10. The Anion Gap is a Predictive Clinical Marker for Death in Patients with Acute Pesticide Intoxication.

    PubMed

    Lee, Sun-Hyo; Park, Samel; Lee, Jung-Won; Hwang, Il-Woong; Moon, Hyung-Jun; Kim, Ki-Hwan; Park, Su-Yeon; Gil, Hyo-Wook; Hong, Sae-Yong

    2016-07-01

    Pesticide formulation includes solvents (methanol and xylene) and antifreeze (ethylene glycol) whose metabolites are anions such as formic acid, hippuric acid, and oxalate. However, the effect of the anion gap on clinical outcome in acute pesticide intoxication requires clarification. In this prospective study, we compared the anion gap and other parameters between surviving versus deceased patients with acute pesticide intoxication. The following parameters were assessed in 1,058 patients with acute pesticide intoxication: blood chemistry (blood urea nitrogen, creatinine, glucose, lactic acid, liver enzymes, albumin, globulin, and urate), urinalysis (ketone bodies), arterial blood gas analysis, electrolytes (Na(+), K(+), Cl(-) HCO3 (-), Ca(++)), pesticide field of use, class, and ingestion amount, clinical outcome (death rate, length of hospital stay, length of intensive care unit stay, and seriousness of toxic symptoms), and the calculated anion gap. Among the 481 patients with a high anion gap, 52.2% had a blood pH in the physiologic range, 35.8% had metabolic acidosis, and 12.1% had acidemia. Age, anion gap, pesticide field of use, pesticide class, seriousness of symptoms (all P < 0.001), and time lag after ingestion (P = 0.048) were significant risk factors for death in univariate analyses. Among these, age, anion gap, and pesticide class were significant risk factors for death in a multiple logistic regression analysis (P < 0.001). In conclusions, high anion gap is a significant risk factor for death, regardless of the accompanying acid-base balance status in patients with acute pesticide intoxication.

  11. Systematic Assessment of Gamma Hydroxybutyrate (GHB) Effects During and After Acute Intoxication

    PubMed Central

    Kim, Susan Y.; Barker, Judith C.; Anderson, Ilene B.; Dyer, Jo Ellen; Earnest, Gillian; Blanc, Paul D.

    2009-01-01

    We adapted and tested a previously published questionnaire battery eliciting sensory and cognitive symptoms during (acute) and immediately after (post-acute) GHB intoxication. Studying 125GHBusers, we assessed the instrument’s internal consistency using Cronbach’s alpha (CA) and responsiveness to change comparing acute and post-acute symptoms. The final 14-item battery demonstrated good internal consistency (CA ≥ 0.85, both acute and post-acute). The median symptom score (possible range 0–64) was 30 (acute) and 6 (post-acute; difference p < 0.001). This modified substance-specific symptom battery, which is easily administered, demonstrated excellent performance characteristics. It can be used to study GHB and, potentially, related drugs of abuse. PMID:18612887

  12. Porcine model characterizing various parameters assessing the outcome after acetaminophen intoxication induced acute liver failure

    PubMed Central

    Thiel, Karolin; Klingert, Wilfried; Klingert, Kathrin; Morgalla, Matthias H; Schuhmann, Martin U; Leckie, Pamela; Sharifi, Yalda; Davies, Nathan A; Jalan, Rajiv; Peter, Andreas; Grasshoff, Christian; Königsrainer, Alfred; Schenk, Martin; Thiel, Christian

    2017-01-01

    AIM To investigate the changes of hemodynamic and laboratory parameters during the course of acute liver failure following acetaminophen overdose. METHODS Eight pigs underwent a midline laparotomy following jejunal catheter placement for further acetaminophen intoxication and positioning of a portal vein Doppler flow-probe. Acute liver failure was realized by intrajejunal acetaminophen administration in six animals, two animals were sham operated. All animals were invasively monitored and received standardized intensive care support throughout the study. Portal blood flow, hemodynamic and ventilation parameters were continuously recorded. Laboratory parameters were analysed every eight hours. Liver biopsies were sampled every 24 h following intoxication and upon autopsy. RESULTS Acute liver failure (ALF) occurred after 28 ± 5 h resulted in multiple organ failure and death despite maximal support after further 21 ± 1 h (study end). Portal blood flow (baseline 1100 ± 156 mL/min) increased to a maximum flow of 1873 ± 175 mL/min at manifestation of ALF, which was significantly elevated (P < 0.01). Immediately after peaking, portal flow declined rapidly to 283 ± 135 mL/min at study end. Thrombocyte values (baseline 307 × 103/µL ± 34 × 103/µL) of intoxicated animals declined slowly to values of 145 × 103/µL ± 46 × 103/µL when liver failure occurred. Subsequent appearance of severe thrombocytopenia in liver failure resulted in values of 11 × 103/µL ± 3 × 103/µL preceding fatality within few hours which was significant (P > 0.01). CONCLUSION Declining portal blood flow and subsequent severe thrombocytopenia after acetaminophen intoxication precede fatality in a porcine acute liver failure model. PMID:28321158

  13. From divination to madness: features of acute intoxication with Salvia use.

    PubMed

    Winslow, Munidasa; Mahendran, Rathi

    2014-04-01

    Salvia divinorum is a psychoactive botanical plant that is increasingly used for the 'legal' highs that it can produce. It is readily available for purchase on the Internet, and most abusers are unaware of the toxicity and abuse potential associated with its use. As the use of novel compounds among abusers is not uncommon, physicians need to increase their awareness and recognition of these new substances. Herein, we report a case of an acute presentation of Salvia intoxication.

  14. From divination to madness: features of acute intoxication with Salvia use

    PubMed Central

    Winslow, Munidasa; Mahendran, Rathi

    2014-01-01

    Salvia divinorum is a psychoactive botanical plant that is increasingly used for the ‘legal’ highs that it can produce. It is readily available for purchase on the Internet, and most abusers are unaware of the toxicity and abuse potential associated with its use. As the use of novel compounds among abusers is not uncommon, physicians need to increase their awareness and recognition of these new substances. Herein, we report a case of an acute presentation of Salvia intoxication. PMID:24763842

  15. The Anion Gap is a Predictive Clinical Marker for Death in Patients with Acute Pesticide Intoxication

    PubMed Central

    2016-01-01

    Pesticide formulation includes solvents (methanol and xylene) and antifreeze (ethylene glycol) whose metabolites are anions such as formic acid, hippuric acid, and oxalate. However, the effect of the anion gap on clinical outcome in acute pesticide intoxication requires clarification. In this prospective study, we compared the anion gap and other parameters between surviving versus deceased patients with acute pesticide intoxication. The following parameters were assessed in 1,058 patients with acute pesticide intoxication: blood chemistry (blood urea nitrogen, creatinine, glucose, lactic acid, liver enzymes, albumin, globulin, and urate), urinalysis (ketone bodies), arterial blood gas analysis, electrolytes (Na+, K+, Cl- HCO3-, Ca++), pesticide field of use, class, and ingestion amount, clinical outcome (death rate, length of hospital stay, length of intensive care unit stay, and seriousness of toxic symptoms), and the calculated anion gap. Among the 481 patients with a high anion gap, 52.2% had a blood pH in the physiologic range, 35.8% had metabolic acidosis, and 12.1% had acidemia. Age, anion gap, pesticide field of use, pesticide class, seriousness of symptoms (all P < 0.001), and time lag after ingestion (P = 0.048) were significant risk factors for death in univariate analyses. Among these, age, anion gap, and pesticide class were significant risk factors for death in a multiple logistic regression analysis (P < 0.001). In conclusions, high anion gap is a significant risk factor for death, regardless of the accompanying acid-base balance status in patients with acute pesticide intoxication. PMID:27366016

  16. Intravenous Lipid Emulsion Therapy for Acute Synthetic Cannabinoid Intoxication: Clinical Experience in Four Cases

    PubMed Central

    Aksel, Gökhan; Güneysel, Özlem; Taşyürek, Tanju; Kozan, Ergül; Çevik, Şebnem Eren

    2015-01-01

    There is no specific antidote for intoxication with synthetic cannabinoids. In this case series, we considered the efficiency of intravenous lipid emulsion therapy in four cases, who presented to emergency department with synthetic cannabinoid (bonzai) intoxication. The first patient had a GCS of 3 and a left bundle branch block on electrocardiography. The electrocardiography revealed sinus rhythm with normal QRS width after the treatment. The second patient had bradycardia, hypotension, and a GCS of 14. After intravenous lipid emulsion therapy, the bradycardia resolved, and the patient's GCS improved to 15. The third patient presented with a GCS of 8, and had hypotension and bradycardia. After the treatment, not only did the bradycardia resolve, but also the GCS improved to 15. The fourth patient, whose electrocardiography revealed accelerated junctional rhythm, had a GCS of 13. The patient's rhythm was sinus after the treatment. Cardiovascular recovery was seen in all four cases, and neurological recovery was also seen in three of them. Based on the fact that intravenous lipid emulsion is beneficial in patients intoxicated with lipophilic drugs, unstable patients presenting to the emergency department with acute synthetic cannabinoid intoxication may be candidates for intravenous lipid emulsion treatment. PMID:26078891

  17. Intralipid in acute caffeine intoxication: a case report.

    PubMed

    Muraro, Luisa; Longo, Laura; Geraldini, Federico; Bortot, Andrea; Paoli, Andrea; Boscolo, Annalisa

    2016-10-01

    Caffeine is arguably the most widely used stimulant drug in the world. Here we describe a suicide attempt involving caffeine overdose whereby the patient's severe intoxication was successfully treated with the prompt infusion of Intralipid. A 19-year-old man was found in an agitated state at home by the volunteer emergency team about 1 h after the intentional ingestion of 40 g of caffeine (tablets). His consciousness decreased rapidly, followed quickly by seizures, and electrocardiographic monitoring showed ventricular fibrillation. Advanced life support maneuvers were started immediately, with the patient defibrillated 10 times and administered 5 mg epinephrine in total and 300 + 150 mg of amiodarone (as well as lidocaine and magnesium sulfate). The cardiac rhythm eventually evolved to asystole, necessitating the intravenous injection of epinephrine to achieve the return of spontaneous circulation. However, critical hemodynamic instability persisted, with the patient's cardiac rhythm alternating between refractory irregular narrow complex tachycardia and wide complex tachycardia associated with hypotension. In an attempt to restore stability we administered three successive doses of Intralipid (120 + 250 + 100 mg), which successfully prevented a severe cardiovascular collapse due to a supra-lethal plasma caffeine level (>120 mg/L after lipid emulsion). The patient survived without any neurologic complications and was transferred to a psychiatric ward a few days later. The case emphasizes the efficacy of intravenous lipid emulsion in the resuscitation of patients from non-local anesthetic systemic toxicity. Intralipid appears to act initially as a vehicle that carries the stimulant drug away from heart and brain to less well-perfused organs (scavenging mechanism) and then, with a sufficient drop in the caffeine concentration, possibly as a tonic to the depressed heart.

  18. Analytical findings of an acute intoxication after inhalation of methoxetamine.

    PubMed

    Imbert, Laurent; Boucher, Alexandra; Delhome, Gilles; Cueto, Thierry; Boudinaud, Michel; Maublanc, Julie; Dulaurent, Sylvain; Descotes, Jacques; Lachâtre, Gérard; Gaulier, Jean-Michel

    2014-09-01

    Methoxetamine (MXE) is increasingly used and abused, as it is frequently presented as being safer than ketamine, and legal. Cases of only MXE consumption being associated with the occurrence of seizures are rarely reported. A single MXE intoxication case by inhalation is described concerning a 21-year-old man, not known to be epileptic, who was found collapsed in his bedroom, supposedly after an epileptic seizure. He was transferred to the Emergency Department of the Henri Mondor Hospital, Aurillac, France. He was conscious, but with a sinus bradycardia (48/min) and an ST-segment elevation on the electrocardiogram, and a slightly increased creatine kinase level (270 U/L) and hyponatremia (127 mmol/L). New seizure activity occurred during hospitalization, but the clinical course in the intensive care unit was favorable. Quantitation of MXE in serum and urine using gas chromatography coupled to mass spectrometry (GC-MS) was developed, as well as a liquid chromatography coupled to tandem mass spectrometry (LC-MS-MS) method for the determination of MXE in hair. Limits of detection and quantification were, respectively, 2 and 10 µg/L for the GC-MS method and both 0.5 pg/mg for the LC-MS-MS method. Concentrations of 30 and 408 µg/L were, respectively, measured in serum and urine. Concentrations of 135 and 145 pg/mg were detected in two 2.5 cm hair strands, consistent with one or several consumptions during the 2 ½ months prior to sampling. A sample of the powder consumed was available and also analyzed. This case illustrates the dangers of this drug, which justify its classification as a narcotic in France since August 2013.

  19. Does acute alcohol intoxication cause transaminase elevations in children and adolescents?

    PubMed

    Binder, Christoph; Knibbe, Karoline; Kreissl, Alexandra; Repa, Andreas; Thanhaeuser, Margarita; Greber-Platzer, Susanne; Berger, Angelika; Jilma, Bernd; Haiden, Nadja

    2016-03-01

    Several long-term effects of alcohol abuse in children and adolescents are well described. Alcohol abuse has severe effects on neurodevelopmental outcome, such as learning disabilities, memory deficits, and decreased cognitive performance. Additionally, chronic alcohol intake is associated with chronic liver disease. However, the effects of acute alcohol intoxication on liver function in children and adolescents are not well characterized. The aim of this study was to determine if a single event of acute alcohol intoxication has short-term effects on liver function and metabolism. All children and adolescents admitted to the Department of Pediatrics and Adolescent Medicine between 2004 and 2011 with the diagnosis "acute alcohol intoxication" were included in this retrospective analysis. Clinical records were evaluated for age, gender, alcohol consumption, blood alcohol concentration, symptoms, and therapy. Blood values of the liver parameters, CK, creatinine, LDH, AP, and the values of the blood gas analysis were analyzed. During the 8-year study period, 249 children and adolescents with the diagnosis "acute alcohol intoxication" were admitted, 132 (53%) girls and 117 (47%) boys. The mean age was 15.3 ± 1.2 years and the mean blood alcohol concentration was 0.201 ± 0.049%. Girls consumed significantly less alcohol than boys (64 g vs. 90 g), but reached the same blood alcohol concentration (girls: 0.199 ± 0.049%; boys: 0.204 ± 0.049%). The mean values of liver parameters were in normal ranges, but AST was increased in 9.1%, ALT in 3.9%, and γGT in 1.4%. In contrast, the mean value of AST/ALT ratio was increased and the ratio was elevated in 92.6% of all patients. Data of the present study showed significant differences in the AST/ALT ratio (p < 0.01) in comparison to a control group. Data of the present study indicate that there might be an effect of acute alcohol intoxication on transaminase levels. The AST/ALT ratio seems to reflect the damage in hepatocytes

  20. Acute intoxication caused by synthetic cannabinoids 5F-ADB and MMB-2201: A case series.

    PubMed

    Barceló, Bernardino; Pichini, Simona; López-Corominas, Victoria; Gomila, Isabel; Yates, Christopher; Busardò, Francesco Paolo; Pellegrini, Manuela

    2017-04-01

    Synthetic cannabinoids are relatively new substances of abuse. Recently, abuse of synthetic cannabinoids has been increasingly reported in the lay press and medical literature. When new compounds are introduced, their use is initially not restricted by prohibition therefore their consumption cannot be verified by standard drug tests. The use of these compounds among adolescents and young adults is constantly growing, making it important for emergency services to be familiar with the signs and symptoms of intoxication present. Overdose and chronic use of these substances can cause adverse effects including altered mental status, tachycardia, and loss of consciousness. Here, we report five cases of acute intoxication by synthetic cannabinoids 5F-ADB and MMB-2201 with analytical confirmation.

  1. Features of Neurotoxicity on Brain CT of Acutely Intoxicated Unconscious Patients

    PubMed Central

    Sanei Taheri, Morteza; Noori, Maryam; Nahvi, Vahideh; Moharamzad, Yashar

    2010-01-01

    Diagnostic imaging is a valuable device in clinical management of poisoned patients presenting to emergency units in a comatose state. Some toxic agents have adverse effects on the central nervous system (CNS). Non-contrast computed tomography (CT) of the brain, as an available diagnostic method with a high resolution, can provide useful information about structural disturbances of unconscious patients with suspected drug or chemical intoxication. The authors would describe various presentations of toxic substances detected on the brain CT scans of ten patients with acute intoxication. While non-specific, CT findings of low-attenuation lesions in the basal ganglia, infarctions in young patients, or diffuse edema should raise suspicion for poisoning or overdose. PMID:21270943

  2. Acute Abdominal Aorta Thrombosis and Ischemic Rhabdomyolysis Secondary to Severe Alcohol Intoxication

    PubMed Central

    Abbas, Syed Farhat; Farooq, Madeeha; Rasheed, Amna; Ali, Furqan

    2016-01-01

    Acute alcohol intoxication is a common cause of emergency visits worldwide. Although moderate alcohol consumption is protective against coronary artery disease, binge drinking is associated with adverse cardiovascular and neurological outcomes and may even cause sudden death. Although, few past accounts of venous thrombosis with alcohol binge drinking are available, arterial thrombosis with the condition has never been reported in the literature. We present the unusual case of a young Afghan male, who presented to us with painful, tender and swollen legs three days after a heavy alcohol binge on a Saturday night. He was diagnosed as a case of acute limb ischemia secondary to massive abdominal aorta and bilateral femoral artery thrombosis. He also had acute renal failure secondary to rhabdomyolysis. Cardiac workup revealed new onset paroxysmal atrial fibrillation and a large thrombus in the left ventricular cavity. His blood ethanol level was high. He was treated by a multidisciplinary team; urgent surgical thrombectomy for thrombotic complications, intravenous fluid hydration and later renal replacement therapy for acute renal failure. To the best of our knowledge, such a constellation of clinical features in association with severe acute alcohol intoxication has not been reported in the literature. We believe, the procoagulant nature of high blood ethanol levels and the onset of atrial fibrillation after the heavy alcohol binge, known as the holiday heart syndrome, precipitated the thrombotic events leading to rhabdomyolysis and acute renal failure. Through this case, we conclude that a very heavy alcohol binge may cause thrombotic occlusion of the abdominal aorta and femoral arteries resulting in ischemic rhabdomyolysis and acute renal failure. A high index of suspicion must be kept, especially for a patient presenting with tender, swollen lower limbs and acute renal failure after an alcohol binge. PMID:28083449

  3. Ultrastructural changes in rat thyroid tissue after acute organophosphate poisoning and effects of antidotal therapy with atropine and pralidoxime: A single-blind, ex vivo study

    PubMed Central

    Satar, Deniz; Satar, Salim; Mete, Ufuk Ozgu; Suchard, Jeffrey R.; Topal, Metin; Karakoc, Emre; Kaya, Mehmet

    2008-01-01

    Background: Organophosphate (OP) insecticides are widely used in both agricultural and landscape pest control, and the potential for human exposure to these compounds is significant. Objectives: The aims of this study were to investigate the effects of acute poisoning with the OP methamidophos and the effects of antidotal therapy with atropine and pralidoxime on rat thyroid tissue ultrastructure. Methods: In this single-blind, ex vivo study, male Wistar albino rats weighing 220 to 230 g were divided into 4 treatment groups. Group 1 received a median lethal dose of methamidophos (30 mg/kg) via oral gavage. Group 2 received saline via oral gavage and served as the control group for group 1. Group 3 received methamidophos (30 mg/kg) via oral gavage, and after 8 minutes atropine 0.05 mg/kg and pralidoxime chloride (2-FAM) (40 mg/kg) were administered intraperitoneally (IP). Atropine was titrated to reverse signs of cholinergic excess. Group 4 received saline via oral gavage followed by IP injections and served as the control for group 3. Rat thyroid tissues were examined using electron microscopy, and the histologic changes were examined by a histopathologist who was blinded to treatment. All rats were euthanized by intracardiac blood collection. The rats in groups 1 and 2 were euthanized 8 minutes after treatment. The rats in groups 3 and 4 were euthanized 96 hours after treatment. Results: Thirty-four male rats (aged 16 weeks) were included in the study. The rats were grouped accordingly: group 1 (n = 10); group 2 (n = 7); group 3 (n = 10); and group 4 (n = 7). The mean (SD) pseudocholinesterase (FCE) activity was significantly lower in the methamidophos-treated rats (group 1) compared with the corresponding control group (group 2) (32.6 [17.0] vs 579.4 [59.0] U/L, respectively; P < 0.001). PCE activity was significantly higher in rats treated with atropine and 2-PAM (group 3) (392.5 [39.4] U/L; P < 0.001) compared with those not receiving antidotal therapy (group 1

  4. Acute lead intoxication in a female battery worker: Diagnosis and management.

    PubMed

    Dounias, George; Rachiotis, George; Hadjichristodoulou, Christos

    2010-07-07

    Lead is a significant occupational and environmental hazard. Battery industry is one of the settings related to lead intoxication. Published information on the use of oral chelating agents for the treatment of anaemia in the context of acute lead intoxication is limited. The patient was a 33 year immigrant female worker in a battery manufacture for 3 months. She complained for malaise that has been developed over the past two weeks. Pallor of skin and conjunctiva was the only sign found in physical examination. The blood test on admission revealed normochromic anaemia. Endoscopic investigation of the gastrointestinal system was negative for bleeding. The bone marrow biopsy was unrevealing.At baseline no attention has been paid to patient's occupational history. Afterwards the patient's occupational history has been re-evaluated and she has been screened for lead intoxication. The increased levels of the lead related biomarkers of exposure and effect confirmed the diagnosis. The patient received an oral chelating agent and an improvement in clinical picture, and levels of haematological and lead related biochemical parameters have been recorded. No side effect and no rebound effect were observed. This case report emphasizes the importance of the occupational history in the context of the differential diagnosis. Moreover, this report indicates that lead remains a significant occupational hazard especially in the small scale battery industry.

  5. Late-onset distal polyneuropathy due to acute organophosphate intoxication case report.

    PubMed

    Genel, Ferah; Arslanoğlu, Sertaç; Uran, Nedret; Doğan, Mustafa; Atlihan, Füsun

    2003-01-01

    Intoxications due to organophosphate insecticides are common in our country, since agriculture has an important place. Besides the well known acute cholinergic toxicity, these compounds may cause late-onset distal polyneuropathy occurring two to three weeks after the acute exposure. An eight-year-old boy and a 13-year-old girl admitted to the hospital with gait disturbances. Beginning 15 and 20 days, respectively, after organophosphate ingestion. Neurologic examination revealed bilateral dropped foot, absent Achilles tendon reflexes and peripheral sensory loss. Electromyography demonstrated motor weighed sensory-motor polyneuropathy with axonal degeneration significant in the distal parts of bilateral lower extremities. Biochemical, radiological findings and magnetic resonance imagings were normal. The two cases were taken under a physiotherapy program. The two cases are presented here since organophosphate poisonings are common in our country, and since late-onset polyneuropathy is not a well known clinical presentation as acute toxicity.

  6. Diffusion Kurtosis Imaging Detects Microstructural Changes in the Brain after Acute Alcohol Intoxication in Rats

    PubMed Central

    Chen, Xi-ran; Zeng, Jie-ying; Shen, Zhi-Wei; Kong, Ling-mei

    2017-01-01

    The aim of this study was to test the technical feasibility of diffusion kurtosis imaging (DKI) in the brain after acute alcohol intoxication. Diffusion tensor imaging (DTI) and DKI during 7.0 T MRI were performed in the frontal lobe and thalamus before and 30 min, 2 h, and 6 h after ethyl alcohol administration. Compared with controls, mean kurtosis values of the frontal lobe and thalamus first decreased by 44% and 38% within 30 min (p < 0.01 all) and then increased by 14% and 46% at 2 h (frontal lobe, p > 0.05; thalamus, p < 0.01) and by 29% and 68% at 6 h (frontal lobe, p < 0.05; thalamus, p < 0.01) after acute intake. Mean diffusivity decreased significantly in both the frontal lobe and the thalamus at various stages. However, fractional anisotropy decreased only in the frontal lobe, with no detectable change in the thalamus. This demonstrates that DKI possesses sufficient sensitivity for tracking pathophysiological changes at various stages associated with acute alcohol intoxication and may provide additional information that may be missed by conventional DTI parameters. PMID:28194415

  7. [Treatment of acute lithium intoxication with high-flux haemodialysis membranes].

    PubMed

    Peces, R; Fernández, E J; Regidor, D; Peces, C; Sánchez, R; Montero, A; Selgas, R

    2006-01-01

    Lithium carbonate is commonly prescribed for the treatment of bipolar (manic-depressive) disorders. However, because of its narrow therapeutic index an excessive elevation of serum lithium concentration, either during chronic maintenance therapy or after an acute overdose, can result in serious toxicity. In addition to supportive care, the established treatment of severe lithium toxicity is haemodialysis. Conventional haemodialysis can reduce serum lithium rapidly, but post-dialysis rebound elevations with recurrent toxicity have been documented in old publications. High-flux membranes should be capable of removing more lithium per hour of haemodialysis, but published values are not available. We report here three patients with acute lithium intoxication who were treated successfully with bicarbonate and high-flux haemodialysis membranes. Our patients presented with a severe degree of intoxication, based on the amount of drug ingested, the initial serum lithium level, the severity of neurologic symptoms and systemic manifestations. Two patients developed acute renal failure probably as a result of volume depletion since it was rapidly reversible by haemodialysis and infusion therapy. In addition, consecutive haemodialysis sessions and improvement of renal function allowed a rapid decrease in serum lithium levels without haemodynamic instability or rebound elevations in lithium concentration. The effectiveness of the procedure in these cases can be attributed to the use of bicarbonate dialysate and high-efficiency dialysers. This is the first report describing the effect of high-efficiency dialysers on lithium pharmacokinetic. Using this technique the elimination rate of lithium was found to be greater than previously reported with haemodialysis.

  8. Blood, urine, and hair kinetic analysis following an acute lead intoxication.

    PubMed

    Ho, G; Keutgens, A; Schoofs, R; Kotolenko, S; Denooz, R; Charlier, C

    2011-01-01

    A case of lead exposure resulting from the accidental ingestion of a lead-containing solution is reported. Because of clinical management rapidly performed through chelation therapy by 2,3-dimercaptopropane sulfonate sodium and meso-2,3-dimercaptosuccinic acid, blood lead levels of this 51-year-old patient were moderate (412.9 μg/L) and no clinical symptoms were observed. Numerous blood and urine samples were collected for kinetic analysis of lead elimination. However, we report the first case in which hair samples were analyzed to determine the excretion level of lead after acute intoxication.

  9. [Comparative characteristics of glucose metabolism in the liver of rats under acute alcohol and morphine intoxication].

    PubMed

    Lelevich, S V

    2011-01-01

    The comparative analysis effect of acute alcohol and morphine intoxications on rats on hepatic glycolysis and pentose phosphate pathway was done. The dose-dependent inhibitory effect of ethanol on activity of limiting enzymes of these metabolic ways, as well as anaerobic reorientation of glucose metabolism was recognised with the increase of the dose of the intake alcohol. Morfine (10 mg/kg) activated enymes of glycolysis and pentose phosphate pathway, but in contrast to ethanol it did not influence these parameters at the dose 20 or 40 mg/kg.

  10. Corrections by melatonin of liver mitochondrial disorders under diabetes and acute intoxication in rats.

    PubMed

    Cheshchevik, Vitali T; Dremza, Iosif K; Lapshina, Elena A; Zabrodskaya, Svetlana V; Kujawa, Jolanta; Zavodnik, Ilya B

    2011-08-01

    The aim of the present work was to investigate the mechanisms of oxidative damage of the liver mitochondria under diabetes and intoxication in rats as well as to evaluate the possibility of corrections of mitochondrial disorders by pharmacological doses of melatonin. The experimental (30 days) streptozotocin-induced diabetes mellitus caused a significant damage of the respiratory activity in rat liver mitochondria. In the case of succinate as a respiratory substrate, the ADP-stimulated respiration rate V₃ considerably decreased (by 25%, p < 0·05) as well as the acceptor control ratio (ACR) V₃/V₂ markedly diminished (by 25%, p < 0·01). We observed a decrease of the ADP-stimulated respiration rate V₃ by 35% (p < 0·05), with glutamate as substrate. In this case, ACR also decreased (by 20%, p < 0·05). Surprisingly, the phosphorylation coefficient ADP/O did not change under diabetic liver damage. Acute rat carbon tetrachloride-induced intoxication resulted in considerable decrease of the phosphorylation coefficient because of uncoupling of the oxidation and phosphorylation processes in the liver mitochondria. The melatonin administration during diabetes (10 mg·kg⁻¹ body weight, 30 days, daily) showed a considerable protective effect on the liver mitochondrial function, reversing the decreased respiration rate V₃ and the diminished ACR to the control values both for succinate-dependent respiration and for glutamate-dependent respiration. The melatonin administration to intoxicated animals (10 mg·kg⁻¹ body weight, three times) partially increased the rate of succinate-dependent respiration coupled with phosphorylation. The impairment of mitochondrial respiratory plays a key role in the development of liver injury under diabetes and intoxication. Melatonin might be considered as an effector that regulates the mitochondrial function under diabetes.

  11. Plasma glucose, lactate, sodium, and potassium levels in children hospitalized with acute alcohol intoxication.

    PubMed

    Tõnisson, Mailis; Tillmann, Vallo; Kuudeberg, Anne; Väli, Marika

    2010-09-01

    The aim of our research was to study prevalence of changes in plasma levels of lactate, potassium, glucose, and sodium in relation to alcohol concentration in children hospitalized with acute alcohol intoxication (AAI). Data from 194 under 18-year-old children hospitalized to the two only children's hospital in Estonia over a 2-year period were analyzed. The pediatrician on call filled in a special form on the clinical symptoms of AAI; a blood sample was drawn for biochemical tests, and a urine sample taken to exclude narcotic intoxication. The most common finding was hyperlactinemia occurring in 66% of the patients (n=128) followed by hypokalemia (<3.5 mmol/L) in 50% (n=97), and glucose above of reference value (>6.1 mmol/L) in 40.2% of the children (n=78). Hypernatremia was present in five children. In conclusion, hyperlactinemia, hypokalemia, and glucose levels above of reference value are common biochemical findings in children hospitalized with acute AAI.

  12. Probing the modulation of acute ethanol intoxication by pharmacological manipulation of the NMDAR glycine coagonist site

    PubMed Central

    Debrouse, Lauren; Hurd, Benita; Kiselycznyk, Carly; Plitt, Aaron; Todaro, Alyssa; Mishina, Masayoshi; Grant, Seth; Camp, Marguerite; Gunduz-Cinar, Ozge; Holmes, Andrew

    2012-01-01

    BACKGROUND Stimulating the glycineB binding site on the N-methyl-D-aspartate receptor (NMDAR) has been proposed as a novel mechanism for modulating behavioral effects of ethanol (EtOH) that are mediated via the NMDAR, including acute intoxication. Here, we pharmacologically interrogated this hypothesis in mice. METHODS Effects of systemic injection of the glycineB agonist, D-serine, the GlyT-1 glycine transporter inhibitor, ALX-5407, and the glycineB antagonist, L-701,324, were tested for effects on EtOH-induced ataxia, hypothermia, loss of righting reflex duration (LORR) in C57BL/6J (B6) and 129S1/SvImJ (S1) inbred mice. Effects of the glycineB partial agonist, D-cycloserine, the GlyT-1 inhibitor, NFPS, and the glycineB antagonist, DCKA, on EtOH-induced LORR duration were also tested. Interaction effects on EtOH-induced LORR duration were examined via combined treatment with D-serine and ALX-5407, D-serine and MK-801, D-serine and L-701,324, as well as L-701,324 and ALX-5407, in B6 mice, as D-serine in GluN2A and PSD-95 KO mice. The effect of dietary depletion of Magnesium (Mg), an element which interacts the glycineB site, was also tested. RESULTS Neither D-serine, D-cycloserine, ALX-5407, nor NFPS significantly affected EtOH intoxication on any of the measures or strains studied. L-701,324, but not DCKA, dose-dependently potentiated the ataxia-inducing effects of EtOH and increased EtOH-induced (but not pentobarbital-induced) LORR duration. D-serine did not have interactive effects on EtOH-induced LORR duration when combined with ALX-5407. The EtOH-potentiating effects of L-701,324, but not MK-801, on LORR duration were prevented by D-serine, but not ALX-5407. Mg depletion potentiated LORR duration in B6 mice and was lethal in a large proportion of S1 mice. CONCLUSIONS GlycineB site activation failed to produce the hypothesized reduction in EtOH intoxication across a range of measures and genetic strains, but blockade of the glycineB site potentiated Et

  13. Are there biomedical criteria to assess an acute carbon dioxide intoxication by a volcanic emission?

    NASA Astrophysics Data System (ADS)

    Stupfel, Maurice; Le Guern, François

    1989-11-01

    On August 21, 1987, more than 1800 people, thousands of head of cattle and countless wild animals, including birds, were killed by a gas release which occurred during about 4 hours at the lake in the crater Iwi at Nyos in Cameroon; plant life was mostly unaffected. An international inquiry was performed by British, French, Italian, Japanese and U.S. volcanologists and physicians to determine what had been the cause of this disaster. An international conference organised by United Nations Educational Scientific, and Cultural Organisation (U.N.E.S.C.O.), the Cameroon Government and the U.N. Economic Commission for Africa held in Yaoundé March, 1987 concluded: 'that the cause of sudden death was suffocation (asphyxia) in a carbon dioxide atmosphere' The medical findings have been explained by asphyxia caused by carbon dioxide. The presence of other volcanic gases, e.g. hydrogen sulfide, cannot be ruled out' (Sigvaldason, 1989, this issue). This paper reviews what is mainly known about an acute carbon dioxide intoxication in order to disprove or confirm the diagnosis and helps to interpret the field observations and testimonies to provide a basis to discuss the prevention of such an intoxication.

  14. Neurocognitive performance during acute THC intoxication in heavy and occasional cannabis users.

    PubMed

    Ramaekers, J G; Kauert, G; Theunissen, E L; Toennes, S W; Moeller, M R

    2009-05-01

    Performance impairment during Delta(9)-tetrahydrocannabinol (THC) intoxication has been well described in occasional cannabis users. It is less clear whether tolerance develops to the impairing effects of THC in heavy users of cannabis. The aim of the present study was to assess neurocognitive performance during acute THC intoxication in occasional and heavy users. Twenty-four subjects (12 occasional cannabis users and 12 heavy cannabis users) participated in a double-blind, placebo-controlled, two-way mixed model design. Both groups received single doses of THC placebo and 500 microg/kg THC by smoking. Performance tests were conducted at regular intervals between 0 and 8 h after smoking, and included measures of perceptual motor control (critical tracking task), dual task processing (divided attention task), motor inhibition (stop signal task) and cognition (Tower of London). THC significantly impaired performance of occasional cannabis users on critical tracking, divided attention and the stop signal task. THC did not affect the performance of heavy cannabis users except in the stop signal task, i.e. stop reaction time increased, particularly at high THC concentrations. Group comparisons of overall performance in occasional and heavy users did not reveal any persistent performance differences due to residual THC in heavy users. These data indicate that cannabis use history strongly determines the behavioural response to single doses of THC.

  15. Acute multiple focal neuropathies and delayed postanoxic encephalopathy after alcohol intoxication

    PubMed Central

    Wang, Wei-Che; Yang, Hsiu-Chun; Chen, Yao-Jen

    2015-01-01

    Acute-onset alcohol-associated neuropathy is only occasionally reported, and delayed postanoxic encephalopathy is rare. Here, we report a male who developed acute multiple focal neuropathies and later delayed postanoxic encephalopathy after alcohol intoxication. He had hypoxia and rhabdomyolysis, presenting with acute renal failure initially, and cardiopulmonary support, including mechanical ventilation, led to improvement of the patient at the acute stage. He suffered from bilateral hand numbness and mild weakness of the right lower limb thereafter. Nerve-conduction study revealed no pickup of compound muscle action potential or sensory nerve action potential in the bilateral ulnar nerve, but showed attenuated amplitude of compound muscle action potential in the right femoral nerve. Multiple focal neuropathies were suspected, and he received outpatient rehabilitation after being discharged. However, the patient developed gradual onset of weakness in four limbs and cognitive impairment 23 days after the hypoxia event. Brain computed tomography showed low attenuation over bilateral globus pallidus, and brain magnetic resonance imaging disclosed diffuse increased signal intensity on T2-weighted images and fluid-attenuated inversion recovery in bilateral white matter. He was admitted again under the impression of delayed postanoxic brain injury. Supportive treatment and active rehabilitation were given. He had gradual improvement in motor and functional status after rehabilitation. He could walk with festinating gait under supervision, and needed only minimal assistance in performing activities of daily living approximately 1 year later. PMID:26229472

  16. Assessment of Expression of Genes Coding GABAA Receptors during Chronic and Acute Intoxication of Laboratory Rats with Ethanol.

    PubMed

    Osechkina, N S; Ivanov, M B; Nazarov, G V; Batotsyrenova, E G; Lapina, N V; Babkin, A V; Berdinskikh, I S; Melekhova, A S; Voitsekhovich, K O; Lisitskii, D S; Kashina, T V

    2016-02-01

    Expression of genes encoding the individual subunits of ionotropic GABAA receptor was assessed after acute and chronic intoxication of rats with ethanol. The chronic 1-month-long exposure to ethanol signifi cantly decreased (by 38%) expression of Gabrb1 gene in the hippocampus. Acute exposure to ethanol elevated expression of genes Gabrb1 (by 1.7 times), Gabra1 (by 3.8 times), and Gabra4 (by 6.5 times), although it diminished expression of Gabra2 gene by 1.4 times. In preliminarily alcoholized rats, acute intoxication with ethanol enhanced expression of genes Gabrb1 and Gabra5 by 1.7 and 8.7 times, respectively. There was neither acute nor chronic effect of ethanol on expression of gene Gabra3.

  17. Detecting impairment: sensitive cognitive measures of dose-related acute alcohol intoxication.

    PubMed

    Cash, Catherine; Peacock, Amy; Barrington, Helen; Sinnett, Nicholas; Bruno, Raimondo

    2015-04-01

    The cognitive impairment that results from acute alcohol intoxication is associated with considerable safety risks. Other psychoactive substances, such as medications, pose a similar risk to road and workplace safety. However, there is currently no legal limit for operating vehicles or working while experiencing drug-related impairment. The current study sought to identify a brief cognitive task sensitive to a meaningful degree of impairment from acute alcohol intoxication to potentially stand as a reference from which to quantify impairment from other similar substances. A placebo-controlled single-blind crossover design was employed to determine the relative sensitivity of four commonly-administered cognitive tasks (Compensatory Tracking Task, Digit Symbol Substitution Test, Brief Stop Signal Task and Inspection Time Task) to alcohol-related impairment in male social drinkers at ~0.05% ascending breath alcohol concentration (BrAC), ~0.08% peak BrAC and 0.05% descending BrAC. The Inspection Time Task was identified as the most sensitive task, detecting a medium to large magnitude increase in impairment (g ≈ 0.60) at 0.05% ascending and descending BrAC, and a large magnitude effect size (g = 0.80) at 0.08% peak BrAC. The remaining tasks failed to demonstrate sensitivity to dose-dependent and limb-dependent changes in alcohol-induced impairment. The Inspection Time Task was deemed the most sensitive task for screening alcohol-related impairment based on the present results. Confirmation of equivalence with other drug-related impairment and sensitivity to alcohol-induced impairment in real-world settings should be established in future research.

  18. A Heart too Drunk to Drive; AV Block following Acute Alcohol Intoxication.

    PubMed

    van Stigt, Arthur H; Overduin, Ruben J; Staats, Liza C; Loen, Vera; van der Heyden, Marcel A G

    2016-02-29

    Acute excessive alcohol consumption is associated with heart rhythm disorders like atrial fibrillation but also premature ventricular contractions, collectively known as the "holiday heart syndrome". More rarely but clinically significant are reports of atrioventricular (AV) conduction disturbances in binge drinkers with no underlying heart disease or chronic alcohol consumption. To obtain better insights into common denominators and the potential underlying mechanisms we collected and compared individual case reports of AV block following acute alcohol intoxication in otherwise healthy people. By screening PubMed, Google Scholar, Scopus and JSTOR, fifteen cases were found of which eight were sufficiently documented for full analysis. Blood alcohol levels ranged from 90 to 958 mg/dl (19 to 205 mM). Second and third degree AV block was observed most (6/8) albeit that in two of these patients a vagal stimulus led to deterioration from first into higher order AV block. In all cases, patients reverted to normal sinus rhythm upon becoming sober again. Mildly lowered body temperature (35.9 ± 0.5°C) was observed but can be excluded as a major cause of conduction blockade. We hypothesize that ethanol induced partial inhibition of calcium and potentially also sodium currents in conductive tissue structures may be one of the mechanisms of conduction slowing and block that may become exaggerated upon increased vagal tone. An impairment of gap junction function cannot be excluded as a contributing factor. In conclusion, cases of documented alcohol induced AV block are very rare but events can occur at relatively low serum alcohol levels which should prompt to awareness of this phenomenon in alcohol intoxicated patients.

  19. Murine Motor and Behavior Functional Evaluations for Acute 1-Methyl-4-Phenyl-1,2,3,6-Tetrahydropyridine (MPTP) Intoxication

    PubMed Central

    Hutter-Saunders, Jessica A. L.; Mosley, R. Lee

    2011-01-01

    Acute intoxication with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) induces nigrostriatal neurodegeneration that reflects Parkinson’s disease (PD) pathobiology. The model is commonly used for rodent studies of PD pathogenesis and diagnostics and for developmental therapeutics. However, tests of motor function in MPTP-intoxicated mice have yielded mixed results. This unmet need reflects, in part, lesion severity, animal variability, and the overall test sensitivity and specificity. In attempts to standardize rodent motor function and behavioral tests, mice were trained on the rotarod or habituated in an open field test chamber, and baseline performance measurements were collected prior to MPTP intoxication. One week following MPTP intoxication, motor function and behavior were assessed and baseline measurements applied to post-MPTP measurements with normalization to PBS controls. Rotarod and open field tests assessed in this manner demonstrated significant differences between MPTP- and saline-treated mice, while tests of neuromuscular strength and endurance did not. We conclude that the rotarod and open field tests provide reliable measures of motor function for MPTP-intoxicated mice. PMID:21431472

  20. [Myocardial electrogenesis in laboratory rats under conditions of acute nitrite intoxication].

    PubMed

    Shumilova, T E; Shereshkov, V I; Ianvareva, I N; Nozdrachev, A D

    2010-01-01

    In anesthetized male rats the arterial blood pressure in femoral artery and electrocardiogram in standard leads were recorded uninterruptedly for 1-1.5 h under conditions of acute nitrite intoxication produced by a subcutaneous injection of water solution of sodium nitrite (donor of nitric oxide) at concentrations of 10, 30, and 50 mg/kg body mass. Results of the study have shown dose-dependent changes of arterial pressure as well as of time and amplitude characteristics of electrocardiogram under effect of NaNO2. At the threshold hypoxic dose, an increase of amplitude of R and S waves was observed by the 30-45th min, while at the maximal NaNO2 dose, amplitude of all waves rose by the 15th min of intoxication. High nitric doses often caused an increase of the ST segment above the isoelectric line and a rise of the amplitude of the T wave, on which a notch appeared in some cases. The change of the ECG time parameters was expressed in the dose-dependent development of bradycardia for the first 4-7 min; its level correlated with the progressively decreasing arterial pressure in the beginning (the 2-4th min) of nitrite intoxication. Variation analysis of heart rate spectral characteristics by Baevskii has revealed a rise of the total spectral power of pulse oscillations. Under effect of nitrite, in the spectrum of cardiointervals, quent recovery of the normal ECG spectrum in the end of the experimental period. The maximal nitrite dose produced more pronounced shifts of the heart rate spectrum towards the LF and VLF diapasons that were not restored for 1 h of experiment. Transitory processes of readjustment of the cardiac rhythm had discrete character. The nitrite dose of 50 mg/kg body mass increased the RR-interval after 4-7 min with amplitude steps of 3-5 imp/s and the time constant of 20-40 s. The revealed ECG changes had the reflex (enhancement of parasympathetic tonus) and metabolic (the hypoxic and histotoxic damage of myocardium) nature.

  1. Acute heroin intoxication in a baby chronically exposed to cocaine and heroin: a case report

    PubMed Central

    2011-01-01

    Introduction Acute intoxication with drugs of abuse in children is often only the tip of the iceberg, actually hiding chronic exposure. Analysis using non-conventional matrices such as hair can provide long-term information about exposure to recreational drugs. Case presentation We report the case of a one-month-old Caucasian boy admitted to our pediatric emergency unit with respiratory distress and neurological abnormalities. A routine urine test was positive for opiates, suggesting an acute opiate ingestion. No other drugs of misuse, such as cocaine, cannabis, amphetamines or derivatives, were detected in the baby's urine. Subsequently, hair samples from the baby and the parents were collected to evaluate the possibility of chronic exposure to drug misuse by segmental analysis. Opiates and cocaine metabolites were detected in hair samples from the baby boy and his parents. Conclusions In light of these and previous results, we recommend hair analysis in babies and children from risky environments to detect exposure to heroin and other drug misuse, which could provide the basis for specific social and health interventions. PMID:21729296

  2. Marijuana intoxication

    MedlinePlus

    Cannabis intoxication; Intoxication - marijuana (cannabis); Pot; Mary Jane; Weed; Grass; Cannabis ... The intoxicating effects of marijuana include relaxation, ... to fast and predictable signs and symptoms. Eating marijuana ...

  3. Intravenous injection of Xuebijing attenuates acute kidney injury in rats with paraquat intoxication

    PubMed Central

    Xu, Jia-jun; Zhen, Jian-tao; Tang, Li; Lin, Qing-ming

    2017-01-01

    BACKGROUND: The study aimed to investigate the therapeutic benefits of intravenous Xuebijing on acute kidney injury (AKI) in rats with paraquat intoxication. METHODS: Male Sprague-Dawley rats were randomly divided equally into three groups: sham group (n=8), paraquat group (n=8) and Xuebijing-treated group (n=8) using a random number table. The rats were intraperitoneally injected with 50 mg/kg of paraquat. One hour after paraquat administration, the rats were treated intravenously with Xuebijing (8 mL/kg). At 12 hours after paraquat administration, serum was collected to evaluate kidney function, then the rats were sacrificed and kidney samples were immediately harvested. AKI scores were evaluated by renal histopathology and pro-inflammatory cytokines mRNA levels in kidney were assayed using real-time RT-PCR. RESULTS: Serum urea nitrogen, creatinine and AKI scores were significantly higher in the paraquat group, compared with the sham group (P<0.05, respectively). Moreover, interleukin (IL)-1β, IL-6 and TNF-α mRNA levels were significantly higher in the paraquat group (P<0.01, respectively). However, intravenous Xuebijing significantly decreased serum urea nitrogen, creatinine, AKI scores and IL-1β, IL-6 and TNF-α mRNA levels, compared with the paraquat group (P<0.05, respectively). CONCLUSION: Intravenous Xuebijing attenuates AKI following paraquat poisoning by suppressing inflammatory response. PMID:28123623

  4. Acute effects of intoxication and arousal on approach / avoidance biases toward sexual risk stimuli in heterosexual men

    PubMed Central

    Simons, Jeffrey S.; Maisto, Stephen A.; Wray, Tyler B.; Emery, Noah N.

    2015-01-01

    This study tested the effects of alcohol intoxication and physiological arousal on cognitive biases toward erotic stimuli and condoms. Ninety-seven heterosexual men were randomized to 1 of 6 independent conditions in a 2 (high arousal or control) × 3 (alcohol target BAC = 0.08), placebo, or juice control) design and then completed a variant of the Approach Avoidance Task (AAT). The AAT assessed reaction times toward approaching and avoiding erotic stimuli and condoms with a joystick. Consistent with hypotheses, the alcohol condition exhibited an approach bias toward erotic stimuli, whereas the control and placebo groups exhibited an approach bias toward condom stimuli. Similarly, the participants in the high arousal condition exhibited an approach bias toward erotic stimuli and the low arousal control condition exhibited an approach bias toward condoms. The results suggest that acute changes in intoxication and physiological arousal independently foster biased responding towards sexual stimuli and these biases are associated with sexual risk intentions. PMID:25808719

  5. Arousal effects of orexin A on acute alcohol intoxication-induced coma in rats.

    PubMed

    Jia, Xiaojun; Yan, Jie; Xia, Jianxia; Xiong, Jiaxiang; Wang, Tianhao; Chen, Yuan; Qi, Aiping; Yang, Nian; Fan, Shuangyi; Ye, Jianning; Hu, Zhian

    2012-02-01

    The key role of the hypothalamic neuropeptides orexins in maintenance and promotion of arousal has been well established in normal mammalian animals, but whether orexins exert arousal effects under pathological condition such as coma was little studied. In this study, a model of unconscious rats induced by acute alcohol intoxication was used to examine the effects of orexins through intracerebroventricular injection. The results revealed that either orexin A or orexin B induced decrease of duration of loss of right reflex in alcohol-induced unconscious rats. In the presence of the selective orexin receptor 1 antagonist SB 334867 and orexin receptor 2 antagonist TCS OX2 29, the excitatory action of orexin A was completely blocked. Our data further presented that orexin A also induced reduction of delta power in EEG in these rats. Single-unit recording experiment in vivo demonstrated that orexin A could evoke increase of firing activity of prefrontal cortex neurons in unconscious rats. This excitation was completely inhibited by an H(1) receptor antagonist, pyrilamine, whereas application of α(1)-adrenoreceptor antagonist prazosin or 5-HT(2) selective receptor antagonist ritanserin partially attenuated the excitatory effects of orexin A on these neurons. Consistently, the results of EEG recordings showed that microinjection of pyrilamine, prazosin, or ritanserin suppressed reduction of delta power in EEG induced by orexin A on unconscious rats. Thus, these data suggest that orexins exert arousal effects on alcohol-induced unconscious rats by the promotion of cortical activity through activation of histaminergic, noradrenergic and serotonergic systems. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.

  6. Acute Alcohol Intoxication Prolongs Neuroinflammation without Exacerbating Neurobehavioral Dysfunction following Mild Traumatic Brain Injury

    PubMed Central

    Teng, Sophie X.

    2014-01-01

    Abstract Traumatic brain injury (TBI) represents a leading cause of death and disability among young persons with ∼1.7 million reported cases in the United States annually. Although acute alcohol intoxication (AAI) is frequently present at the time of TBI, conflicting animal and clinical reports have failed to establish whether AAI significantly impacts short-term outcomes after TBI. The objective of this study was to determine whether AAI at the time of TBI aggravates neurobehavioral outcomes and neuroinflammatory sequelae post-TBI. Adult male Sprague-Dawley rats were surgically instrumented with gastric and vascular catheters before a left lateral craniotomy. After recovery, rats received either a primed constant intragastric alcohol infusion (2.5 g/kg+0.3 g/kg/h for 15 h) or isocaloric/isovolumic dextrose infusion followed by a lateral fluid percussion TBI (∼1.4 J, ∼30 ms). TBI induced apnea and a delay in righting reflex. AAI at the time of injury increased the TBI induced delay in righting reflex without altering apnea duration. Neurological and behavioral dysfunction was observed at 6 h and 24 h post-TBI, and this was not exacerbated by AAI. TBI induced a transient upregulation of cortical interleukin (IL)-6 and monocyte chemotactic protein (MCP)-1 mRNA expression at 6 h, which was resolved at 24 h. AAI did not modulate the inflammatory response at 6 h but prevented resolution of inflammation (IL-1, IL-6, tumor necrosis factor-α, and MCP-1 expression) at 24 h post-TBI. AAI at the time of TBI did not delay the recovery of neurological and neurobehavioral function but prevented the resolution of neuroinflammation post-TBI. PMID:24050411

  7. Dormant Masculinity: Moderating Effects of Acute Alcohol Intoxication on the Relation Between Male Role Norms and Antigay Aggression.

    PubMed

    Leone, Ruschelle M; Parrott, Dominic J

    2014-04-21

    Acute alcohol intoxication was examined as a moderator of the association between men's adherence to traditional gender norms and aggression towards a gay male. Participants were 164 heterosexual drinking men between the ages of 21-30. Participants completed a battery of questionnaires that included a measure of adherence to male role norms (i.e., status, toughness, antifemininity), were randomly assigned to consume an alcohol or no-alcohol control beverage, and completed the Taylor Aggression Paradigm in which electric shocks were administered to, and received from, a fictitious gay or heterosexual male opponent. Results indicated a greater adherence to both the toughness (β = .50, p = .002) and antifeminine (β = .37, p = .023) norms predicted high levels of aggression towards a gay man only among participants who were intoxicated. This interaction effect was not detected for the status norm. Consistent with previous research, findings suggest that adherence to the toughness norm does not increase sober men's risk of aggression toward gay men. However, this is the first study to demonstrate that alcohol intoxication may activate concepts of toughness, and thus influence men to act in line with this facet of the masculine concept. Importantly, these data support the view that men's adherence to various dimensions of masculinity may be dormant in some contexts, only to be activated, and subsequently demonstrated, in other contexts.

  8. Dormant Masculinity: Moderating Effects of Acute Alcohol Intoxication on the Relation Between Male Role Norms and Antigay Aggression

    PubMed Central

    Leone, Ruschelle M.; Parrott, Dominic J.

    2014-01-01

    Acute alcohol intoxication was examined as a moderator of the association between men’s adherence to traditional gender norms and aggression towards a gay male. Participants were 164 heterosexual drinking men between the ages of 21–30. Participants completed a battery of questionnaires that included a measure of adherence to male role norms (i.e., status, toughness, antifemininity), were randomly assigned to consume an alcohol or no-alcohol control beverage, and completed the Taylor Aggression Paradigm in which electric shocks were administered to, and received from, a fictitious gay or heterosexual male opponent. Results indicated a greater adherence to both the toughness (β = .50, p = .002) and antifeminine (β = .37, p = .023) norms predicted high levels of aggression towards a gay man only among participants who were intoxicated. This interaction effect was not detected for the status norm. Consistent with previous research, findings suggest that adherence to the toughness norm does not increase sober men’s risk of aggression toward gay men. However, this is the first study to demonstrate that alcohol intoxication may activate concepts of toughness, and thus influence men to act in line with this facet of the masculine concept. Importantly, these data support the view that men’s adherence to various dimensions of masculinity may be dormant in some contexts, only to be activated, and subsequently demonstrated, in other contexts. PMID:25750591

  9. Breakdown of Blood-Brain and Blood-Spinal Cord Barriers During Acute Methamphetamine Intoxication: Role of Brain Temperature.

    PubMed

    Kiyatkin, Eugene A; Sharma, Hari S

    2016-01-01

    Methamphetamine (METH) is a powerful and often-abused stimulant with potent addictive and neurotoxic properties. While it is generally believed that structural brain damage induced by METH results from oxidative stress, in this work we present data suggesting robust disruption of blood-brain and blood-spinal cord barriers during acute METH intoxication in rats. We demonstrate the relationships between METH-induced brain hyperthermia and widespread but structure-specific barrier leakage, acute glial cell activation, changes in brain water and ionic homeostasis, and structural damage of different types of cells in the brain and spinal cord. Therefore, METH-induced leakage of the blood-brain and blood-spinal cord barriers is a significant contributor to different types of functional and structural brain abnormalities that determine acute toxicity of this drug and possibly neurotoxicity during its chronic use.

  10. Brain acetylcholinesterase activity recovery following acute methyl parathion intoxication in two feral rodent species: comparison to laboratory rodents

    SciTech Connect

    Roberts, D.K.; Silvey, N.J.; Bailey, E.M. Jr.

    1988-07-01

    Widespread use of organophosphorus insecticides (OPs) has produced both acute and chronic intoxication among nontarget organisms. Most such studies have included fish and birds as opposed to mammals. However, numerous OP toxicity studies have been conducted on laboratory rodents creating a temptation to apply this data to feral rodents. Chronic OP exposure has been reported to produce cholinergic adaptation which in turn lowers mortality rates following a subsequent acute anticholinesterase exposure. The relevance that these laboratory rodent studies have on feral rodents is subject to debate. Field studies involving OP exposure among nontarget feral mammals have produced contradictory results. Increased mortality as a result of repeated OP application has been reported. This observation may be of considerable importance to nontarget feral rodent populations due to the repetitive nature of OP application protocols. The ability of feral rodents to recover brain AChE activity (BAA) between OP application intervals undoubtedly promotes their survival. This study investigated and compared BAA recovery following acute oral methyl parathion intoxication among 2 feral rodent species and among 2 common laboratory rodent species.

  11. Digitalis must be banished from the table: a rare case of acute accidental Digitalis intoxication of a whole family.

    PubMed

    Maffè, Stefano; Cucchi, Lorenzo; Zenone, Franco; Bertoncelli, Cristina; Beldì, Federico; Colombo, Maria Laura; Bielli, Massimo; Paino, Anna Maria; Parravicini, Umberto; Paffoni, Paola; Dellavesa, Pierfranco; Perucca, Antonello; Pardo, Nicolò Franchetti; Signorotti, Fabiana; Didino, Claudio; Zanetta, Marco

    2009-09-01

    Advanced Digitalis intoxication is a rare event, mainly associated with overdose in patients with Digitalis therapy. We report an unusual case of acute 'familiar' digitalis poisoning in three patients who had eaten potato dumplings flavoured with leaves of Borago officinalis L. unconsciously mixed with leaves of Digitalis purpurea L. A complicated clinical course with marked bradyarrhythmias was presented, with good evolution thanks to the use of digoxin-specific antibody Fab fragments. The theme of the domestic use of plants with medicinal effects has been treated and discussed.

  12. Brief motivational intervention for adolescents treated in emergency departments for acute alcohol intoxication – a randomized-controlled trial

    PubMed Central

    2014-01-01

    Background Alcohol misuse among youth is a major public health concern and numbers of adolescents admitted to the emergency department for acute alcoholic intoxication in Germany are recently growing. The emergency setting offers an opportunity to reach at-risk alcohol consuming adolescents and provide brief interventions in a potential “teachable moment”. However, studies on brief interventions targeting adolescents in emergency care are scarce and little is known about their effectiveness when delivered immediately following hospitalization for acute alcohol intoxication. In this protocol we present the HaLT-Hamburg trial evaluating a brief motivational intervention for adolescents treated in the emergency department after an episode of acute alcoholic intoxication. Methods The trial design is a parallel two-arm cluster randomized-controlled trial with follow-up assessment after 3 and 6 months. N = 312 participants aged 17 years and younger will be recruited Fridays to Sundays in 6 pediatric clinics over a period of 30 months. Intervention condition is a manual-based brief motivational intervention with a telephone booster after 6 weeks and a manual-guided intervention for caregivers which will be compared to treatment as usual. Primary outcomes are reduction in binge drinking episodes, quantity of alcohol use on a typical drinking day and alcohol-related problems. Secondary outcome is further treatment seeking. Linear mixed models adjusted for baseline differences will be conducted according to intention-to-treat (ITT) and completers (per-protocol) principles to examine intervention effects. We also examine quantitative and qualitative process data on feasibility, intervention delivery, implementation and receipt from intervention providers, receivers and regular emergency department staff. Discussion The study has a number of strengths. First, a rigorous evaluation of HaLT-Hamburg is timely because variations of the HaLT project are widely used in

  13. Rat liver mitochondrial damage under acute or chronic carbon tetrachloride-induced intoxication: Protection by melatonin and cranberry flavonoids

    SciTech Connect

    Cheshchevik, V.T.; Lapshina, E.A.; Dremza, I.K.; Zabrodskaya, S.V.; Reiter, R.J.; Prokopchik, N.I.; Zavodnik, I.B.

    2012-06-15

    In current societies, the risk of toxic liver damage has markedly increased. The aim of the present work was to carry out further research into the mechanism(s) of liver mitochondrial damage induced by acute (0.8 g/kg body weight, single injection) or chronic (1.6 g/ kg body weight, 30 days, biweekly injections) carbon tetrachloride – induced intoxication and to evaluate the hepatoprotective potential of the antioxidant, melatonin, as well as succinate and cranberry flavonoids in rats. Acute intoxication resulted in considerable impairment of mitochondrial respiratory parameters in the liver. The activity of mitochondrial succinate dehydrogenase (complex II) decreased (by 25%, p < 0.05). Short-term melatonin treatment (10 mg/kg, three times) of rats did not reduce the degree of toxic mitochondrial dysfunction but decreased the enhanced NO production. After 30-day chronic intoxication, no significant change in the respiratory activity of liver mitochondria was observed, despite marked changes in the redox-balance of mitochondria. The activities of the mitochondrial enzymes, succinate dehydrogenase and glutathione peroxidase, as well as that of cytoplasmic catalase in liver cells were inhibited significantly. Mitochondria isolated from the livers of the rats chronically treated with CCl{sub 4} displayed obvious irreversible impairments. Long-term melatonin administration (10 mg/kg, 30 days, daily) to chronically intoxicated rats diminished the toxic effects of CCl{sub 4}, reducing elevated plasma activities of alanine aminotransferase and aspartate aminotransferase and bilirubin concentration, prevented accumulation of membrane lipid peroxidation products in rat liver and resulted in apparent preservation of the mitochondrial ultrastructure. The treatment of the animals by the complex of melatonin (10 mg/kg) plus succinate (50 mg/kg) plus cranberry flavonoids (7 mg/kg) was even more effective in prevention of toxic liver injury and liver mitochondria damage

  14. Acute Alcohol Intoxication Decreases Glucose Metabolism but Increases Acetate Uptake in the Human Brain

    PubMed Central

    Volkow, Nora D.; Kim, Sung Won; Wang, Gene-Jack; Alexoff, David; Logan, Jean; Muench, Lisa; Shea, Colleen; Telang, Frank; Fowler, Joanna S.; Wong, Christopher; Benveniste, Helene; Tomasi, Dardo

    2012-01-01

    Alcohol intoxication results in marked reductions in brain glucose metabolism, which we hypothesized reflect not just its GABAergic enhancing effects but also metabolism of acetate as an alternative brain energy source. To test this hypothesis we separately assessed the effects of alcohol intoxication on brain glucose and acetate metabolism using Positron Emission Tomography (PET). We found that alcohol intoxication significantly decreased whole brain glucose metabolism (measured with FDG) with the largest decrements in cerebellum and occipital cortex and the smallest in thalamus. In contrast, alcohol intoxication caused a significant increase in [1-11C]acetate brain uptake (measured as standard uptake value, SUV), with the largest increases occurring in cerebellum and the smallest in thalamus. In heavy alcohol drinkers [1-11C]acetate brain uptake during alcohol challenge trended to be higher than in occasional drinkers (p <0.06) and the increases in [1-11C]acetate uptake in cerebellum with alcohol were positively associated with the reported amount of alcohol consumed (r=0.66, p<0.01). Our findings corroborate a reduction of brain glucose metabolism during intoxication and document an increase in brain acetate uptake. The opposite changes observed between regional brain metabolic decrements and regional increases in [1-11C]acetate uptake support the hypothesis that during alcohol intoxication the brain may rely on acetate as an alternative brain energy source and provides preliminary evidence that heavy alcohol exposures may facilitate the use of acetate as an energy substrate. These findings raise the question of the potential therapeutic benefits that increasing plasma acetate concentration (ie ketogenic diets) may have in alcoholics undergoing alcohol detoxification. PMID:22947541

  15. Sex-dependent changes in blood-brain barrier permeability and brain NA(+),K(+) ATPase activity in rats following acute water intoxication.

    PubMed

    Oztaş, B; Koçak, H; Oner, P; Küçük, M

    2000-12-01

    To understand the increased susceptibility of the development of serious complications to hypoosmotic hyponatremia in young females, we examined the resistance of blood brain barrier (BBB) permeability to water along with the synaptosomal Na(+),K(+)ATPase activity in both sexes of rats during acute water intoxication. Four groups of rats were used: Group I and II were normal female and male rats injected with only Evans-blue. Group III and IV were water intoxicated female and male rats respectively. BBB permeability in female rats was found to be increased following acute water intoxication. In contrast, synaptosomal Na(+),K(+)ATPase activities in both water intoxicated male and female rats were found significantly lower than those in control rats. But inhibition in enzyme activity in synaptosomes from water intoxicated female rats was more pronounced than those of corresponding male rats. Our results concluded that female sex steroids may be responsible for the highly significant decrease in synaptosomal Na(+),K(+)ATPase activity and increased BBB permeability in female rats following water intoxication.

  16. Depression of mitochondrial respiratory enzyme activity in rostral ventrolateral medulla during acute mevinphos intoxication in the rat.

    PubMed

    Yen, David H T; Chan, Julie Y H; Tseng, H P; Huang, C I; Lee, C H; Chan, Samuel H H; Chang, Alice Y W

    2004-04-01

    We investigated possible changes in bioenergetics at the rostral ventrolateral medulla (RVLM), a medullary site where sympathetic vasomotor tone originates and where the organophosphate poison mevinphos (Mev) acts to elicit cardiovascular intoxication. In Sprague-Dawley rats maintained under propofol anesthesia, microinjection bilaterally of Mev (10 nmol) into the RVLM induced progressive hypotension that was accompanied by an early augmentation (80-100 min post-Mev; Phase I), followed by a decrease (>100 min post-Mev; Phase II) in the power density of the vasomotor components (0-0.8 Hz) in systemic arterial pressure (SAP) signals. Enzyme assay revealed that local application of Mev into the RVLM also significantly and progressively depressed the activity of NADH cytochrome c reductase (marker for Complexes I and III) and cytochrome c oxidase (marker for Complex IV) in the mitochondrial respiratory chain of the RVLM, but not the heart. On the other hand, the activity of succinate cytochrome c reductase (marker for Complexes II and III) remained unaltered. Both the cardiovascular consequences and depression of mitochondrial respiratory chain enzymes elicited by Mev were significantly antagonized on comicroinjection of atropine (3.5 or 7 nmol) bilaterally into the RVLM. We conclude that Mev adversely effects cardiovascular control by acting as a cholinesterase inhibitor in the RVLM, whose neuronal activity is intimately related to the death process. The resulting accumulation of acetylcholine and prolonged activation of muscarinic receptors in the RVLM is manifested by a selective dysfunction of respiratory enzyme Complexes I and IV in the mitochondrial respiratory chain that underlies cardiovascular toxicity associated with organophosphate poisons such as Mev.

  17. Influences of methamphetamine-induced acute intoxication on urinary and plasma metabolic profiles in the rat.

    PubMed

    Shima, Noriaki; Miyawaki, Izuru; Bando, Kiyoko; Horie, Hiroshi; Zaitsu, Kei; Katagi, Munehiro; Bamba, Takeshi; Tsuchihashi, Hitoshi; Fukusaki, Eiichiro

    2011-09-05

    Methamphetamine (MA) is an illicit psychostimulant, and its abuse has become an international public health problem. MA intoxication can cause life-threatening hyperthermia, renal and liver failure, cardiac arrhythmias, and neurological damage. To investigate the relationship between the underlying mechanism of such intoxication and metabolic networks, mass spectrometry-based metabolomics experiments were performed on Sprague-Dawley rats treated with MA at 10mgkg(-1)h(-1) for 4h. Using a combination of gas chromatography-time-of-flight mass spectrometry and capillary electrophoresis-tandem mass spectrometry, global and targeted analyses were performed on biological samples collected during 0-24 and 72-96h (for urine), and at 24 and 96h (for plasma) after the last drug administration. Body temperature and plasma biochemical parameters were also measured to detect abnormal reactions in neuronal and other several tissues. 5-Oxoproline, saccharic acid, uracil, 3-hydroxybutyrate (3-HB), adipic acid, glucose, glucose 6-phosphate, fructose 1,6-bisphosphate, and tricarboxylic acid (TCA) cycle intermediates, such as fumarate, were proposed as potential biomarkers related to MA-induced intoxications. In particular, the observation of decreased TCA cycle intermediates and 3-HB and increased glucose suggested that high doses of MA inhibit biogenic energy production by glycolysis, oxidative phosphorylation via the TCA cycle, and the beta-oxidation of fatty acids. These results may provide not only a clue to clarify the underlying mechanism of diverse intoxication effects, but also biological fluid-based diagnostic and forensic methods with which to objectively demonstrate intoxication without directly determining the drug.

  18. Treatment of Metformin Intoxication Complicated by Lactic Acidosis and Acute Kidney Injury: The Role of Prolonged Intermittent Hemodialysis.

    PubMed

    Regolisti, Giuseppe; Antoniotti, Riccardo; Fani, Filippo; Greco, Paolo; Fiaccadori, Enrico

    2017-02-17

    Metformin intoxication with lactic acidosis, a potentially lethal condition, may develop in diabetic patients when the drug dose is inappropriate and/or its clearance is reduced. Diagnosis and therapy may be delayed due to nonspecific symptoms at presentation, with severe anion gap metabolic acidosis and elevated serum creatinine values being the most prominent laboratory findings. Confirmation requires measurement of serum metformin by high-performance liquid chromatography-tandem mass spectrometry, but this technique is available only at specialized institutions and cannot be relied on as a guide to immediate treatment. Thus, based on strong clinical suspicion, renal replacement therapy must be started promptly to achieve efficient drug clearance and correct the metabolic acidosis. However, because metformin accumulates in the intracellular compartment with prolonged treatment, a rebound in serum concentrations due to redistribution is expected at the end of dialysis. We report a case of metformin intoxication, severe lactic acidosis, and acute kidney injury in a diabetic patient with pre-existing chronic kidney disease stage 3, treated effectively with sustained low-efficiency dialysis. We discuss the pathophysiology, differential diagnosis, and treatment options and highlight specific pharmacokinetic issues that should be considered in selecting the appropriate modality of renal replacement therapy.

  19. Evaluation of Acute Alcohol Intoxication as the Primary Cause of Death: A Diagnostic Challenge for Forensic Pathologists.

    PubMed

    Li, Rong; Hu, Li; Hu, Lingli; Zhang, Xiang; Phipps, Rebecca; Fowler, David R; Chen, Feng; Li, Ling

    2017-01-25

    Deaths caused by acute alcohol intoxication (AAI) remain a major public health issue. This study is retrospective and descriptive: an 8-year case analysis of deaths due to AAI in Maryland. Study showed that of 150 AAI deaths, the death rate among Hispanics (10.41/100,000 population) was significantly higher than all the non-Hispanics combined (1.88/100,000 population). The majority of individuals were young adults, overweight, and binge drinkers. The obese group showed significantly lower mean heart and peripheral blood alcohol concentration (BAC) (0.36%, 0.37%) than the normal weight group (0.45%, 0.42%). Based on the PBAC and urine AC ratio, 49.6% deaths likely occurred close to peak phase, followed by postabsorptive phase (31.6%) and absorptive phase (18.8%). Our results indicate that forensic pathologists should evaluate postmortem BAC in the light of individual's age, drinking history, body weight, possible phase of alcohol intoxication, and other autopsy findings when certifying AAI as primary cause of death.

  20. [The morphofunctional features of the heart associated with acute morphine poisoning during the period of chronic drug intoxication].

    PubMed

    Altaeva, A Zh; Galitsky, F A; Zhakupova, T Z; Aidarkulov, A Sh; Selivokhina, N V; Zhunisov, S S

    2016-01-01

    The objective of the present study was to improve forensic medical diagnostics of the cases of death associated with morphine poisoning based on the investigation into the biochemical changes in blood and pericardial fluid as well as morphological changes in the myocardial structures. The studies were carried out with the use of thin-layer chromatography, colorimetric and morphological methods including hematoxylin and eosin, Lee's methylene blue, and van Gieson's picrofuscin staining. These techniques were supplemented by light and polarization microscopy. The study has demonstrated the presence of morphine in 99.16% of the blood and pericardial samples obtained in the cases of poisoning. The comparison of the results of biochemical and pathomorphological studies of the myocardium made it possible to evaluate the functional and morphological conditions of the heart in the case of acute morphine poisoning during the period of chronic drug intoxication.

  1. Acute cyanide intoxication treated with a combination of hydroxycobalamin, sodium nitrite, and sodium thiosulfate.

    PubMed

    Mannaioni, Guido; Vannacci, Alfredo; Marzocca, Cosimo; Zorn, Anna Monica; Peruzzi, Sandro; Moroni, Flavio

    2002-01-01

    An 80-year-old diabetic patient was admitted to the hospital because of sudden unconsciousness and severe metabolic acidosis. His son reported the possibility of cyanide poisoning. Clinical data and the detection of cyanide in blood and gastric material confirmed this possibility. Supportive therapy and the following antidotes--sodium nitrite two doses 300 mg i.v., sodium thiosulfate 3 g i.v., and hydroxocobalamin 4 g in 24 hours--were administered immediately and the patient completely recovered in 48 hours. Our observations suggest that timely and appropriate use of antidotes for cyanide intoxication may prevent death, even in aged diabetic patients.

  2. Skin discolouration with acute onset parkinsonism secondary to systemic zirconium intoxication.

    PubMed

    Ryu, Hwa J; Yoon, Su J; Park, Jong-Tae; Kim, Young H; Jung, Jin M; Park, Moon-Ho; Rhyu, Im J; Kwon, Do-Young

    2014-01-01

    A 72-year-old woman presented with suspected parkinsonism and discolouration of the skin especially on sun-exposed areas. Thorough investigation revealed systemic zirconium intoxication due to intake of metallic colloids as a home remedy as a cause of the skin colour change. There may be an association between skin discolouration and her parkinsonism. This is unique in that various clinical manifestations developed following systemic ingestion of zirconium and this should serve as a warning on the risk of taking illicit dietary supplements.

  3. Rare combination of bilateral putaminal necrosis, optic neuritis, and polyneuropathy in a case of acute methanol intoxication among patients met with hooch tragedy in Gujarat, India

    PubMed Central

    Jarwani, Bhavesh S; Motiani, Puja; Divetia, Ruchir; Thakkar, Gurudutta

    2012-01-01

    Methanol poisoning is a rare but extremely hazardous form of intoxication, generally occurring after suicidal or accidental events. Methanol is a cheap and potent adulterant of illicit liquors. In India, we have witnessed number of mass emergencies due to adulterated alcohol consumption. Although Gujarat State had banned alcohol consumption since 1961, worse hooch tragedies have often taken place. The most severe consequences of methanol intoxication are blindness, a profound metabolic acidosis and various forms of neurological impairment; which occur characteristically after a latent period of several hours or days after ingestion. We present a unique case of acute methanol intoxication presented with, apart from metabolic acidosis and optic neuritis, involvement of central nervous system and peripheral nervous system. He had bilateral optic neuritis, delayed onset polyneuropathy with axonopathy, and radiculopathy. Magnetic resonance imaging findings were consistent with bilateral putaminal necrosis. PMID:23248510

  4. Acute Alcohol Intoxication and Suicide Among U.S. Ethnic/Racial Groups: Findings from the National Violent Death Reporting System

    PubMed Central

    Caetano, Raul; Kaplan, Mark S.; Huguet, Nathalie; McFarland, Bentson H.; Conner, Kenneth; Giesbrecht, Norman; Nolte, Kurt B.

    2012-01-01

    Background To assess the prevalence and sociodemographic correlates of suicide involving acute alcohol intoxication among U.S. ethnic minorities. Methods Data were derived from the restricted 2003–2009 National Violent Death Reporting System (NVDRS). The study focused on the sociodemographic and toxicological information of 59,384 male and female suicide decedents for 16 states of the U.S. Acute alcohol intoxication was defined as having a blood alcohol content (BAC) ≥ 0.08 g/dl. Overall, 76% of decedents were tested for the presence of alcohol. Results The proportion of suicide decedents with a positive BAC ranged from 47% among American Indians/Alaska Natives (AIs/ANs) to 23% among Asians/Pacific Islanders (PIs). Average BAC was highest among AIs/ANs. Among those who were tested for BAC, the proportion of decedents legally intoxicated prior to suicide was: Blacks, 15%; AIs/ANs, 36%; Asians/PIs, 13%; Hispanics, 28%. Bivariate associations showed that most suicide decedents who were legally intoxicated were male, younger than 30 years of age, with a high school education, not married, non-veterans, lived in metropolitan areas, and used a firearm to complete suicide. However, with the exception of Whites, most of these associations became not statistically significant in multivariate analysis. Conclusions Alcohol use and legal intoxication prior to completing suicide are common among U.S. ethnic groups, especially among males and those who are younger than 30 years of age. The AI/AN group had the highest mean BAC, the highest rate of legal intoxication and decedents who were particularly young. Suicide prevention strategies should address alcohol use as a risk factor. Alcohol problems prevention strategies should focus on suicide as a consequence of alcohol use, especially among AI/AN youth and young adults. PMID:23384174

  5. Plasma copeptin as a predictor of intoxication severity and delayed neurological sequelae in acute carbon monoxide poisoning.

    PubMed

    Pang, Li; Wang, He-Lei; Wang, Zhi-Hao; Wu, Yang; Dong, Ning; Xu, Da-Hai; Wang, Da-Wei; Xu, Hong; Zhang, Nan

    2014-09-01

    The present study was designed to assess the usefulness of measuring plasma levels of copeptin (a peptide co-released with the hypothalamic stress hormone vasopressin) as a biomarker for the severity of carbon monoxide (CO) poisoning and for predicting delayed neurological sequelae (DNS). Seventy-two patients with CO poisoning and 72 sex and age matched healthy individuals were recruited. Plasma copeptin levels were measured on admission from CO poisoning patients and for healthy individuals at study entry by using a sandwich immunoassay. The CO poisoning patients were divided into two groups according to severity (unconscious and conscious) and occurrence of DNS. The mean plasma copeptin levels (52.5±18.5 pmol/L) in the unconscious group were significantly higher than in the conscious group (26.3±12.7 pmol/L) (P<0.001). Plasma copeptin levels of more than 39.0 pmol/L detected CO poisoning with severe neurological symptoms e.g. unconsciousness (sensitivity 84.6% and specificity 81.4%). The plasma copeptin levels were higher in patients with DNS compared to patients without DNS (52.2±20.6 pmol/L vs. 27.9±14.8 pmol/L, P<0.001). Plasma copeptin levels higher than 40.5 pmol/L predicted the development of DNS (sensitivity 77.8%, specificity 82.1%). Plasma copeptin levels were identified as an independent predictor for intoxication severity [odds ratio (OR) 1.261, 95% confidence interval (CI) 1.112-1.638, P=0.002] and DNS (OR 1.313, 95% CI 1.106-1.859, P=0.001). Thus, plasma copeptin levels independently related to intoxication severity and were identified as a novel biomarker for predicting DNS after acute CO poisoning.

  6. An acute case of intoxication with cyanobacteria and cyanotoxins in recreational water in Salto Grande Dam, Argentina.

    PubMed

    Giannuzzi, Leda; Sedan, Daniela; Echenique, Ricardo; Andrinolo, Dario

    2011-01-01

    Cyanobacterial blooms and hepatotoxic microcystins (MCs) usually occur in summer, constituting a sanitary and environmental problem in Salto Grande Dam, Argentina. Water sports and recreational activities take place in summer in this lake. We reported an acute case of cyanobacterial poisoning in Salto Grande dam, Argentina, which occurred in January 2007. Accidentally, a young man was immersed in an intense bloom of Microcystis spp. A level of 48.6 μg·L(-1) of microcystin-LR was detected in water samples. Four hours after exposure, the patient showed nausea, abdominal pain and fever. Three days later, dyspnea and respiratory distress were reported. The patient was hospitalized in intensive care and diagnosed with an atypical pneumonia. Finally, a week after the exposure, the patient developed a hepatotoxicosis with a significant increase of hepatic damage biomarkers (ALT, AST and γGT). Complete recovery took place within 20 days. This is the first study to show an acute intoxication with microcystin-producing cyanobacteria blooms in recreational water.

  7. An Acute Case of Intoxication with Cyanobacteria and Cyanotoxins in Recreational Water in Salto Grande Dam, Argentina

    PubMed Central

    Giannuzzi, Leda; Sedan, Daniela; Echenique, Ricardo; Andrinolo, Dario

    2011-01-01

    Cyanobacterial blooms and hepatotoxic microcystins (MCs) usually occur in summer, constituting a sanitary and environmental problem in Salto Grande Dam, Argentina. Water sports and recreational activities take place in summer in this lake. We reported an acute case of cyanobacterial poisoning in Salto Grande dam, Argentina, which occurred in January 2007. Accidentally, a young man was immersed in an intense bloom of Microcystis spp. A level of 48.6 μg·L−1 of microcystin-LR was detected in water samples. Four hours after exposure, the patient showed nausea, abdominal pain and fever. Three days later, dyspnea and respiratory distress were reported. The patient was hospitalized in intensive care and diagnosed with an atypical pneumonia. Finally, a week after the exposure, the patient developed a hepatotoxicosis with a significant increase of hepatic damage biomarkers (ALT, AST and γGT). Complete recovery took place within 20 days. This is the first study to show an acute intoxication with microcystin-producing cyanobacteria blooms in recreational water. PMID:22163179

  8. In vitro and in vivo comparison of sulfur donors as antidotes to acute cyanide intoxication.

    PubMed

    Baskin, S I; Porter, D W; Rockwood, G A; Romano, J A; Patel, H C; Kiser, R C; Cook, C M; Ternay, A L

    1999-01-01

    Antidotes for cyanide (CN) intoxication include the use of sulfane sulfur donors (SSDs), such as thiosulfate, which increase the conversion of CN to thiocyanate by the enzyme rhodanese. To develop pretreatments that might be useful against CN, SSDs with greater lipophilicity than thiosulfate were synthesized and assessed. The ability of SSDs to protect mice against 2LD50 of sodium cyanide (NaCN) administered either 15 or 60 min following administration of an SSD was assessed. To study the mechanism of action of the SSD, the candidate compounds were examined in vitro for their effect on rhodanese and 3-mercaptopyruvate sulfurtransferase (MST) activity under increasing SSD concentrations. Tests were conducted on nine candidate SSDs: ICD1021 (3-hydroxypyridin-2-yl N-[(N-methyl-3-aminopropyl)]-2-aminoethyl disulfide dihydrochloride), ICD1022, (3-hydroxypyridin-2-yl N-[(N-methyl-3-aminopropyl)]-2-aminoethyl disulfide trihydrochloride), ICD1584 (diethyl tetrasulfide), ICD1585 (diallyl tetrasulfide), ICD1587 (diisopropyl tetrasulfide); ICD1738 (N-(3-aminopropyl)-2-aminoethyl 2-oxopropyl disulfide dihydrochloride), ICD1816 (3,3'-tetrathiobis-N-acctyl-L-alanine), ICD2214 (2-aminoethyl 4-methoxyphenyl disulfide hydrochloride) and ICD2467 (bis(4-methoxyphenyl) disulfide). These tests demonstrated that altering the chemical substituent of the longer chain sulfide modified the ability of the candidate SSD to protect against CN toxicity. At least two of the SSDs at selected doses provided 100% protection against 2LD50 of NaCN, normally an LD99. All compounds were evaluated using locomotor activity as a measure of potential adverse behavioral effects. Positive hypoactivity relationships were found with several disulfides but none was found with ICD1584, a tetrasulfide. Separate studies suggest that the chemical reaction of potassium cyanide (KCN) and cystine forms the toxic metabolite 2-iminothiazolidine-4-carboxylic acid. An alternative detoxification pathway, one not primarily

  9. [Acute alcohol intoxication among children and adolescents admitted to the Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical University of Silesia, Katowice during 2000-2010--preliminary study].

    PubMed

    Kamińska, Halla; Agnieszka, Zachurzok-Buczyńska; Gawlik, Aneta; Małecka-Tendera, Ewa

    2012-01-01

    The alcohol drinking at the young age is a risk factor of alcohol addiction later in life, and is connected with school problems, binge drinking, tobacco addiction, illegal drug use, violence, crime commitment, and risky sexual behaviors. Alcohol drinking in the last 12 months is declared by 78% Polish children. The aim of the study was to evaluate the frequency of admissions due to alcohol intoxication to the Department of Pediatrics, Pediatric Endocrinology and Diabetes, Pediatric Center of Silesia and the identification of the risk factors of the acute alcohol intoxication among Polish children and adolescents. Ten-year retrospective study includes investigation of patients medical records from the Department of Pediatrics. Among 8048 patients hospitalized in the Department of Pediatrics between the years 2000-2010, 220 (2.7%) cases of acute alcohol poisoning occurred The detailed data analysis from 139 patients [66 (47.5%) girls, 73 (52,5%) boys] was done. In the years 2006-2010 the number of girls admitted to the department increased in comparison to boys. The largest group of patients was at age between 14 and 16 years [61 (44%) children]. The blood alcohol concentration at the moment of admission to the hospital was 0.1 to 4.0 per thousand. In most cases (92.8%) the alcohol intoxication was intentional. Five percent of them were suicide attempts. In the youngest group of children alcohol abuse was unintentional. 23 (16.5%) of patients initially needed admission to the intensive care unit. In 30 (21.6%) patient the family was incomplete and five times more often father was absent. The alcohol addiction occurs in 18 (13.0%) fathers and 10 (7.2%) mothers of our patients. It is concluded that over the last decade the number of girls admitted due to alcohol abuse increased. Children at school grade between 7-9 are intoxicated most often. One six of intoxicated patents needed hospitalization at intensive care unit.

  10. Acute unintentional intoxication with paraffin in a 25-year old patient - clinical case report.

    PubMed

    Chibishev, Andon; Simonovska, Natasa

    2014-08-01

    "Fire-breathing" or "fire-eating" is a special kind of street art where the acts are always stunning, spectacular and amazing. People exhibiting this kind of show are professionals, not rare amateurs, who use different kind of fuels, usually hydrocarbons, in order to produce a pillar of fire. Intoxications caused by ingestion or inhalation of liquid paraffin, used as a fuel while performing, are numerous and various. We present a clinical case report of a 25-year old, previously healthy, amateur "fire-breather". During October, 2010 this young men arrived at the Emergency Unit of the University Clinic for toxicology and Urgent Internal Medicine in a severe clinical condition, after his unsuccessful attempt to perform real "fire-breathing". He had fever, strong headaches, mild abdominal and chest pain and he also had difficulties breathing and persistent dry cough. The patient was extremely dyspneic with peripheral cyanosis and shortness of breath. "Fire-breathers" must be viewed as a population at risk of paraffin-induced pneumonia, which has low mortality rate, but still is related with numerous and various chronic complications. Our patient was first in a life threatening, extremely serious clinical condition which was urgently treated with appropriate vigorous and effective therapy. This therapeutic protocol led to successful full recovery of these young men, who luckily didn't exhibit any chronic complications.

  11. Spatio-temporal processing of words and nonwords: hemispheric laterality and acute alcohol intoxication

    PubMed Central

    Marinkovic, Ksenija; Rosen, Burke Q.; Cox, Brendan; Hagler, Donald J.

    2014-01-01

    This study examined neurofunctional correlates of reading by modulating semantic, lexical, and orthographic attributes of letter strings. It compared the spatio-temporal activity patterns elicited by real words (RW), pseudowords, orthographically regular, pronounceable nonwords (PN) that carry no meaning, and orthographically illegal, nonpronounceable nonwords (NN). A double-duty lexical decision paradigm instructed participants to detect RW while ignoring nonwords and to additionally respond to words that refer to animals (AW). Healthy social drinkers (N=22) participated in both alcohol (0.6 g/kg ethanol for men, 0.55 g/kg for women) and placebo conditions in a counterbalanced design. Whole-head MEG signals were analyzed with an anatomically-constrained MEG method. Simultaneously acquired ERPs confirm previous evidence. Spatio-temporal MEG estimates to RW and PN are consistent with the highly replicable left-lateralized ventral visual processing stream. However, the PN elicit weaker activity than other stimuli starting at ~230 ms and extending to the M400 (magnetic equivalent of N400) in the left lateral temporal area, indicating their reduced access to lexicosemantic stores. In contrast, the NN uniquely engage the right hemisphere during the M400. Increased demands on lexicosemantic access imposed by AW result in greater activity in the left temporal cortex starting at ~230 ms and persisting through the M400 and response preparation stages. Alcohol intoxication strongly attenuates early visual responses occipito-temporally overall. Subsequently, alcohol selectively affects the left prefrontal cortex as a function of orthographic and semantic dimensions, suggesting that it modulates the dynamics of the lexicosemantic processing in a top-down manner, by increasing difficulty of semantic retrieval. PMID:24565928

  12. [Acute intoxication with nutmeg used as a recreational purpose--a case report].

    PubMed

    Sein Anand, Jacek; Barwina, Małgorzata; Waldman, Wojciech

    2013-01-01

    We present a case of acute nutmeg poisoning used for recreational purposes. Poisoning had a stormy clinical course with symptoms of gastrointestinal, cardiovascular and nervous system. The widespread availability of nutmeg suggests that real number of these poisonings may be underestimated in our country.

  13. Quantifying alcohol-related emergency admissions in a UK tertiary referral hospital: a cross-sectional study of chronic alcohol dependency and acute alcohol intoxication

    PubMed Central

    Vardy, J; Keliher, T; Fisher, J; Ritchie, F; Bell, C; Chekroud, M; Clarey, F; Blackwood, L; Barry, L; Paton, E; Clark, A; Connelly, R

    2016-01-01

    Objectives Alcohol is responsible for a proportion of emergency admissions to hospital, with acute alcohol intoxication and chronic alcohol dependency (CAD) implicated. This study aims to quantify the proportion of hospital admissions through our emergency department (ED) which were thought by the admitting doctor to be (largely or partially) a result of alcohol consumption. Setting ED of a UK tertiary referral hospital. Participants All ED admissions occurring over 14 weeks from 1 September to 8 December 2012. Data obtained for 5497 of 5746 admissions (95.67%). Primary outcome measures Proportion of emergency admissions related to alcohol as defined by the admitting ED clinician. Secondary outcome measures Proportion of emergency admissions due to alcohol diagnosed with acute alcohol intoxication or CAD according to ICD-10 criteria. Results 1152 (21.0%, 95% CI 19.9% to 22.0%) of emergency admissions were thought to be due to alcohol. 74.6% of patients admitted due to alcohol had CAD, and significantly greater than the 26.4% with ‘Severe’ or ‘Very Severe’ acute alcohol intoxication (p<0.001). Admissions due to alcohol differed to admissions not due to alcohol being on average younger (45 vs 56 years, p<0.001) more often male (73.4% vs 45.1% males, p<0.001) and more likely to have a diagnosis synonymous with alcohol or related to recreational drug use, pancreatitis, deliberate self-harm, head injury, gastritis, suicidal ideation, upper gastrointestinal bleeds or seizures (p<0.001). An increase in admissions due to alcohol on Saturdays reflects a surge in admissions with acute alcohol intoxication above the weekly average (p=0.003). Conclusions Alcohol was thought to be implicated in 21% of emergency admissions in this cohort. CAD is responsible for a significantly greater proportion of admissions due to alcohol than acute intoxication. Interventions designed to reduce alcohol-related admissions must incorporate measures to tackle CAD. PMID:27324707

  14. Acute kidney injury in patients with paraquat intoxication; a case report and review of the literature

    PubMed Central

    Safaei Asl, Afshin; Dadashzadeh, Peyman

    2016-01-01

    Paraquat and diquat are classified as bipyridyl compounds not only leads to acute organ damage, but also to a variety of complications. Patients with severe paraquat-induced poisoning may succumb to multiple organ failure involving the circulatory and respiratory systems. Deliberate self-poisoning with paraquat continues to be a major public health concern in many developing countries. At present there is no specific antidote to paraquat poisoning, hence the need to more focus on prevention and in cases of poisoning aggressive decontamination to prevent further absorption. This article presented a 12-year-old male with acute kidney injury following the ingestion of paraquat in suicidal attempt and serves to explore the complications associated with paraquat poisoning and current recommended treatment PMID:27689124

  15. Drinking to near death--acute water intoxication leading to neurogenic stunned myocardium.

    PubMed

    Losonczy, Lia I; Lovallo, Emily; Schnorr, C Daniel; Mantuani, Daniel

    2016-01-01

    Neurogenic stunned myocardium is a rare disease entity that has been typically described as a consequence of subarachnoid hemorrhage and, less commonly, seizures. Here we describe a case of a healthy young woman who drank excessive free water causing acute hyponatremia complicated by cerebral edema and seizure, leading to cardiogenic shock from neurogenic stunned myocardium. Two days later, she had complete return of her normal cardiac function.

  16. Motor behavior and brain enzymatic changes after acute lead intoxication on different strains of mice.

    PubMed

    Correa, Mercè; Roig-Navarro, Antoni F; Aragon, Carlos M G

    2004-03-05

    Lead is a nonphysiological metal that has been implicated in toxic processes that affect several organ systems in humans and other animals. Although the brain generally has stronger protective mechanisms against toxic substances than other organs have, exposure to lead results in several neurophysiological and behavioral symptoms. The administration of a single injection (i.p.) of lead acetate in mice is a model of acute Pb2 + toxicity. In the present study, this model was used to explore the magnitude of the effect of different doses, time intervals and mice strains on several biobehavioral parameters. We investigated the effects of acute lead acetate administration on body and brain weight, brain lead acetate accumulation and specially, spontaneous locomotion and brain catalase activity. Lead acetate was injected i.p. in outbred (Swiss or CD1) and inbred (BALB/c, C57BL/J6 or DBA/2) mice at doses of 0, 50, 100, 150 or 200 mg/kg. At different time intervals following this acute treatment, several biochemical, physiological and behavioral responses were recorded. Results indicated that acute lead acetate has deleterious dose-dependent effects on brain and body weight. The effect on body weight in the present study was transient, although lead acetate was detected in neural tissues for several days after administration. Spontaneous locomotor activity only was reduced up until 24 hours. The effect of lead on body weight was strain-dependent, with Swiss mice showing greater resistance compared to the other strains. Total brain catalase activity in lead-pretreated Swiss mice showed a significant induction. This enzymatic upregulation could provide a protective mechanism for oxidative stress in these mice.

  17. Cytokine Changes following Acute Ethanol Intoxication in Healthy Men: A Crossover Study

    PubMed Central

    Skulberg, Andreas; Skulberg, Knut Ragnvald; Aass, Hans Christian D.; Bramness, Jørgen G.

    2016-01-01

    Alcohol is a known modulator of the innate immune system. Owing to the absence of human studies, alcohol's effect on circulating cytokine profile remains unclear. We investigated the effect of acute high dose alcohol consumption on systemic cytokine release. After an overnight fasting, alcohol-experienced healthy male volunteers (N = 20) aged 25–45 years were given oral ethanol in the form of vodka (4.28 mL/kg) which they drank over a period of 30 minutes reaching peak blood alcohol concentration of 0.12% (SD 0.028). Blood samples were obtained prior to alcohol intake as well as 2, 7, and 12 hours thereafter. Serum levels of the inflammatory cytokines IL-1β, IL-1Ra, IL-6, IL-10, IL-17, IFN-γ, MCP-1, and TNF-α were determined by the multibead-based assay. Baseline cytokine levels were not related to BMI, hepatic parameters, electrolytes, glucose, or morning cortisol levels. Within 2 hours of alcohol intake, levels of IL-1Ra were elevated and remained so throughout the assessment period (p for trend = 0.015). In contrast, the levels of the chemokine MCP-1 dropped acutely followed by steadily increasing levels during the observation period (p < 0.001). The impact of sustained elevated levels of MCP-1 even after the clearance of blood alcohol content deserves attention. PMID:28090151

  18. Bioconcentration and Acute Intoxication of Brazilian Freshwater Fishes by the Methyl Parathion Organophosphate Pesticide

    PubMed Central

    Bosco de Salles, João; Matos Lopes, Renato; de Salles, Cristiane M. C.; Cassano, Vicente P. F.; de Oliveira, Manildo Marcião; Cunha Bastos, Vera L. F.; Bastos, Jayme Cunha

    2015-01-01

    Three species of freshwater Brazilian fishes (pacu, Piaractus mesopotamicus; piavussu, Leporinus macrocephalus, and curimbatá, Prochilodus lineatus) were exposed to an acute dose of 5 ppm methyl parathion organophosphate pesticide. Three to five individuals per species were exposed, one at a time, to 40 liters tap water spiked with Folidol 600. Pesticide concentrations and cholinesterase (ChE) activities were evaluated in serum, liver, brain, heart, and muscle. The bioconcentration of methyl parathion was similar for all studied fishes. Brain tissue showed the highest pesticide concentration, reaching 80 ppm after exposure for 30 min to methyl parathion. Three to 5 hours of 5 ppm methyl parathion exposure provoked the death of all P. lineatus at 92% brain AChE inhibition, whereas fish from the other two species survived for up to 78 hours with less than 80% brain AChE inhibition. Our results indicate that acute toxic effects of methyl parathion to fish are correlated with brain AChE sensitivity to methyl paraoxon. PMID:26339593

  19. Bioconcentration and Acute Intoxication of Brazilian Freshwater Fishes by the Methyl Parathion Organophosphate Pesticide.

    PubMed

    de Salles, João Bosco; Lopes, Renato Matos; de Salles, Cristiane M C; Cassano, Vicente P F; de Oliveira, Manildo Marcião; Bastos, Vera L F Cunha; Bastos, Jayme Cunha

    2015-01-01

    Three species of freshwater Brazilian fishes (pacu, Piaractus mesopotamicus; piavussu, Leporinus macrocephalus, and curimbatá, Prochilodus lineatus) were exposed to an acute dose of 5 ppm methyl parathion organophosphate pesticide. Three to five individuals per species were exposed, one at a time, to 40 liters tap water spiked with Folidol 600. Pesticide concentrations and cholinesterase (ChE) activities were evaluated in serum, liver, brain, heart, and muscle. The bioconcentration of methyl parathion was similar for all studied fishes. Brain tissue showed the highest pesticide concentration, reaching 80 ppm after exposure for 30 min to methyl parathion. Three to 5 hours of 5 ppm methyl parathion exposure provoked the death of all P. lineatus at 92% brain AChE inhibition, whereas fish from the other two species survived for up to 78 hours with less than 80% brain AChE inhibition. Our results indicate that acute toxic effects of methyl parathion to fish are correlated with brain AChE sensitivity to methyl paraoxon.

  20. Effect of acute and delayed hyperbaric oxygen therapy on cyanide whole blood levels during acute cyanide intoxication.

    PubMed

    Lawson-Smith, P; Jansen, E C; Hilsted, L; Johnsen, A H; Hyldegaard, O

    2011-01-01

    Cyanide and carbon monoxide, which are often found in fire victims, are toxic gases emitted from fires. Cyanide and carbon monoxide have similar molecular structure. Cyanide binds to the enzyme cytochrome oxidase a, a3 similar to carbon monoxide, thus blocking the mitochondrial respiration chain causing depletion of adenosine triphosphate. Hyperbaric oxygen (HBO2) is recommended for treating carbon monoxide poisoning. The therapeutic effect is due to a high oxygen pressure removing carbon monoxide from the cells. We hypothesise that HBO2 induces changes in whole-blood-cyanide by a competitive mechanism forcing cyanide out of cellular tissues. A rat model was developed to study this effect. Female Sprague Dawley rats were anesthetized with a fentanyl + fluanizone combination and midazolam given subcutaneously (s.c.). Rats were poisoned with 5.4 mg/kg KCN injected intra-peritoneally in Group 1 and intra-arterially in Group 2. Blood samples were taken immediately after poisoning, and at one and a half, three and five hours. Blood was drawn from a jugular vein in Group 1 and from a femoral artery in Group 2. Group 1 rats were divided into a control group of 12 rats without HBO2, 10 rats had acute HBO2 immediately after poisoning and a group of 10 rats had HBO2 one and a half hours after poisoning. Group 2 rats were divided into a control group and an acute HBO2 group, with 10 rats in both groups. Whole-blood-cyanide concentrations were measured using the Conway method based on diffusion and the subsequent formation of cyanocobalamin measured by a spectrophotometer. Results showed that whole-blood-cyanide concentration in Group 1 controls and acute HBO2 initially rose and then fell towards zero. In rats treated with delayed HBO2, the reduction in whole-blood-cyanide concentration was significantly less as compared to controls and acute HBO2-treated rats. Group 2 controls whole-blood-cyanide concentration decreased towards zero throughout the observation period. However

  1. Opioid intoxication

    MedlinePlus

    ... morphine, heroin, oxycodone, and synthetic (man-made) opioid narcotics. Prescription opioids are used to treat pain. Intoxication ... central nervous system (such medicine is called a narcotic antagonist) Other medicines as needed Since the effect ...

  2. Expression of heat shock protein (HSP 72 kDa) during acute methamphetamine intoxication depends on brain hyperthermia: neurotoxicity or neuroprotection?

    PubMed

    Kiyatkin, Eugene A; Sharma, Hari S

    2011-01-01

    In the present study, light and electron microscopy were used to examine heat shock protein (HSP 72 kD) expression during acute methamphetamine (METH) intoxication in rats and evaluate its relationships with brain temperature and alterations in a number of other histochemical and morphological parameters. Freely moving rats received METH at the same dose (9 mg/kg, sc) but at different ambient temperatures (23 and 29°C), showing a wide range of brain temperature elevations (37.6-42.5°C); brains were taken for histochemical and morphological evaluations at peak of brain temperature increase. We found that acute METH intoxication induces massive and wide-spread HSP expression in neural and glial cells examined in detail in the cortex, hippocampus, thalamus, and hypothalamus. In each of these structures, the number of HSP-positive cells tightly correlated with brain temperature elevation. The changes in HSP immunoreactivity were also tightly related to alterations in permeability of the blood-brain barrier, acute glial activation, and brain edema assessed by albumin and GFAP immunoreactivity and measuring tissue water content, respectively. While robust and generalized HSP production normally appears to be the part of an adaptive brain response associated with METH-induced metabolic activation, activation of this protective mechanism has its natural limits and could not counteract the damaging effects of oxidative stress, high temperature, and edema--the leading factors of METH-induced neurotoxicity.

  3. [Investigations of the distribution of aripiprazole in the internal organs and biological fluids of the laboratory animals in case of acute intoxication].

    PubMed

    Voronkov, A V; Remezova, I P; Lazaryan, D S; Avramenko, N S; Rybasova, A S

    2015-01-01

    Despite the present-day extensive application of aripiprazole, there are many cases of its overdose and of poisoning with this compound. The objective of the present study was to detect and quantify aripiprazole in the internal organs and biological fluids of the laboratory animals in case of acute intoxication. The experiments were carried out on white mice of both sexes weighing 20.5 and 25.7 g. Aripiprazole was isolated from the liver, kidneys, brain, and heart as described by A.A. Vasil'eva and from the plasma and urine by the newly developed original methods. Aripiprazole was identified and quantitatively determined in the extracts from the aforementioned organs and tissues with the use of HPLC. The data obtained on the completeness of extraction from the liver, kidneys , and brain of the laboratory animals indicate that aripiprazole accumulated in the highest concentrations in the brain and kidneys within 24 hours after acute poisoning. Ist content was significantly lower in the liver while no traces of aripiprazole were found in the heart of the mice. The methods for aripiprazole isolation from the urine and blood plasma are described. The maximum amounts of aripiprazole were detected in blood plasma within 24 hours after acute intoxication. It is concluded that the proposed methods for aripiprazole isolation from the biological fluids (blood plasma and urine) can be included in the scheme of the chemical toxicological analysis of this compound.

  4. Post-exposure administration of diazepam combined with soluble epoxide hydrolase inhibition stops seizures and modulates neuroinflammation in a murine model of acute TETS intoxication

    SciTech Connect

    Vito, Stephen T.; Austin, Adam T.; Banks, Christopher N.; Inceoglu, Bora; Bruun, Donald A.; Zolkowska, Dorota; Tancredi, Daniel J.; Rogawski, Michael A.; Hammock, Bruce D.; Lein, Pamela J.

    2014-12-01

    Tetramethylenedisulfotetramine (TETS) is a potent convulsant poison for which there is currently no approved antidote. The convulsant action of TETS is thought to be mediated by inhibition of type A gamma-aminobutyric acid receptor (GABA{sub A}R) function. We, therefore, investigated the effects of post-exposure administration of diazepam, a GABA{sub A}R positive allosteric modulator, on seizure activity, death and neuroinflammation in adult male Swiss mice injected with a lethal dose of TETS (0.15 mg/kg, ip). Administration of a high dose of diazepam (5 mg/kg, ip) immediately following the second clonic seizure (approximately 20 min post-TETS injection) effectively prevented progression to tonic seizures and death. However, this treatment did not prevent persistent reactive astrogliosis and microglial activation, as determined by GFAP and Iba-1 immunoreactivity and microglial cell morphology. Inhibition of soluble epoxide hydrolase (sEH) has been shown to exert potent anti-inflammatory effects and to increase survival in mice intoxicated with other GABA{sub A}R antagonists. The sEH inhibitor TUPS (1 mg/kg, ip) administered immediately after the second clonic seizure did not protect TETS-intoxicated animals from tonic seizures or death. Combined administration of diazepam (5 mg/kg, ip) and TUPS (1 mg/kg, ip, starting 1 h after diazepam and repeated every 24 h) prevented TETS-induced lethality and influenced signs of neuroinflammation in some brain regions. Significantly decreased microglial activation and enhanced reactive astrogliosis were observed in the hippocampus, with no changes in the cortex. Combining an agent that targets specific anti-inflammatory mechanisms with a traditional antiseizure drug may enhance treatment outcome in TETS intoxication. - Highlights: • Acute TETS intoxication causes delayed and persistent neuroinflammation. • Diazepam given post-TETS prevents lethal tonic seizures but not neuroinflammation. • A soluble epoxide hydrolase

  5. Atropine and Other Anticholinergic Drugs

    DTIC Science & Technology

    2007-01-01

    compromise near- who first analyzed the pharmacology and toxicol- vision in the case of accidental use. Military re- ogy of tabun obtained from captured...Lipp JA and Dola TJ (1978). Effect of atropine upon 290-293. the cerebrovascular system during soman-induced NakajimaT.Ohta S. Morita H etal. (1997...sarin: Clinical manifes- Wills JH (1963). Pharmacological antagonists of the tations and treatment of accidental poisoning by anticholinesterase agents

  6. Is the link between alcohol and cardiovascular death among young Russian men attributable to misclassification of acute alcohol intoxication? Evidence from the city of Izhevsk

    PubMed Central

    Shkolnikov, V; McKee, M; Chervyakov, V; Kyrianov, N

    2002-01-01

    Background: Research on the aetiology of sudden cardiac death among young men in Russia strongly suggests an association with binge drinking. However, the possibility remains that such deaths are misclassified as being attributable to cardiovascular disease when they are really caused by acute alcohol poisoning. Objective: To describe postmortem levels of blood alcohol in Russian men dying from various causes and so determine whether deaths from alcohol poisoning are being misclassified as cardiovascular deaths. Setting: Ishevsk, capital of the Udmurt Republic, situated in the Ural region of the Russian Federation. Methods: The study was part of a larger one on adult mortality. The study sample was 309 deaths among men aged 20–55 dying between August 1998 and March 1999 from other than neoplasms, infectious diseases or unspecified causes and on whom necropsy records could be obtained. Information on cause of death was extracted from death certificates and data on postmortem blood alcohol concentration (BAC) from forensic records. Blood alcohol concentrations were adjusted where necessary to allow for delay in necropsy. Results: Medium or greater levels of intoxication occurred in a quarter of those recorded as dying from cardiovascular disease but in over half of those dying from external causes. BAC levels consistent with at least strong intoxication were seen in 13.5% of deaths from cardiovascular disease and 27.1% from external causes. No cardiovascular deaths had BAC at levels usually thought to be fatal while this level was seen in 26% of deaths from accidental poisoning. Conclusion: Evidence of recent consumption of alcohol is common among Russian men dying under the age of 55, with severe intoxication common where death is from external causes. However, the high death rates from cardiovascular disease in Russia cannot be explained by misclassification of deaths attributable to acute alcohol poisoning. This study thus resolves one of the outstanding

  7. A Young Adult with Unintended Acute Intravenous Iron Intoxication Treated with Oral Chelation: The Use of Liver Ferriscan for Diagnosing and Monitoring Tissue Iron Load

    PubMed Central

    Yassin, Mohamed; Soliman, Ashraf T; De Sanctis, Vincenzo; Moustafa, Abbas; Samaan, Sandra Abou; Nashwan, Abdulqadir

    2017-01-01

    Acute iron intoxication (FeI) in humans has not been adequately studied. The manifestation of FeI, defined as a serum iron concentration >300 μg/dL (55 μmol/L) within 12 hours of ingestion, include various symptoms appearing in progressive stages. Systemic toxicity is expected with an intake of 60 mg/kg. A 27-year-old female nurse presented with unintended acute intravenous iron intoxication (FeI) a week after self-injecting herself with 20 ampoules of IV iron (4,000 mg elemental iron, 60 mg/kg). She had stable vital signs and mild hepatic tenderness. Hepatic MRI (Ferriscan®) showed a moderate/severe liver iron content (LIC: 9 mg/g dry tissue). Her hemogram, electrolytes, hepatic and renal functions were normal. Based on the high dose of iron received and her elevated LIC, chelation therapy was advised. She accepted only oral therapy and was started on deferasirox at a dose of 30 mg/kg daily. This oral chelation proved to be effective in clearing her hepatic iron overload after six months (LIC: 2 mg/g dry tissue), without side effects. This case also proved the value of Ferriscan® in diagnosing the degree of hepatic FeI and monitoring therapy to achieve a safe level of LIC. PMID:28101313

  8. Neuroprotective role of heat shock protein 70 in the rostral ventrolateral medulla during acute mevinphos intoxication in the rat.

    PubMed

    Chang, Chi; Chang, Alice Y W; Chan, Samuel H H

    2004-01-01

    Heat shock protein (HSP) is a family of highly conserved proteins that respond to stress and participate actively in cytoprotection. Within the HSP family, HSP70 is the major inducible member that confers protection against cell death. This study investigated whether HSP70 plays a neuroprotective role at the rostral ventrolateral medulla (RVLM), the origin of sympathetic neurogenic vasomotor tone in the medulla oblongata where the organophosphate insecticide mevinphos (Mev) acts to elicit cardiovascular toxicity. Experiments were carried out in adult male Sprague-Dawley rats that were maintained under propofol anesthesia. Intravenous administration of Mev (960 microg/kg) induced a significant increase in the HSP70 level in the ventrolateral medulla during phase I ('pro-life' phase), and returned to baseline during phase II ('pro-death' phase) Mev intoxication. Compared to artificial cerebrospinal fluid, normal mouse serum (1:20), or sense hsp70 oligonucleotide (50 pmol) pretreatment, microinjection of an anti-HSP70 antiserum (1:20) or an antisense hsp70 oligonucleotide (50 pmol) bilaterally into the RVLM significantly increased mortality, shortened the duration of phase I intoxication and augmented the induced hypotension in rats that received Mev (960 microg/ kg, i.v.). These results suggest that HSP70 induced in the RVLM during Mev intoxication provides neuroprotection against the organophosphate poison via prevention of cardiovascular depression.

  9. Influences of Situational Factors and Alcohol Expectancies on Sexual Desire and Arousal Among Heavy-Episodic Drinking Women: Acute Alcohol Intoxication and Condom Availability

    PubMed Central

    George, William H.; Nguyen, Hong V.; Heiman, Julia R.; Davis, Kelly Cue; Norris, Jeanette

    2013-01-01

    Although studies suggest that alcohol increases women’s sexual desire, no studies to our knowledge have examined the effects of acute alcohol intoxication on women’s sexual desire. The majority of research examining alcohol’s effects on sexual arousal in women suggests that alcohol increases self-reported arousal. In an alcohol administration study in which women projected themselves into an eroticized scenario depicting a consensual sexual encounter with a new male partner, we examined the effects of alcohol and condom condition on women’s sexual desire and arousal. The moderating effects of sex-related alcohol expectancies were also examined. Results revealed that alcohol intoxication was related to less desire to engage in sex with a new partner and condom presence was related to more desire. Alcohol interacted with sexual disinhibition alcohol expectancies, indicating that more expectancy endorsement was associated with greater sexual desire and self-reported arousal in the alcohol condition, but not the control condition. Condom condition had no effect on self-reported sexual arousal. The present research suggests that sexual desire merits research attention in non-clinical samples, and experimental methodology can provide valuable information about alcohol’s influence on women’s sexual desire, thus advancing our understanding of this relationship beyond cross-sectional correlations. The current findings also provide evidence that sex-related alcohol expectancies may play an important role in alcohol-involved sexual experiences including desire and arousal. PMID:23661324

  10. [ROLE OF MICROFLORA OF THE ABDOMINAL CAVITY EXUDATE IN THE ENDOGENIC INTOXICATION OCCURRENCE IN PATIENTS, SUFFERING COMPLICATED ACUTE CHOLECYSTITIS WITH CONCURRENT CARDIAC INSUFFICIENCY OF ISCHEMIC GENESIS].

    PubMed

    Ivantsok, V M

    2015-05-01

    While complicated acute cholecystitis (ACH) course the focus of infection constitutes one of the main causes of the endogenic intoxication (EI) occurrence, what leads to ischemic and hypoxic myocardial damage. There were presented the treatment results analysis in 213 patients, ageing 60 years old and older, managed for an ACH, complicated by peritonitis, paravesical abscess, with concurrent cardiac insufficiency of ischemic genesis, to whom laparoscopic cholecytectomy (LCHE) was conducted. Microflora of the abdominal cavity exudates in the patients, suffering an ACH of various severity, was studied. More rapid regression of inflammatory process, the EI severity and the ischemic-hypoxic myocardial affection reduction, positive impact on hemodynamics, reduction of myocardial ischemia severity were noted while local affection, when bacteriophages for treatment were applied.

  11. [A case of acute ethanol intoxication with remarkable hyperglycemia by "ume-shu", a Japanese apricot liquor made with a large amount of sugar].

    PubMed

    Sugano, Takayuki; Kojima, Naoki; Kaneko, Susumu; Ishida, Junro; Terada, Taizo; Inagawa, Hiroshi; Okada, Yasusei

    2002-07-01

    A 19-year-old woman ingested 2.2 L of "umeshu", a Japanese apricot liquor made with a large amount of sugar. She was unconscious and in shock. The estimated blood ethanol concentration was 607 mg/dl, and the blood glucose level was 576 mg/dl. Because her respiration and circulation was highly suppressed, blood purification was indicated. Continuous hemodiafiltration (CHDF) was performed instead of hemodialysis because her hemodynamics was unstable. After CHDF was instituted, her blood glucose level reduced to normal range, and her consciousness became alert. CHDF was effective in eliminating ethanol and stabilizing her hemodynamics within an early stage. Though acute ethanol intoxication is known to inhibit glucogenesis, leading to hypoglycemia, marked hyperglycemia was seen in this case. Ingestion of a large amount of glucose-rich liquor and being in shock seemed to be the causes of hyperglycemia.

  12. Effects of intralipid and caffeic acid phenethyl ester on neurotoxicity, oxidative stress, and acetylcholinesterase activity in acute chlorpyriphos intoxication

    PubMed Central

    Ozkan, Umit; Osun, Arif; Basarslan, Kagan; Senol, Serkan; Kaplan, Ibrahim; Alp, Harun

    2014-01-01

    Chlorpyriphos is one of the most widely used organophosphate (OP) insecticide in agriculture with potential toxicity. Current post-exposure treatments consist of anti-cholinergic drugs and oxime compounds. We studied the effects of intralipid and caffeic acid phenethyl ester (CAPE) on chlorpyriphos toxicity to compose an alternative or supportive treatment for OP poisoning. Methods: Forty-nine rats were randomly divided into seven groups. Chlorpyriphos was administered for toxicity. Intralipid (IL) and CAPE administered immediately after chlorpyriphos. Serum acetylcholinesterase (AChE) level, total oxidant status (TOS), total antioxidant response (TAR), and histologic examination of cerebellum and brain tissue with Hematoxylin-Eosin and immunohistochemical dyes were examined. Results: Serum enzym levels showed that chlorpyriphos and CAPE inhibited AChE while IL alone had no effect, chlorpyriphos and CAPE intensifies the inhibition effect. Significant difference at AChE levels between the chlorpyriphos+IL and chlorpyriphos+CAPE verified that IL has a protective effect on AChE inhibition. TAR levels were significantly increased in all groups except chlorpyriphos group, TOS levels revealed that CAPE and IL decrease the amount of oxidative stress. Histologic examination revealed that neuronal degeneration was slightly decreased at chlorpyriphos+IL group, but CAPE had a significant effect on protection of neuronal degeneration. Conclusion: The results of this study gave us three key points. 1) AChE activity is important for diagnosis of OP intoxication but it has no value for determining the neuro-degeneration. 2) CAPE inhibits AChE activity and may increase the muscarinic-nicotinic hyperactivation. Therefore it should not be used for treatment of OP intoxication. 3) IL decreases the severity of neurodegeneration and symptoms of OP intoxication and it can be used as a supportive agent. PMID:24955152

  13. Water intoxication associated with oxytocin infusion

    PubMed Central

    Ahmad, Audrey J.; Clark, Elizabeth H.; Jacobs, Howard S.

    1975-01-01

    During a mid-trimester abortion with high dose oxytocin infusion and intravenous fluids, a patient developed an acute dilutational hyponatraemia and coma. The relationship of water intoxication and synthetic oxytocin infusion is discussed and the literature reviewed. PMID:1197156

  14. Interactive effects of contextual cues and acute alcohol intoxication on the associations between alcohol expectancy activation and urge to drink.

    PubMed

    Wardell, Jeffrey D; Read, Jennifer P

    2014-10-01

    This study examined the joint effects of contextual cues and alcohol intoxication on the associations between activation of positive and negative alcohol expectancies in memory and self-reported urges to drink alcohol after a laboratory alcohol administration. Young adult heavy drinkers were randomly assigned to drink a moderate dose of alcohol or a placebo (alcohol manipulation), and then listened to positive or negative drinking scenarios (cue manipulation). Before and after these manipulations, participants completed an alcohol expectancy Stroop task assessing positive and negative expectancy activation, as well as self-report measures of urges to drink. Regression analyses revealed that the alcohol and cue manipulations had a joint, moderating impact on the associations between expectancy activation and postcue changes in urge to drink. Specifically, both increased activation of negative expectancies and decreased activation of positive expectancies predicted decreases in urges to drink, but only for intoxicated participants in the negative cue condition. There were no associations between expectancy activation and urges to drink for those in the positive cue condition regardless of beverage condition. Results suggest that whether memory activation of alcohol expectancies has an impact on urge to drink after alcohol is on board may depend on the relevance of the activated expectancies to the current drinking context. This process appears to be influenced by a complex interaction between contextual cues in the environment and the pharmacological effects of alcohol.

  15. Coenzyme q10 confers cardiovascular protection against acute mevinphos intoxication by ameliorating bioenergetic failure and hypoxia in the rostral ventrolateral medulla of the rat.

    PubMed

    Yen, David H T; Chan, Julie Y H; Huang, C I; Lee, C H; Chan, Samuel H H; Chang, Alice Y W

    2005-04-01

    Coenzyme Q10 (CoQ10, ubiquinone) is a highly mobile electron carrier in the mitochondrial respiratory chain that also acts as an antioxidant. We evaluated the cardiovascular protective efficacy of CoQ10 at the rostral ventrolateral medulla (RVLM), a medullary site where sympathetic vasomotor tone originates and where the organophosphate poison mevinphos (Mev) acts to elicit cardiovascular intoxication. Experiments were carried out in adult male Sprague-Dawley rats that were maintained under propofol anesthesia. Microinjection bilaterally of Mev (10 nmol) into the RVLM induced progressive hypotension and minor bradycardia, alongside significant depression of the activity of NADH cytochrome c reductase (enzyme marker for Complexes I and III) or cytochrome c oxidase (enzyme marker for Complex IV) in the mitochondrial respiratory chain, reduction in ATP concentration, or tissue hypoxia in the RVLM. On the other hand, the activity of succinate cytochrome c reductase (enzyme marker for Complexes II and III) remained unaltered. The Mev-induced hypotension, bioenergetic failure, or hypoxia was significantly reversed when CoQ10 (4 microg) was coadministered bilaterally into the RVLM with the organophosphate poison. We conclude that CoQ10 confers cardiovascular protection against acute Mev intoxication by acting on the RVLM, whose neuronal activity is intimately related to the "life-and-death" process. We also showed that amelioration of the selective dysfunction of respiratory enzyme Complexes I and IV in the mitochondrial respiratory chain, the reduced ATP level, and the induced tissue hypoxia in the RVLM are among some of the underlying mechanisms for the elicited protection.

  16. Acute toxicity of some synthetic cyanogens in rats: time-dependent cyanide generation and cytochrome oxidase inhibition in soft tissues after sub-lethal oral intoxication.

    PubMed

    Rao, Pooja; Singh, Poonam; Yadav, Shiv Kumar; Gujar, Niranjan L; Bhattacharya, Rahul

    2013-09-01

    Cyanogens include complex nitrile-containing compounds that can generate free cyanide of toxicological significance. Acute toxicity, time-dependent cyanide generation and cytochrome oxidase (CYTOX) inhibition in soft tissues, and urinary thiocyanate levels were measured after acute cyanogen intoxication in rats. Order of cyanogens in terms of LD₅₀ was: malononitrile (MCN)>propionitrile (PCN)≈sodium nitroprusside (SNP)>acrylonitrile (ACN)>succinonitrile (SCN)>acetonitrile (ATCN) for oral, and SNP>MCN>ACN>PCN>SCN>ATCN for intraperitoneal and subcutaneous routes. MCN was most toxic by oral (LD₅₀=66.4 mg/kg) and SNP by intraperitoneal (LD₅₀=16.7 mg/kg) and subcutaneous (LD₅₀=11.9 mg/kg) routes. Minimum survival time (25 min) was recorded after 4.0 LD₅₀ ATCN. Order of cyanogens (0.75 LD₅₀; oral) on the basis of maximum blood cyanide and time of peak cyanide generation were: ATCN>SNP>SCN>PCN>MCN>ACN, and MCN (30 min)

  17. Investigation of the possible protective role of gallic acid on paraoxanase and arylesterase activities in livers of rats with acute alcohol intoxication.

    PubMed

    Kartkaya, Kazim; Oğlakçi, Ayşegül; Şentürk, Hakan; Bayramoğlu, Gökhan; Canbek, Mediha; Kanbak, Güngör

    2013-04-01

    Gallic acid, a polyphenyl class natural product from gallnut and green tea, is known to be antioxidant, anti-inflammatory and radical scavenger. In this study, we aimed to investigate the possible protective effects of gallic acid on paraoxonase and arylesterase activities in liver exposed to acute alcohol intoxication. Paraoxonase and arylesterase activities in liver tissue and serum aspartate aminotransferase, alanine aminotransferase and lactate dehydrogenase levels were measured. Histological investigations were also made. In our study, we observed a significant increase of serum alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase activities, which are indicators of liver damage after acute ethanol consumption. Gallic acid therapy has significantly reduced the increase in these biomarkers, indicating a possible hepatoprotective effect of gallic acid. Ethanol consumption caused a significant decrease in liver paraoxonase activity (P < 0.001). Gallic acid treatment partly restored this decreased paraoxonase activity, which resulted from ethanol administration. A gallic acid dose of 100 mg/kg was observed as highest restoring effect for paraoxonase activity (P < 0.05). The activity of arylesterase was decreased in the ethanol group as compared with the control group, but this was not significant. However, 50 mg/kg of gallic acid treatment restored the loss of this activity due to ethanol exposure (P < 0.001). We observed that gallic acid ameliorates the liver damage caused by excessive alcohol consumption in a dose-dependent way. Our results in this study showed that gallic acid might have a protective effect against alcoholic liver disease.

  18. 21 CFR 520.2520b - Trichlorfon and atropine.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Trichlorfon and atropine. 520.2520b Section 520... atropine. (a) Chemical name. (1) For trichlorfon: O,O-Dimethyl 2,2,2-trichloro-1-hydroxyethyl phosphonate. (2) For atropine: Atropine N.F. (b) Sponsor. See No. 000856 in § 510.600(c) of this chapter....

  19. 21 CFR 520.2520b - Trichlorfon and atropine.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Trichlorfon and atropine. 520.2520b Section 520... atropine. (a) Chemical name. (1) For trichlorfon: O,O-Dimethyl 2,2,2-trichloro-1-hydroxyethyl phosphonate. (2) For atropine: Atropine N.F. (b) Sponsor. See No. 000856 in § 510.600(c) of this chapter....

  20. Acute 3,4-methylenedioxy-N-ethylcathinone (ethylone) intoxication and related fatality: a case report with postmortem concentrations.

    PubMed

    McIntyre, Iain M; Hamm, Catherine E; Sherrard, James L; Gary, Ray D; Burton, Christopher G; Mena, Othon

    2015-04-01

    A 30-year-old man reportedly ingested pills and used illicit drugs with another person. They both fell asleep that night and the following afternoon the other person found him dead. There were used hypodermic needles and a metal spoon with dark tarry substance at the death scene, and two recent puncture sites were found on his body. It was uncertain if he had a history of illicit drug use. Postmortem blood initially screened borderline positive for methamphetamine by ELISA. An alkaline drug screen-detected ethylone which was subsequently confirmed and quantified by a specific GC-MS SIM analysis following solid-phase extraction. Concentrations were determined in the peripheral blood (0.39 mg/L), central blood (0.38 mg/L), liver (1.4 mg/kg), vitreous (0.58 mg/L), urine (20 mg/L) and gastric contents (12 mg). Other compounds detected in peripheral blood were morphine (0.05 mg/L), alprazolam (<0.05 mg/L), delta-9-THC (<1 ng/mL), delta-9-carboxy-THC (3.6 ng/mL) and naproxen (<5 mg/L). A urine screen (GC-MS) also confirmed 6-monoacetylmorphine, codeine and sildenafil. The cause of death was certified due to mixed ethylone, heroin and alprazolam intoxication. The manner of death was certified as accident.

  1. A prospective study of the influence of acute alcohol intoxication versus chronic alcohol consumption on outcome following traumatic brain injury.

    PubMed

    Lange, Rael T; Shewchuk, Jason R; Rauscher, Alexander; Jarrett, Michael; Heran, Manraj K S; Brubacher, Jeffrey R; Iverson, Grant L

    2014-08-01

    The purpose of the study was to disentangle the relative contributions of day-of-injury alcohol intoxication and pre-injury alcohol misuse on outcome from TBI. Participants were 142 patients enrolled from a Level 1 Trauma Center (in Vancouver, Canada) following a traumatic brain injury (TBI; 43 uncomplicated mild TBI and 63 complicated mild-severe TBI) or orthopedic injury [36 trauma controls (TC)]. At 6-8 weeks post-injury, diffusion tensor imaging (DTI) of the whole brain was undertaken using a Phillips 3T scanner. Participants also completed neuropsychological testing, an evaluation of lifetime alcohol consumption (LAC), and had blood alcohol levels (BALs) taken at the time of injury. Participants in the uncomplicated mild TBI and complicated mild-severe TBI groups had higher scores on measures of depression and postconcussion symptoms (d = 0.45-0.83), but not anxiety, compared with the TC group. The complicated mild-severe TBI group had more areas of abnormal white matter on DTI measures (all p < .05; d = 0.54-0.61) than the TC group. There were no difference between groups on all neurocognitive measures. Using hierarchical regression analyses and generalized linear modeling, LAC and BAL did provide a unique contribution toward the prediction of attention and executive functioning abilities; however, the variance accounted for was small. LAC and BAL did not provide a unique and meaningful contribution toward the prediction of self-reported symptoms, DTI measures, or the majority of neurocognitive measures. In this study, BAL and LAC were not predictive of mental health symptoms, postconcussion symptoms, cognition, or white-matter changes at 6-8 weeks following TBI.

  2. [Abuse, dependence and intoxication of substances].

    PubMed

    Wada, Kiyoshi

    2015-09-01

    As for substance-related disorders, there were several differences between ICD-10 and DSM-IV, however, the concept of "dependence" had been essential for both criteria. DSM-5 published in 2013 had erased dependence. This confuses us. It is important to recognize dependence again. "Abuse" is the self-intake behavior of drug against the social norms. Repeated abuse results in dependence. Dependence is a state of loss of control against drug use due to craving. Abuse can produce "acute intoxication", and repeated abuse under dependence can produce "chronic intoxication". It is important to understand abuse, dependence and "intoxication" based on their relationship from the point of time course.

  3. Alcohol intoxication: Ion channels and genetics

    SciTech Connect

    Harris, A.R.; Allan, A.M. )

    1989-04-01

    Acute in vitro exposure to ethanol and other intoxicant-anesthetics activates {gamma}-aminobutyric acid (GABA)-stimulated chloride channels and inhibits voltage-dependent calcium and sodium channels of isolated brain membranes. The question of whether these neurochemical actions are responsible for intoxication in vivo has been addressed using animal populations displaying genetic differences in sensitivity to alcohol and benzodiazepine intoxication. These genetic approaches include inbred strains, selected lines, recombinant inbred strains, and heterogeneous stocks. Genetic differences in ion channel function provide strong evidence for a role of the GABA-stimulated chloride channel in ethanol and benzodiazepine intoxication; the role of calcium and sodium channels is less clear.

  4. Blood purification for intoxication.

    PubMed

    Nakae, Hajime

    2010-01-01

    Blood purification is administered in cases of acute intoxication when the substance causing the intoxication is to be eliminated or when the substance leads to a case of organ dysfunction, such as in renal or hepatic failure. The causative substances cover a wide range, from medical drugs or agrichemicals to natural poisons (such as poisonous mushrooms). In removing these substances, gastric lavage, activated carbon administration, laxative administration or enema cleaning are the preferred methods, and blood purification is not routinely conducted. However, when the causative substance is unknown or when there are several causative substances, it is not easy to immediately grasp the disposition of the patient and so judge whether or not blood purification should be performed. In such cases, blood purification must be conducted in a timely manner and in accordance with the crisis management principle of 'prepare for the worst'. In general, substances whose molecular weight is within the removal spectrum, having a small distribution volume and a low protein-binding rate, are easier to remove. For substances with high protein-binding rates, albumin dialysis (MARS and Prometheus) is performed in order to remove albumin-binding substances. Since MARS and Prometheus have not been introduced in Japan, plasma diafiltration, employing selective plasma filtration with dialysis, is a practical alternative.

  5. Pathophysiology of Acute T-2 Intoxication in the Cynomolgus Monkey and Comparison to the Rat as a Model

    DTIC Science & Technology

    1983-09-30

    Mirocha, C. J., and Reddy, K. R. Acute toxicity of 12,13-Epoxytrichothecenes in one-day-old broiler chicks . Applied and Environmcntal Microbiology...in broiler chickens. Vet. Pathol. 18:652-664, 1981. S. . ., | i -i i I II I INDEX SHEET T-2 (2) Toxicity (2) Cynomolgus (2) Lethality (3) Skin

  6. Comparative studies of oral administration of marine collagen peptides from Chum Salmon (Oncorhynchus keta) pre- and post-acute ethanol intoxication in female Sprague-Dawley rats.

    PubMed

    Liang, Jiang; Li, Qiong; Lin, Bing; Yu, Yongchao; Ding, Ye; Dai, Xiaoqian; Li, Yong

    2014-09-01

    The present study aimed to evaluate the effect of an oral administration of marine collagen peptides (MCPs) pre- and post-acute ethanol intoxication in female Sprague-Dawley (SD) rats. MCPs were orally administered to rats at doses of 0 g per kg bw, 2.25 g per kg bw, 4.5 g per kg bw and 9.0 g per kg bw, prior to or after the oral administration of ethanol. Thirty minutes after ethanol treatment, the effect of MCPs on motor incoordination and hypnosis induced by ethanol were investigated using a screen test, fixed speed rotarod test (5 g per kg bw ethanol) and loss of righting reflex (7 g per kg bw ethanol). In addition, the blood ethanol concentrations at 30, 60, 90, and 120 minutes after ethanol administration (5 g per kg bw ethanol) were measured. The results of the screen test and fixed speed rotarod test suggested that treatment with MCPs at 4.5 g per kg bw and 9.0 g per kg bw prior to ethanol could attenuate ethanol-induced loss of motor coordination. Moreover, MCP administered both pre- and post-ethanol treatment had significant potency to alleviate the acute ethanol induced hypnotic states in the loss of righting reflex test. At 30, 60, 90 and 120 minutes after ethanol ingestion at 5 g per kg bw, the blood ethanol concentration (BEC) of control rats significantly increased compared with that in the 4.5 g per kg bw and 9.0 g per kg bw MCP pre-treated groups. However, post-treatment with MCPs did not exert a significant inhibitory effect on the BEC of the post-treated groups until 120 minutes after ethanol administration. Therefore, the anti-inebriation effect of MCPs was verified in SD rats with the possible mechanisms related to inhibiting ethanol absorption and facilitating ethanol metabolism. Moreover, the efficiency was better when MCPs were administered prior to ethanol.

  7. D-Galactosamine Intoxication in Experimental Animals: Is it Only an Experimental Model of Acute Liver Failure?

    PubMed Central

    Saracyn, Marek; Zdanowski, Robert; Brytan, Marek; Kade, Grzegorz; Nowak, Zbigniew; Patera, Janusz; Dyrla, Przemysław; Gil, Jerzy; Wańkowicz, Zofia

    2015-01-01

    Background Short-term administration of Galactosamine to experimental animals causes liver damage and acute liver failure (ALF), as well as acute renal failure in some cases. The aim of our study was to describe kidney disorders that developed in the course of galactosamine-induced liver failure. Material/Methods Sprague-Dawley rats were randomly divided into 2 groups: a study group administered galactosamine intraperitoneally and a control group administered saline. Results All the animals in the study group developed liver damage and failure within 48 h, with significant increase of alanine (p<0.001), aspartate aminotransferases (p<0.0001), bilirubin (p<0.004), and ammonia (p<0.005) and decrease of albumin (p<0.001) concentrations. Acute renal failure was observed in all test animals, with a significant increase in creatinine (p<0.001) and urea (p<0.001) concentrations and a decrease in creatinine clearance (p<0.0012). Moreover, osmotic clearance (p<0.001), daily natriuresis (p<0.003), and fractional sodium excretion (p<0.016) decreased significantly in this group of animals. The ratio of urine osmolality to serum osmolality did not change. Histopathology of the liver revealed massive necrosis of hepatocytes, whereas renal histopathology showed no changes. Conclusions Acute renal failure that developed in the course of galactosamine-induced ALF was of a functional nature, with the kidneys retaining the ability to concentrate urine and retain sodium, and there were no renal changes in the histopathological examination. It seems that the experimental model of ALF induced by galactosamine can be viewed as a model of hepatorenal syndrome that occurs in the course of acute damage and liver failure. PMID:26009004

  8. GHB pharmacology and toxicology: acute intoxication, concentrations in blood and urine in forensic cases and treatment of the withdrawal syndrome.

    PubMed

    Busardò, Francesco P; Jones, Alan W

    2015-01-01

    The illicit recreational drug of abuse, γ-hydroxybutyrate (GHB) is a potent central nervous system depressant and is often encountered during forensic investigations of living and deceased persons. The sodium salt of GHB is registered as a therapeutic agent (Xyrem®), approved in some countries for the treatment of narcolepsy-associated cataplexy and (Alcover®) is an adjuvant medication for detoxification and withdrawal in alcoholics. Trace amounts of GHB are produced endogenously (0.5-1.0 mg/L) in various tissues, including the brain, where it functions as both a precursor and a metabolite of the major inhibitory neurotransmitter γ-aminobutyric acid (GABA). Available information indicates that GHB serves as a neurotransmitter or neuromodulator in the GABAergic system, especially via binding to the GABA-B receptor subtype. Although GHB is listed as a controlled substance in many countries abuse still continues, owing to the availability of precursor drugs, γ-butyrolactone (GBL) and 1,4-butanediol (BD), which are not regulated. After ingestion both GBL and BD are rapidly converted into GHB (t½ ~1 min). The Cmax occurs after 20-40 min and GHB is then eliminated from plasma with a half-life of 30-50 min. Only about 1-5% of the dose of GHB is recoverable in urine and the window of detection is relatively short (3-10 h). This calls for expeditious sampling when evidence of drug use and/or abuse is required in forensic casework. The recreational dose of GHB is not easy to estimate and a concentration in plasma of ~100 mg/L produces euphoria and disinhibition, whereas 500 mg/L might cause death from cardiorespiratory depression. Effective antidotes to reverse the sedative and intoxicating effects of GHB do not exist. The poisoned patients require supportive care, vital signs should be monitored and the airways kept clear in case of emesis. After prolonged regular use of GHB tolerance and dependence develop and abrupt cessation of drug use leads to unpleasant

  9. GHB Pharmacology and Toxicology: Acute Intoxication, Concentrations in Blood and Urine in Forensic Cases and Treatment of the Withdrawal Syndrome

    PubMed Central

    Busardò, Francesco P.; Jones, Alan W.

    2015-01-01

    The illicit recreational drug of abuse, γ-hydroxybutyrate (GHB) is a potent central nervous system depressant and is often encountered during forensic investigations of living and deceased persons. The sodium salt of GHB is registered as a therapeutic agent (Xyrem®), approved in some countries for the treatment of narcolepsy-associated cataplexy and (Alcover®) is an adjuvant medication for detoxification and withdrawal in alcoholics. Trace amounts of GHB are produced endogenously (0.5-1.0 mg/L) in various tissues, including the brain, where it functions as both a precursor and a metabolite of the major inhibitory neurotransmitter γ-aminobutyric acid (GABA). Available information indicates that GHB serves as a neurotransmitter or neuromodulator in the GABAergic system, especially via binding to the GABA-B receptor subtype. Although GHB is listed as a controlled substance in many countries abuse still continues, owing to the availability of precursor drugs, γ-butyrolactone (GBL) and 1,4-butanediol (BD), which are not regulated. After ingestion both GBL and BD are rapidly converted into GHB (t½ ~1 min). The Cmax occurs after 20-40 min and GHB is then eliminated from plasma with a half-life of 30-50 min. Only about 1-5% of the dose of GHB is recoverable in urine and the window of detection is relatively short (3-10 h). This calls for expeditious sampling when evidence of drug use and/or abuse is required in forensic casework. The recreational dose of GHB is not easy to estimate and a concentration in plasma of ~100 mg/L produces euphoria and disinhibition, whereas 500 mg/L might cause death from cardiorespiratory depression. Effective antidotes to reverse the sedative and intoxicating effects of GHB do not exist. The poisoned patients require supportive care, vital signs should be monitored and the airways kept clear in case of emesis. After prolonged regular use of GHB tolerance and dependence develop and abrupt cessation of drug use leads to unpleasant

  10. Topical Atropine in the Control of Myopia.

    PubMed

    Tan, Donald; Tay, Su Ann; Loh, Kai-Lyn; Chia, Audrey

    Efforts to reduce myopia progression in childhood are driven by the increasing incidence of high myopia and its attendant health risks. Interventional approaches to reduce myopia progression in childhood have included the use of spectacles, contact lens, and pharmacological methods, of which the latter appear to be most promising. We review the use of topical atropine eye drops in the retardation of myopia progression in children and discuss the efficacy and safety profiles when used at different concentrations (1.0%, 0.5%, 0.1%, and 0.01%). Topical atropine reduces myopia progression and axial elongation in children in a dose-related manner, but a rebound phenomenon occurs with higher doses. Its use has been shown to be safe, but higher doses cause pupil dilation, loss of accommodation and near vision. Atropine 0.01% has the best therapeutic index, with clinically insignificant amounts of pupil dilation, near vision, and accommodation loss but remains as effective as higher doses.

  11. The effect of acute alcohol intoxication on gut wall integrity in healthy male volunteers; a randomized controlled trial.

    PubMed

    de Jong, W J; Cleveringa, A M; Greijdanus, B; Meyer, P; Heineman, E; Hulscher, J B

    2015-02-01

    The aim of the study is to determine the effect of acute alcohol consumption on enterocytes. Chronic alcohol consumption has been known to induce a decrease in gut wall integrity in actively drinking alcoholics and patients with alcohol-induced liver disease. Data on the extent of the damage induced by acute alcohol consumption in healthy human beings is scarce. Studies show that heavy incidental alcohol consumption is a growing problem in modern society. Data on this matter may provide insights into the consequences of this behavior for healthy individuals. In a randomized clinical trial in crossover design, 15 healthy volunteers consumed water one day and alcohol the other. One blood sample was collected pre-consumption, five every hour post-consumption, and one after 24 h. Intestinal fatty acid binding protein (I-FABP) was used as a marker for enterocyte damage. Liver fatty acid binding protein (L-FABP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT) were used as markers for hepatocyte damage. Lipopolysaccharide binding protein (LBP) and soluble CD14 (sCD14) were used as a measure of translocation. Interleukin-6 (IL-6) was used to assess the acute inflammatory response to endotoxemia. Alcohol consumption caused a significant increase in serum I- and L-FABP levels, compared to water consumption. Levels increased directly post-consumption and decreased to normal levels within 4 h. LBP, sCD14, and IL-6 levels were not significantly higher in the alcohol group. Moderate acute alcohol consumption immediately damages the enterocyte but does not seem to cause endotoxemia.

  12. Thermoregulation After Atropine and Pralidoxime Administration,

    DTIC Science & Technology

    1986-03-01

    decreased eccrine sweating (-60%, P 0.05) wiph ensuent elevated esophageal (+0.4C, Pɘ.05) and skin tempexatures (+2.1FC, Pɘ.05) was observed...expected result of atropine injection, decreased eccrine sweating (-60%, p < 0.05) with ensuent elevated esophageal (+0.40C, p < 0.05) and skin...Pralidoxime was shown to decrease whole body sweating , by a mechanism as yet unexplained. 77 Eccrine sweat gland activity is depressed by systemic atropine

  13. Heat Exchange After Atropine and Pralidoxime Administration

    DTIC Science & Technology

    1986-12-01

    calculated from weight changes. b,,Z&-expected result -of 4 tropine injection, decreased eccrine sweating 6-66%v po<.05) and elevated esophageal W-O- ’ and...The expected result of atropine injection, decreased eccrine sweating (-60%, pɘ.05) and elevated esophageal (+0.4 0C, pɘ.05) and skin temperatures...heat, pralidoxime chloride, sweating rate vii r-1 INTRODUCTION Eccrine sweat gland activity is depressed by systemic or local atropine administration

  14. Muscarinic receptor-independent activation of cyclic adenosine monophosphate-dependent protein kinase in rostral ventrolateral medulla underlies the sympathoexcitatory phase of cardiovascular responses during mevinphos intoxication in the rat.

    PubMed

    Tsai, Ching-Yi; Wu, Carol H Y; Chan, Samuel H H; Chang, Alice Y W

    2007-05-01

    As inhibitors of acetylcholinesterase, clinical presentations of poisoning from organophosphate compounds are generally believed to entail overstimulation by the accumulated acetylcholine on muscarinic receptors at peripheral and central synapses. That some patients still yielded to acute organophosphate poisoning despite repeated dosing of atropine suggests that cellular mechanisms that are independent of muscarinic receptor activation may also be engaged in organophosphate poisoning. The present study was undertaken to test the hypothesis that muscarinic receptor-independent activation of cyclic adenosine monophosphate-dependent protein kinase A (PKA) in rostral ventrolateral medulla (RVLM), a medullary site where sympathetic vasomotor tone originates and where the organophosphate poison mevinphos (Mev) acts, is involved in the cardiovascular responses exhibited during organophosphate intoxication. In Sprague-Dawley rats, microinjection bilaterally of Mev (10 nmol) into the RVLM significantly augmented PKA activity in ventrolateral medulla that was not antagonized by coadministration of an equimolar concentration (1 nmol) of atropine or selective muscarinic receptor type M1 (pirenzepine), M2 (methoctramine), M3 (4-diphenyl-acetoxy-N-dimethylpiperidinium), or M4 (tropicamide) inhibitor. Comicroinjection of two selective PKA antagonists (100 pmol), N-[2-(p-bromocinnamylamino)ethyl]-5-isoquinolinesulfonamide and (9R,10S,12S)-2,3,9,10,11,12-hexahydro-10-hydroxy-9-methyl-1-oxo-9,12-epoxy-1H-diindolol[1,2,3-fg:3',2',1'-kl]pyrrolo[3,4-1][1,6]benzodiazocine-10-carboxylic acid, significantly blunted the initial sympathoexcitatory cardiovascular response and the accompanying augmentation of nitric oxide synthase (NOS I) expression in the ventrolateral medulla exhibited during Mev intoxication; the secondary sympathoinhibitory phase and associated elevation in NOS II expression were unaffected. We conclude that whereas a muscarinic receptor-independent augmentation of PKA

  15. [Acute poisoning with anticholinesterase carbamate pesticides: methomyl-lannate®].

    PubMed

    Chaouali, Nadia; Amira, Dorra; Zitouni, Eya; Gana, Ines; Nouioui, Anouer; Khelifi, Fathia; Belwaer, Ines; Masri, Wafa; Ghorbal, Hayet; Hedhili, Abderazzek

    2014-01-01

    The methomyl is increasingly involved in suicidal and autolytic attempts. Intoxication with carbamate (CM) compounds is still a frequent cause for admission in the Emergency department of the medical assistance center (MAC) in Tunis, Tunisia. The aim of this study was to describe the demographics, clinical features and hospital course of patients presenting with CM intoxication to the ED of MAC in Tunis, Tunisia. This was a retrospective study about 52 cases of acute poisoning by methomyl, compiled in the MAC from 1st January, 2009 to December 31, 2012. Intoxications were all oral, mostly intentional (33 cases: 65%) and in young patients (29 years old). Females outnumbered males by almost 2:1. The most frequent symptom was hypotension (41 cases: 80%), followed by miosis (39 cases: 75%), rhabdomyolysis (29 cases: 55%), vomiting (18 cases: 43%), bronchorrhea (14 cases: 27%), diarrhea (11 cases: 21%) and fasciculations (8 cases: 17%). Treatments included gastric lavage in 16 patients (32%), assisted ventilation in 8 cases (17%) and atropine in 44 patients (85%). Seven patients died during hospitalization. Pesticide poisoning is a significant public health problem and some preventive measures must be strictly enforced to limit this kind of intoxication.

  16. Bilateral vagotomy or atropine pre-treatment reduces experimental diesel-soot induced lung inflammation

    SciTech Connect

    McQueen, D.S. . E-mail: D.S.McQueen@ed.ac.uk; Donaldson, K.; McNeilly, J.D.; Barton, N.J.; Duffin, R.

    2007-02-15

    To investigate the role of the vagus nerve in acute inflammatory and cardiorespiratory responses to diesel particulate (DP) in the rat airway, we measured changes in respiration, blood pressure and neutrophils in lungs of urethane anesthetized Wistar rats 6-h post-instillation of DP (500 {mu}g) and studied the effect of mid-cervical vagotomy or atropine (1 mg kg{sup -1}) pre-treatment. In conscious rats, we investigated DP, with and without atropine pre-treatment. DP increased neutrophil level in BAL (bronchoalveolar lavage) fluid from intact anesthetized rats to 2.5 {+-} 0.7 x 10{sup 6} cells (n = 8), compared with saline instillation (0.3 {+-} 0.1 x 10{sup 6}, n = 7; P < 0.05). Vagotomy reduced DP neutrophilia to 0.8 {+-} 0.2 x 10{sup 6} cells (n = 8; P < 0.05 vs. intact); atropine reduced DP-induced neutrophilia to 0.3 {+-} 0.2 x 10{sup 6} (n = 4; P < 0.05). In conscious rats, DP neutrophilia of 8.5 {+-} 1.8 x 10{sup 6}, n = 4, was reduced by pre-treatment with atropine to 2.2 {+-} 1.2 x 10{sup 6} cells, n = 3. Hyperventilation occurred 6 h after DP in anesthetized rats with intact vagi, but not in bilaterally vagotomized or atropine pre-treated animals and was abolished by vagotomy (P < 0.05, paired test). There were no significant differences in the other variables (mean blood pressure, heart rate and heart rate variability) measured before and 360 min after DP. In conclusion, DP activates a pro-inflammatory vago-vagal reflex which is reduced by atropine. Muscarinic ACh receptors in the rat lung are involved in DP-induced neutrophilia, and hence muscarinic antagonists may reduce airway and/or cardiovascular inflammation evoked by inhaled atmospheric DP in susceptible individuals.

  17. Organophosphate and carbamate intoxication in La Paz, Bolivia.

    PubMed

    Exner, Christopher J; Ayala, Guillermo Urquizo

    2009-05-01

    Intoxication with organophosphate (OP) and carbamate (CM) compounds is a common reason for presentation to the Emergency Department (ED) in La Paz, Bolivia. The objective of this study was to describe the demographics, presenting symptoms, and hospital course of patients presenting with OP or CM intoxication to the ED of the Hospital de Clinicas, La Paz, Bolivia, with the aim of determining which factors might predict a complicated hospital course. This was a retrospective chart review, using predefined criteria, of 300 patients who presented from January 1, 2003 to December 31, 2003. The intoxications were all oral, mostly intentional (97%), and in young patients (mean age 23.9 years, range 13-62 years). Females outnumbered males almost 2:1. The most common symptoms on presentation were abdominal pain (83%), nausea/vomiting (79%), miosis (72%), bronchorrhea (44%), diarrhea (41%), and fasciculations (31%). The most frequent complications were aspiration (18%), cardiopulmonary arrest (9%), and seizure (7%); mortality was 6%. Treatments included gastric lavage in 96% of patients, and atropine (median 5 mg per patient, range 0-48 mg). Miosis, bronchorrhea, diarrhea, and fasciculations at presentation were associated with a higher rate of complications. Although almost all intoxications were suicide attempts, less than half of patients received a psychiatric consultation. OP intoxication is a common cause of self-inflicted morbidity and mortality among young people in La Paz, Bolivia. Presence of miosis, bronchorrhea, diarrhea, and fasciculations at presentation suggest a higher likelihood of complications.

  18. Development of a Combined Solution Formulation of Atropine Sulfate and Obidoxime Chloride for Autoinjector and Evaluation of Its Stability

    PubMed Central

    Ettehadi, Hossein Ali; Ghalandari, Rouhollah; Shafaati, Alireza; Foroutan, Seyed Mohsen

    2013-01-01

    Atropine (AT) and oximes, alone or in combination, have been proven greatly valuable therapeutics in the treatment of organophosphates intoxications. An injectable mixture of AT and obidoxime (OB) was formulated for the administration by automatic self-injector. The aqueous single dose solution contained 275 mg obidoxime chloride and 2.5 mg atropine sulfate per 1 mL (220 mg and 2 mg per 0.8 effective dose, respectively). The final solution was sterilized by filtration through a 0.22 μm pore size filter. This more concentrated solution allowed to use a smaller size and lighter weight cartridge. Quality control tests, including assay of the two major compounds were performed separately, using reversed-phase HPLC methods. Besides, the stability test was carried out according to ICH guideline for the accelerated test. The obtained results showed that the proposed formulation is stable over a period of 2 years after preparation. PMID:24250669

  19. [Research on whether atropine can be substituted by the powerful cycloplegic cyclopentolate].

    PubMed

    Xu, Jiang-tao

    2012-09-01

    For a long time, atropine eye ointment has been widely used as the cycloplegic for children's optometry in China, while internationally, cyclopentolate gutta is widely used as the first choice for cycloplegic. In recent years, 1% cyclopentolate hydrochloride ocular humor has been introduced to our country. This effective and powerful cycloplegic has already been paid close attention to by domestic pedo-ophthalmologists. According to a serious of studies both home and abroad on the therapeutic effects of the own control drugs, the cycloplegia effect of cyclopentolate is close to the atropine. Cyclopentolate can be widely used for the cycloplegia before optometry for the Chinese children. However, the effect of cyclopentolate is still not as good as atropine. So, for the children with farsightedness within 7 years old, all esotropia children, Am children, and children who suffer from decreased vision acuteness and needs to be excluded from accommodative myopia, atropine eye ointment should be routinely used for cycloplegia before optometry. In this article, we also discuss the medication dosage, medication method, possible drug adverse reactions of cyclopentolate humor ocular and the coping measures at the same time.

  20. Fatal intoxication with methoxetamine.

    PubMed

    Adamowicz, Piotr; Zuba, Dariusz

    2015-01-01

    Methoxetamine (MXE) is a new synthetic drug of abuse structurally related to ketamine and phencyclidine. A case of a 29-year-old male with acute toxicity related to the analytically confirmed use of MXE is reported. The man was found dead at his residence. Biological material was analyzed using liquid chromatography-tandem mass spectrometry. The concentration of MXE in urine of the deceased was 85 μg/mL. Despite the vial containing the blood sample being destroyed during transportation and the blood leaking out into the cardboard packaging, the blood level of MXE was estimated. After determination of the cardboard grammage (approx. 400 g/m(3) ) and the mean mass of the blood obtained after drying (0.1785 ± 0.0173 g per 1 mL), the estimated blood concentration of MXE was found to be 5.8 μg/mL. The high concentration of MXE in blood and urine and the circumstances of the case indicate an unintentional, fatal intoxication with this substance.

  1. Intoxication and violent women.

    PubMed

    Weizmann-Henelius, Ghitta; Putkonen, Hanna; Naukkarinen, Hannu; Eronen, Markku

    2009-02-01

    Alcohol and drugs have been linked to severe violent offending among women as well as men. The purpose of this study was to make a contribution to the limited knowledge of characteristics related to the state of intoxication in violent female offenders. The putative differences in the characteristics of female offenders and their violent offenses in relation to the state of intoxication at the time of the violent offending were examined. Of a nation-wide sample of 109 female offenders found guilty of homicide and other violent crimes and incarcerated in 1999-2000 in Finland, 60 offenders participated in the study. Of these offenders 49 (81.7%) had been intoxicated at the time the of index offenses. These were compared with 11 (18.3%) non-intoxicated offenders using a structured interview, the Structured Clinical Interview II for DSM-IV (SCID-II) and the Hare Psychopathy Checklist-Revised (PCL-R). The prevalence of substance abuse or dependence (73.3% and 0%), personality disorder (89.6% and 36.4%), particularly antisocial personality disorder (66.7% and 0%), as well as a history of criminality (69.4% and 0%) were significantly higher among the intoxicated women than among the non-intoxicated. The PCL-R scores were also significantly higher among the intoxicated offenders than among non-intoxicated offenders. The victims of the intoxicated women (23.9%) were less often emotionally close to the perpetrator than were the victims of the non-intoxicated women (66.6%). No differences emerged between the groups in experiences of childhood and adulthood abuse or stressful life events prior to the index crime. The findings indicate that intoxicated violent female offenders exhibit more of the characteristics previously found in violent men, than do the non-intoxicated female offenders. Moreover, the non-intoxicated group comprises both psychotic non-responsible and non-psychotic, fairly well-adjusted women, who are educated, working or studying at the time of the offense

  2. Topical Atropine in the Control of Myopia

    PubMed Central

    GALVIS, Virgilio; TELLO, Alejandro; PARRA, M. Margarita; MERAYO-LLOVES, Jesus; LARREA, Jaime; JULIAN RODRIGUEZ, Carlos; CAMACHO, Paul Anthony

    2016-01-01

    Atropine has been used for more than a century to arrest myopia progression. Compelling evidence of its protective effect has been reported in well-designed clinical studies, mainly performed during the last two decades. However, its exact mechanism of action has not been determined. Experimental findings have shown that the mechanism is not related to accommodation, as was thought for decades. A review of the published literature revealed a significant amount of evidence supporting its safety and efficacy at a concentration of 1.0%, and at lower concentrations (as low as 0.01%). PMID:28293653

  3. A successful management of aluminum phosphide intoxication

    PubMed Central

    Moazezi, Zoleika; Abedi, Seyed Hassan

    2011-01-01

    Background: Aluminum Phosphide or rice tablet is one of the most common pesticides which leads to accidental or intentional acute intoxication and finally death. In this paper, we describe a successful management of intoxication with rice tablet in a young girl. Case Presentation: A 14-year-old girl was admitted due to consumption of rice tablet. Gastric washing with two vials of sodium bicarbonate and discharge suction was done. In the first 24 hours, the patient underwent recurrent hydration, dopamine infusion with sodium bicarbonate, calcium, magnesium and amiodarone. On the second day of admission, the patient was transferred to intensive care unit (ICU) and five days later, she was discharged without liver or renal complications. Conclusion: Short interval between consumption of this tablet and start of the treatment and on time rescue to the patient can be some of the important factors to prevent early death in intoxication with this tablet. PMID:24049589

  4. PROTEOSE INTOXICATIONS AND INJURY OF BODY PROTEIN

    PubMed Central

    Whipple, G. H.; Van Slyke, Donald D.

    1918-01-01

    The acute intoxication following an injection of a toxic proteose is usually associated with a large increase (40 per cent or more) in the non-protein nitrogen of the blood. This increase is found chiefly in the blood urea nitrogen, but the amino and peptide nitrogens also may show small increases. The changes observed in the blood non-protein nitrogen are identical with those which follow the feeding of large amounts of meat (8). These facts indicate that the proteose intoxication causes an abnormally rapid autodigestion of tissue proteins, but that the nitrogenous end-products are, in chief part at least, the same that result from normal catabolism of food proteins. There is no evidence that the autolytic products play any part in causing the intoxication. The possibility of such a part and a resultant vicious circle is not excluded, but from the available facts the autolysis appears more as a result rather than cause of the intoxication. It appears possible that in disease or intoxication tissue catabolism may be enormously accelerated and yet yield the end-products of normal protein metabolism. PMID:19868251

  5. Barbiturate intoxication and overdose

    MedlinePlus

    ... barbiturate intoxication and overdose include: Altered level of consciousness Difficulty in thinking Drowsiness or coma Faulty judgment ... who use them on purpose to alter their consciousness The second group is among the most difficult ...

  6. Development of status epilepticus, sustained calcium elevations and neuronal injury in a rat survival model of lethal paraoxon intoxication

    PubMed Central

    Deshpande, Laxmikant S.; Carter, Dawn S.; Phillips, Kristin F.; Blair, Robert E.; DeLorenzo, Robert J.

    2014-01-01

    Paraoxon (POX) is an active metabolite of organophosphate (OP) pesticide parathion that has been weaponized and used against civilian populations. Exposure to POX produces high mortality. OP poisoning is often associated with chronic neurological disorders. In this study, we optimize a rat survival model of lethal POX exposures in order to mimic both acute and long-term effects of POX intoxication. Male Sprague-Dawley rats injected with POX (4 mg/kg, ice-cold PBS, s.c.) produced a rapid cholinergic crisis that evolved into status epilepticus (SE) and death within 6–8 min. The EEG profile for POX induced SE was characterized and showed clinical and electrographic seizures with 7–10 Hz spike activity. Treatment of 100% lethal POX intoxication with an optimized three drug regimen (atropine, 2 mg/kg, i.p., 2-PAM, 25 mg/kg, i.m. and diazepam, 5 mg/kg, i.p.) promptly stopped SE and reduced acute mortality to 12% and chronic mortality to 18%. This model is ideally suited to test effective countermeasures against lethal POX exposure. Animals that survived the POX SE manifested prolonged elevations in hippocampal [Ca2+]i (Ca2+ plateau) and significant multifocal neuronal injury. POX SE induced Ca2+ plateau had its origin in Ca2+ release from intracellular Ca2+ stores since inhibition of ryanodine/ IP3 receptor lowered elevated Ca2+ levels post SE. POX SE induced neuronal injury and alterations in Ca2+ dynamics may underlie some of the long term morbidity associated with OP toxicity. PMID:24785379

  7. Prevention of acrylonitrile-induced gastrointestinal bleeding by sulfhydryl compounds, atropine and cimetidine

    SciTech Connect

    Ghanayem, B.I.; Ahmed, A.E.

    1986-07-01

    We have recently demonstrated that acrylonitrile (VCN) causes acute gastric hemorrhage and mucosal erosions. The current studies were undertaken to investigate the effects of the sulfhydryl-containing compounds, cysteine and cysteamine, the cholinergic blocking agent atropine and the histamine H2 receptor antagonist, cimetidine on the VCN-induced gastrointestinal (GI) bleeding in rats. Our data shows that pretreatment with L-cysteine, cysteamine, atropine or cimetidine has significantly protected rats against the VCN-induced GI bleeding. A possible mechanism of the VCN-induced GI bleeding may involve the interaction of VCN with critical sulfhydryl groups that, in turn, causes alteration of acetylcholine muscarinic receptors to lead to gastric hemorrhagic lesions and bleeding.

  8. Post-exposure administration of diazepam combined with soluble epoxide hydrolase inhibition stops seizures and modulates neuroinflammation in a murine model of acute TETS intoxication.

    PubMed

    Vito, Stephen T; Austin, Adam T; Banks, Christopher N; Inceoglu, Bora; Bruun, Donald A; Zolkowska, Dorota; Tancredi, Daniel J; Rogawski, Michael A; Hammock, Bruce D; Lein, Pamela J

    2014-12-01

    Tetramethylenedisulfotetramine (TETS) is a potent convulsant poison for which there is currently no approved antidote. The convulsant action of TETS is thought to be mediated by inhibition of type A gamma-aminobutyric acid receptor (GABAAR) function. We, therefore, investigated the effects of post-exposure administration of diazepam, a GABAAR positive allosteric modulator, on seizure activity, death and neuroinflammation in adult male Swiss mice injected with a lethal dose of TETS (0.15mg/kg, ip). Administration of a high dose of diazepam (5mg/kg, ip) immediately following the second clonic seizure (approximately 20min post-TETS injection) effectively prevented progression to tonic seizures and death. However, this treatment did not prevent persistent reactive astrogliosis and microglial activation, as determined by GFAP and Iba-1 immunoreactivity and microglial cell morphology. Inhibition of soluble epoxide hydrolase (sEH) has been shown to exert potent anti-inflammatory effects and to increase survival in mice intoxicated with other GABAAR antagonists. The sEH inhibitor TUPS (1mg/kg, ip) administered immediately after the second clonic seizure did not protect TETS-intoxicated animals from tonic seizures or death. Combined administration of diazepam (5mg/kg, ip) and TUPS (1mg/kg, ip, starting 1h after diazepam and repeated every 24h) prevented TETS-induced lethality and influenced signs of neuroinflammation in some brain regions. Significantly decreased microglial activation and enhanced reactive astrogliosis were observed in the hippocampus, with no changes in the cortex. Combining an agent that targets specific anti-inflammatory mechanisms with a traditional antiseizure drug may enhance treatment outcome in TETS intoxication.

  9. Seizure disorders and anemia associated with chronic borax intoxication.

    PubMed

    Gordon, A S; Prichard, J S; Freedman, M H

    1973-03-17

    During the course of investigation of two infants with seizure disorders it was discovered that both had been given large amounts of a preparation of borax and honey which resulted in chronic borate intoxication. In one child a profound anemia developed as well. The symptoms of chronic borate intoxication are different from those of the acute poisoning with which we are more familiar. The borax and honey preparations are highly dangerous and should no longer be manufactured or distributed for sale.

  10. Atropine aggravates signs and symptoms of Takotsubo cardiomyopathy.

    PubMed

    Sandhu, Gagangeet; Servetnyk, Zhanna; Croitor, Sherryl; Herzog, Eyal

    2010-02-01

    We present a novel case of Takotsubo cardiomyopathy, associated with worsening chest pain and T-wave inversions on electrocardiogram after atropine use. Our patient was an 82-year-old woman who complained of substernal chest discomfort of 5 hours duration. Atropine 0.5 mg was administered intravenously by the emergency medical service for symptomatic bradycardia. The patient subsequently complained of worsening chest pain and developed new T-wave inversions on the electrocardiogram. Cardiac catheterization was diagnostic and revealed normal coronary arteries but akinesis of the apical segment. Although the pathogenesis of Takotsubo cardiomyopathy is not completely understood, catecholamine-mediated myocardial stunning due to enhanced sympathetic activity is the most widely accepted underlying mechanism. The withdrawal of parasympathetic drive in such cases should exacerbate sympathetic activity, leading to the genesis or worsening of disease activity. The role of atropine in relation to Takotsubo cardiomyopathy has been questioned before. However, it was always in the setting of general anesthesia induction, at which time atropine had been used for reversal of symptomatic bradycardia; consequently, determining the exact role of atropine in the disease process was difficult. Our patient received only atropine and therefore illustrated its capacity to worsen signs and symptoms of Takotsubo Cardiomyopathy. Because patients with Takotsubo cardiomyopathy may present with recurrent chest pain, we would recommend caution against the use of atropine for symptomatic bradycardia in such patients in the emergency department. Transcutaneous pacemaker should be preferred.

  11. Clinical pharmacology of lysergic acid diethylamide: case reports and review of the treatment of intoxication.

    PubMed

    Blaho, K; Merigian, K; Winbery, S; Geraci, S A; Smartt, C

    1997-01-01

    Intoxication and overdose are common presenting complaints to the emergency department. Acute intoxication with lysergic acid diethylamide (LSD) has become a relatively rare event, especially when compared with the incidence of ethanol and cocaine intoxication. We recently had an outbreak of presumed LSD intoxications occurring over one weekend. All patients had attended a performance by the musical group The Grateful Dead. At present, LSD intoxication or overdose can only be suspected based on clinical findings because there are no readily available rapid laboratory tests for detecting either the parent compound or the metabolites of the drug. The clinical findings and outcomes of five patients with suspected LSD intoxication are presented. The pharmacological effects of LSD and treatment modalities of intoxication are reviewed. All patients were treated conservatively based on clinical signs and symptoms. Only one patient required hospital admission for combative behavior that was initially refractory to pharmacological restraint.

  12. Glycopyrrolate compared with atropine in association with ketamine anaesthesia.

    PubMed

    Toft, P; Rømer, U D

    1987-07-01

    Atropine and glycopyrrolate given intravenously before the induction of a ketamine anaesthesia to diminish salivary secretion were compared for their effect on psychotomimetic side-effects, awakening time and heart rate. Though atropine is a tertiary amine that crosses the blood-brain barrier, which glycopyrrolate as a quaternary ammonium compound does not, it did not increase the incidence of psychotomimetic side-effects nor did it significantly prolong the awakening time after ketamine anaesthesia. During intubation the increase in heart rate was significantly higher following atropine than following glycopyrrolate.

  13. Effectiveness of a drinking-motive-tailored emergency-room intervention among adolescents admitted to hospital due to acute alcohol intoxication — A randomized controlled trial

    PubMed Central

    Wurdak, Mara; Wolstein, Jörg; Kuntsche, Emmanuel

    2015-01-01

    The aim of this study is to develop and test the effectiveness of a drinking-motive-tailored intervention for adolescents hospitalized due to alcohol intoxication in eight cities in Germany between December 2011 and May 2012 against a similar, non-motive-tailored intervention. In a randomized controlled trial, 254 adolescents received a psychosocial intervention plus motive-tailored (intervention group; IG) or general exercises (control group; CG). Adolescents in the IG received exercises in accordance with their drinking motives as indicated at baseline (e.g. alternative ways of spending leisure time or dealing with stress). Exercises for the CG contained alcohol-related information in general (e.g. legal issues). The data of 81 adolescents (age: M = 15.6, SD = 1.0; 42.0% female) who participated in both the baseline and the follow-up were compared using ANOVA with repeated measurements and effect sizes (available case analyses). Adolescents reported lower alcohol use at the four-week follow-up independently of the kind of intervention. Significant interaction effects between time and IG were found for girls in terms of drinking frequency (F = 7.770, p < 0.01) and binge drinking (F = 7.0005, p < 0.05) but not for boys. For the former, the proportional reductions and corresponding effect sizes of drinking frequency (d = − 1.18), binge drinking (d = − 1.61) and drunkenness (d = − 2.87) were much higher than the .8 threshold for large effects. Conducting psychosocial interventions in a motive-tailored way appears more effective for girls admitted to hospital due to alcohol intoxication than without motive-tailoring. Further research is required to address the specific needs of boys in such interventions. (German Clinical Trials Register, DRKS ID: DRKS00005588). PMID:26844193

  14. Effects of Heat Acclimation on Atropine Impaired Thermoregulation,

    DTIC Science & Technology

    1983-01-01

    atropine injection (2 mg, im) on eccrine sweating and performancb time in seven healthy male subjects were evaluated during treadmill walking (1.34 ms-) in...The effects of saline or atropine injection (2 mg, ir) on eccrine sweating and performance time in seven healthy male subjects were evaluated during...heat stress; physiological responses 47> 4. 3 The evaporation of eccrine sweat gland secretion provides the major defense against heat storage in a

  15. Atropine-Induced Cutaneous Vasodilation Decreases Body Temperature during Exercise,

    DTIC Science & Technology

    1987-07-01

    during exercise in a cool environment after atropine treatment decreased body temperature and resulted in further suppression of eccrine sweating , thereby...block nsumber) FIEL GRUP SB-GOUP cholinergic blockage, skin blood flow, sweating , temperature regulation, vasodilation * 19. ABSTRACT (Contine on...revese sf neceury and Ilentify by block number) Jil ystemic atropine enhances forearm cutaneous blood flow (FBF) but depresses forearm sweating (Ia5) in

  16. Atropine: A Cure for Persistent Post Laparoscopic Pyloromyotomy Emesis?

    PubMed Central

    Cubas, Robert Frank; Longshore, Shannon; Rodriguez, Samuel; Tagge, Edward; Baerg, Joanne; Moores, Donald

    2017-01-01

    Background: Atropine has been used as a successful primary medical treatment for hypertrophic pyloric stenosis. Several authors have reported a higher rate of incomplete pyloromyotomy with the laparoscopic approach compared to open. In this study, we evaluated the use of atropine as a medical treatment for infants with emesis persisting greater than 48 hours after a laparoscopic pyloromyotomy. Materials and Methods: We performed a retrospective chart review of infants receiving a laparoscopic pyloromyotomy between November 1998 and November 2012. Infants with emesis that persisted beyond 48 hours postoperatively were given 0.01mg/kg of oral atropine 10 minutes prior to feeding. Infants remained inpatient until they tolerated two consecutive feedings without emesis. Results: 965 patients underwent laparoscopic pyloromyotomy; 816 (84.6%) male and 149 (15.4%) female. Twenty-four (2.5%) received oral atropine. The mean length of stay for patients who received atropine was 5.6 ± 2.6 days, an average of 3 additional days. They were discharged home with a one-month supply of oral atropine. Follow up evaluation did not reveal any complications from receiving atropine. The median follow up was 21 days. None returned to the operating room for incomplete pyloromyotomy. There were 17 (1.8%) operative complications in our series; 9 mucosal perforations, 2 duodenal perforations, and 6 conversions to open for equipment failure or poor exposure. There were 4 (0.4%) post-operative complications: 2 episodes of apnea requiring reintubation and 2 incisional hernias that required a second operation. There were no deaths. Conclusion: Oral atropine is a viable treatment for persistent emesis after a pyloromyotomy and reduces the need for a second operation due to incomplete pyloromyotomy. PMID:28083488

  17. Driving While Intoxicated.

    ERIC Educational Resources Information Center

    Brick, John

    Alcohol intoxication increases the risk of highway accidents, the relative risk of crash probability increasing as a function of blood alcohol content (BAC). Because alcohol use is more prevalent than use of other drugs, more is known about the relationship between alcohol use and driving. Most states presume a BAC of .10% to be evidence of drunk…

  18. Chronic manganese intoxication

    SciTech Connect

    Huang, C.C.; Chu, N.S.; Lu, C.S.; Wang, J.D.; Tsai, J.L.; Tzeng, J.L.; Wolters, E.C.; Calne, D.B. )

    1989-10-01

    We report six cases of chronic manganese intoxication in workers at a ferromanganese factory in Taiwan. Diagnosis was confirmed by assessing increased manganese concentrations in the blood, scalp, and pubic hair. In addition, increased manganese levels in the environmental air were established. The patients showed a bradykinetic-rigid syndrome indistinguishable from Parkinson's disease that responded to treatment with levodopa.

  19. Intravenous atropine treatment in infantile hypertrophic pyloric stenosis

    PubMed Central

    Kawahara, H; Imura, K; Nishikawa, M; Yagi, M; Kubota, A

    2002-01-01

    Aims: To assess the efficacy of a new regimen of intravenous atropine treatment for infantile hypertrophic pyloric stenosis (IHPS) with special reference to regression of pyloric hypertrophy. Methods: Atropine was given intravenously at a dose of 0.01 mg/kg six times a day before feeding in 19 patients with IHPS diagnosed from radiographic and ultrasonographic findings. When vomiting ceased and the infants were able to ingest 150 ml/kg/day formula after stepwise increases in feeding volume, they were given 0.02 mg/kg atropine six times a day orally and the dose was decreased stepwise. Results: Of the 19 infants, 17 (89%) ceased projectile vomiting after treatment with intravenous (median seven days) and subsequent oral (median 44 days) atropine administration. The remaining two infants required surgery. No significant complications were encountered. Ultrasonography showed a significant (p < 0.05) decrease in pyloric muscle thickness, but no significant shortening of the pyloric canal after completion of the atropine treatment. The patients exhibited failure to thrive at presentation, but were thriving at 6 months of age (p < 0.01). Conclusions: This atropine therapy resulted in satisfactory clinical recovery. Pyloric muscle thickness was significantly reduced. PMID:12089130

  20. A case of acute intoxication due to combined use of fentanyl and 3,4-dichloro-N-[2-(dimethylamino)cyclohexyl]-N-methylbenzamide (U-47700).

    PubMed

    Coopman, Vera; Blanckaert, Peter; Van Parys, Geert; Van Calenbergh, Serge; Cordonnier, Jan

    2016-09-01

    A 30-year old man was found dead in his home after inhaling fumes of a powder burned on aluminum foil. Blood and urine were taken by the medical examiner during the external body examination and submitted to the laboratory for a comprehensive systematic toxicological analysis. A toxic fentanyl level of 10.9μg/L was measured in the subclavian blood. Police investigation revealed that the man searched the internet for information on new psychotropic substances, among others including U-47700. A powder found in the victims' home was transferred to the laboratory for analysis, in which trace amounts of fentanyl (0.0035%, m/m) and U-47700 (0.0012%, m/m) were identified by gas chromatography mass spectrometry. U-47700 is an opioid analgesic drug, considered to have a potency of approximately 7.5 times that of morphine. A target analysis on U-47700 was performed using liquid-liquid extraction and ultra performance liquid chromatography tandem mass spectrometry operating in multiple reaction monitoring mode. The method validation was based on the Scientific Working Group of Forensic Toxicology document 'Standard Practices of Method Validation in Forensic Toxicology'. In blood and urine the U-47700 concentration was 13.8 and 71.0μg/L, respectively. To the author's knowledge, this is the first case report of a fatal intoxication involving U-47700 abused as a new psychotropic substance.

  1. Effect of atropine on denervated rabbit ear blood vessels.

    PubMed

    Liu, Shu-Qin; Zang, Wei-Jin; Li, Zeng-Li; Yu, Xiao-Jiang; Li, Bao-Ping

    2004-01-01

    Surgical denervation of rabbit ear blood vessel beds was combined with the isolated perfused rabbit ear technique to investigate the mechanism of atropine's vasodilator action. Intramuscular injection of atropine 0.2 mg/kg dilated the denervated blood vessels in the rabbit ear like innervated ones in vivo. Atropine at the maximal concentration (Cmax) of 3 x 10(-6) to 3 x 10(-4) M did not increase effluent flow of the isolated perfused denervated rabbit ear under constant perfusion pressure, but chlorpromazine at a Cmax of 10(-6) M and acetylcholine (ACh) at 2.5 x 10(-7) M significantly increased it and noradrenaline (NA) at 10(-7) M significantly decreased it. Atropine at Cmax of 3 x 10(-7) M did not affect, but at 3 x 10(-6) M it abolished the increase of the effluent flow induced by ACh 2.5 x 10(-7) M. Atropine at 3 x 10(-7) M did not affect it, but at 10(-6), 3 x 10(-6), and 10(-5) it significantly alleviated the decrease of effluent flow induced by NA 10(-7) M. Because the increase of effluent flow of rabbit ear under constant perfusion pressure reflects vasodilation of the ear to some extent, the study suggests that atropine has no direct vasodilator action; its vasodilator action is not attributed to blockade of M-cholinoreceptors located on the vascular wall; however, the alpha1-adrenoceptor might be a target site mediating atropine's vasodilator action in vivo.

  2. [Thin layer chromatography and infrared spectroscopy in the diagnosis of salicylic intoxication].

    PubMed

    Rodríguez-Tito, José Carlos; Clapé-Laffita, Oneyda; Marín-Sánchez, Dayana; Pérez-Garrido, Neyda; Bonne-Hernández, Raúl

    2010-01-01

    Drugs are the main causal agents in intoxications with suicidal purpose. Salicylates are few frequently related. In this paper we reported a patient with suspicion of acute exogenous intoxication with salicylates. The patient showed clinical symptoms of fever, hypoglycemia, low cardiac rhythm, hyperventilation, pulmonary edema and coma. We employed analytical toxicology to elucidate the drug involved in the intoxication, using thin layer chromatography (TLC) and infrared spectrometry to detect acetyl salicylic acid, as the cause agent of intoxication clinical pattern, in acids extracts from urine and gastric content. The analytical results corresponds with clinical symptoms showed by the patient and the information obtained by medical monitoring of him.

  3. [Intoxication of botulinum toxin].

    PubMed

    Chudzicka, Aleksandra

    2015-09-01

    Botulinum toxin is an egzotoxin produced by Gram positive bacteria Clostridium botulinum. It is among the most potent toxins known. The 3 main clinical presentations of botulism are as follows: foodborne botulism, infant botulism and wound botulism. The main symptom of intoxication is flat muscles paralysis. The treatment is supportive care and administration of antitoxin. In prevention the correct preparing of canned food is most important. Botulinum toxin is accepted as a biological weapon.

  4. Overnight orthokeratology is comparable with atropine in controlling myopia

    PubMed Central

    2014-01-01

    Background Many efforts have been invested in slowing progression of myopia. Among the methods, atropine administration and orthokeratology (OK) are most widely used. This study analyzed the efficacy of atropine and OK lens in controlling myopia progression and elongation of axial length. Methods This retrospective study included 105 patients (210 eyes) who wore OK lenses and 105 patients (210 eyes) who applied 0.125% atropine every night during the 3 following period. Student t-test, linear regression analysis, repeated measure ANOVA, and Pearson’s correlation coefficient were used for statistical analysis. Results The change in axial length per year was 0.28 ± 0.08 mm, 0.30 ± 0.09 mm, and 0.27 ± 0.10 mm in the OK lens group, and 0.38 ± 0.09 mm, 0.37 ± 0.12 mm, and 0.36 ± 0.08 mm in the atropine group for years 1, 2, and 3, respectively. Linear regression analysis revealed an increase in myopia of 0.28 D and 0.34 D per year, and an increase in axial length of 0.28 mm and 0.37 mm per year in the OK lens and atropine groups, respectively. Repeated measure ANOVA showed significant differences in myopia (p = 0.001) and axial length (p < 0.001) between the atropine and OK lens groups; in astigmatism, there was no significant difference in these parameters (p = 0.320). Comparison of increases in axial length in relation to baseline myopia showed significant correlations both in the OK lens group (Pearson’s correlation coefficient, r = 0.259; p < 0.001) and atropine group (r = 0.169; p = 0.014). High myopia patients benefited more from both OK lenses and atropine than did low myopia patients. The correlation of baseline myopia and myopia progression was stronger in the OK lens group then in the atropine group. Conclusions OK lens is a useful method for controlling myopia progression even in high myopia patients. PMID:24685184

  5. Atropine penalisation versus occlusion as the primary treatment for amblyopia

    PubMed Central

    Foley-Nolan, A.; McCann, A.; O'Keefe, M.

    1997-01-01

    AIMS/BACKGROUND—Pharmacological penalisation of non-amblyopic eyes is an infrequently used alternative to occlusion for treating amblyopia. The authors compared the efficacy of atropine penalisation and that of occlusion as a primary treatment for amblyopia.
METHODS—Thirty six newly diagnosed patients with amblyopia were allocated to two groups for treatment. Eighteen patients in each group were treated either with atropine penalisation (group A) or occlusion therapy (group P).
RESULTS—There was a statistically significant improvement in visual acuity in both groups treated. In group A improvement of the geometric mean visual acuity of the amblyopic eye was from 6/50 to 6/11 (p<0.001). In group P improvement of the geometric mean visual acuity was from 6/60 to 6/19 (p<0.001). In group A non-compliance with treatment was only 6% (2/18). Non-compliance in group P was 45% (8/18) at some stages of the treatment. Neither group produced an incidence of occlusion amblyopia.
CONCLUSIONS—In this study atropine penalisation has been shown to be as effective as occlusion therapy in the treatment of amblyopia. Patient acceptance of atropine penalisation was superior to that for occlusion therapy as was shown by the compliance rate. Atropine treatment was also advantageous in that compliance could be readily checked by inspection.

 PMID:9135409

  6. Physostigmine (alone and together with adjunct) pretreatment against soman, sarin, tabun and vx intoxication. (Reannouncement with new availability information)

    SciTech Connect

    Harris, L.W.; Talbot, B.G.; Lennox, W.J.; Anderson, D.R.; Solana, R.P.

    1991-12-31

    A pretreatment for organophosphorus (OP) anticholinesterase (e. g. , soman) intoxication should prevent lethality and convulsions (CNV) at 2 LD50s and be behavioral-decrement-free when given alone. Behavioral-deficit-free pretreatment regimens (PRGs) for guinea pigs consisted of Physostigmine (0.15 mg/kg, im) and adjunct. Adjuncts MG/KG, IM tested were akineton 0.25, aprophen 8, trihexyphenidyl 2, atropine 16, azaprophen 51, BENACTYZINE 1.25, cogentin 4, dextromethorphan 7.5, ethopropazine 12, kemadrin 11, MEMANTINE 5, promethazine 5, scopolamine 0.081 AND CONTROL 2. PRGs were given 30 min before soman (60 ug/kg, sc; 2 LD50S) or other OP agents. Animals were then observed and graded for signs of intoxication, including CNV at 7 time points and at 24 hr. Physostigmine alone reduced the incidence of CNV and lethality induced by 2 LD50s of soman by 42 and 60%, respectively. All of the PRGs tested abolished lethality and 12 shortened recovery time to 2 hr or less. Also, PRGs including azaprophen or atropine prevented CNV. When selected PRGs were tested against intoxication by sarin, tabun or VX, the efficacy was generally superior to that for soman. The data show that several PRGs are effective against soman intoxication in guinea pigs. Pretreatment, physostigmine, anticholinesterases, soman (GD).

  7. [Intoxications with plants].

    PubMed

    Kupper, Jacqueline; Reichert, Cornelia

    2009-05-01

    Ingestions of plants rarely lead to life-threatening intoxications. Highly toxic plants, which can cause death, are monkshood (Aconitum sp.), yew (Taxus sp.) and autumn crocus (Colchicum autumnale). Lethal ingestions of monkshood and yew are usually suicides, intoxications with autumn crocus are mostly accidental ingestions of the leaves mistaken for wild garlic (Allium ursinum). Severe intoxications can occur with plants of the nightshade family like deadly nightshade (Atropa belladonna), angel's trumpet (Datura suaveolens) or jimsonweed (Datura stramonium). These plants are ingested for their psychoactive effects. Ingestion of plant material by children most often only causes minor symptoms or no symptoms at all, as children usually do not eat great quantities of the plants. They are especially attracted by the colorful berries. There are plants with mostly cardiovascular effects like monkshood, yew and Digitalis sp. Some of the most dangerous plants belong to this group. Plants of the nightshade family cause an anticholinergic syndrome. With golden chain (Laburnum anagyroides), castor bean (Ricinus communis) and raw beans (Phaseolus vulgaris) we see severe gastrointestinal effects. Autumn crocus contains a cell toxin, colchicine, which leads to multiorgan failure. Different plants are irritative or even caustic to the skin. Treatment is usually symptomatic. Activated charcoal is administered within one hour after ingestion (1 g/kg). Endoscopic removal of plant material can be considered with ingestions of great quantities of highly toxic plants. Administration of repeated doses of charcoal (1-2 g/h every 2-4 hours) may be effective in case of oleander poisoning. There exist only two antidotes: Anti-digoxin Fab fragments can be used with cardenolide glycoside-containing plants (Digitalis sp., Oleander). Physostigmine is the antidote for severe anticholinergic symptoms of the CNS. Antibodies against colchicine, having been developed in France, are not available at

  8. Datura stramonium intoxication in two children.

    PubMed

    Rakotomavo, Falihery; Andriamasy, Caroline; Rasamoelina, Ndrantoniaina; Raveloson, Nasolotsiry

    2014-06-01

    Datura stramonium is a toxic plant member of the Solanaceae family. Its consumption may result in severe anticholinergic toxicity. We report the intoxication of 5- and 4-year-old brothers with Datura stramonium, which presented in two different manners. The first child presented agitation, hallucination and mydriasis that improved rapidly with benzodiazepine medication. The second presented comatose, mydriasis and Babinski signs. Gastric lavage and activated charcoal administration were performed. The child was intubated and mechanically ventilated until consciousness improvement. Datura stramonium poisoning may be considered by physicians in case of acute onset of decreased consciousness or behaviour trouble associated with anticholinergic signs and symptoms.

  9. [Issues regarding alcoholic intoxication and driving].

    PubMed

    Lanzetta, B M

    2006-01-01

    After recalling the risks deriving from alcohol abuse at work, the paper discusses the complex problems (medical, social, juridical) related to drinking and driving. Acute intoxication may be adequately identified (also in the medico-legal setting) through direct or indirect measurement of blood ethanol concentration, whereas the diagnosis of alcohol abuse and binge drinking (useful to assess fitness to work and/or driving) is complicated by the scarce efficiency of the currently available biomarkers. Alcohol abuse control and prevention among Italian Police Forces are ruled by the Ministerial Decree 30 June 2003, n. 198.

  10. [Suicidal buflomedil intoxication].

    PubMed

    Babel, Bernward; Tatschner, Thomas; Patzelt, Dieter

    2004-01-01

    A suicidal intoxication of a young woman following an overdose of buflomedil is reported. She died in a hospital 17 hours after ingestion. In various body fluids the following buflomedil concentrations were determined: heart blood 24.5 microg/ml, liquor 21.3 microg/ml, bile 39.1 mg/ml and urine 138.6 mg/ml. Additionally the results of autopsy and histology are presented. Anemia of the internal organs was conspicuous; this finding is attributed to the vasodilating effect of buflomedil on the peripheral vessels.

  11. Unpacking intoxication, racialising disability.

    PubMed

    Chen, Mel Y

    2015-06-01

    This article examines concepts whose strictly medical applications have only partly informed their widespread use and suggests that demonstrably shared logics motivate our thinking across domains in the interest of a politically just engagement. It considers exchanges between the culturally complex concepts of 'toxicity' and 'intoxication', assessing the racialised conditions of their animation in several geopolitically--and quite radically--distinct scenarios. First, the article sets the framework through considering the racial implications of impairment and disability language of 'non-toxic' finance capital in the contemporary US financial crisis. Shifting material foci from 'illiquid financial bodies' to opiates while insisting that neither is 'more' metaphorically toxic than the other, the article turns to address the role of opium and temporality in the interanimations of race and disability in two sites of 19th-century British empire: Langdon Down's clinic for idiocy, and China's retort on opium to Queen Victoria. The article concludes with a provocation that suggests yet another crossing of borders, that between researcher and researched: 'intoxicated method' is a hypothetical mode of approach that refuses idealised research positions by 'critically disabling' the idealised cognitive and conceptual lens of analysis.

  12. Behavioral Effects of Atropine and Benactyzine: Man-Monkey Comparisons.

    DTIC Science & Technology

    1981-05-01

    Dose - response curves for atropine- or benactyzine-induced performance decrements were estimated for both humans and monkeys. Monkeys were more...tolerant than humans to both drugs, and their dose - response curves were not as steep. Thus, no simple correction coefficient would allow extrapolation of

  13. Exercise After Atropine and Pralidoxime Increases the Rational Effective Temperature,

    DTIC Science & Technology

    1986-07-01

    antidotal treatment, used in organophosphate poisioning , affected the ET* of men exercising in a moderate environment. Although atropine treatment a...that vasodilation can d" occur via a prostaglandin-mediated mechanism (13), lead us to postulate that the cutaneous vasodilation observed in this study

  14. Seizure disorders and anemia associated with chronic borax intoxication

    PubMed Central

    Gordon, A. S.; Prichard, J. S.; Freedman, M. H.

    1973-01-01

    During the course of investigation of two infants with seizure disorders it was discovered that both had been given large amounts of a preparation of borax and honey which resulted in chronic borate intoxication. In one child a profound anemia developed as well. The symptoms of chronic borate intoxication are different from those of the acute poisoning with which we are more familiar. The borax and honey preparations are highly dangerous and should no longer be manufactured or distributed for sale. ImagesFIG. 1FIG. 2 PMID:4691106

  15. Effect of Atropine on the Exercise-Heat Performance of Man,

    DTIC Science & Technology

    1983-07-01

    acting on the eccrine sweat gland which results in a Suppression of sweating *. Atropine exerts this ’pharacological effect by competing with Ach for...Identify by block number) atropine; core temperature; dose response; exercise performance; heat acclimation; heart rate; sweat rate; thermal regulation...atropine by enabling a reduced rectal temperature; and (6) heat acclimation increases the sweat output of individuals under the influence of atropine

  16. Immediate and Long-Term Outcome of Acute H2S Intoxication Induced Coma in Unanesthetized Rats: Effects of Methylene Blue

    PubMed Central

    Sonobe, Takashi; Chenuel, Bruno; Cooper, Timothy K.; Haouzi, Philippe

    2015-01-01

    Background Acute hydrogen sulfide (H2S) poisoning produces a coma, the outcome of which ranges from full recovery to severe neurological deficits. The aim of our study was to 1- describe the immediate and long-term neurological effects following H2S-induced coma in un-anesthetized rats, and 2- determine the potential benefit of methylene blue (MB), a compound we previously found to counteract acute sulfide cardiac toxicity. Methods NaHS was administered IP in un-sedated rats to produce a coma (n = 34). One minute into coma, the rats received MB (4 mg/kg IV) or saline. The surviving rats were followed clinically and assigned to Morris water maze (MWM) and open field testing then sacrificed at day 7. Results Sixty percent of the non-treated comatose rats died by pulseless electrical activity. Nine percent recovered with neurological deficits requiring euthanasia, their brain examination revealed major neuronal necrosis of the superficial and middle layers of the cerebral cortex and the posterior thalamus, with variable necrosis of the caudate putamen, but no lesions of the hippocampus or the cerebellum, in contrast to the typical distribution of post-ischemic lesions. The remaining animals displayed, on average, a significantly less effective search strategy than the control rats (n = 21) during MWM testing. Meanwhile, 75% of rats that received MB survived and could perform the MWM test (P<0.05 vs non-treated animals). The treated animals displayed a significantly higher occurrence of spatial search than the non-treated animals. However, a similar proportion of cortical necrosis was observed in both groups, with a milder clinical presentation following MB. Conclusion In conclusion, in rats surviving H2S induced coma, spatial search patterns were used less frequently than in control animals. A small percentage of rats presented necrotic neuronal lesions, which distribution differed from post-ischemic lesions. MB dramatically improved the immediate survival and spatial

  17. The Role of Atropine Eye Drops in Myopia Control.

    PubMed

    Grzybowski, Andrzej; Armesto, Alejandro; Szwajkowska, Maria; Iribarren, Guillermo; Iribarren, Rafael

    2015-01-01

    High myopia is a major cause of uncorrectable visual impairment. It imposes major challenges and costs for refractive correction, and for the treatment of associated pathological complications. In the last 60 years, there has been a marked increase in the prevalence of high myopia in younger generations in developed countries in East and Southeast Asia, and there are signs of similar, but less pronounced increases in North America and Europe. In some parts of the world, 70-90% of children completing high schools are now myopic, and as many as 20% may be highly myopic. It is now clear that myopia results from excessive axial elongation of the eye, and this greater rate of axial elongation appears to be environmentally driven. Experimental studies have examined the biochemical mechanisms involved in regulation of axial elongation; and, from these studies, some options have emerged for preventing the development of myopia or slowing myopia progression. Atropine eye drops have been quite extensively used in clinical practice in Asian countries. This long-lasting treatment could be beneficial, but has clear limitations and complications. Recent reports suggest that a low concentration of atropine, which has less severe side-effects, is also effective. But, a decision to use an invasive treatment such as atropine drops, even at low doses, requires careful consideration of the risk of myopia progression. A decision to use atropine in pre-myopic patients would require even more careful consideration of the risks. Here, we review the current literature relevant to the prevention of myopia progression with atropine drops.

  18. The neurological effects of methyl bromide intoxication.

    PubMed

    de Souza, Aaron; Narvencar, Kedareshwar P S; Sindhoora, K V

    2013-12-15

    Used primarily as a fumigant or as a substrate in chemical processes, methyl bromide is a highly toxic gas. The gas is usually absorbed by inhalation and effects on the lungs, gastrointestinal tract, skin, and brain are seen. Numerous instances of acute and chronic neurologic injury have been reported: acute poisoning results in seizures, myoclonus, ataxia or cerebral oedema beginning as early as 30 min after exposure while subacute or chronic intoxication presents with diverse slowly progressive neurological and neurobehavioral symptoms. Serum bromide levels may be elevated, but often return rapidly to normal. Electroencephalography may show frontally-predominant slow waves or polyspikes with following slow wave, and MRI reveals characteristic involvement in the dentate nucleus of the cerebellum, the brainstem, and the splenium of the corpus callosum. Symmetric and selective lesions in characteristic sites are observed on imaging and on histopathological examination. These are likely produced by methylation of intracellular lipids, protein and glutathione; production of toxic metabolites; defective neurotransmitter function; and abnormal oxidative phosphorylation. This article reviews the toxic effects of this gas, the pathophysiology and symptoms of its effects on the nervous system, and characteristic findings on MRI; and presents an illustrative case of methyl bromide intoxication due to exposure at a factory producing the compound commercially.

  19. Carbon monoxide intoxication

    SciTech Connect

    Kales, S.N. )

    1993-11-01

    Carbon monoxide poisoning usually results from inhalation of exhaust fumes from motor vehicles, smoke from fires or fumes from faulty heating systems. Carbon monoxide has a high affinity for hemoglobin, with which it forms carboxyhemoglobin. The resulting decrease in both oxygen-carrying capacity and oxygen release can lead to end-organ hypoxia. The clinical presentation is nonspecific. Headache, dizziness, fatigue and nausea are common in mild to moderate carbon monoxide poisoning. In more severe cases, tachycardia, tachypnea and central nervous system depression occur. When carbon monoxide intoxication is suspected, empiric treatment with 100 percent oxygen should be initiated immediately. The diagnosis is confirmed by documenting an elevated carboxyhemoglobin level. Hyperbaric oxygen therapy is recommended in patients with neurologic dysfunction, cardiac dysfunction or a history of unconsciousness. 26 refs.

  20. Chelation in Metal Intoxication

    PubMed Central

    Flora, Swaran J.S.; Pachauri, Vidhu

    2010-01-01

    Chelation therapy is the preferred medical treatment for reducing the toxic effects of metals. Chelating agents are capable of binding to toxic metal ions to form complex structures which are easily excreted from the body removing them from intracellular or extracellular spaces. 2,3-Dimercaprol has long been the mainstay of chelation therapy for lead or arsenic poisoning, however its serious side effects have led researchers to develop less toxic analogues. Hydrophilic chelators like meso-2,3-dimercaptosuccinic acid effectively promote renal metal excretion, but their ability to access intracellular metals is weak. Newer strategies to address these drawbacks like combination therapy (use of structurally different chelating agents) or co-administration of antioxidants have been reported recently. In this review we provide an update of the existing chelating agents and the various strategies available for the treatment of heavy metals and metalloid intoxications. PMID:20717537

  1. Multiple organ dysfunction syndrome, an unusual complication of heroin intoxication: a case report and review of literature.

    PubMed

    Feng, Gang; Luo, Qiancheng; Guo, Enwei; Yao, Yulan; Yang, Feng; Zhang, Bingyu; Li, Longxuan

    2015-01-01

    Multiple organ dysfunction syndrome (MODS) has rarely been described in patients with heroin intoxication. Here, we report a rare case of MODS involving six organs, due to heroin intoxication. The patient was a 32-year-old Chinese man with severe heroin intoxication complicated by acute pulmonary edema and respiratory insufficiency, shock, myocardial damage and cardiac insufficiency, rhabdomyolysis and acute renal insufficiency, acute liver injury and hepatic insufficiency, toxic leukoencephalopathy, and hypoglycemia. He managed to survive and was discharged after 10 weeks of intensive care. The possible pathogenesis and therapeutic measures of MODS induced by heroin intoxication and some suggestions for preventing and treating severe complications of heroin intoxication, based on clinical evidence and the pertinent literature, are discussed in this report.

  2. Hyponatraemia associated rhabdomyolysis following water intoxication

    PubMed Central

    Katsarou, Alexia; Singh, Suveer

    2010-01-01

    A young man with bipolar disorder was admitted in a coma. Cerebral oedema secondary to severe hyponatraemia was implicated. This was due to self-induced water intoxication. He developed rhabdomyolysis, a massive creatine kinase (out of proportion to longstanding antipsychotic medication) and acute renal failure. In the intensive care unit, hyponatraemia was corrected, and following appropriate fluid resuscitation, with forced alkaline diuresis, the rhabdomyolysis and renal function normalised, averting renal support. While a full recovery ensued, the persisting risk factors for hyponatraemia, that is polydipsia, and its association with rhabdomyolysis, increased the chances of a recurrence. Closely supervised regulation of his water intake, and monitoring of antipsychotic efficacy (for biochemical homeostatsis) are essential for secondary prevention. Rhabdomyolysis is a rare complication of hyponatraemia. When associated with psychogenic polydipsia, the acute and chronic management are challenging. Vaptans, which are aquaretics, that preferentially prevent renal tubular water reabsorption, may be beneficial in this situation. PMID:22778200

  3. Hyponatraemia associated rhabdomyolysis following water intoxication.

    PubMed

    Katsarou, Alexia; Singh, Suveer

    2010-09-09

    A young man with bipolar disorder was admitted in a coma. Cerebral oedema secondary to severe hyponatraemia was implicated. This was due to self-induced water intoxication. He developed rhabdomyolysis, a massive creatine kinase (out of proportion to longstanding antipsychotic medication) and acute renal failure. In the intensive care unit, hyponatraemia was corrected, and following appropriate fluid resuscitation, with forced alkaline diuresis, the rhabdomyolysis and renal function normalised, averting renal support. While a full recovery ensued, the persisting risk factors for hyponatraemia, that is polydipsia, and its association with rhabdomyolysis, increased the chances of a recurrence. Closely supervised regulation of his water intake, and monitoring of antipsychotic efficacy (for biochemical homeostatsis) are essential for secondary prevention. Rhabdomyolysis is a rare complication of hyponatraemia. When associated with psychogenic polydipsia, the acute and chronic management are challenging. Vaptans, which are aquaretics, that preferentially prevent renal tubular water reabsorption, may be beneficial in this situation.

  4. Can anisodamine be a potential substitute for high-dose atropine in cases of organophosphate poisoning?

    PubMed

    Wang, W; Chen, Q-F; Ruan, H-L; Chen, K; Chen, B; Wen, J-M

    2014-11-01

    A case of organophosphate (OP) poisoning was admitted to the emergency room. The patient accepted treatment with pralidoxime (PAM), atropine, and supporting therapy. It was observed that even after 22 h after treatment, 960 mg of atropine was not enough for the patient to be atropinized. However, a 160-mg follow-up treatment of anisodamine was quite enough for atropinization after 4 h. As a case report, more studies are required before any definite conclusion can be reached regarding the use of anisodamine as a potential substitute for high-dose atropine in cases of OP poisoning.

  5. Human Thermoregulation After Atropine and/or Pralidoxime Administration

    DTIC Science & Technology

    1987-06-01

    regulation and performance eccrine sweat glands. Am. J. Physiol. 1981; 240:R44-R51. during prolonged exercise. Eur. J. Appl. Physiol. 1978; 38:225 15...atropine flush" accompanies these inhibitory effects on the sweat and/or pralidoxime administration. Aviat. Space Environ. Med. gland (4), but whether the...been was meoasureI hIwIce each minute by venous occlusion pieth- undertaken. ysmogrophy.->Wholo body sweating was calculated from weight Pralidoxime

  6. Heat Exchange Following Atropine Injection Before and AFter Heat Acclimation,

    DTIC Science & Technology

    1983-08-01

    poisoning and in chronic disorders such as peptic ulcer or Parkinsonism (9). The competition by atropine for similar receptor sites on the eccrine sweat ...block number) C. antimuscarinic drugs; exercise; heat acclimatization; mean body temperature; rational effective temperature; sweating rate L&J -J 20...20.5*C). Partitional calorimetric analysis was done for the periods in which maximum sweat inhibition occurred (30 min). Mean skin temperature (Tsk

  7. Neurological manifestation of methyl bromide intoxication.

    PubMed

    Suwanlaong, Kanokrat; Phanthumchinda, Kammant

    2008-03-01

    Methyl bromide is a highly toxic gas with poor olfactory warning properties. It is widely used as insecticidal fumigant for dry foodstuffs and can be toxic to central and peripheral nervous systems. Most neurological manifestations of methyl bromide intoxication occur from inhalation. Acute toxicity characterized by headache, dizziness, abdominal pain, nausea, vomiting and visual disturbances. Tremor, convulsion, unconsciousness and permanent brain damage may occur in severe poisoning. Chronic exposure can cause neuropathy, pyramidal and cerebellar dysfunction, as well as neuropsychiatric disturbances. The first case of methyl bromide intoxication in Thailand has been described. The patient was a 24-year-old man who worked in a warehouse of imported vegetables fumigated with methyl bromide. He presented with unstable gait, vertigo and paresthesia of both feet, for two weeks. He had a history of chronic exposure to methyl bromide for three years. His fourteen co-workers also developed the same symptoms but less in severity. Neurological examination revealed ataxic gait, decreased pain and vibratory sense on both feet, impaired cerebellar signs and hyperactive reflex in all extremities. The serum concentration of methyl bromide was 8.18 mg/dl. Electrophysilogical study was normal. Magnetic resonance imaging of the brain (MRI) revealed bilateral symmetrical lesion of abnormal hypersignal intensity on T2 and fluid-attenuation inversion recovery (FLAIR) sequences at bilateral dentate nuclei of cerebellum and periventricular area of the fourth ventricle. This incident stresses the need for improvement of worker education and safety precautions during all stages of methyl bromide fumigation.

  8. Successful Pancreas Transplantation From a Deceased Donor Intoxicated With Oral Antidiabetic Agent: A Case Report.

    PubMed

    Rodríguez-Villar, C; Conget, I; Ferrer-Fàbrega, J; Paredes, D; Ruíz, A; Roque, R; Rull, R; López-Boado, M; Ricart, M J; Garcia, R; Adalia, R

    2015-10-01

    Simultaneous kidney pancreas transplantation (SKP) is a common procedure for the patient with long-term type 1 diabetes mellitus (DM) with terminal renal failure. It is unusual to consider the pancreas from a deceased donor who died after an acute intoxication with oral antidiabetic agent (OAA), which would suggest an abnormal functionality of the organ and preclude the potential use of the graft. We present a case of a successful pancreatic transplantation from a donor who died of acute cerebral edema secondary to severe hypoglycemia induced by OAA acute intoxication.

  9. MR changes after acute cyanide intoxication.

    PubMed

    Rachinger, Johanna; Fellner, Franz A; Stieglbauer, Karl; Trenkler, Johannes

    2002-09-01

    We describe MR changes that occurred 3 and 6 weeks after a suicide attempt with cyanide. The toxicity of cyanide causes damage, primarily to the basal ganglia, and those changes were visible as altered signal intensity on the first MR images. Extensive areas of hemorrhagic necrosis were seen 6 weeks later. Our case shows pseudolaminar necrosis along the central cerebral cortex 3 weeks after cyanide poisoning, showing that the sensorimotor cortex is also a site for toxic necrosis because of its high oxygen dependency.

  10. Marine trauma, envenomations, and intoxications.

    PubMed

    Brown, C K; Shepherd, S M

    1992-05-01

    When humans encounter marine creatures a variety of maladies may occur, ranging from dermatitis to life-threatening trauma, allergy, envenomations, or intoxications. The emergency physician should be prepared to recognize quickly and address appropriately the potential life threats, which are primarily neurologic, respiratory, and cardiovascular. A high degree of suspicion for these illnesses is needed. Intoxications may be especially confusing. Although most of the syndromes are self-limited and treatment supportive, time is of the essence if neuromuscular paralysis, hypotension, or respiratory compromise is present. Much folklore exists regarding detection and prevention of these entities and should be regarded as such. The last several decades have seen a marked increase in our knowledge base regarding these fascinating envenomations and intoxications. Research in the next several decades probably will produce a variety of diagnostic and therapeutic tools, which will further our understanding of, and ability to specifically manage, these syndromes.

  11. Water intoxication in adult cattle.

    PubMed

    Kawahara, Naoya; Ofuji, Sosuke; Abe, Sakae; Tanaka, Ai; Uematsu, Masami; Ogata, Yoshimi

    2016-05-01

    Water intoxication is a common disorder in calves and is usually characterized by transient hemoglobinuria. In contrast, the condition is very rare in adult cattle, with few reports on naturally occurring cases. In the present report, four female Japanese Black cattle, aged 16-25 months, showed neurological signs when they drank water following a water outage. Hemoglobinuria was not grossly observed, while severe hyponatremia was revealed by laboratory tests. Autopsy indicated cerebral edema with accumulation of serous fluid in expanded Virchow-Robin spaces. These results indicate the possibility of water intoxication associated with cerebral edema due to severe dilutional hyponatremia in adult cattle.

  12. Cutaneous Blood Flow and Local Sweating After Systemic Atropine Administration,

    DTIC Science & Technology

    1986-12-01

    r .. .’, ,- ...- .... . -. .o. -. .... . .. . . . . . .- ; .- ’V,.4 $ L ’.,f - .-. .- - . ," ,;" .’""°""- .- """ . " .- ’:-’ * p , .t .j S% S...plethysmography. Injection of atropine (2 mg) caused an increased sensitivity (+85%, p <O.Ol) in FBF to Tes with no change in the vasodilator threshold. An...elevated Tes onset (0.3°C, p <O.05) for sweating occurred with no change in the sensitivity of ms to Tes (-27%, p < 0.20). No elevation in either fore arm

  13. A case of Wernicke encephalopathy combined with disulfiram intoxication.

    PubMed

    Tartara, Elena; Fanucchi, Simona; D'Errico, Ignazio; Farina, Lisa M; Casoni, Francesca; Sinforiani, Elena; Micieli, Giuseppe; Costa, Alfredo

    2013-06-01

    There have been several reports of disulfiram intoxication, but little evidence of neurologic conditions resulting from disulfiram-induced brain damage combined with Wernicke encephalopathy-associated lesions. We report a rare patient with both Wernicke encephalopathy and disulfiram intoxication. This 50-year-old woman, who was taking disulfiram for chronic alcohol abuse, presented with an acute confusional state, dysarthria, nystagmus, supranuclear ophthalmoplegia, and paraparesis. Biochemical serum and cerebrospinal fluid analyses were normal. An electromyogram detected a motor polyneuropathy. Cognitive assessment revealed severe impairment of memory, attention, and logical and executive abilities. Magnetic resonance imaging with gadolinium enhancement showed brain lesions consistent with Wernicke encephalopathy, but also symmetric hyperintensities on T2-weighted images in the globus pallidus. Stopping the disulfiram and treating with hydration, high-dose thiamine supplements, and benzodiazepines significantly improved the patient's consciousness and oculomotor function. A magnetic resonance imaging scan after 1 month of treatment showed complete disappearance of the brain lesions and the hyperintensities in the globus pallidus. After a further month of intensive neurorehabilitation, the patient was able to interact with the medical staff, and her neuropsychological tests showed only mild memory impairment. Patients with alcoholism who present at emergency departments are at high risk for misdiagnosis, especially because there is no specific routine laboratory test for detecting asymptomatic disulfiram intoxication. Although uncommon, the combination of Wernicke encephalopathy and disulfiram intoxication should be suspected in patients with alcoholism. The disorder can be detected through a careful history and prompt clinical evaluation, together with characteristic magnetic resonance imaging findings.

  14. Acute neurotoxicity after trichloroethylene ingestion. Case report.

    PubMed

    Perticoni, G F; Bondi, L

    1988-04-01

    Trichloroethylene (TCE), a solvent widely used in the chemical industry, in dry cleaning because of its degreasing action and as a household grease remover, is known to have a toxic action, especially on the nervous system. Cases of intoxication, acute and chronic, due to inhalation, are reported. We report a case, certainly an unusual one, of acute oral intoxication.

  15. [Intoxication from accidental ingestion of cannabis: analysis of eight cases].

    PubMed

    Patissier, C; Akdhar, M; Manin, C; Rosellini, D; Tambat, A; Tiprez, C; Wendremaire, P; Renoux, M-C

    2015-01-01

    Consultations at pediatric emergency units for acute consciousness alterations is frequent. Miscellaneous causes include cranial trauma, meningoencephalitis, metabolic disorders, drugs, or other intoxications. We report here eight cases of infants who were brought to the emergency division due to acute consciousness failure after accidental ingestion of hashish, confirmed by urinary dosage of Δ9-tetrahydrocannabinol. This series of under 24-month-old infants only emphasizes the value of screening for cannabis in urine in cases of abnormal consciousness and/or abnormal behavior in an infant.

  16. Swallowing disorder and inhibition of cough reflex induced by atropine sulfate in conscious dogs.

    PubMed

    Tsubouchi, Tadashi; Tsujimoto, Shinji; Sugimoto, Shinichi; Katsura, Yasunori; Mino, Terumasa; Seki, Takaki

    2008-03-01

    In this study, the effects of atropine sulfate (atropine) on swallowing and cough reflex were evaluated in the two experimental models in conscious dogs. To evaluate the effects of atropine on swallowing, 1 mL of marker (contrast medium) was injected into the pharynx under X-ray exposure to induce swallowing. Baclofen, used as a positive control, caused marker congestion in the upper esophagus. In our experimental model, atropine (0.02 and 0.1 mg/kg, i.v.) dose-dependently increased not only the number of marker congestions but also that of the swallows. In addition, atropine significantly shortened the onset of first swallowing. In the evaluation of atropine effects on electrically evoked cough reflex induced by two electrodes implanted into the trachea, atropine strongly inhibited the number of coughs at 0.01 or 0.05 mg/kg accompanied with 0.01 or 0.05 mg/kg per hour (i.v.), respectively. These findings indicate that atropine has the potential of causing aspiration pneumonia through induction of swallowing disorder and inhibition of the cough reflex.

  17. Arsenic: homicidal intoxication

    SciTech Connect

    Massey, E.W.; Wold, D.; Heyman, A.

    1984-07-01

    Arsenic-induced deaths have been known to occur from accidental poisoning, as a result of medical therapy, and from intentional poisonings in homicide and suicide. Twenty-eight arsenic deaths in North Carolina from 1972 to 1982 included 14 homicides and seven suicides. In addition, 56 hospitalized victims of arsenic poisoning were identified at Duke Medical Center from 1970 to 1980. Four case histories of arsenic poisoning in North Carolina are presented and clinical manifestations are discussed. In view of the continued widespread use of arsenic in industry and agriculture, and its ubiquity in the environment, arsenic poisoning will continue to occur. A need for knowledge of its toxicity and of the clinical manifestations of acute and chronic arsenic poisoning will also continue.

  18. Use of pralidoxime without atropine in rivastigmine (carbamate) toxicity.

    PubMed

    Hoffman, R S; Manini, A F; Russell-Haders, A L; Felberbaum, M; Mercurio-Zappala, M

    2009-09-01

    Some experimental models suggest that the use of pralidoxime in carbamate toxicity is deleterious. Although pretreatment with atropine minimizes the adverse effect of pralidoxime reported in these models, concerns over the risks of pralidoxime in humans with carbamate poisoning continue. We present a unique case of carbamate toxicity treated successfully with pralidoxime alone. An 80-year-old woman with Alzheimer's dementia presented to the emergency department with 3-4 days of lightheadedness, vomiting, diarrhea, and bilateral lower extremity muscle pain. Extensive review of systems was otherwise negative. Her vital signs were BP, 207/85 mmHg; pulse, 101 beats/min; rectal temperature, 36.6( degrees )C; respirations, 18/min; and SpO(2), 95% breathing room air. Her bedside glucose measurement was 6.7 mmol/L. Physical examination revealed a confused, diaphoretic, ill-appearing woman with miosis and fasciculations of the tongue, eyelids, gastrocnemius and quadriceps bilaterally. The heart, lung, abdominal and head, eyes, ears, nose and throat examinations were otherwise unremarkable. Nine 5-cm(2) rivastigmine patches (9.5 mg/24-hour) were found adherent to her torso and lower extremities. The patches were immediately removed and underlying skin cleansed with soap and water. Laboratory values including complete blood count, basic metabolic panel, calcium, magnesium, phosphorus, troponin, coagulation studies and urinalysis were unremarkable. Due to the absence of pulmonary muscarinic findings, no atropine was administered. However, 1 g of pralidoxime was administered intravenously over 30 min to treat fasciculations. Within 30 min of this treatment, there was significant improvement in symptoms and resolution of fasciculations. She was admitted to the hospital, required no further pralidoxime therapy and was discharged after 3 days. Rivastigmine is a reversible (carbamate) cholinesterase inhibitor used to treat dementia. In overdose, cholinergic crisis is expected and

  19. Alcohol-based hand sanitizers: severe intoxication in children.

    PubMed

    2012-07-01

    Alcohol-based hand sanitizers are an alternative to hand washing with soap and water when water is unavailable. Their use has increased over the last decade. Cases of acute intoxication have been reported in children after accidental ingestion of alcohol-based hand sanitizers, sometimes leading to inebriation, agitation, drowsiness, impaired consciousness, and blood alcohol levels sometimes exceeding 2 g/I. In practice, alcohol-based hand sanitizers should be kept out of reach of children and should only be used when hand washing with soap and water is not possible. The possibility of alcohol intoxication should be borne in mind when a child suddenly presents with behaviour problems or altered consciousness.

  20. Unintentional baclofen intoxication in the management of alcohol use disorder.

    PubMed

    Reichmuth, Philipp; Blanc, Anne-Laure; Tagan, Damien

    2015-09-22

    In recent years, there has been a growing interest in using baclofen for the management of alcohol use disorder. This off-label indication usually involves high doses of the medication. We report a case of severe baclofen overdose in a 66-year-old man. The patient was found severely agitated, and he presented with delirium and auditory hallucinations. At hospital admission, his daily dose was 180 mg baclofen. He was admitted to the intensive care unit for sedation and supportive care. When sedation was withdrawn, the patient presented with a normal neurological status. In this clinical context, baclofen intoxication was suspected. This was confirmed by measuring blood baclofen levels. This intoxication was probably mediated by a combination of risk factors including a high daily dose of baclofen and acute renal failure, conducive to drug accumulation.

  1. An interesting thinner intoxication case: intrathoracic injection.

    PubMed

    Solak, Ilhami; Cankayali, Ilkin; Aksu, Hasim; Moral, Ali Resat

    2006-01-01

    Thinners, including aromatic hydrocarbons such as toluene, xylene, and N-hexane, are widely used in industry for the production of plastics, varnish, paint, and glue. Use of these toxic agents frequently leads to chronic intoxication caused by abuse or misuse of solvents, which are usually taken in through inhalation. Thinners may have neurotoxic, myotoxic, hepatotoxic, nephrotoxic, and cardiotoxic systemic effects. The patient described in this report attempted to commit suicide by injecting 10 cc thinner into the left hemithorax. Acute chemical empyema developed at the left hemithorax. No bacterial growth was noted in empyema liquid and blood samples. Empyema was treated with tube thoracostomy, and full remission was observed after 33 d. No systemic toxic signs were noted, other than a low level of hepatotoxicity. Although pleural effusion, atelectasis, and pleural thickening were observed at the acute phase on computed tomography (CT) of the thorax, only pleural thickening persisted on CT of the thorax after 1 y. Investigators could not find a documented case of parenteral use of thinners in the medical literature.

  2. Sublingual atropine drops for the treatment of pediatric sialorrhea.

    PubMed

    Rapoport, Adam

    2010-11-01

    Excess oral secretions or sialorrhea is a common problem affecting children and adults with neurological disorders, as well as those approaching the end of life because of a variety of underlying illnesses. Systemic anticholinergic medications are often prescribed in an attempt to improve quality of life and reduce complications; yet, response rates are variable, and a sizable proportion of patients discontinue these drugs as a result of intolerable side effects. This report describes the successful use of a local treatment, sublingually delivered ophthalmic atropine drops, to reduce sialorrhea in a child receiving palliative care. In addition, medical evidence for the safety and efficacy of traditionally prescribed systemic medications for the treatment of pediatric sialorrhea is reviewed.

  3. Rhodnius prolixus intoxicated.

    PubMed

    Alzogaray, Raúl A; Zerba, Eduardo N

    Rhodnius prolixus (Hemiptera: Reduviidae) is a hematophagous insect native from South America. By the end of the 20th century, it was one of the main vectors of Chagas disease in Venezuela, Colombia, several Central American countries and southern Mexico. The aim of the present article is to review the literature regarding R. prolixus toxicology. British entomologist Vincent B. Wigglesworth carried out the first studies on this subject over seventy years ago. A wide bibliographical search allowed to locate one hundred and thirty scientific articles describing the effects of different insecticides on R. prolixus. About one-third of these articles report the acute toxicity and/or sublethal effects produced by the main synthetic neurotoxic families of insecticides (organochlorines, organophosphates, carbamates and pyrethroids). Only a couple of these studies have regarded the toxicokinetics or toxicodynamics of these insecticides. Insect growth or development disruptors, such as juvenoids, chitin synthesis inhibitors, precocenes, azadirachtin and lignoids, have been thoroughly studied in R. prolixus. Important aspects on the mode of action of ureases were also described in this species. By the end of the 1960's, resistance to insecticides was detected in R. prolixus from Venezuela. Some years later, the existence of pyrethroid-resistant individuals was also reported. Control programmes for R. prolixus in countries where Chagas is endemic have only used synthetic neurotoxic insecticides. In 2011, Central America and southern Mexico were declared free of this insect. The recent sequencing of the R. prolixus genome will provide valuable information to understand the molecular basis of insecticide resistance in this species.

  4. Intoxicated eyewitnesses: Better than their reputation?

    PubMed

    Compo, Nadja Schreiber; Evans, Jacqueline R; Carol, Rolando N; Villalba, Daniella; Ham, Lindsay S; Garcia, Tracy; Rose, Stefan

    2012-04-01

    According to law enforcement, many witnesses are intoxicated either at the time of the crime, the interview, or both (Evans et al., Public Policy Law 15(3):194-221, 2009). However, no study to date has examined whether intoxicated witnesses' recall is different from sober witnesses' and whether they are more vulnerable to misinformation using an ecologically valid experimental design. Intoxicated, placebo, and sober witnesses observed a live, staged theft, overheard subsequent misinformation about the theft, and took part in an investigative interview. Participants generally believed they witnessed a real crime and experienced a real interview. Intoxicated witnesses were not different from placebo or sober witnesses in the number of accurate details, inaccurate details, or "don't know" answers reported. All the participants demonstrated a misinformation effect, but there were no differences between intoxication levels: Intoxicated participants were not more susceptible to misinformation than sober or placebo participants. Results are discussed in the light of their theoretical and applied relevance.

  5. [Biochemical diagnostics of fatal opium intoxication].

    PubMed

    Papyshev, I P; Astashkina, O G; Tuchik, E S; Nikolaev, B S; Cherniaev, A L

    2013-01-01

    Biochemical diagnostics of fatal opium intoxication remains a topical problem in forensic medical science and practice. We investigated materials obtained in the course of forensic medical expertise of the cases of fatal opium intoxication. The study revealed significant differences between myoglobin levels in blood, urine, myocardium, and skeletal muscles. The proposed approach to biochemical diagnostics of fatal opium intoxication enhances the accuracy and the level of evidence of expert conclusions.

  6. Carbon monoxide intoxication.

    PubMed

    Bleecker, Margit L

    2015-01-01

    Carbon monoxide (CO) is a colorless, odorless, nonirritant gas that accounts for numerous cases of CO poisoning every year from a variety of sources of incomplete combustion of hydrocarbons. These include poorly functioning heating systems, indoor propane-powered forklifts, indoor burning of charcoal burning briquettes, riding in the back of pick-up trucks, ice skating rinks using propane-powered resurfacing machines, and gasoline-powered generators that are not in correct locations. Once CO is inhaled it binds with hemoglobin to form carboxyhemoglobin (COHb) with an affinity 200 times greater than oxygen that leads to decreased oxygen-carrying capacity and decreased release of oxygen to tissues leading to tissue hypoxia. Ischemia occurs with CO poisoning when there is loss of consciousness that is accompanied by hypotension and ischemia in the arterial border zones of the brain. Besides binding to many heme-containing proteins, CO disrupts oxidative metabolism leading to the formation of free radicals. Once hypotension and unconsciousness occur with CO poisoning, lipid peroxidation and apoptosis follow. Because COHb has a short half-life, examination of other biomarkers of CO neurotoxicity that reflect inflammation or neuronal damage has not demonstrated consistent results. The initial symptoms with CO exposure when COHb is 15-30% are nonspecific, namely, headache, dizziness, nausea, fatigue, and impaired manual dexterity. However individuals with ischemic heart disease may experience chest pain and decreased exercise duration at COHb levels between 1% and 9%. COHb levels between 30% and 70% lead to loss of consciousness and eventually death. Following resolution of acute symptoms there may be a lucid interval of 2-40 days before the development of delayed neurologic sequelae (DNS), with diffuse demyelination in the brain accompanied by lethargy, behavior changes, forgetfulness, memory loss, and parkinsonian features. Seventy-five percent of patients with DNS

  7. Atropine-induced inhibition of sperm and semen transport impairs fertility in male rats.

    PubMed

    Sato, Takahiro; Ban, Yoshiki; Uchida, Miki; Gondo, Eri; Yamamoto, Masakatsu; Sekiguchi, Yoshiko; Sakaue, Akiko; Kemi, Masayuki; Nakatsuka, Toshio

    2005-08-01

    Previous studies revealed that atropine reduced male fertility in rats without any effects on mating performance, sperm production and motility, and testicular morphology. The present study was conducted to investigate whether the impairment of male fertility induced by atropine was related to the inhibition of sperm and semen transports from the vas deferens and seminal vesicle to the urethra during the process of emission. Male rats were treated with atropine at 125 mg/kg/day for 10-17 days prior to mating with untreated females. After confirmation of mating, male rats were euthanized and sperm number in the vas deferens and weights of the seminal vesicle and copulatory plug were determined as indicators of inhibition of sperm and semen transports, respectively. Reproductive status of mated females was determined on gestation days 15-17. A low pregnancy rate associated with a decreased number of implants was observed in females that mated with the atropine-treated males. The average number of sperm in the vas deferens was increased in the atropine-treated males. The average seminal vesicle weight in the atropine-treated males was greater than that of controls. The copulatory plug weights were decreased in the atropine-treated males. These results suggest that inhibitions of sperm and semen transports from the vas deferens and seminal vesicle to the urethra during the process of emission result in reduced male fertility in rats.

  8. Effectuation of adaptive stability and postural alignment strategies are decreased by alcohol intoxication.

    PubMed

    Hafström, A; Modig, F; Magnusson, M; Fransson, P A

    2014-06-01

    Human stability control is a complex process comprising contributions from several partly independent mechanisms such as coordination, feedback and feed-forward control, and adaptation. Acute alcohol intoxication impairs these functions and is recognized as a major contributor to fall traumas. The study aimed to investigate how alcohol intoxication at .06% and .10% blood alcohol concentration (BAC) affected the movement spans and control of posture alignment. The angular positions of the head, shoulder, hip and knees relative to the ankles were measured with a 3D motion analysis system in 25 healthy adults during standing with eyes open or closed and with or without vibratory balance perturbations. Alcohol intoxication significantly increased the movement spans of the head, shoulders, hip and knees in anteroposterior and lateral directions during quiet stance (p < or = .047 and p < or = .003) and balance perturbations (p<.001, both directions). Alcohol intoxication also decreased the ability to reduce the movement spans through adaptation in both anteroposterior (p < or = .011) and lateral (p < or = .004) directions. When sober and submitted to balance perturbations, the subjects aligned the head, shoulders, hip and knees more forward relative to the ankle joint (p < .001), hence adopting a more resilient posture increasing the safety margin for backward falls. Alcohol intoxication significantly delayed this forward realignment (p < or = .022). Alcohol intoxication did not cause any significant posture realignment in the lateral direction. Thus, initiation of adaptive posture realignments to alcohol or other disruptions might be context dependent and associated with reaching a certain level of stability threats.

  9. Efficacy of antidotes (midazolam, atropine and HI-6) on nerve agent induced molecular and neuropathological changes

    PubMed Central

    2014-01-01

    Background Recent alleged attacks with nerve agent sarin on civilians in Syria indicate their potential threat to both civilian and military population. Acute nerve agent exposure can cause rapid death or leads to multiple and long term neurological effects. The biochemical changes that occur following nerve agent exposure needs to be elucidated to understand the mechanisms behind their long term neurological effects and to design better therapeutic drugs to block their multiple neurotoxic effects. In the present study, we intend to study the efficacy of antidotes comprising of HI-6 (1-[[[4-(aminocarbonyl)-pyridinio]-methoxy]-methyl]-2-[(hydroxyimino) methyl] pyridinium dichloride), atropine and midazolam on soman induced neurodegeneration and the expression of c-Fos, Calpain, and Bax levels in discrete rat brain areas. Results Therapeutic regime consisting of HI-6 (50 mg/kg, i.m), atropine (10 mg/kg, i.m) and midazolam (5 mg/kg, i.m) protected animals against soman (2 × LD50, s.c) lethality completely at 2 h and 80% at 24 h. HI-6 treatment reactivated soman inhibited plasma and RBC cholinesterase up to 40%. Fluoro-Jade B (FJ-B) staining of neurodegenerative neurons showed that soman induced significant necrotic neuronal cell death, which was reduced by this antidotal treatment. Soman increased the expression of neuronal proteins including c-Fos, Bax and Calpain levels in the hippocampus, cerebral cortex and cerebellum regions of the brain. This therapeutic regime also reduced the soman induced Bax, Calpain expression levels to near control levels in the different brain regions studied, except a mild induction of c-Fos expression in the hippocampus. Conclusion Rats that received antidotal treatment after soman exposure were protected from mortality and showed reduction in the soman induced expression of c-Fos, Bax and Calpain and necrosis. Results highlight the need for timely administration of better antidotes than standard therapy in order to prevent the

  10. Effect of acid secretion blockade on acute gastric mucosal lesions induced by Tityus serrulatus scorpion toxin in anaesthetized rats.

    PubMed

    Melo, Júnio Rios; de Araújo, Gnana Keith Marques; da Luz, Magda Maria Profeta; da Conceição, Sérgio Alexandre; Lisboa, Felipe Assis; Moraes-Santos, Tasso; Cunha-Melo, José Renan

    2006-10-01

    Scorpion venom (TX) promotes gastric acid and pepsin secretion leading to acute gastric mucosal lesions (AGML), when injected in animals. The goal of the present study was to observe the effects of acid gastric secretion blockers over the incidence of TX-induced AGML in vivo. To verify this model, we used male albino rats, fasted 18-20 h (n=122) and anaesthetized with urethane (1.4 g/kg, i.p.). Their trachea and left femoral vein were both cannulated; the first to avoid airway obstructions during scorpion intoxication and the second for administration of saline, TX and acid blockers. Following the surgical procedure, the animals were divided in 10 groups of at least 10 animals each. Control groups were injected with NaCl 0.9% 1 ml/kg (n=10) or TX 375 microg/kg (n=32). Test groups (n=10, each) received atropine 5 mg/kg, cimetidine 10mg/kg, ranitidine 2.5mg/kg, ranitidine 5mg/kg, omeprazol 1 mg/kg, omeprazol 4 mg/kg, octreotide 80 and octreotide 100 microg/kg 10 min before the TX was injected. After 1h of intoxication, the stomach was resected for macroscopic study and the gastric secretion was collected for volume, pH and acid output assessment. We observed that all blockers were able to completely or partially prevent the TX-induced acid secretion as well as the AGML (p<0.05). Our data suggest the TX-induced AGML can be prevented by different class of acid blockers injected before the intoxication.

  11. Effects of Alcohol Intoxication on Anger Experience and Expression among Partner Assaultive Men

    ERIC Educational Resources Information Center

    Eckhardt, Christopher I.

    2007-01-01

    The author investigated the acute effects of alcohol intoxication on anger experience and expression among 46 maritally violent (MV) and 56 maritally nonviolent (NV) men randomly assigned to receive alcohol, placebo, or no alcohol. Participants completed an anger-arousing articulated thoughts in simulated situations (ATSS) paradigm and imagined…

  12. AMPA receptor potentiation can prevent ethanol-induced intoxication.

    PubMed

    Jones, Nicholas; Messenger, Marcus J; O'Neill, Michael J; Oldershaw, Anna; Gilmour, Gary; Simmons, Rosa M A; Iyengar, Smriti; Libri, Vincenzo; Tricklebank, Mark; Williams, Steve C R

    2008-06-01

    We present a substantial series of behavioral and imaging experiments, which demonstrate, for the first time, that increasing AMPA receptor-mediated neurotransmission via administration of potent and selective biarylsulfonamide AMPA potentiators LY404187 and LY451395 reverses the central effects of an acutely intoxicating dose of ethanol in the rat. Using pharmacological magnetic resonance imaging (phMRI), we observed that LY404187 attenuated ethanol-induced reductions in blood oxygenation level dependent (BOLD) in the anesthetized rat brain. A similar attenuation was apparent when measuring local cerebral glucose utilization (LCGU) via C14-2-deoxyglucose autoradiography in freely moving conscious rats. Both LY404187 and LY451395 significantly and dose-dependently reversed ethanol-induced deficits in both motor coordination and disruptions in an operant task where animals were trained to press a lever for food reward. Both prophylactic and acute intervention treatment with LY404187 reversed ethanol-induced deficits in motor coordination. Given that LY451395 and related AMPA receptor potentiators/ampakines are tolerated in both healthy volunteers and elderly patients, these data suggest that such compounds may form a potential management strategy for acute alcohol intoxication.

  13. Intoxication in cattle from Cestrum diurnum.

    PubMed

    Durand, R; Figueredo, J M; Mendoza, E

    1999-02-01

    Twenty-six Holstein calves with clinical and pathological effects suggesting a toxic plant intoxication were studied. A view of the plants in the region and blood examination (hemogram, albumin, total protein, calcium and phosphorus) and determination of bone calcium were done. Five calves were slaughtered and pathological examinations were performed. Observed metabolic, pathological and clinical alterations were compatible with intoxication from Cestrum diurnum.

  14. Acetylcholine-Atropine Interactions: Paradoxical Effects on Atrial Fibrillation Inducibility.

    PubMed

    Liu, Yu; Scherlag, Benjamin J; Fan, Youqi; Xia, Wenfang; Huang, He; Po, Sunny S

    2017-03-21

    Atropine (ATr) is well known as a cholinergic antagonist, however, at low concentrations ATr could paradoxically accentuate the parasympathetic actions of acetylcholine (ACh). In 22 pentobarbital anesthetized dogs, via a left and right thoracotomy, a leak proof barrier was attached to isolate the atrial appendages (AAs) from the rest of the atria. In Group 1(Ach+ATr+Ach), ACh, 100 mM, was placed on the AA followed by the application of ATr, 2mg/cc. The average AFdur was 17±7 minutes. After ATr was applied to the AA and ACh again tested, the AFdur was markedly attenuated (2±2 minutes, p<0.05). In Group 2 (ATr+Ach), ATr was initially applied to the AA followed by the application of ACh, 100 mM. There was no significant difference in AF duration (16±4 minutes vs 18±2 minutes, p=NS). The inhibitory effect of ATr on induced HR reduction (electrical stimulation of the anterior right ganglionated plexi and vagal nerves) was no difference between Groups 1 and 2. These observations suggest that when ATr is initially administered it attaches to the allosteric site of the muscarinic ACh receptor (M2 AChRs) leaving the orthosteric site free to be occupied by ACh. The M3 receptor that controls HR slowing does not show the same allosteric properties.

  15. Effect of atropine on intracortical evoked potentials during classical aversive conditioning in cats.

    PubMed

    Molnár, M; Karmos, G; Csépe, V

    1988-12-01

    In this article, intracortical evoked potentials (EPs) were recorded simultaneously from six different depths of the auditory cortex of freely moving cats. The effect of (a) different states of vigilance and that of atropine, (b) classical aversive conditioning, and (c) the effect of atropine during conditioning was studied on the intracortical EP profiles. Atropine induced EP changes that were similar to those seen in slow wave sleep. During classical aversive conditioning signal stimuli elicited a middle-latency negative EP component which was localized to the superficial cortical layers. Atropine (2 mg/kg body weight) did not abolish the appearance of this component but only increased its latency. It is proposed that the cholinergic part of the ascending activating system did not play an essential role in its generation.

  16. Intoxication and settled insanity: a finding of not guilty by reason of insanity.

    PubMed

    Feix, Jeff; Wolber, Greg

    2007-01-01

    This article presents a case of first-degree murder for which the defendant was acquitted as not guilty by reason of insanity, based on a defense involving the concept of "settled insanity." The literature on settled insanity is reviewed and discussed in the context of voluntary and involuntary intoxication. Statute and case law from those jurisdictions in which settled insanity is specifically allowed as an acceptable threshold condition for the insanity defense define the concept as a permanent condition resulting from substance abuse, rather than the effects of intoxication, no matter how severe. Also discussed are potential criteria for this defense, including evidence that psychotic symptoms thought to be responsible for the crime were, in some manner, separate and apart from symptoms caused solely by voluntary acute intoxication. Other factors that may assist evaluators in differentiating settled insanity from the effects of acute intoxication are presented. It is recommended that evaluators attempt to determine the timing of the onset of psychotic symptoms in relation to substance abuse, the persistence of such symptoms beyond detoxification, and whether ongoing psychiatric treatment is necessary to ameliorate the symptoms beyond intoxication. In the case described, psychotic symptoms persisted long after acute intoxication and beyond the time when drugs or alcohol were detected in the accused's body, requiring clinical intervention for psychosis. Also, before the crime, the defendant had exhibited significant psychological difficulty. The evaluating clinician must still determine, even when a threshold condition is considered to be present, whether statutory criteria for the insanity defense (for the jurisdiction in which the crime allegedly took place) are met.

  17. Heat Exchange through Cutaneous Vasodilation After Atropine Treatment in Two Environments

    DTIC Science & Technology

    1987-10-01

    anticholinergic effect of systemic atropine treatment on the eccrine sweat gland is well known and the inhibition of sweat secretion during exercise and heat...anticholinergic, dry heat exchange, sweating , I thermoregulation, vasodilation 19 ABSTRACT (Continue on reverse if necessary and identify by block...local sweating rate (-60%) occurred in both environments in the atropine treated subjects.’ During exercise, FBF was 85% greater at 30C and 95% greater at

  18. Cytotoxicity of atropine to human corneal endothelial cells by inducing mitochondrion-dependent apoptosis.

    PubMed

    Wen, Qian; Fan, Ting-Jun; Tian, Cheng-Lei

    2016-07-01

    Atropine, a widely used topical anticholinergic drug, might have adverse effects on human corneas in vivo. However, its cytotoxic effect on human corneal endothelium (HCE) and its possible mechanisms are unclear. Here, we investigated the cytotoxicity of atropine and its underlying cellular and molecular mechanisms using an in vitro model of HCE cells and verified the cytotoxicity using cat corneal endothelium (CCE) in vivo. Our results showed that atropine at concentrations above 0.3125 g/L could induce abnormal morphology and viability decline in a dose- and time-dependent manner in vitro. The cytotoxicity of atropine was proven by the induced density decrease and abnormality of morphology and ultrastructure of CCE cells in vivo. Meanwhile, atropine could also induce dose- and time-dependent elevation of plasma membrane permeability, G1 phase arrest, phosphatidylserine externalization, DNA fragmentation, and apoptotic body formation of HCE cells. Moreover, 2.5 g/L atropine could also induce caspase-2/-3/-9 activation, mitochondrial transmembrane potential disruption, downregulation of anti-apoptotic Bcl-2 and Bcl-xL, upregulation of pro-apoptotic Bax and Bad, and upregulation of cytoplasmic cytochrome c and apoptosis-inducing factor. In conclusion, atropine above 1/128 of its clinical therapeutic dosage has a dose- and time-dependent cytotoxicity to HCE cells in vitro which is confirmed by CCE cells in vivo, and its cytotoxicity is achieved by inducing HCE cell apoptosis via a death receptor-mediated mitochondrion-dependent signaling pathway. Our findings provide new insights into the cytotoxicity and apoptosis-inducing effect of atropine which should be used with great caution in eye clinic.

  19. Cytotoxicity of atropine to human corneal endothelial cells by inducing mitochondrion-dependent apoptosis

    PubMed Central

    Wen, Qian; Tian, Cheng-Lei

    2016-01-01

    Atropine, a widely used topical anticholinergic drug, might have adverse effects on human corneas in vivo. However, its cytotoxic effect on human corneal endothelium (HCE) and its possible mechanisms are unclear. Here, we investigated the cytotoxicity of atropine and its underlying cellular and molecular mechanisms using an in vitro model of HCE cells and verified the cytotoxicity using cat corneal endothelium (CCE) in vivo. Our results showed that atropine at concentrations above 0.3125 g/L could induce abnormal morphology and viability decline in a dose- and time-dependent manner in vitro. The cytotoxicity of atropine was proven by the induced density decrease and abnormality of morphology and ultrastructure of CCE cells in vivo. Meanwhile, atropine could also induce dose- and time-dependent elevation of plasma membrane permeability, G1 phase arrest, phosphatidylserine externalization, DNA fragmentation, and apoptotic body formation of HCE cells. Moreover, 2.5 g/L atropine could also induce caspase-2/-3/-9 activation, mitochondrial transmembrane potential disruption, downregulation of anti-apoptotic Bcl-2 and Bcl-xL, upregulation of pro-apoptotic Bax and Bad, and upregulation of cytoplasmic cytochrome c and apoptosis-inducing factor. In conclusion, atropine above 1/128 of its clinical therapeutic dosage has a dose- and time-dependent cytotoxicity to HCE cells in vitro which is confirmed by CCE cells in vivo, and its cytotoxicity is achieved by inducing HCE cell apoptosis via a death receptor-mediated mitochondrion-dependent signaling pathway. Our findings provide new insights into the cytotoxicity and apoptosis-inducing effect of atropine which should be used with great caution in eye clinic. PMID:27022135

  20. Atropine’s Effects upon the Heart and Its Systemic Output,

    DTIC Science & Technology

    1986-01-01

    REPORT DOCUMENTATION PAGE OMB No 0704-0188 Exp Date Jun30, 1986 Ia. REPORT SECURITY CLASSIFICATION lb RESTRICTIVE MARKINGS Unclassified 2a. SECURITY...larger doses of atropine. However, two points restricted total credible acceptance of the aforementioned results, namely, the few tests run and the lack of...proportional to the dose.𔄀 Patients with the sick sinus syndrome -2’ will manifest a restricted response to 1-2 mg of atropine with a maximum increase

  1. Usefulness of adenosine triphosphate-atropine stress echocardiography for detecting coronary artery stenosis.

    PubMed

    Miyazono, Y; Kisanuki, A; Toyonaga, K; Matsushita, R; Otsuji, Y; Arima, S; Nakao, S; Tanaka, H

    1998-08-01

    There have been few studies on adenosine triphosphate (AT) stress echocardiography. The AT stress test may have fewer adverse effects than the adenosine stress test. The addition of atropine to AT echocardiography may enhance the sensitivity for detection of coronary artery disease (CAD). The purpose of this study was to determine the utility of AT-atropine echocardiography for detection of CAD. The group studied consisted of 112 patients with suspected CAD. Sixty-one patients did not have a history of prior myocardial infarction (group I) and 51 patients did (group II). AT was infused intravenously at 180 microg/kg/min for 14 minutes. Atropine (0.25 mg intravenously, repeated up to maximum total dose of 1 mg) was administered starting after 8 minutes of AT infusion. Ischemic response was defined as new or worsening wall motion abnormality occurring during the infusion. The sensitivity and specificity for detection of CAD were assessed using the representative echocardiograms during single AT infusion and AT-atropine infusion. Sixty-two patients had CAD. Fifty-eight patients (52%) developed minor side effects that resolved promptly. The rate-pressure product (10(3)/mm Hg beats/min) was significantly increased at 12 minutes of infusion (12.4+/-3.2) compared with that at baseline (9.1+/-2.3) and that at 6 minutes of infusion (9.4+/-2.1). The sensitivity for detection of CAD was 45% for AT echocardiography and 74% for AT-atropine echocardiography. The specificity was 94% for AT echocardiography and 90% for AT-atropine echocardiography. The sensitivity and specificity of AT-atropine echocardiography was 78% and 93%, respectively, in group I, and 70% and 86%, respectively, in group II. In conclusion, AT-atropine stress echocardiography seems to be well tolerated, safe, and useful for detection of CAD.

  2. Atropine Absorption after Administration with 2-Pralidoxime Chloride by Automatic Injector.

    DTIC Science & Technology

    1987-12-01

    racemic mixture of d-,l- hyoscyamine which consists of 2 hyoscyamines and 1 sulfate (MW=695); it also usually includes 1 water of hydration (ignored here...immunogen; measures primarily d-,l- hyoscyamine ATROPINE (RRA) - serum atropine measured by radioreceptor assay, a bioassay measuring affinity for...muscarinic receptor binding; measures primarily 1- hyoscyamine and metabolites which compete for muscarinic receptors COMBOPEN - the larger of the two

  3. [Intoxication with Monkshood (Aconitum napellus)].

    PubMed

    Tuinema, Rinske M; Uijlings, Ruben; Dijkman, Marieke A; van den Broek, Marcel P H; de Lange, Dylan W

    2009-01-01

    Three patients presented with an intoxication caused by Aconitum napellus, commonly known as Aconite, Monkshood or Wolfsbane. The first patient, a woman aged 24, was resuscitated after accidental ingestion of plant material 'from nature'. She experienced severe ventricular tachyarrhythmias. After discharge she returned with identical symptoms, which were now interpreted as intentional intoxication in a suicide attempt. She was referred to the Psychiatry department. The second patient was a 2-year-old boy who had cutaneous exposure to Aconite. Except for some red spots around his mouth there were no other symptoms. The third patient was a 34-year-old woman who ate Monkshood, which she mistook for parsley. Alarmed by the bitter taste she contacted the hospital. She was treated with stomach lavage which removed most of the ingested plant material, and with activated charcoal. She had no symptoms during observation in the hospital. Aconite alkaloids are known to cause ventricular arrhythmia by a prolonged activation of sodium channels. Because there is no antidote, treatment is largely supportive but serious arrhythmias and respiratory arrest need to be anticipated.

  4. Evaluation of the antimuscarinic activity of atropine, terfenadine and mequitazine in healthy volunteers.

    PubMed Central

    Brion, N; Beaumont, D; Advenier, C

    1988-01-01

    1 The anticholinergic effects of atropine and two antihistamines (terfenadine and mequitazine) were investigated vs placebo in a double-blind study. 2 Salivary secretion, basal pupil diameter, pilocarpine (0.25%) induced miosis and heart rate were determined in eight healthy volunteers, seven male and one female, aged between 23 and 35 years. Each volunteer received all four separate courses of treatment: i.e. terfenadine 60 mg or mequitazine 5 mg twice daily for 3 days, and one single dose on the day of the trial; for the placebo or atropine courses they received the placebo twice daily during 3 days and, on the morning of test day, either the placebo again or atropine 1 mg. Pupillary diameter was measured under standardized conditions using a pupil gauge (Smith and Nephew Pharmaceuticals Ltd). 3 Atropine significantly reduced salivary output (-2.25 +/- 0.36 ml from control values of 4.17 +/- 0.42 ml, P less than 0.001) and heart rate (-9.7 +/- 3.7 beats min-1 from 77.5 +/- 2.7, P less than 0.05). These maximal effects were observed 3 h after atropine dosing for salivary secretion and 1 h for heart rate. Atropine did not affect basal pupil diameter or pilocarpine-induced miosis. 4 Mequitazine and terfenadine did not affect salivary flow, heart rate or pilocarpine-induced miosis. 5 Terfenadine and mequitazine had no anticholinergic effect in these tests involving a limited number of subjects. PMID:3130890

  5. Atropine unmasks bed-rest effect - A spectral analysis of cardiac interbeat intervals

    NASA Technical Reports Server (NTRS)

    Goldberger, Ary L.; Goldwater, Danielle; Bhargava, Valmik

    1986-01-01

    Heart rate spectral data obtained for 10 male subjects between 35-49 years following orthostatic tolerance testing with lower body negative pressure prebed rest and after 7-10 days of bed rest, while on placebo and after intravenous atropine are analyzed. Comparison of the spectral atropine rms for subjects prebed rest and after bed rest reveal a decrease from 63 + or - 24 ms to 40 + or - 23 ms. It is observed that heart rate interval variability for subjects after bed rest and with atropine is reduced; the heart rate at bed rest with atropine is increased from 70.4 + or - 12.4 beats/min prebed rest to 83.7 + or - 18.9 beats/min; and the exercise tolerance time for subjects in the atropine prebed-rest phase (658 + or - 352 s) is higher than the bed-rest phase (505 + or - 252 s). It is noted that bed rest impairs the cardiovascular capacity to adaptively modulate physiological responses, atropine exposes bed-rest deconditioning effects, and spectral analysis is useful for studying the effects of bed-rest deconditioning on cardiac dynamics.

  6. Patching vs Atropine to Treat Amblyopia in Children Aged 7 to 12 Years: A Randomized Trial

    PubMed Central

    2008-01-01

    Objective To compare patching with atropine eye drops in the treatment of moderate amblyopia (20/40 -20/100) in children age 7 to 12 years. Methods In a randomized multi-center clinical trial, 193 children with amblyopia were randomized to weekend atropine or patching 2 hours per day of the sound eye. Main Outcome Measure Masked assessment of amblyopic eye visual acuity using the EETDRS testing protocol at 17 weeks. Results At 17 weeks, visual acuity had improved from baseline by an average of 7.6 letters in the atropine group and 8.6 letters in the patching group. The mean difference (patching minus atropine) between groups adjusted for baseline acuity was 1.2 letters (ends of complementary 1-sided 95% confidence intervals for noninferiority = -0.7 and +3.1 letters). Based on the confidence intervals this difference met the pre-specified definition for equivalence (ends of confidence intervals <5 letters). Amblyopic eye visual acuity was 20/25 or better in 15 subjects (17%) in the atropine group and 20 subjects (24%) in the patching group (difference = 7%, 95% confidence interval = -3% to 17%). Conclusions Treatment with atropine or patching leads to similar degrees of improvement in 7 to 12 year old children with moderate amblyopia. About 1 in 5 achieves 20/25 or better visual acuity in the amblyopic eye. Application to Clinical Practice Treatment of older children with unilateral amblyopia. PMID:19064841

  7. Large-scale Digitoxin Intoxication

    PubMed Central

    Lely, A. H.; Van Enter, C. H. J.

    1970-01-01

    Because of an error in the manufacture of digoxin tablets a large number of patients took tablets that contained 0·20 mg. of digitoxin and 0·05 mg. of digoxin instead of the prescribed 0·25 mg. of digoxin. The symptoms are described of 179 patients who took these tablets and suffered from digitalis intoxication. Of these patients, 125 had taken the faultily composed tablets for more than three weeks. In 48 patients 105 separate disturbances in rhythm or in atrioventricular conduction were observed on the electrocardiogram. Extreme fatigue and serious eye conditions were observed in 95% of the patients. Twelve patients had a transient psychosis. Extensive ophthalmological observations indicated that the visual complaints were most probably caused by a transient retrobulbar neuritis. PMID:5273245

  8. Detoxifying emulsion for overdosed aspirin intoxication.

    PubMed

    Zhang, Wenjun; Stambouli, Moncef; Pareau, Dominique

    2013-01-30

    Aspirin overdose could lead to intoxication, with the clinical manifestations of vomit, pulmonary edema and severe dyspnea. Stomach washing, emetics and activated charcoal are the common treatments with a limited efficiency for the intoxication. In this study, an active emulsion for aspirin intoxication was prepared with the detoxifying efficiency of 100% in less than 15 min, with the conditions of dodecane used as the oil phase, 8% Abil EM90 as the surfactant and 0.1 mol/L sodium hydroxide as the inner aqueous phase in a volume ratio of 2 between internal aqueous phase and the oil phase.

  9. Illicit opioid intoxication: diagnosis and treatment.

    PubMed

    Fareed, A; Stout, S; Casarella, J; Vayalapalli, S; Cox, J; Drexler, K

    2011-01-01

    Opioid intoxications and overdose are associated with high rates of morbidity and mortality. Opioid overdose may occur in the setting of intravenous or intranasal heroin use, illicit use of diverted opioid medications, intentional or accidental misuse of prescription pain medications, or iatrogenic overdose. In this review, we focused on the epidemiology of illict opioid use in the United States and on the mechanism of action of opioid drugs. We also described the signs and symptoms, and diagnoses of intoxication and overdose. Lastly, we updated the reader about the most recent recommendations for treatment and prevention of opioid intoxications and overdose.

  10. Is oxygen required before atropine administration in organophosphorus or carbamate pesticide poisoning? – A cohort study

    PubMed Central

    Konickx, L. A.; Bingham, K.

    2014-01-01

    Background Early and adequate atropine administration in organophosphorus (OP) or carbamate insecticide poisoning improves outcome. However, some authors advise that oxygen must be given before atropine due to the risk of inducing ventricular dysrhythmias in hypoxic patients. Because oxygen is frequently unavailable in district hospitals of rural Asia, where the majority of patients with insecticide poisoning present, this guidance has significant implications for patient care. The published evidence for this advice is weak. We therefore performed a patient cohort analysis to look for early cardiac deaths in patients poisoned by anticholinesterase pesticides. Methods We analysed a prospective Sri Lankan cohort of OP or carbamate-poisoned patients treated with early atropine without the benefit of oxygen for evidence of early deaths. The incidence of fatal primary cardiac arrests within 3 h of admission was used as a sensitive (but non-specific) marker of possible ventricular dysrhythmias. Results The cohort consisted of 1957 patients. The incidence of a primary cardiac death within 3 h of atropine administration was 4 (0.2%) of 1957 patients. The majority of deaths occurred at a later time point from respiratory complications of poisoning. Conclusion We found no evidence of a high number of early deaths in an observational study of 1957 patients routinely given atropine before oxygen that might support guidance that oxygen must be given before atropine. The published literature indicates that early and rapid administration of atropine during resuscitation is life-saving. Therefore, whether oxygen is available or not, early atropinisation of OP- and carbamate-poisoned patients should be performed. PMID:24810796

  11. Stress echocardiography in warmblood horses: comparison of dobutamine/atropine with treadmill exercise as cardiac stressors.

    PubMed

    Gehlen, Heidrun; Marnette, Silke; Rohn, Karl; Stadler, Peter

    2006-01-01

    The purpose of this study was to determine whether the combination of dobutamine and atropine causes cardiac stress equivalent to treadmill exercise. Therefore, electrocardiography and echocardiography were performed on 10 warmblood horses before, during, and after different cardiac stress tests. Stressors consisted of a standardized treadmill exercise and combined administration of dobutamine (7.5 microg/kg/min) and atropine (5 microg/kg). Maxima heart rates were achieved during the treadmill exercise (175 +/- 10 bpm). After exercise, a rapid decrease in heart rate was observed. Subsequently, a stress echocardiography for which a heart rate >100 bpm was required could only be performed within 1 minute after exercise. The mean heart rate during echocardiography was 136 +/- 8 bpm after exercise. The combination of dobutamine and atropine also resulted in a significant increase in heart rate, up to 141 +/- 20 bpm. Maxima heart rate was significantly higher during the treadmill exercise, but the decrease in heart rate was significantly slower after dobutamine and atropine administration. Over a period of 7.9 minutes, the mean heart rate was 123 +/- 8 bpm during dobutamine and atropine administration. Consequently, the combination of both drugs offered sufficient time for detailed examinations. Overall, echocardiographic examination identified a decrease in left ventricular (LV) dimensions, an increase in LV wall thickness, and a decrease in stroke volume after the treadmill exercise and during pharmacologic stress testing compared with baseline. Changes in echocardiographic variables generally were more pronounced during dobutamine and atropine administration. Similar to stress echocardiography in humans, in horses the combination of dobutamine and atropine is useful to produce an increase in heart rate comparable with what is achieved with exercise but without the need of increasing dobutamine dosage.

  12. Accidental intoxication with Veratrum album.

    PubMed

    Grobosch, T; Binscheck, T; Martens, F; Lampe, D

    2008-01-01

    A 49-year-old man consumed two glasses (approximately 2 x 20 mL) of a beverage containing yellow gentian (Gentiana lutea). Shortly after ingestion, he developed nausea, vomiting, and oral paraesthesia. On admission to the hospital he suffered from severe bradycardia (35 beats/min) and hypotension (50/30 mm Hg), and he was treated with activated charcoal, antiemetics (metoclopramide, ondansetron), atropine, and intravenous electrolytic solution. The initial suspicion of Veratrum poisoning could be confirmed by identifying protoveratrines A (ProA) and protoveratrine B (ProB) in a sample from the beverage as well as in the patients serum by liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS-MS). The yellow-colored beverage contained 25% ethanol (by headspace gas chromatography), 20.4 mg/L ProA, and 13.7 mg/L ProB. The serum concentration of ProA was 1162 ng/L and ProB was 402 ng/L. Veratridine, cevadine, and jervine were not detected, neither in the beverage nor in the serum sample. The lower limits of quantitation for all compounds is 10 microg/L (S/N > 10, beverage) and 100 ng/L (S/N > 10, serum). After treatment, the patient completely recovered from the symptoms within 24 h and was discharged from the hospital. The analytical method described was developed for the simultaneous identification and quantitation of five Veratrum alkaloids. The method is based on a liquid-liquid extraction followed by LC-MS-MS analysis. The time needed for analysis was 6 min.

  13. New Drugs for Pretreatment of Organophosphonate Intoxication

    DTIC Science & Technology

    1990-02-20

    COPY A D L£> SRI PROJECT PYU-4681 NEW DRUGS FOR PRETREATMENT OF ORGANOPHOSPHONATE INTOXICATION FINAL REPORT AD-B145 250 Daniel W. Parish, Allen...BB WORK UNIT ACCESSION NO. 099 11. TITLE (indud* Security Oaofficattofl) New Drugs for Pretreatment of Organophosphonate Intoxication...undertaken for the U.S. Army Medical Research and Development Command (MRDC) under Contract DAMD17-88-C-8001, " New Drugs for Pretreatment of

  14. Construction and analytical application of ion-selective piezoelectric sensor for atropine sulfate.

    PubMed

    Long, Y; Lei, L; Li, W; He, D; Nie, L; Yao, S

    1999-11-01

    The method describes the use of a piezoelectric quartz crystal (PQC) as a substitute for ion-selective electrodes. The approach is feasible when the membrane materials are electrically non-conductive and membrane potential measurements are consequently not possible. An ion-selective piezoelectric sensor sensitive to atropine sulfate was constructed by coating a PVC membrane containing activant on one the side of a PQC. On the basis of selective adsorption of atropine ions across the modified film and the sensitive mass response of PQC, the method exhibits a sensitive, rapid response and is easy to operate without pretreatment of the sample. The logarithm of the frequency shift gave a linear relationship with the logarithm of atropine sulfate concentration in the 1.0 x 10(-8)-1.0 x 10(-3) M range with a detection limit of 5.0 x 10(-9) M at pH 7.0. Recoveries were from 98.7-102.2%. Two activants, atropine tetraphenylborate and atropine dipicrylaminate, were synthesized and investigated. Influencing factors were also examined and optimized. The results for real samples obtained by the proposed method agreed with those obtained by conventional methods.

  15. Effects of ethanol intoxication on speech suprasegmentals

    NASA Astrophysics Data System (ADS)

    Hollien, Harry; Dejong, Gea; Martin, Camilo A.; Schwartz, Reva; Liljegren, Kristen

    2001-12-01

    The effects of ingesting ethanol have been shown to be somewhat variable in humans. To date, there appear to be but few universals. Yet, the question often arises: is it possible to determine if a person is intoxicated by observing them in some manner? A closely related question is: can speech be used for this purpose and, if so, can the degree of intoxication be determined? One of the many issues associated with these questions involves the relationships between a person's paralinguistic characteristics and the presence and level of inebriation. To this end, young, healthy speakers of both sexes were carefully selected and sorted into roughly equal groups of light, moderate, and heavy drinkers. They were asked to produce four types of utterances during a learning phase, when sober and at four strictly controlled levels of intoxication (three ascending and one descending). The primary motor speech measures employed were speaking fundamental frequency, speech intensity, speaking rate and nonfluencies. Several statistically significant changes were found for increasing intoxication; the primary ones included rises in F0, in task duration and for nonfluencies. Minor gender differences were found but they lacked statistical significance. So did the small differences among the drinking category subgroups and the subject groupings related to levels of perceived intoxication. Finally, although it may be concluded that certain changes in speech suprasegmentals will occur as a function of increasing intoxication, these patterns cannot be viewed as universal since a few subjects (about 20%) exhibited no (or negative) changes.

  16. Characterization of a Mouse Model of Oral Potassium Cyanide Intoxication.

    PubMed

    Sabourin, Patrick J; Kobs, Christina L; Gibbs, Seth T; Hong, Peter; Matthews, Claire M; Patton, Kristen M; Sabourin, Carol L; Wakayama, Edgar J

    2016-09-01

    Potassium cyanide (KCN) is an inhibitor of cytochrome C oxidase causing rapid death due to hypoxia. A well-characterized model of oral KCN intoxication is needed to test new therapeutics under the Food and Drug Administration Animal Rule. Clinical signs, plasma pH and lactate concentrations, biomarkers, histopathology, and cyanide and thiocyanate toxicokinetics were used to characterize the pathology of KCN intoxication in adult and juvenile mice. The acute oral LD50s were determined to be 11.8, 11.0, 10.9, and 9.9 mg/kg in water for adult male, adult female, juvenile male, and juvenile female mice, respectively. The time to death was rapid and dose dependent; juvenile mice had a shorter mean time to death. Juvenile mice displayed a more rapid onset and higher incidence of seizures. The time to observance of respiratory signs and prostration was rapid, but mice surviving beyond 2 hours generally recovered fully within 8 hours. At doses up to the LD50, there were no gross necropsy or microscopic findings clearly attributed to administration of KCN in juvenile or adult CD-1 mice from 24 hours to 28 days post-KCN challenge. Toxicokinetic analysis indicated rapid uptake, metabolism, and clearance of plasma cyanide. Potassium cyanide caused a rapid, dose-related decrease in blood pH and increase in serum lactate concentration. An increase in fatty acid-binding protein 3 was observed at 11.5 mg/kg KCN in adult but not in juvenile mice. These studies provide a characterization of KCN intoxication in adult and juvenile mice that can be used to screen or conduct preclinical efficacy studies of potential countermeasures.

  17. Histamine, histamine intoxication and intolerance.

    PubMed

    Kovacova-Hanuskova, E; Buday, T; Gavliakova, S; Plevkova, J

    2015-01-01

    Excessive accumulation of histamine in the body leads to miscellaneous symptoms mediated by its bond to corresponding receptors (H1-H4). Increased concentration of histamine in blood can occur in healthy individuals after ingestion of foods with high contents of histamine, leading to histamine intoxication. In individuals with histamine intolerance (HIT) ingestion of food with normal contents of histamine causes histamine-mediated symptoms. HIT is a pathological process, in which the enzymatic activity of histamine-degrading enzymes is decreased or inhibited and they are insufficient to inactivate histamine from food and to prevent its passage to blood-stream. Diagnosis of HIT is difficult. Multi-faced, non-specific clinical symptoms provoked by certain kinds of foods, beverages and drugs are often attributed to different diseases, such as allergy and food intolerance, mastocytosis, psychosomatic diseases, anorexia nervosa or adverse drug reactions. Correct diagnosis of HIT followed by therapy based on histamine-free diet and supplementation of diamine oxidase can improve patient's quality of life.

  18. Profound Hypoglycemia with Ecstasy Intoxication

    PubMed Central

    Carrera, Perliveh; Iyer, Vivek N.

    2015-01-01

    Background. 3,4-Methylenedioxymethamphetamine (MDMA) or ecstasy is a synthetic drug that is commonly abused for its stimulant and euphoric effects. Adverse MDMA effects include hyperthermia, psychomotor agitation, hemodynamic compromise, renal failure, hyponatremia, and coma. However, endogenous hyperinsulinemia with severe persistent hypoglycemia has not been reported with MDMA use. Case Report. We report the case of a 29-year-old woman who remained severely hypoglycemic requiring continuous intravenous infusion of high-dose dextrose solutions for more than 24 hours after MDMA intoxication. Serum insulin and C-peptide levels confirmed marked endogenous hyperinsulinemia as the cause of the severe hypoglycemia. Why Should an Emergency Physician Be Aware of This? Immediate and frequent monitoring of blood glucose should be instituted in patients presenting with MDMA ingestion particularly if found to be initially hypoglycemic. Early recognition can help prevent the deleterious effects of untreated hypoglycemia that can add to the morbidity from MDMA use. Clinicians need to be aware of this side effect of MDMA so they can carefully monitor and treat it, especially in patients presenting with altered mental status. PMID:25692049

  19. Fatal intoxication with tianeptine (Stablon).

    PubMed

    Proença, Paula; Teixeira, Helena; Pinheiro, João; Monsanto, Paula V; Vieira, Duarte Nuno

    2007-08-06

    Tianeptine (Stablon), although structurally similar to tricyclic antidepressants, acts by enhancing the reuptake of serotonin. A fatal case is presented involving a 26-year-old man, found lying in bed with a "mushroom of foam" around his mouth. Empty blister packs of Stablon and a suicide note were found next to the body. A liquid-liquid extraction procedure with n-hexane: ethyl acetate and n-hexane: 2-propanol, followed by LC-DAD-MS analysis, using positive mode electrospray ionization was performed. The detection limit was 0.001 microg/mL. The toxicological results revealed the following tianeptine concentrations in the post-mortem samples: blood 5.1 microg/mL; urine 2.0 microg/mL; liver 23 microg/g; stomach contents 22 mg. Femoral blood analyses also revealed an ethanol concentration of 0.53 g/L. The present method was also developed and validated for the other post-mortem specimens, since no previous published data had confirmed the post-mortem distribution of tianeptine. The absence of other suitable direct causes of death (macroscopic or histological) and the positive results achieved with the toxicological analysis led the pathologist to rule that death was due to an intoxication caused by the suicidal ingestion of tianeptine in combination with alcohol.

  20. Combined approach to demonstrate acetylcholinesterase activity changes in the rat brain following tabun intoxication and its treatment.

    PubMed

    Bajgar, Jiri; Hajek, Petr; Kassa, Jiri; Slizova, Dasa; Krs, Otakar; Karasova, Jana Zdarova; Fusek, Josef; Capek, Lukas; Voicu, Victor A

    2012-01-01

    Reactivation effects of K203 and currently available oximes (obidoxime, HI-6) in combination with atropine on acetylcholinesterase activities in the brain parts of rats poisoned with tabun were studied. The activity was determined by quantitative histochemical and biochemical methods correlating between them very well. The tabun-induced changes in acetylcholinsterase activity as well as in reactivation potency of reactivators used were different in various parts of the brain. Pontomedullar area seems to be important for observed changes following tabun intoxication and its treatment. From the oximes studied, the reactivation effect of K203 was comparable with obidoxime; HI-6 was ineffective. Combination of bio- and histochemical methods allow fine differentiation among the action of different oximes following tabun poisoning.

  1. [Severe hydrogen sulfide intoxication: a pediatric case of survival].

    PubMed

    Claudet, I; Marcoux, M-O; Karsenty, C; Rittié, J-L; Honorat, R; Lelong-Tissier, M-C

    2012-03-01

    We report a paediatric case of survival following severe hydrogen sulfide (H2S) gas intoxication. A 13-year-old boy was found submerged to the neck in a manure tank. He was hypothermic, unresponsive with bilateral mydriasis, and had poor oxygen saturation. After intubation, he was transferred to the paediatric intensive care unit of a tertiary care children's hospital. He developed acute respiratory distress syndrome (ARDS) requiring high frequency percussive ventilation. Cardiac evaluation was significant for myocardial infarction and left ventricular function impairment. He completely recovered from the respiratory and cardiac failure. Neurological examinations showed abnormal signals on MRI in the semi-oval center and in the frontal cortex. Follow-up detected partial impairment of axonal fibers of the right external popliteal sciatic nerve. Paediatric cases of survival after H2S intoxication have been rarely reported. Such exposures can evolve to severe ARDS and benefit from high frequency percussive ventilation. Hypothermia and other metabolic abnormalities are now better explained thanks to actual knowledge about endogenous H2S function. Lessons learned from paediatric accidents should result in better information about this threat for farmers and families living in houses with septic tanks, reducing the risk to their own and their children's safety.

  2. Chronic Treatment with Naltrexone Prevents Memory Retention Deficits in Rats Poisoned with the Sarin Analog Diisopropylfluorophosphate (DFP) and Treated with Atropine and Pralidoxime.

    PubMed

    Brewer, Kori L; Tran, Tuan; Meggs, William J

    2015-12-01

    Humans and rats poisoned with sarin develop chronic neurological disabilities that are not prevented with standardized antidotal therapy. We hypothesized that rats poisoned with the sarin analogue diisopropylfluorophosphate (DFP) and resuscitated with atropine and pralidoxime would have long-term memory deficits that were preventable with naltrexone treatment. Long Evans rats (250-275 g) were randomized to: DFP (N = 8): single subcutaneous (SC) injection of DFP (5 mg/kg). Treatment (N = 9): DFP (5 mg/kg) followed by chronic naltrexone (5 mg/kg/day × 12 weeks). Control (N = 12): single SC injection of isopropyl alcohol, (DFP vehicle) followed by chronic naltrexone (5 mg/kg/day). If toxicity developed after injection, antidotal therapy was initiated with atropine (2 mg/kg) and pralidoxime (25 mg/kg) and repeated as needed. After 12 weeks, rats underwent testing for place learning (acquisition) across 5 days of training using the Morris Water Maze. On day 6 a memory retention test was performed. Statistical analysis was performed using IBM SPSS Statistics. Rats receiving DFP rapidly developed toxicity requiring antidotal rescue. No differences in acquisition were seen between the DFP vs. DFP + naltrexone rats. During memory testing, DFP-poisoned rats spent significantly less time (29.4 ± 2.11 versus 38.5 ± 2.5 s, p < 0.05) and traveled less distance (267 ± 24.6 versus 370 ± 27.5 cm, p < 0.05) in the target quadrant compared to the treatment group. Treatment rats performed as well as control rats (p > 0.05) on the test for memory retention. Poisoning with DFP induced impaired memory retention. Deficits were not prevented by acute rescue with atropine and pralidoxime. Chronic naltrexone treatment led to preserved memory after DFP poisoning.

  3. Augmentation of cholinesterases and ATPase activities in the cerebellum and pons-medulla oblongata, by a combination of antioxidants (resveratrol, ascorbic acid, alpha-lipoic acid and vitamin E), in acutely lindane intoxicated mice.

    PubMed

    Bist, Renu; Bhatt, Devendra Kumar

    2010-09-15

    In the present investigation neurotoxic effects of lindane and the protective potential of a combination of antioxidants against lindane-induced toxicity were evaluated in Swiss mice. The investigation was carried out on acetylcholinesterase (AChE), butyrylcholinesterase (BChE) and adenosine triphosphatase (ATPase) activities of the cerebellum and pons-medulla oblongata. Healthy mice, 7-8 weeks old were administered acute dose of lindane (40 mg/kg b.w.), antioxidants, both lindane and antioxidants, and vehicle in four separate groups, subcutaneously. Resveratrol (Res), ascorbic acid (C), alpha-lipoic acid (ALA) and vitamin E (E) were used in the combination for neuroprotection at the concentration of 5 mg/kg b.w., 50 mg/kg b.w., 20 mg/kg b.w. and 50 mg/kg b.w. respectively. Enzymatic activities were used as biochemical marker for manifestation of lindane-induced acute toxicity. Protective effects of antioxidants were also evaluated using the same parameters. Treatment of lindane to normal control animals resulted in a significant decrease in AChE, BChE and ATPase levels in crude homogenates of cerebellum and pons-medulla. Antioxidants treatment significantly increased the levels of enzymes. Critical difference (CD) of AChE, BChE and ATPase levels in various groups was found significant at 1% in cerebellum and pons-medulla both (i.e. P<0.01).

  4. Fatal alcohol intoxication in women: A forensic autopsy study from Slovakia

    PubMed Central

    2011-01-01

    Background Plenty of information related to alcoholism can be found in the literature, however, the studies have mostly dealt with the predominance of male alcoholism and data related to addiction in women are desperately scarce and difficult to find. Basic demographic data focusing on the impact of acute alcohol intoxication on the circumstances of death and social behaviour in the alcohol addicted female population are needed especially in the prevention of alcohol related mortality. Methods A retrospective forensic autopsy study of all accidental deaths due to alcohol intoxication over a 12-year period was performed in order to evaluate the locations, circumstances, mechanisms and causes of death. Results A sample of 171 cases of intoxicated women who died due to blood alcohol concentration (BAC) equal to or higher than 2 g/kg was selected. Among them 36.26% (62/171) of women died due to acute alcohol intoxication (AAI). We noted an increase in the number of deaths in women due to AAI from 2 in 1994 up to 5 in 2005 (an elevation of 150% between the years 1994-2005). The age structure of deaths in women due to BAC and AAI followed the Gaussian distribution with a dominant group of women aged 41-50 years (45.16% and 35.09% respectively). The most frequent place of death (98%) among women intoxicated by alcohol was their own home. The study suggests a close connection between AAI and violence against women. Conclusions The increasing number of cases of death of women suffering from AAI has drawn attention to the serious problem of alcoholism in women in the Slovak Republic during the process of integration into "western" lifestyle and culture. PMID:22168833

  5. Accidental salinomycin intoxication in calves

    PubMed Central

    Omidi, Arash; Aslani, Mohammad R.; Movassaghi, Ahmad R.; Mohri, Mehrdad; Dadfar, Mohammad

    2010-01-01

    Twenty-four 10- to 16-week-old calves in a dairy herd in Birjand, Iran, inadvertently received an excessive dose of salinomycin mixed with barley grain. There was 58% mortality within 10 d. The calves had high serum AST, LDH, and CK activities; histopathologic lesions in myocardium, liver, and kidneys; and clinical signs associated with acute and congestive heart failure. PMID:21197208

  6. A Double-Blind Atropine Trial for Active Learning of Autonomic Function

    ERIC Educational Resources Information Center

    Fry, Jeffrey R.; Burr, Steven A.

    2011-01-01

    Here, we describe a human physiology laboratory class measuring changes in autonomic function over time in response to atropine. Students use themselves as subjects, generating ownership and self-interest in the learning as well as directly experiencing the active link between physiology and pharmacology in people. The class is designed to…

  7. The effect of topical atropine on the choroidal thickness of healthy children

    PubMed Central

    Zhang, Zhengwei; Zhou, Yuanting; Xie, Zhifang; Chen, Tiantian; Gu, Yan; Lu, Shui; Wu, Zhifeng

    2016-01-01

    The purpose of the current study was to investigate the effect of topical atropine on choroidal thickness using spectral-domain optical coherence tomography. A total of 30 healthy eyes from 30 children were analyzed in this study. A single drop of 1% atropine gel was administered twice daily for a week. Choroidal thickness (CT) was measured using SD-OCT, and changes in CT before and after administration of the eye drops were analyzed at the subfovea and at 1.0-mm intervals (up to 3.0 mm) from the fovea at superior, inferior, nasal, and temporal locations. Pre- and post-cycloplegic axial length (AL) was also measured using the IOLMaster. We observed that administration of 1% atropine gel led to a significant increase in the choroidal thickness under the fovea and at all intervals from the fovea. The greatest change in CT was observed in the inferior meridian, while the nasal meridian exhibited the least change. AL did not significantly differ before and after cycloplegia, and there was no significant correlation between the changes in AL and subfoveal CT. It was concluded that administration of 1% atropine gel can significantly increase CT in the eyes of young Chinese children, albeit with different magnitude at different locations. PMID:27713535

  8. Permanent alterations in muscarinic receptors and pupil size produced by chronic atropinization in kittens

    SciTech Connect

    Smith, E.L.; Redburn, D.A.; Harwerth, R.S.; Maguire, G.W.

    1984-02-01

    Chronic mydriasis was induced in six kittens (four monocular, two binocular) and two adult cats (both monocular) by the daily topical application of atropine. Both the kittens and the adult cats were atropinized for a 13-week period with the treatment regimen beginning at the time of eye opening for the kittens. Pupil size measurements, obtained 1 year after the atropinization were discontinued, revealed that, although the pupils of the adult cats were normal, the pupils of the kittens' treated eyes were consistently smaller than pupils in control eyes. The status of the muscarinic receptors in the kittens' irides was investigated using /sup 3/H-QNB binding assays. In comparison with iris muscle homogenates from the control eyes, those from the treated eyes demonstrated an eightfold increase in the number of receptor binding sites. The results indicate that pupil size can be altered permanently by chronic mydriasis initiated early in the life of a kitten and that the permanent change in pupil size may result, in part, from a type of permanent supersensitivity response in the muscle following chronic blockade of muscarinic transmission by atropine.

  9. [Metabolic encephalopathy secondary to vitamin D intoxication].

    PubMed

    Herrera Martínez, Aura; Viñals Torràs, Montserrat; Muñoz Jiménez, Ma Concepción; Arenas de Larriva, Antonio Pablo; Molina Puerta, Ma José; Manzano García, Gregorio; Gálvez Moreno, Ma Ángeles; Calañas-Continente, Alfonso

    2014-10-25

    The association between vitamin D deficiency and increased risk of, among others, cardiovascular and autoimmune diseases has lead in the last years to an enhanced interest in the usage of supplements to achieve the normalization of plasmatic values at 25(OH) D. Apparently this search for normalization is resulting in an higher incidence on vitamin D intoxication. We present the case of an 81 years old woman with metabolic encephalopathy and renal failure secondary to iatrogenic vitamin D intoxication. Calcium and vitamin D oral supplements were prescribed after an osteoporotic vertebral fracture. The patient improved clinically as well as analytically after receiving treatment with diuretics and hydration. We emphasize the importance of discarding hypercalcemia as a cause of metabolic encephalopathy; moreover we highly recommend keeping vitamin D intoxication in mind as an uncommon although always possible etiology of reversible hypercalcemia and renal failure.

  10. [Suicidal intoxication with sodium azide--a case report].

    PubMed

    Wiergowski, Marek; Galer-Tatarowicz, Katarzyna; Krzyzanowski, Maciej; Jankowski, Zbigniew; Sein Anand, Jacek

    2012-01-01

    Sodium azide (NaN3) is an inorganic matrix compound with a very high toxicity. Mechanism of action is not clarified, and it is assumed to interfere with the processes of oxidative phosphorylation. The acute intoxications with sodium azide are extremely rare. We described a case of 19-year-old man who was found dead. In the course of prosecution the empty container, with label "NaN3, 20 g", was found near the body. There were traces of white powder detected in the container. Azide ions were determined by derivatization, i.e. they were transformed to pentafluorobenzaldehyde azide compound. Analysis of the final extract after derivatization was performed by gas chromatography coupled with mass spectrometry GC/MS. The largest concentration of azide ions were determined in the stomach content and vitreous humour, and much less one in whole blood, urine and kidney fluid.

  11. Case report of a fatal intoxication by Nucynta.

    PubMed

    Franco, Dori M; Ali, Zabiullah; Levine, Barry; Middleberg, Robert A; Fowler, David R

    2014-12-01

    Tapentadol (Nucynta) is a centrally acting opioid analgesic prescribed for the treatment of moderate to severe acute pain. Its efficacy is believed to be due to μ-opioid receptor agonist activity and inhibition of norepinephrine reuptake resulting in increased norepinephrine concentrations. There is only one other case in the literature relating to the toxicity of this agent or report of a fatality. This case report documents a case in which tapentadol was identified as the cause of death. The tapentadol concentration found in the heart blood submitted in this case was more than 20 times the upper limit of the therapeutic range. Possible mechanisms of death include respiratory depression, central nervous system depression, and serotonin syndrome. Based on the scene investigation and autopsy findings in this case, the medical examiner determined that the cause of death was narcotic (Nucynta) intoxication and the manner of death was undetermined.

  12. Crisis management during anaesthesia: water intoxication

    PubMed Central

    Kluger, M; Szekely, S; Singleton, R; Helps, S

    2005-01-01

    Background: Irrigation of closed body spaces may lead to substantial perioperative fluid and electrolyte shifts. A syndrome occurring during transurethral resection of prostate (TURP), and a similar syndrome described in women undergoing transcervical endometrial ablation (TCEA) are both characterised by a spectrum of symptoms which may range from asymptomatic hyponatraemia to convulsions, coma, and death. Such potentially serious consequences require prompt recognition and appropriate management of this "water intoxication" syndrome. Objectives: To examine the role of a previously described core algorithm "COVER ABCD–A SWIFT CHECK", supplemented by a specific sub-algorithm for water intoxication, in the management of this syndrome occurring in association with anaesthesia. Methods: The potential performance of this structured approach for each of the relevant incidents among the first 4000 reported to the Australian Incident Monitoring Study (AIMS) was compared with the actual management as reported by the anaesthetists involved. Results: From the first 4000 incidents reported to AIMS, 10 reports of water intoxication were identified, two from endometrial ablations under general anaesthesia and eight from male urological procedures under spinal anaesthesia. The "core" crisis management algorithm detected a problem in seven cases; however, it was deficient in dealing with neurological presentations. Diagnosis of the cause of the incident would have required a specific water intoxication sub-algorithm in eight cases and a hypotension algorithm in a further two cases. Corrective strategies also required a specific sub-algorithm in eight cases, while the hypotension and cardiac arrest sub-algorithms were required in conjunction with the water intoxication sub-algorithm in the remaining two. Conclusion: This relatively uncommon problem is managed poorly using the "core" crisis management sub-algorithm and requires a simple specific sub-algorithm for water

  13. Sudden death during arrest and phencyclidine intoxication.

    PubMed

    Pestaner, Joseph P; Southall, Pamela E

    2003-06-01

    Deaths of individuals being arrested are important and complex medicolegal cases. Conclusions regarding the cause and manner of death for such cases must take into account multiple factors that may have played a role, as well as anticipate the forensic issues that will arise. In this article, we review the deaths of 2 individuals in which phencyclidine intoxication was a factor that contributed to death during arrest. Most cases of sudden death during arrest have involved cocaine intoxication; because phencyclidine's pharmacologic properties are quite different from those of cocaine, these cases allow for comparisons to those factors that may have greater importance.

  14. Gangliosides, or sialic acid, antagonize ethanol intoxication

    SciTech Connect

    Klemm, W.R.; Boyles, R.; Matthew, J.; Cherian, L.

    1988-01-01

    Because ethanol elicits a dose-dependent hydrolysis of brain sialogangliosides, the authors tested the possibility that injected gangliosides might antagonize intoxicating doses of ethanol. Clear anti-intoxication effects were seen at 24 hr post-injection of mixed mouse-brain gangliosides at 125-130 mg/kg, but not at lower or higher doses. Sleep time was reduced on the order of 50%, and roto-rod agility was significantly enhanced. Sialic acid (SA) similarly antagonized ethanol; however, the precursor of SA, N-acetyl-D-mannosamine, as well as ceramide and asialoganglioside did not.

  15. Mechanism of Cooperativity and Nonlinear Release Kinetics in Multivalent Dendrimer-Atropine Complexes.

    PubMed

    Mukherjee, Jhindan; Wong, Pamela T; Tang, Shengzhuang; Gam, Kristina; Coulter, Alexa; Baker, James R; Choi, Seok Ki

    2015-12-07

    Despite extensive studies on drug delivery using multivalent complexation systems, the biophysical basis for release kinetics remains poorly defined. The present study addresses this aspect involved in the complexation of a fifth generation poly(amidoamine) (PAMAM) dendrimer with atropine, an essential antidote used for treating organophosphate poisoning. First, we designed (1)H NMR titration studies for determining the molecular basis of the drug complexation with a glutarate-modified anionic dendrimer. These provide evidence pointing to a combination of electrostatic and hydrophobic interactions as the driving forces for dendrimer complexation with the alkaloid drug molecule. Second, using LC-MS/MS spectrometry, we determined the dissociation constants (KD) at steady state and also measured the drug release kinetics of atropine complexes with four negatively charged dendrimer types. Each of these dendrimers has a high payload capacity for up to ∼ 100 atropine molecules. However, the affinity of the atropine to the carrier was highly dependent on the drug to dendrimer ratio. Thus, a complex made at a lower loading ratio (≤ 0.1) displayed greater atropine affinity (KD ≈ μM) than other complexes prepared at higher ratios (>10), which showed only mM affinity. This negative cooperative variation in affinity is tightly associated with the nonlinear release kinetics observed for each complex in which drug release occurs more slowly at the later time phase at a lower loading ratio. In summary, the present study provides novel insights on the cooperativity as the mechanistic basis for nonlinear release kinetics observed in multivalent carrier systems.

  16. 30 CFR 57.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Intoxicating beverages and narcotics. 57.20001... Miscellaneous § 57.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  17. 30 CFR 56.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Intoxicating beverages and narcotics. 56.20001... § 56.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  18. 7 CFR 501.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Intoxicating beverages and narcotics. 501.7 Section... § 501.7 Intoxicating beverages and narcotics. Entering Research Center property or the operating of a motor vehicle thereon, by a person under the influence of intoxicating beverages or narcotic...

  19. 7 CFR 500.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Intoxicating beverages and narcotics. 500.7 Section... Intoxicating beverages and narcotics. (a) Entering USNA property or the operation of a motor vehicle thereon, by a person under the influence of intoxicating beverages or a narcotic drug, is prohibited....

  20. 30 CFR 56.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Intoxicating beverages and narcotics. 56.20001... § 56.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  1. 7 CFR 502.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Intoxicating beverages and narcotics. 502.8 Section..., MARYLAND § 502.8 Intoxicating beverages and narcotics. Entering BARC property or the operation of a motor vehicle thereon, by a person under the influence of intoxicating beverages or narcotic drug,...

  2. 31 CFR 407.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Intoxicating beverages and narcotics... TREASURY ANNEX § 407.8 Intoxicating beverages and narcotics. Entering or being on the property, or operating a motor vehicle thereon, by a person under the influence of intoxicating beverages or...

  3. 7 CFR 500.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Intoxicating beverages and narcotics. 500.7 Section... Intoxicating beverages and narcotics. (a) Entering USNA property or the operation of a motor vehicle thereon, by a person under the influence of intoxicating beverages or a narcotic drug, is prohibited....

  4. 7 CFR 501.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Intoxicating beverages and narcotics. 501.7 Section... § 501.7 Intoxicating beverages and narcotics. Entering Research Center property or the operating of a motor vehicle thereon, by a person under the influence of intoxicating beverages or narcotic...

  5. 7 CFR 501.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Intoxicating beverages and narcotics. 501.7 Section... § 501.7 Intoxicating beverages and narcotics. Entering Research Center property or the operating of a motor vehicle thereon, by a person under the influence of intoxicating beverages or narcotic...

  6. 7 CFR 502.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Intoxicating beverages and narcotics. 502.8 Section..., MARYLAND § 502.8 Intoxicating beverages and narcotics. Entering BARC property or the operation of a motor vehicle thereon, by a person under the influence of intoxicating beverages or narcotic drug,...

  7. 7 CFR 501.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Intoxicating beverages and narcotics. 501.7 Section... § 501.7 Intoxicating beverages and narcotics. Entering Research Center property or the operating of a motor vehicle thereon, by a person under the influence of intoxicating beverages or narcotic...

  8. 30 CFR 56.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Intoxicating beverages and narcotics. 56.20001... § 56.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  9. 30 CFR 57.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Intoxicating beverages and narcotics. 57.20001... Miscellaneous § 57.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  10. 30 CFR 56.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Intoxicating beverages and narcotics. 56.20001... § 56.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  11. 7 CFR 500.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Intoxicating beverages and narcotics. 500.7 Section... Intoxicating beverages and narcotics. (a) Entering USNA property or the operation of a motor vehicle thereon, by a person under the influence of intoxicating beverages or a narcotic drug, is prohibited....

  12. 31 CFR 407.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Intoxicating beverages and narcotics... TREASURY ANNEX § 407.8 Intoxicating beverages and narcotics. Entering or being on the property, or operating a motor vehicle thereon, by a person under the influence of intoxicating beverages or...

  13. 7 CFR 502.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Intoxicating beverages and narcotics. 502.8 Section..., MARYLAND § 502.8 Intoxicating beverages and narcotics. Entering BARC property or the operation of a motor vehicle thereon, by a person under the influence of intoxicating beverages or narcotic drug,...

  14. 7 CFR 501.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Intoxicating beverages and narcotics. 501.7 Section... § 501.7 Intoxicating beverages and narcotics. Entering Research Center property or the operating of a motor vehicle thereon, by a person under the influence of intoxicating beverages or narcotic...

  15. 7 CFR 502.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Intoxicating beverages and narcotics. 502.8 Section..., MARYLAND § 502.8 Intoxicating beverages and narcotics. Entering BARC property or the operation of a motor vehicle thereon, by a person under the influence of intoxicating beverages or narcotic drug,...

  16. 7 CFR 500.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Intoxicating beverages and narcotics. 500.7 Section... Intoxicating beverages and narcotics. (a) Entering USNA property or the operation of a motor vehicle thereon, by a person under the influence of intoxicating beverages or a narcotic drug, is prohibited....

  17. 30 CFR 57.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Intoxicating beverages and narcotics. 57.20001... Miscellaneous § 57.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  18. 30 CFR 56.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Intoxicating beverages and narcotics. 56.20001... § 56.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  19. 31 CFR 407.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false Intoxicating beverages and narcotics... TREASURY ANNEX § 407.8 Intoxicating beverages and narcotics. Entering or being on the property, or operating a motor vehicle thereon, by a person under the influence of intoxicating beverages or...

  20. 7 CFR 502.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Intoxicating beverages and narcotics. 502.8 Section..., MARYLAND § 502.8 Intoxicating beverages and narcotics. Entering BARC property or the operation of a motor vehicle thereon, by a person under the influence of intoxicating beverages or narcotic drug,...

  1. 30 CFR 57.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Intoxicating beverages and narcotics. 57.20001... Miscellaneous § 57.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  2. 31 CFR 407.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 2 2014-07-01 2014-07-01 false Intoxicating beverages and narcotics... TREASURY ANNEX § 407.8 Intoxicating beverages and narcotics. Entering or being on the property, or operating a motor vehicle thereon, by a person under the influence of intoxicating beverages or...

  3. 31 CFR 407.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false Intoxicating beverages and narcotics... TREASURY ANNEX § 407.8 Intoxicating beverages and narcotics. Entering or being on the property, or operating a motor vehicle thereon, by a person under the influence of intoxicating beverages or...

  4. 7 CFR 500.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Intoxicating beverages and narcotics. 500.7 Section... Intoxicating beverages and narcotics. (a) Entering USNA property or the operation of a motor vehicle thereon, by a person under the influence of intoxicating beverages or a narcotic drug, is prohibited....

  5. 30 CFR 57.20001 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Intoxicating beverages and narcotics. 57.20001... Miscellaneous § 57.20001 Intoxicating beverages and narcotics. Intoxicating beverages and narcotics shall not be permitted or used in or around mines. Persons under the influence of alcohol or narcotics shall not...

  6. Open-label randomized clinical trial of atropine bolus injection versus incremental boluses plus infusion for organophosphate poisoning in Bangladesh.

    PubMed

    Abedin, Mohammed Joynal; Sayeed, Abdullah Abu; Basher, Ariful; Maude, Richard J; Hoque, Gofranul; Faiz, M A

    2012-06-01

    Severe organophosphate compound (OPC) poisoning is an important clinical problem in many countries of the world. Unfortunately, little clinical research has been performed and little evidence exists with which to determine the best therapy. A study was therefore undertaken to determine the optimal dosing regimen for atropine in the treatment of OPC poisoning. An open-label randomized clinical trial was conducted in Chittagong Medical College Hospital, Chittagong, Bangladesh, on 156 hospitalized individuals with OPC poisoning from June to September 2006. The aim was to compare the efficacy and safety of conventional bolus doses with individualized incremental doses of atropine for atropinization followed by continuous atropine infusion for management of OPC poisoning. Inclusion criteria were patients with a clear history of OPC poisoning with clear clinical signs of toxicity, i.e. features of cholinergic crisis. The patients were observed for at least 96 h. Immediate outcome and complications were recorded. Out of 156 patients, 81 patients received conventional bolus dose atropine (group A) and 75 patients received rapidly incremental doses of atropine followed by infusion (group B). The mortality in group 'A' was 22.5% (18/80) and in group 'B' 8% (6/75) (p < 0.05). The mean duration of atropinization in group 'A' was 151.74 min compared to 23.90 min for group 'B' (p < 0.001). More patients in group A experienced atropine toxicity than in group 'B' (28.4% versus 12.0%, p < 0.05); intermediate syndrome was more common in group 'A' than in group 'B' (13.6% versus 4%, p < 0.05), and respiratory support was required more often for patients in group 'A' than in group 'B' (24.7% versus 8%, p < 0.05). Rapid incremental dose atropinization followed by atropine infusion reduces mortality and morbidity from OPC poisoning and shortens the length of hospital stay and recovery. Incremental atropine and infusion should become the treatment of choice for OPC

  7. Cytotoxicity of atropine to human corneal epithelial cells by inducing cell cycle arrest and mitochondrion-dependent apoptosis.

    PubMed

    Tian, Cheng-Lei; Wen, Qian; Fan, Ting-Jun

    2015-10-01

    Atropine is an anticholinergic drug for mydriasis in eye clinic, and its abuse might be cytotoxic to the cornea and result in blurred vision. However, the cytotoxicity of atropine to the cornea and its cellular and molecular mechanisms remain unknown. In this study, we investigated the cytotoxicity of atropine to corneal epithelium and its underlying mechanisms using an in vitro model of non-transfected human corneal epithelial (HCEP) cells. Our results showed that atropine, above the concentration of 0.3125 g/l (1/32 of its therapeutic dosage in eye clinic), had a dose- and time-dependent toxicity to HCEP cells by inducing morphological abnormality, cytopathic effect, viability decline, and proliferation retardation. Moreover, the proliferation-retarding effect of atropine on the cells was achieved by inducing G1/S phase arrest and downregulation of E-cadherin and β-catenin. Besides, atropine also had an apoptosis-inducing effect on the cells by inducing phosphatidylserine externalization, plasma membrane permeability elevation, DNA fragmentation and apoptotic body formation. Furthermore, atropine could also induce activations of caspase-2, -3 and -9, disruption of mitochondrial transmembrane potential, downregulation of Bcl-2 and Bcl-xL, upregulation of Bax and Bad, and upregulation of cytoplasmic cytochrome c and apoptosis-inducing factor, implying a death receptor-mediated mitochondrion-dependent pathway is most probably involved in the apoptosis of HCEP cells induced by atropine. Taken together, our results suggest that atropine has remarkable cytotoxicity to HCEP cells by inducing cell cycle arrest and death receptor-mediated mitochondrion-dependent apoptosis.

  8. Prescription of atropine eye drops among children diagnosed with myopia in Taiwan from 2000 to 2007: a nationwide study

    PubMed Central

    Fang, Y-T; Chou, Y-J; Pu, C; Lin, P-J; Liu, T-L; Huang, N; Chou, P

    2013-01-01

    Purpose This study was conducted to examine the atropine eye drop prescription trend for children diagnosed with myopia, and to determine the factors associated with the prescription of atropine eye drops. Design This was a population-based cross-sectional study. Methods This study was conducted using a national representative sample from the National Health Insurance (NHI) claims data. All school children between 4 and 18 years of age who had visited an ophthalmologist and were diagnosed with myopia between 2000 and 2007 were included herein. The main outcome measure was the proportion of subjects who were prescribed atropine eye drops in each year. Logistic regression was used to identify the factors associated with atropine eye drops being prescribed. Results The prescription of atropine eye drops for children diagnosed with myopia increased significantly from the school years 2000 (36.9%) to 2007 (49.5%). There was also a shift from prescribing high concentrations (0.5 and 1%) of atropine eye drops to lower concentration ones (0.3, 0.25, and 0.1%) within this period. Atropine eye drops were more frequently prescribed to 9–12-year-old children (OR=1.26–1.42, compared with those 7–8 years old), and to children from families with a high socioeconomic status (OR=1.19–1.25); however, they were less prescribed to those living in mid to low urbanized areas (OR=0.65–0.84). Conclusions This study revealed an increasing trend of atropine eye drop prescription for children with myopia in Taiwan. Our study provides eye-care professionals worldwide a reference for the potential integration of atropine eye drops into their clinical practice toward children with myopia. PMID:23288141

  9. Effect of five acetylcholinesterase reactivators on tabun-intoxicated rats: induction of oxidative stress versus reactivation efficacy.

    PubMed

    Pohanka, Miroslav; Karasova, Jana Zdarova; Musilek, Kamil; Kuca, Kamil; Kassa, Jiri

    2009-08-01

    Oxime reactivators HI-6, obidoxime, trimedoxime, K347 and K628 were investigated as drugs designed for treatment of tabun intoxication. The experiments were performed on rats in order to simulate real conditions. Rats were intoxicated with one LD(50 )of tabun and treated with atropine and mentioned reactivators. Activities of erythrocyte acetylcholinesterase (AChE), plasma butyrylcholinesterase (BChE) and brain AChE were measured as markers of reactivation efficacy. An estimation of low molecular weight antioxidant levels using cyclic voltammetry was the second examination parameter. The evaluation of cholinesterases activity showed good reactivation potency of blood AChE and plasma BChE by commercially available obidoxime and newly synthesized K347. The potency of oximes to reactivate brain AChE was lower due to the poor blood-brain barrier penetration of used compounds. Commercially available reactivator HI-6 and newly synthesized K628 caused oxidative stress measured by cyclic voltammetry as antioxidant level. The oxidative stress provoked by HI-6 and K628 was found to be significant on probability level P = 0.05. The others reactivators did not affect antioxidant levels.

  10. Platelet aggregation associated with ethanol intoxication

    SciTech Connect

    Volk, S.; Walenga, J.; Fareed, J.; Schumacher, H. )

    1989-02-09

    Alcohol is known to produce profound effects on blood; during chronic intoxication, prolongation of bleeding time has been reported. Utilizing human platelet rich plasma, we have studied the effect of alcohol on epinephrine, arachidonic acid and ADP induced aggregation. Control responses were obtained with saline from which the relative inhibition by alcohol was calculated. These studies were carried out at a concentration of 1.25-5.0 mg/ml which represents 0.125-0.5% alcohol blood levels. From 25 normal male and female volunteers, without prior hemostatic defects or drug ingestion, a dose-dependent inhibition by alcohol of all three agonist induced aggregations was noted. Alcohol itself did not produce any aggregation response. These studies demonstrate that alcohol at levels which are reached during intoxication is capable of impairing platelet function. The implication of this finding on the bleeding complications in healthy intoxicated patients may be significant during traumatic events, and individuals taking antiplatelet drugs may present a more serious hemostatic deficit during alcohol intoxication.

  11. Recognition of intoxication by alcohol counselors.

    PubMed

    Carroll, N; Rosenberg, H; Funke, S

    1988-01-01

    Recent studies have found that police officers, bartenders, social drinkers, and trained interviewers are often unable to recognize when others are intoxicated. The present two studies were conducted to evaluate: (a) the recognition ability of alcohol counselors compared to mental health counselors, and (b) the recognition ability of less-experienced versus more-experienced alcohol counselors. Subjects viewed four videotapes of a 21-year-old male engaged in simulated counseling interviews after he was given drinks containing alcohol to achieve one of four target Blood Alcohol Level (BAL) goals: .00%, .05%, .10%, .15%. Results indicated that alcohol counselors were not uniformly more accurate than mental health therapists, nor were more-experienced alcohol counselors uniformly more accurate than less-experienced alcohol counselors at recognizing intoxication or estimating BAL. In addition, subjects generally underestimated the target's sober-intoxicated status and BAL when he was given alcohol, but almost every subject recognized that the target was at least moderately intoxicated when his BAL was .15%.

  12. Passive marijuana usage and water intoxication.

    PubMed Central

    Quinton, B. A.; Logan, S. J.; Ramdial, H. L.; Walton, S. A.

    1993-01-01

    This article reports a case of a 3-month-old male presenting with hyponatremic seizure and hypothermia. The presence of marijuana in the infant's urine was remarkable. An etiologic role for the drug is questioned. A review of the literature is provided and the hypothesis of child neglect in the genesis of water intoxication is explored. PMID:8478974

  13. Increased acetylcholine esterase activity produced by the administration of an aqueous extract of the seed kernel of Thevetia peruviana and its role on acute and subchronic intoxication in mice

    PubMed Central

    Marroquín-Segura, Rubén; Calvillo-Esparza, Ricardo; Mora-Guevara, José Luis Alfredo; Tovalín-Ahumada, José Horacio; Aguilar-Contreras, Abigail; Hernández-Abad, Vicente Jesús

    2014-01-01

    Background: The real mechanism for Thevetia peruviana poisoning remains unclear. Cholinergic activity is important for cardiac function regulation, however, the effect of T. peruviana on cholinergic activity is not well-known. Objective: To study the effect of the acute administration of an aqueous extract of the seed kernel of T. peruviana on the acetylcholine esterase (AChE) activity in CD1 mice as well its implications in the sub-chronic toxicity of the extract. Materials and Methods: A dose of 100 mg/kg of the extract was administered to CD1 mice and after 7 days, serum was obtained for ceruloplasmin (CP) quantitation and liver function tests. Another group of mice received a 50 mg/kg dose of the extract 3 times within 1 h time interval and AChE activity was determined for those animals. Heart tissue histological preparation was obtained from a group of mice that received a daily 50 mg/kg dose of the extract by a 30-days period. Results: CP levels for the treated group were higher than those for the control group (Student's t-test, P ≤ 0.001). AChE activity in the treated group was significantly higher than the control group (Tukey test, control vs. T. peruviana, P ≤ 0.001). Heart tissue histological preparations showed leukocyte infiltrates and necrotic areas, consistent with infarcts. Conclusion: The increased levels of AChE and the hearth tissue infiltrative lesions induced by the aqueous seed kernel extract of T. peruviana explains in part the poisoning caused by this plant, which can be related to an inflammatory process. PMID:24914300

  14. A double-blind atropine trial for active learning of autonomic function.

    PubMed

    Fry, Jeffrey R; Burr, Steven A

    2011-12-01

    Here, we describe a human physiology laboratory class measuring changes in autonomic function over time in response to atropine. Students use themselves as subjects, generating ownership and self-interest in the learning as well as directly experiencing the active link between physiology and pharmacology in people. The class is designed to concomitantly convey the importance of bias in experimentation by adopting a double-blind placebo-controlled approach. We have used this class effectively in various forms with ∼600 students receiving atropine over the last 16 yr. This class has received favorable feedback from staff and students of medicine, pharmacy, and neuroscience, and we recommend it for such undergraduates. The learning objectives that students are expected to achieve are to be able to 1) know the ethical, safety, and hygiene requirements for using human volunteers as subjects; 2) implement and explain a double-blind placebo-controlled trial; 3) design, agree, and execute a protocol for making (and accurately recording) precise reproducible measurements of pulse rate, pupil diameter, and salivary flow; 4) evaluate the importance of predose periods and measurement consistency to detect effects (including any reversibility) after an intervention; 5) experience direct cause-and-effect relationships integrating physiology with pharmacology in people; 6) calculate appropriate summary statistics to describe the data and determine the data's statistical significance; 7) recognize normal variability both within and between subjects in baseline physiological parameters and also recognize normal variability in response to pharmacological treatment; 8) infer the distribution and role of muscarinic receptors in the autonomic nervous system with respect to the heart, eye, and mouth; 9) identify and explain the clinical significance of differences in effect due to the route and formulation of atropine; 10) produce and deliver a concise oral presentation of

  15. Genetically determined differences in ethanol sensitivity influenced by body temperature during intoxication

    SciTech Connect

    Alkana, R.L.; Finn, D.A.; Bejanian, M.; Crabbe, J.C.

    1988-01-01

    The present study investigated the importance of body temperature during intoxication in mediating differences between five inbred strains of mice (C57BL/6J; BALB/cJ; DBA/2J; A/HeJ; 129/J) in their acute sensitivity to the hypnotic effects of ethanol. Mice exposed to 22/degrees/C after ethanol injection became hypothermic and exhibited statistically significant differences between strains in rectal temperatures at the return of the righting reflex (RORR), duration of loss of the righting reflex (LORR), and blood and brain ethanol concentrations at RORR. Exposure to 34/degrees/C after injection offset ethanol-hypothermia and markedly reduced strain-related differences in rectal temperatures and blood and brain ethanol concentrations at RORR. Brain ethanol concentrations at RORR were significantly lower in C57, BALB, DBA and A/He mice exposed to 34/degrees/C compared to mice exposed to 22/degrees/C during intoxication suggesting that offsetting hypothermia increased ethanol sensitivity in these strains. Taken with previous in vitro studies, these results suggest that genetically determined differences in acute sensitivity to the behavioral effects of ethanol reflect differences in body temperature during intoxication as well as differences in sensitivity to the initial actions of ethanol at the cellular level.

  16. Chronic fructose intoxication after infancy in children with hereditary fructose intolerance. A cause of growth retardation.

    PubMed

    Mock, D M; Perman, J A; Thaler, M; Morris, R C

    1983-09-29

    In two unrelated boys, 5.3 and 3.8 years of age with hereditary fructose intolerance, apparently isolated growth retardation (-2.71 S.D. and -2.40 S.D.) occurred after infancy, even though acute symptomatic fructose intoxication was prevented by restriction of dietary fructose. When more stringent restriction of dietary fructose was instituted (approximately 40 mg per kilogram of body weight per day), growth velocity increased from the 25th to the 97th percentile in one child and from well below the 3d to above the 75th percentile in the other. When restriction of dietary fructose was experimentally relaxed (from 10 to 250 mg per kilogram per day), neither boy had symptoms, hypoglycemia, or evidence of hepatic or renal dysfunction, but both had sustained hyperuricemia and hyperuricosuria and increases in the plasma concentration and urinary excretion of magnesium. We conclude that in patients with hereditary fructose intolerance, clinically important chronic fructose intoxication can occur after infancy without causing symptoms of acute fructose intoxication and can be expressed as an apparently isolated, reversible retardation of somatic growth with a continuing disorder of adenine nucleotide metabolism, characterized in part by recurrently increased rates of degradation of adenine nucleotides.

  17. [Morphological signs of ethanol poisoning, alcohol abstinence and chronic alcoholic intoxication in the mesocorticolimbic dopaminergic system].

    PubMed

    Droblenkov, A V

    2011-01-01

    Forensic medical diagnostics of ethanol poisoning, alcohol abstinence, and chronic alcoholic intoxication of the mesocorticolimbic dopaminergic system remains an unresolved problem and encounters difficulties. This situation is due not only to the marked vulnerability of the neurons of the dopaminergic system but also to the fact that its mechanisms are poorly understood. The objective of the present work was to substantiate and develop diagnostic criteria for ethanol poisoning, alcohol abstinence, and chronic alcoholic intoxication of the neurons both in the mesocorticolimbic dopaminergic system and in other brain regions. The object of the study was the brain of healthy adult subjects who died from alcohol intoxication (in the period of ethanol resorption) and under conditions of alcohol abstinence (completion of the abstinence course). The purpose of the study was to elucidate factors responsible for the different degree of damage to the neurons of various identification groups (intact, hypochromic, picnomorphic, shadow) and macrogliocytes. The cells of all these types were counted at an area of 0.25 sq. mm within 4 squares each having a side of 250 mcm in length. The absolute and relative number of neurons in each group as well as the number of polyneuronal satellite cells per one intact neuron was determined. It was shown that alcohol intoxication is associated with acute swelling of and severe damage to brain neurons caused by the combination of such factors as toxic effect of ethanol, excessive production of catecholamines, and functional overstrain of dopaminergic neurons. The severity of acute alcohol damage to the neurons decreased with the distance from the mid-brain dopaminergic nuclei. Restoration of neurons during alcohol abstinence was due to compensatory activation of interactions between neurons and glial cells. It decreased in the sequence from the paranigral nucleus of the ventral portion of mesencephalic tegumentum to the medial portion of the

  18. Optimal choice of acetylcholinesterase reactivators for antidotal treatment of nerve agent intoxication.

    PubMed

    Bajgar, Jirí

    2010-01-01

    The studies dealing with mechanism of organophosphates (OP)/nerve agent action, prophylaxis and treatment of intoxications is a very hot topic at present. Though the research is very intensive, unfortunately, up to now, there is not universal or significantly better reactivator sufficiently effective against all nerve agents/OP when compared with presently available oximes (pralidoxime, methoxime, obidoxime, trimedoxime, HI-6). The use of the most effective reactivator (HI-6) using simple type of autoinjector (e.g. ComboPen) is strictly limited because of decomposition of HI-6 in solution. Thanks to better solubility it is clear that another salt of HI-6 (dimethanesulfonate, HI-6 DMS) is more convenient for the use as antidote against nerve agents in the autoinjector than HI-6 chloride (Cl). It was clearly demonstrated that reactivation potency of HI-6 DMS in comparison with HI-6 Cl in vivo was the same and bioavailability of HI-6 DMS is better than that of HI-6 Cl. Three chambered autoinjector allows administration of all three antidotes (atropine, reactivator, diazepam) simultaneously. Moreover, the content of chambers can be changed according to proposed requirements. Possible way to solve the problem of universal reactivator could be the use of two reactivators. Three chambered autoinjector is an ideal device for this purpose.

  19. The Effects of Atropine and Pyridostigmine on Thermoregulation and Work Tolerance in the Patas Monkey

    DTIC Science & Technology

    1990-09-01

    12 13. Gisolfi, C. F., Sato, K., Wall, P. T., and Satc, F. In vivo and in vitro characteristics of eccrine sweating in patas and rhesus monkeys. J... sweating , and even- tually, evaporative heat loss through its anticholinergic activity (2) resulting in increased net heat storage (1, 15), decreased heat...those reported for humans. The suppressed sweating capacity of the atropine significantly affected the heat loss mechanisms of the exercising animals

  20. Vasoactive Intestinal Polypeptide and Muscarinic Receptors: Supersensitivity Induced by Long-Term Atropine Treatment

    NASA Astrophysics Data System (ADS)

    Hedlund, Britta; Abens, Janis; Bartfai, Tamas

    1983-04-01

    Long-term treatment of rats with atropine induced large increases in the numbers of muscarinic receptors and receptors for vasoactive intestinal polypeptide in the salivary glands. Since receptors for vasoactive intestinal polypeptide coexist with muscarinic receptors on the same neurons in this preparation, the results suggest that a drug that alters the sensitivity of one receptor may also affect the sensitivity of the receptor for a costored transmitter and in this way contribute to the therapeutic or side effects of the drug.

  1. Safety of dobutamine-atropine stress echocardiography in patients with suspected or proven coronary artery disease.

    PubMed

    Poldermans, D; Fioretti, P M; Boersma, E; Forster, T; van Urk, H; Cornel, J H; Arnese, M; Roelandt, R T

    1994-03-01

    The purpose of this study was to establish the safety of high-dose dobutamine-atropine stress echocardiography in patients with suspected or proven coronary artery disease. Six hundred fifty consecutive examinations were completed. Mean age of patients was 61 years; 300 had a previous myocardial infarction. Heart rate increased from 73 to 129 beats/min during stress testing, blood pressure did not change significantly (from 140/81 to 150/80 mm Hg). Atropine was added to dobutamine in 239 patients when no ischemia was induced with dobutamine alone and the peak heart rate was < 85% of the theoretical maximal heart rate. Atropine was more frequently administered to patients taking beta blockers (77 vs 27%, p < 0.001). New wall motion abnormalities developed in 243 patients (37%). Significant or symptomatic cardiac tachyarrhythmias, or both, developed during 24 examinations: 1 patient developed ventricular fibrillation, 3 patients developed sustained ventricular tachycardia, 12 patients experienced nonsustained ventricular tachycardia (< 10 beats) and 8 patients had paroxysmal atrial fibrillation. Cardiac arrhythmias were more frequent in patients with a history of ventricular arrhythmias (ventricular tachycardia and fibrillation) (odds ratio 9.9, 2.0 to 45) or left ventricular dysfunction at rest (wall motion score > 1.12) (odds ratio 2.9, 1.1-7.6), but not associated with atropine addition. No death or myocardial infarction occurred. The full dose was not given to 13 patients despite absence of signs or markers of ischemia for limiting side effect, yielding an overall feasibility of the stress test of 98%.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Inhibition by atropine of the increased turnover of noradrenaline in the hypothalamus of rats exposed to cold

    PubMed Central

    Simmonds, M. A.

    1971-01-01

    1. Small doses of (-)-[3H] noradrenaline were injected into the lateral cerebral ventricles in rats to label radioactively the endogenous noradrenaline (NA) stores. 2. Intraventricular injection of 25 μg atropine methonitrate at the same time inhibited the increased rate of disappearance of [3H] NA from the hypothalamus at an environmental temperature of 9° C, when compared with the values at 24° C, without impairing temperature regulation. 3. At 32° C, 25 μg atropine methonitrate caused a lethal hyperthermia. A dose of 5 μg was not lethal and did not inhibit the increased rate of disappearance of [3H] NA from the hypothalamus. 4. It is concluded that the pathway which stimulates an increased turnover of NA in the cold contains an atropine sensitive synapse but is not the principal pathway of heat production. The increased turnover of NA in the heat probably does not involve an atropine sensitive synapse. PMID:5091157

  3. Datura stramonium toxicity mistakenly diagnosed as "bath salt" intoxication: a case report.

    PubMed

    Melvin, Kelly; Hourani, David

    2014-01-01

    Datura stramonium is a wildly growing plant found in West Virginia and in temperate regions throughout the world that is sometimes abused by young people because of its hallucinogenic effects. D. Stramonium overdose produces a classic anticholinergic syndrome that can lead to severe and sometimes fatal complications. Poisoning can be confused with more commonly seen drugs of abuse, particularly synthetic drugs which are not revealed by standard drug screens. Misdiagnosis can delay appropriate care and potentially lead to poorer outcomes. We present a case of a 15 year-old male with acute D. Stramonium poisoning initially misdiagnosed with bath salt intoxication who required treatment by two emergency departments, a pediatric ICU, and who was ultimately transferred to an inpatient psychiatric facility. We then discuss differential diagnosis of D. Stramonium poisoning and bath salt intoxication and present management strategies for the two conditions.

  4. Plasma-exchange treatment for severe carbamazepine intoxication: a case study.

    PubMed

    Kozanoglu, Ilknur; Kahveci, Suat; Asma, Suheyl; Yeral, Mahmut; Noyan, Aytul; Boga, Can; Ozdogu, Hakan

    2014-06-01

    Acute poisoning is an important cause of morbidity and mortality during childhood. This manuscript reports the positive outcome of a pediatric case with a history of accidental carbamazepine intake treated using plasma exchange. A 3-year-old male presented with severe carbamazepine intoxication. He was comatose and had generalized tonic clonic seizure, ventricular tachycardia, and hypotension. Although he did not respond to classical therapies, we performed two sessions of plasma exchange. The patient recovered rapidly and was discharged from the hospital six days from the time of carbamazepine ingestion with no complication or neurologic impairment. Plasma exchange can be performed safely in very small children, and it might be the first line treatment, particularly for intoxication with drugs that have high plasma-protein-binding properties.

  5. Water intoxication-a dangerous condition in labor and delivery rooms.

    PubMed

    Ophir, Ella; Solt, Ido; Odeh, Marwan; Bornstein, Jacob

    2007-11-01

    Water intoxication, a form of acute hyponatremia, has been described in various clinical situations. Although hyponatremia is a common metabolic disorder in hospitalized patients, it is generally not well known as a hazard in the labor and delivery room. However, several factors predispose laboring women to develop hyponatremia. Moreover, because the fetus acquires water from the maternal circulation via the placenta, and there is a close correlation between maternal and cord blood serum sodium levels, the newborn infant of a hyponatremic mother is also at considerable risk of developing water intoxication. We review the epidemiology, pathophysiology, clinical features, and treatment of this hazardous disorder. We emphasize the need for awareness of this condition, and call attention to the risk of fluid overload during labor.

  6. Physiological responses wearing MOPP-IV after atropine and pralidoxime administration in warm and cool environments

    SciTech Connect

    Kolka, M.A.; Cadarette, B.S.

    1988-04-01

    The effect of cholinolytic and oxime (2 mg atropine + 600 mg pralidoxime) therapy on temperature regulation was evaluated in 8 subjects wearing chemical warfare protective clothing (MOPP-level IV). Subjects were tested in two environments: 35 c, 60% rh and 13 C, 44% rh during very light physical activity (1-2 Met) over a six-hour period. Sweating was suppressed approximately 40% by atropine and pralidoxime, and heart rate increased approximately 30 beats/min with drug treatment. At 13 C, all eight subjects completed 350 minutes of exposure in both drug and control experiments. Rectal temperature (t sub re) averaged 38.24 C in both treatments when subjects terminated their exposure at 35 C. Mean skin temperature averaged 37.42 C for both groups at termination. The treatment of subjects with atropine and pralidoxime when wearing chemical protective clothing does not adversely affect the length of time individuals can remain in a cool environment during very light work. However, the wearing of chemical protective clothing will decrease exposure time significantly (approx. 40%) in both control and drug treated subjects in a warm environment.

  7. Safety and feasibility of dobutamine-atropine stress echocardiography in patients with ischemic left ventricular dysfunction.

    PubMed

    Cornel, J H; Balk, A H; Boersma, E; Maat, A P; Elhendy, A; Arnese, M; Salustri, A; Roelandt, J R; Fioretti, P M

    1996-01-01

    The aim of this study was to analyze whether left ventricular dysfunction affects the safety and feasibility of high-dose dobutamine-atropine stress echocardiography. We examined the results of the test in 318 consecutive patients who were referred for high-dose dobutamine-atropine stress echocardiography and also underwent diagnostic cardiac catheterization. Forty-four patients had a left ventricular ejection fraction of 25% or less (mean, 21%; range, 15% to 25%). In the entire group of 318 patients, no serious complications (death, myocardial infarction, or ventricular fibrillation) occurred. The overall feasibility of completing the test was excellent (97%). A trial fibrillation occurred in four patients, nonsustained ventricular tachycardia in 12, and sustained ventricular tachycardia in one. A decrease in systolic blood pressure of greater than 40 mm Hg or a peak systolic pressure of less than 80 mm Hg was present in eight cases. In the group with an ejection fraction of 25% or less, there was a higher rate of significant tachyarrhythmias (14% versus 5%; p = 0.03), whereas the feasibility of the test was slightly lower (89%; p < 0.01), but no difference for hypotension was found. By multivariate analysis, a history of tachyarrhythmias was the only predictor of stress-induced arrhythmias. Advanced left ventricular dysfunction does not represent a contraindication for dobutamine-atropine stress testing.

  8. Effects of the Chemical Defense Antidote Atropine Sulfate on Helicopter Pilot Performance: An In-Flight Study

    DTIC Science & Technology

    1991-06-01

    reported minor hallucinations . Digging ;,rt -,-,7in -e wis degraded overall and number facility was impaired en the aiernoon of the atropine day...at higher doses; 4) loss of coordination with doses higher than 10 mg; and 5) hallucinations with very large doses of atropine. Longo’s (1966) review...diopter of refractive error, possessed normal hearing , and was between the ages of 24 and 32 (mean=29.1). Each one received a complete physical

  9. Atropine-enhanced, antigen challenge-induced airway hyperreactivity in guinea pigs is mediated by eosinophils and nerve growth factor.

    PubMed

    Verbout, Norah G; Jacoby, David B; Gleich, Gerald J; Fryer, Allison D

    2009-08-01

    Although anticholinergic therapy inhibits bronchoconstriction in asthmatic patients and antigen-challenged animals, administration of atropine 1 h before antigen challenge significantly potentiates airway hyperreactivity and eosinophil activation measured 24 h later. This potentiation in airway hyperreactivity is related to increased eosinophil activation and is mediated at the level of the airway nerves. Since eosinophils produce nerve growth factor (NGF), which is known to play a role in antigen-induced airway hyperreactivity, we tested whether NGF mediates atropine-enhanced, antigen challenge-induced hyperreactivity. Antibody to NGF (Ab NGF) was administered to sensitized guinea pigs with and without atropine pretreatment (1 mg/kg iv) 1 h before challenge. At 24 h after challenge, animals were anesthetized, vagotomized, paralyzed, and ventilated. Electrical stimulation of both vagus nerves caused bronchoconstriction that was increased in challenged animals. Atropine pretreatment potentiated antigen challenge-induced hyperreactivity. Ab NGF did not affect eosinophils or inflammatory cells in any group, nor did it prevent hyperreactivity in challenged animals that were not pretreated with atropine. However, Ab NGF did prevent atropine-enhanced, antigen challenge-induced hyperreactivity and eosinophil activation (assessed by immunohistochemistry). This effect was specific to NGF, since animals given control IgG remained hyperreactive. These data suggest that anticholinergic therapy amplifies eosinophil interactions with airway nerves via NGF. Therefore, therapeutic strategies that target both eosinophil activation and NGF-mediated inflammatory processes in allergic asthma are likely to be beneficial.

  10. Fatal intoxication with hydrocarbons in deltamethrin preparation.

    PubMed

    Magdalan, Jan; Zawadzki, Marcin; Merwid-Lad, Anna

    2009-12-01

    Pyrethroid insecticides are very widely used in agriculture and household due to high effectiveness and low toxicity to humans. We have described a case of a fatal oral intoxication with decis, the insecticide containing pyrethroid (deltamethrin) in a hydrocarbon base. Pyrethroids, including deltamethrin, undergo rapid biotransformation by liver enzymes, which limit their systemic toxicity. Thus, we assume that in the presented case, fatal outcome of poisoning with decis was rather connected with toxic effects of hydrocarbon base (solvent naphtha) than with deltamethrin action. In the described case, detection of aromatic hydrocarbons in blood and lung tissue and their metabolites in urine confirms that these substances were absorbed from gastrointestinal tract to the systemic circulation. Predominant among the clinical outcomes in our patient was profound depression of CNS with apnea, which could be connected with narcotic action of organic solvents. The cardiac arrest was in mechanism of asystolia with prior non-responsive to catecholamines bradycardia and vascular collapse. We connect it with hydrocarbon-induced cardiotoxicity. It is worth remembering that many pyrethroid-containing insecticides are formulated in a hydrocarbon base. Intoxication with such preparations should always be considered not only as poisoning with pyrethroid alone but also as intoxication with hydrocarbons.

  11. Interstitial Pulmonary Edema Following Bromocarbamide Intoxication

    PubMed Central

    Sugihara, H.; Hagedorn, M.; Bōttcher, D.; Neuhof, H.; Mittermayer, Ch.

    1974-01-01

    Bromocarbamides are sleep-inducing drugs which can lead, in man, to intoxication and death due to respiratory failure. To prove whether hemodynamic factors or the changed endothelial permeability induce pulmonary edema, animal experiments were performed. The fine structural changes in pulmonary edema in rabbits were observed at 60, 90 and 120 minutes after oral administration. The major findings were a) large blebs between capillary endothelium and alveolar epithelium and b) interstitial edema of the vessel wall. The bleb contents were much less electron dense than the blood contents in the capillary. Colloidal carbon did not enter the bleb or the edematous interstitial tissue. Exogenous peroxidase uptake in pinocytotie vesicles increased in pathologic cases. The hemodynamic measurements in animal receiving artificial respiration which maintained the blood pO2 at a steady state showed similar blebs in the pulmonary vessels, indicating that anoxia is not the major cause of the vascular lesion. Moreover, pulmonary arterial pressure and pulmonary vascular resistance could be held in the normal range in artificially respirated animals under bromocarbamide intoxication. Thus, hemodynamic factors are not likely to play a pathogenetic role in bringing about pulmonary edema. The chief, early factor is the increased endothelial permeability due to increased cytoplasmic transport. From this a practical suggestion for treating patients with bromocarbamide intoxication is derived: the usual fluid replacement in shock patients should be handled with great care to avoid fluid overload of the lung. ImagesFig 1Fig 2Fig 3Fig 4Fig 5Fig 6 PMID:4835993

  12. Spirituality, intoxication and addiction: six forms of relationship.

    PubMed

    Room, Robin

    2013-09-01

    The paper considers six connections between spirituality and intoxication or addiction. They are: intoxication as a means of communication with a spiritual world; intoxication as destroying spirituality; shared use and intoxication as creating and validating community; spirituality and religion as a means of collective sobering-up; spirituality in individual sobering up; and abstinence as a spiritual practice, a witness, or a badge of membership in a spiritual community. Intoxication can either enhance or impede spirituality, both at individual and collective levels. Spirituality is often important in sobering up, both individually and collectively, and abstinence is a part of spiritual or religious practice in some traditions. But a full account must acknowledge the diversity in the interactions of spirituality and intoxication or addiction.

  13. Acute cyanide Intoxication: A rare case of survival.

    PubMed

    Jethava, Durga; Gupta, Priyamvada; Kothari, Sandeep; Rijhwani, Puneet; Kumar, Ankit

    2014-05-01

    A 30-year-old male jewellery factory worker accidentally ingested silver potassium cyanide and was brought to the emergency department in a state of shock and profound metabolic acidosis. This patient was managed hypothetically with use of injection thiopentone sodium intravenously until the antidote was received. Cyanide is a highly cytotoxic poison and it rapidly reacts with the trivalent iron of cytochrome oxidase thus paralysing the aerobic respiration. The result is severe lactic acidosis, profound shock, and its fatal outcome. The patient dies of cardio-respiratory arrest secondary to dysfunction of the medullary centres. It is rapidly absorbed, symptoms begin few seconds after exposure and death usually occurs in <30 min. The average lethal dose for potassium cyanide is about 250 mg. We used repeated doses of thiopentone sodium till the antidote kit was finally in our hands, hypothesising that it contains thiol group similar to the antidote thiosulphate. Moreover, it is an anticonvulsant. We were successful in our attempts and the patient survived though the specific antidotes could be administered after about an hour.

  14. Brain neuronal chromatin responses in acute soman intoxicated rats.

    PubMed

    Martin, L J; Doebler, J A; Wall, T J; Shih, T M; Anthony, A

    1986-08-01

    Male Sprague-Dawley rats (200 g) were injected subcutaneously with soman, a potent neuronal acetylcholinesterase (AChE) inhibitor, at doses of 0.5, 0.8 and 1.0 LD50 (1 LD50 = 135 micrograms/kg) before decapitation at 1 and 24 h post-exposure. Correlative data were obtained on the severity of brain AChE inactivation and physicochemical changes in nuclear chromatin of cerebrocortical (layer V) and striatal neurons using Feulgen-DNA (F-DNA) cytophotometry and ocular filar micrometry. Decreased lability of neurons to F-DNA acid hydrolysis (reduced F-DNA yield), nuclear shrinkage and chromatin aggregation (decreased chromophore area) were used as indices of suppression of genomic template activity; conversely, increases in F-DNA yield and chromophore area signify enhanced neuroexcitation. At 1 hr post-soman there was a dose-dependent inactivation of AChE with a moderate increase in chromatin activation, i.e., nuclear hypertrophy and chromatin dispersion. At 24 hr post-soman there was a partial restoration of AChE activity, notably in striatal neurons, with a suppression in chromatin template activity. These data indicate that actions of soman on neuronal functioning are time-dependent. The absence of any dose-related neuronal chromatin changes may signify existence of non-cholinergic mediated events.

  15. Acute barium intoxication following ingestion of soap water solution.

    PubMed

    Joshi, Nandita; Sharma, Chhavi Sarabpreert; Sai; Sharma, Jai Prakash

    2012-10-01

    We present a rare case in which a young girl ingested a solution of a hair-removing soap. The ingestion resulted in profound hypokalemia and severe acidosis leading to flaccid paralysis, respiratory arrest and ventricular arrhythmias. Ultimately the patient made complete recovery. The soapwas found to contain barium sulfide. The degree of paralysis and acidosis appeared to be directly related to serum potassium levels.

  16. Acute barium intoxication following ingestion of soap water solution

    PubMed Central

    Joshi, Nandita; Sharma, Chhavi Sarabpreert; Sai; Sharma, Jai Prakash

    2012-01-01

    We present a rare case in which a young girl ingested a solution of a hair-removing soap. The ingestion resulted in profound hypokalemia and severe acidosis leading to flaccid paralysis, respiratory arrest and ventricular arrhythmias. Ultimately the patient made complete recovery. The soapwas found to contain barium sulfide. The degree of paralysis and acidosis appeared to be directly related to serum potassium levels. PMID:23559738

  17. Disturbances of electrolytes and blood chemistry in acute alcohol intoxication.

    PubMed

    Rauchenzauner, Markus; Kountchev, Jordan; Ulmer, Hanno; Pechlaner, Christoph; Bellmann, Romuald; Wiedermann, Christian J; Joannidis, Michael

    2005-02-01

    Prevalence of electrolyte disturbances and biochemical changes were determined in patients admitted to the emergency room of the Department of Internal Medicine in Innsbruck, Austria during a six-month period. The value of biochemical parameters for the detection of chronic alcohol abuse was also investigated. The most frequent electrolyte disturbances found were hypernatremia (41%), hyperchloremia (21%), hypermagnesemia (17%) and hypocalcemia (15%), whereas hypokalemia and hypophosphatemia were observed quite rarely (5% and 3.4%, respectively). The most frequent biochemical changes observed were consistent with signs of cellular toxicity i.e. increased liver enzymes (elevated gamma-glutamyltransferase (GGT), aspartate aminotransferase, alanine aminotransferase and lactic dehydrogenase) as well as signs of pancreatitis (elevated serum lipase and amylase) and muscle damage (elevated creatine kinase). The most frequent changes in blood counts were leucocytosis (23%), thrombocytopenia (14%), and anemia (12%). C-reactive protein showed only minimal elevation. Male sex and level of blood alcohol were detected as major risk factors for the diagnosis of chronic alcohol abuse in the patient sample investigated. When testing the value of routinely measured parameters for predicting the presence of chronic alcohol abuse, GGT and mean corpuscular volume of red blood cells (MCV) appeared to be of equal value. A combination of elevated blood alcohol with an increase in either of these markers may be interpreted as high risk for chronic alcohol abuse in this particular group of patients.

  18. The effects of atropine and methotrimeprazine on the epinephrine-induced arrhythmias in halothane-anesthetized dogs.

    PubMed Central

    Neto, F J; Massone, F; Luna, S P; Camacho, A A; Júnior, J R; Ishiy, H M

    2001-01-01

    The effects of atropine and methotrimeprazine on epinephrine-induced ventricular arrhythmias were evaluated in halothane-anesthetized dogs. Ten mixed-breed dogs were assigned to 3 treatments (saline, atropine, and methotrimeprazine) in a randomized complete block design. Anesthesia was induced and maintained with halothane (1.5 minimum alveolar concentration) in oxygen. Controlled ventilation was used throughout to maintain eucapnia. Saline, atropine (0.05 mg/kg, i.v.) or methotrimeprazine (0.5 mg/kg, i.v.) were administered and, 5 minutes later the arrhythmogenic dose of epinephrine (ADE) was measured by i.v. infusion of progressively increasing infusion rates of epinephrine, until the ventricular arrhythmia criterion was met (at least 4 ectopic ventricular contractions (EVCs) during a 15-second period). Data were analyzed using a student's t-test for ADE values and multivariate profile analysis for heart rate (HR), arterial blood pressure (ABP), and rate pressure product (RPP). The ADE increased in atropine- and methotrimeprazine-treated groups, whereas 1 and 4 animals from these groups did not develop any ventricular arrhythmia, respectively. Epinephrine induced multiform premature ventricular contractions (PVCs) in the atropine group, whereas ventricular escape beats were observed in the control and methotrimeprazine groups. Heart rate and RPP decreased, and ABP increased at the time of ADE observation in the control group. Epinephrine infusion in the atropine group caused marked increases in HR, ABP, and RPP, which were associated with pulsus alternans in 2 animals. It was concluded that 1) the presence of cholinergic blockade influences the type of ventricular arrhythmia induced by epinephrine; 2) increased ADE values recorded following atropine administration must be cautiously interpreted, since in this situation the PVCs were associated with signs of increased myocardial work and ventricular failure; and 3) the use of a broader arrhythmia criterion (EVCs

  19. Post-exposure treatment with nasal atropine methyl bromide protects against microinstillation inhalation exposure to sarin in guinea pigs

    SciTech Connect

    Che, Magnus M.; Conti, Michele; Boylan, Megan; Sabnekar, Praveena; Rezk, Peter; Sciuto, Alfred M.; Doctor, Bhupendra P.; Nambiar, Madhusoodana P.

    2009-09-15

    We evaluated the protective efficacy of nasal atropine methyl bromide (AMB) which does not cross the blood-brain barrier against sarin inhalation exposure. Age and weight matched male guinea pigs were exposed to 846.5 mg/m{sup 3} sarin using a microinstillation inhalation exposure technique for 4 min. The survival rate at this dose was 20%. Post-exposure treatment with nasal AMB (2.5 mg/kg, 1 min) completely protected against sarin induced toxicity (100% survival). Development of muscular tremors was decreased in animals treated with nasal AMB. Post-exposure treatment with nasal AMB also normalized acute decrease in blood oxygen saturation and heart rate following sarin exposure. Inhibition of blood AChE and BChE activities following sarin exposure was reduced in animals treated with nasal AMB, indicating that survival increases the metabolism of sarin or expression of AChE. The body weight loss of animals exposed to sarin and treated with nasal AMB was similar to saline controls. No differences were observed in lung accessory lobe or tracheal edema following exposure to sarin and subsequent treatment with nasal AMB. Total bronchoalveolar lavage fluid (BALF) protein, a biomarker of lung injury, showed trends similar to saline controls. Surfactant levels post-exposure treatment with nasal AMB returned to normal, similar to saline controls. Alkaline phosphatase levels post-exposure treatment with nasal AMB were decreased. Taken together, these data suggest that nasal AMB blocks the copious airway secretion and peripheral cholinergic effects and protects against lethal inhalation exposure to sarin thus increasing survival.

  20. Post-exposure treatment with nasal atropine methyl bromide protects against microinstillation inhalation exposure to sarin in guinea pigs.

    PubMed

    Che, Magnus M; Conti, Michele; Chanda, Soma; Boylan, Megan; Sabnekar, Praveena; Rezk, Peter; Amari, Ethery; Sciuto, Alfred M; Gordon, Richard K; Doctor, Bhupendra P; Nambiar, Madhusoodana P

    2009-09-15

    We evaluated the protective efficacy of nasal atropine methyl bromide (AMB) which does not cross the blood-brain barrier against sarin inhalation exposure. Age and weight matched male guinea pigs were exposed to 846.5 mg/m(3) sarin using a microinstillation inhalation exposure technique for 4 min. The survival rate at this dose was 20%. Post-exposure treatment with nasal AMB (2.5 mg/kg, 1 min) completely protected against sarin induced toxicity (100% survival). Development of muscular tremors was decreased in animals treated with nasal AMB. Post-exposure treatment with nasal AMB also normalized acute decrease in blood oxygen saturation and heart rate following sarin exposure. Inhibition of blood AChE and BChE activities following sarin exposure was reduced in animals treated with nasal AMB, indicating that survival increases the metabolism of sarin or expression of AChE. The body weight loss of animals exposed to sarin and treated with nasal AMB was similar to saline controls. No differences were observed in lung accessory lobe or tracheal edema following exposure to sarin and subsequent treatment with nasal AMB. Total bronchoalveolar lavage fluid (BALF) protein, a biomarker of lung injury, showed trends similar to saline controls. Surfactant levels post-exposure treatment with nasal AMB returned to normal, similar to saline controls. Alkaline phosphatase levels post-exposure treatment with nasal AMB were decreased. Taken together, these data suggest that nasal AMB blocks the copious airway secretion and peripheral cholinergic effects and protects against lethal inhalation exposure to sarin thus increasing survival.

  1. Scavenging of photogenerated oxidative species by antimuscarinic drugs: atropine and derivatives.

    PubMed

    Criado, Susana; Guardianelli, Carina; Tuninetti, Jimena; Molina, Patricia; García, Norman A

    2002-01-01

    The quenching ability of photogenerated oxidative species by some antimuscarinic drugs generically named atropines (e.g. atropine [I] eucatropine [II], homatropine [III] and scopolamine [IV]) have been investigated employing stationary photolysis, polarographic detection of dissolved oxygen, stationary and time-resolved fluorescence spectroscopy, and laser flash photolysis. Using Rose Bengal as a dye sensitiser for singlet molecular oxygen, O(2)((1)Delta(g)), generation, compounds I-IV behave as moderate chemical plus physical quenchers of the oxidative species. Correlation between kinetic and electrochemical data indicates that the process is possibly driven by a charge-transfer interaction. The situation is somewhat more complicated employing the natural pigment riboflavin (Rf) as a sensitiser. Compounds I and II complex Rf ground state, diminishing the quenching ability towards singlet and triplet excited state of the pigment. On the other hand, compounds III and IV effectively quench Rf excited states, protecting the pigment against photodegradation. Under anaerobic conditions, semireduced Rf (Rf(.-)) is formed through quenching of excited triplet Rf. Nevertheless, although Rf(.-) is a well-known generator of the reactive species superoxide radical anion by reductive quenching in the presence of oxygen, the process of O(2)((1)Delta(g)) production prevails over superoxide radical generation, due to the relatively low rate constants for the quenching of triplet Rf by the atropines (in the order of 10(7) M(-1)s(-1) for compounds III and IV) in comparison to the rate constant for the quenching by ground state oxygen, approximately two orders of magnitude higher, yielding O(2)((1)Delta(g)). Compound I is the most promising O(2)((1)Delta(g)) physical scavenger, provided that it exhibits the higher value for the overall quenching rate constant and only 11% of the quenching process leads to its own chemical damage.

  2. Psychiatric and medical management of marijuana intoxication in the emergency department.

    PubMed

    Bui, Quan M; Simpson, Scott; Nordstrom, Kimberly

    2015-05-01

    We use a case report to describe the acute psychiatric and medical management of marijuana intoxication in the emergency setting. A 34-year-old woman presented with erratic, disruptive behavior and psychotic symptoms after recreational ingestion of edible cannabis. She was also found to have mild hypokalemia and QT interval prolongation. Psychiatric management of cannabis psychosis involves symptomatic treatment and maintenance of safety during detoxification. Acute medical complications of marijuana use are primarily cardiovascular and respiratory in nature; electrolyte and electrocardiogram monitoring is indicated. This patient's psychosis, hypokalemia and prolonged QTc interval resolved over two days with supportive treatment and minimal intervention in the emergency department. Patients with cannabis psychosis are at risk for further psychotic sequelae. Emergency providers may reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care.

  3. Psychiatric and Medical Management of Marijuana Intoxication in the Emergency Department

    PubMed Central

    Bui, Quan M.; Simpson, Scott; Nordstrom, Kimberly

    2015-01-01

    We use a case report to describe the acute psychiatric and medical management of marijuana intoxication in the emergency setting. A 34-year-old woman presented with erratic, disruptive behavior and psychotic symptoms after recreational ingestion of edible cannabis. She was also found to have mild hypokalemia and QT interval prolongation. Psychiatric management of cannabis psychosis involves symptomatic treatment and maintenance of safety during detoxification. Acute medical complications of marijuana use are primarily cardiovascular and respiratory in nature; electrolyte and electrocardiogram monitoring is indicated. This patient’s psychosis, hypokalemia and prolonged QTc interval resolved over two days with supportive treatment and minimal intervention in the emergency department. Patients with cannabis psychosis are at risk for further psychotic sequelae. Emergency providers may reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care. PMID:25987916

  4. Atropine Ophthalmic

    MedlinePlus

    ... eye examinations to dilate (open) the pupil, the black part of the eye through which you see. ... hands thoroughly with soap and water. Use a mirror or have someone else apply the ointment. Avoid ...

  5. [STRUCTURE OF THE SPLEEN AT CHRONIC INTOXICATION OF THE ORGANISM BY SODIUM TETRABORATE AND AFTER INTOXICATION].

    PubMed

    Umbetov, T; Berdalinova, A; Koyshybayev, A; 2Umbetova, K; Sultanova, G

    2016-05-01

    The structure of a spleen of 110 white not purebred rats - males (10 intact, 50 control, 50 experimental) at chronic intoxication by sodium tetraborate and the after intoxication period - the 7, 14, 30 and 60 days were studied. Chronic impact of sodium tetraborate on an organism resulted into increase in the relative weight of a spleen in comparison with body weight that led to increase in weight coefficient of a spleen. Increase in the relative area of all functional zones (periarterial zone, the germinal center, mantle and marginal zones) of lymphoid slug of a white pulp is established. Decrease of an index a red/white pulp, as a result of increase of the area of a white pulp in response to chronic intoxication of an organism is revealed. During the after intoxication period as a result of decrease in immune tension there occured decrease of body weight and decrease in the area of a white pulp. During this period there was a reliable decrease of the area of lymphoid slug and decrease in the area of its functional zones (a periarterial zone, the center of manifolding, mantle and marginal zones).

  6. Effects of diiospropyl-1,3-dithiol-2-ylidene malonate (NKK-105) on acute toxicity of various drugs and heavy metals.

    PubMed

    Kitagawa, H; Saito, H; Sugimoto, T; Yanaura, S; Kitagawa, H; Hosokawa, T; Sakamoto, K

    1982-05-01

    The influence of NKK-105 on the acute toxicity of strychnine nitrate, potassium cyanide, chloral hydrate, atropine, tetrodotoxin, mercuric chloride, cadmium chloride, lead acetate and arsenic trioxide were examined in rats. NKK-105 prolonged the time of death induced by strychnine, potassium cyanide and tetrodotoxin in acute toxicity. Survival time was prolonged in rats treated with the toxic metals by pretreatment with NKK-105. NKK-105 counteracted the lethal effect of strychnine, potassium cyanide, chloral hydrate, mercuric chloride and cadmium chloride. NKK-105 significantly decreased the acute toxicity of these drugs but the inhibitory effect was not observed in the acute toxicity of atropine, tetrodotoxin, lead acetate and arsenic trioxide.

  7. Pulses of cholinergic receptor escape from atropine blocking reflect major natural periodicities.

    PubMed

    Rounds, H D

    1983-01-01

    1. Semi-lunar variation in cardiac response to applied acetylcholine was reconfirmed. 2. Atropine completely blocked the effects of acetylcholine on the heart except for brief pulses of escape at 12-hr intervals which began at moonset and progressed through midday at 10 to 14-day intervals. 3. The direction of escape, i.e. inhibition or acceleration, reversed at the winter solstice and at both equinoxes. 4. Cholinergic receptors in the cardiac preparation seem to reflect the following: 12-hr intervals beginning at moonset, 24.8 hr. 10 to 14-day intervals, 14.8-day intervals and the equinoxes and solstices. 90-day intervals.

  8. Effect of atropine on oral clearance of a radiolabeled sulfur colloid

    SciTech Connect

    LaForce, F.M.; Thompson, B.; Trow, R.

    1984-11-01

    Physical clearance is an important oral defense mechanism against gram-negative rods. The authors describe a simple technique that uses commercially available technetium-99m sulfur colloid to measure oral clearance. Technetium-99m sulfur colloid was sprayed into the mouth, and clearance was measured as the percent decrease in radiolabel counts over 2 hours using a radioisotope camera. Results using this technique compared favorably with clearance data using Tc-99m radiolabeled Escherichia coli. Atropine significantly decreased oral clearance rates of the colloid. Decreased clearance may be an important risk factor in the development of gram-negative rod colonization in hospitalized patients. 15 references, 3 figures.

  9. Combined Atropine and 2-PAM Cl Effects on Tracking Performance and Visual, Physiological, and Psychological Functions

    DTIC Science & Technology

    1988-12-01

    cholinergic innervations ReeAth loundainick. and l•ait!cy.lorer Neu psyehialrn Instituto throughout the human nervous system, any perturba- of the...of the Visual Functions: aSiolite frackIng earm (N =10). Nate the differenCe In erdinate it) D~istance~ Arnty-The time course of drug effects Saulest...netsr D-M. Beatrice ES. liffects of atropine on human puriuit visul. nd isua-moor ffecs bc ms sinifcan .frocking performance. Aviat, Space Vinviron

  10. Safety of dobutamine-atropine stress echocardiography: A prospective experience of 4,033 consecutive studies.

    PubMed

    Mathias, W; Arruda, A; Santos, F C; Arruda, A L; Mattos, E; Osório, A; Campos, O; Gil, M; Andrade, J L; Carvalho, A C

    1999-10-01

    Dobutamine-atropine stress echocardiography (DASE) is an established method and has been shown to be accurate for the detection of coronary artery disease. Still, there are few large clinical studies that analyze the safety of DASE in general or the safety of performing it on an ambulatory basis. Most studies use a target heart rate as the primary end point regardless of whether asymptomatic ischemia occurs. Such studies have shown a serious cardiac event rate of approximately 0.3%. We prospectively studied 4,033 consecutive patients on an ambulatory basis and in the hospital with the use of DASE from July 1991 to December 1998. All tests were performed by an experienced physician, and all clinical and DASE data were stored in a large database organized at the beginning of the study. Dobutamine was infused in scalar doses of 5, 10, 20, 30, and 40 microg/kg per minute in 3-minute stages. Development of a new wall motion abnormality, achievement of 85% of target heart, and end of the DASE infusion protocol were used as an end point. If 85% of the target heart rate was not achieved, atropine was infused up to 1 mg in the absence of myocardial ischemia, which was used in 1,280 studies. There were 3,645 diagnostic tests, and 388 (10%) were found to be nondiagnostic. This result was due to poor image quality in 115 (3%), end of protocol in negative-submaximal examinations in 124 (3%), and limiting side effects in 149 (4%). Thirty-seven percent of the tests showed positive results for myocardial ischemia. Major test-related cardiac complications occurred in 10 (0.25%) patients and included 1 ventricular fibrillation, 1 case of myocardial infarction, and 8 cases of sustained ventricular tachycardia. Atropine poisoning was observed in 5 (0.12%) patients. No deaths occurred as a direct or indirect consequence of DASE. We conclude that dobutamine-atropine stress echocardiography is a reasonably safe method for detection of coronary artery disease in the hospital or in an

  11. Two Fatal Intoxications Involving Butyryl Fentanyl.

    PubMed

    Poklis, Justin; Poklis, Alphonse; Wolf, Carl; Hathaway, Cindie; Arbefeville, Elise; Chrostowski, Leszek; Devers, Kelly; Hair, Laura; Mainland, Mary; Merves, Michele; Pearson, Julia

    2016-10-01

    We present the case histories, autopsy findings and toxicology findings of two fatal intoxications involving the designer drug, butyryl fentanyl. The quantitative analysis of butyryl fentanyl in postmortem fluids and tissues was performed by an ultrahigh-performance liquid chromatography tandem mass spectrometry method. In the first case, butyryl fentanyl was the only drug detected with concentrations of 99 ng/mL in peripheral blood, 220 ng/mL in heart blood, 32 ng/mL in vitreous humor, 590 ng/mL in gastric contents, 93 ng/g in brain, 41 ng/g in liver, 260 ng/mL in bile and 64 ng/mL in urine. The cause of death was ruled fatal intoxication by butyryl fentanyl. In the second case, butyryl fentanyl was detected along with acetyl fentanyl, alprazolam and ethanol. The butyryl fentanyl concentrations were 3.7 ng/mL in peripheral blood, 9.2 ng/mL in heart blood, 9.8 ng/mL in vitreous humor, 4,000 ng/mL in gastric contents, 63 ng/g in brain, 39 ng/g in liver, 49 ng/mL in bile and 2 ng/mL in urine. The acetyl fentanyl concentrations were 21 ng/mL in peripheral blood, 95 ng/mL in heart blood, 68 ng/mL in vitreous humor, 28,000 ng/mL in gastric contents, 200 ng/g in brain, 160 ng/g in liver, 330 ng/mL in bile and 8 ng/mL in urine. In addition, the alprazolam concentration was 40 ng/mL and the ethanol concentration was 0.11 g/dL, both measured in peripheral blood. The cause of death in the second case was ruled a mixed drug intoxication. In both cases, the manner of death was accident.

  12. Fatal water intoxication of an Army trainee during urine drug testing.

    PubMed

    Gutmann, Frank D; Gardner, John W

    2002-05-01

    An Army trainee developed acute water intoxication, hyponatremia, pulmonary edema, and fatal cerebral edema. This is the first report of a fatality related to urine drug testing. This resulted from supervised excessive water ingestion in an attempt to induce a sufficient urine specimen for substance abuse testing. To avoid a similar preventable death in the future, we make several recommendations. These include limiting the volume of ingested fluid to eight ounces every 30 to 45 minutes, not to exceed 40 ounces, and providing a relaxed, reassuring environment when obtaining urine specimens for substance abuse detection.

  13. Lithium intoxication, hypercalcemia and "accidentally" induced food and water aversion: a case report.

    PubMed

    Bilanakis, Nikos; Gibiriti, Mariana

    2004-01-01

    Lithium is widely used in the management of patients with affective and other behavioral disorders. In addition to its therapeutic role, it is important to recognize that it occasionally causes severe side effects. Associated with its long-term use, parathyroid hypersecretion and hypercalcemia is a rare but reported side effect. A 54-year-old patient is reported who previously had a good response to lithium carbonate treatment of his bipolar disorder. Suddenly, and after 15 years of lithium carbonate use, he presented food and water aversion, hypercalcemia, lithium intoxication (SLi of 4.30 mmol/l) and acute renal insufficiency. Haemodialysis was carried out and the patient improved dramatically.

  14. Effects of Methemoglobin Versus Potassium Cyanide Intoxication

    DTIC Science & Technology

    1987-08-01

    initial phase, two female dogs were administered a-ketoglutaric acid (800 mg/ml in 0.1 M phosphate buffer) via oral gavage at a dose of 4 g/kg body...the test solution. Two additional female dogs were administered a-ketoglutaric acid (285.7 mg/ml in 0.1 M phosphate buffer) via oral gavage at a dose of...effective as a possible antidote against lethal cyanide intoxication due to vomiting of the test solution. An acidic dosing solution caused gastric

  15. Possible unaware intoxication by anticoagulant rodenticide

    PubMed Central

    Dashti-Khavidaki, Simin; Ghaffari, Saba; Nassiri-Toossi, Mohsen; Amini, Mohsen; Edalatifard, Maryam

    2014-01-01

    Superwarfarin toxicity may be a serious problem. It needs high clinical suspicious in patients with bleeding diathesis without hematologic or liver diseases even in patients with apparent negative history of warfarin or other anticoagulant accessibility. Here we reported a patient with a negative history of any medical diseases or drug administration who was referred with generalized ecchymosis. Increased international normalized ratio and decreased vitamin K-dependent coagulation factors were detected in this patient. His hematologic and liver evaluations were normal. Clinical pharmacist emphasis in taking history revealed using anticoagulant rodenticide all over the farm the patient lived in that might result in unaware intoxication in this patient who suffered dementia. PMID:25535623

  16. Peganum Harmala (Aspand) Intoxication; a Case Report

    PubMed Central

    Sadr Mohammadi, Rezvan; Bidaki, Reza; Mirdrikvand, Fazlollah; Mostafavi Yazdi, Seyyed Nader; Yazdian Anari, Pouria

    2016-01-01

    There are several reports in the literature indicating a great variety of pharmacological effects for peganum harmala or aspand such as sedative anti-bacterial, anti-fungal, antiviral and antiprotozoal. Some people believe that can be used for treatment of some organic or psychiatric disorders. We introduce a woman with history of long time constipation that was disappointed in novel medical treatment and decided to use comminuted Aspand to relieve her problem. Two hours after use, the intoxication symptoms manifested as blurred vision, phonophobia, floating feeling, and tinnitus ringing. Here we report the treatment process and outcome of this case. PMID:27274523

  17. Peganum Harmala (Aspand) Intoxication; a Case Report.

    PubMed

    Sadr Mohammadi, Rezvan; Bidaki, Reza; Mirdrikvand, Fazlollah; Mostafavi Yazdi, Seyyed Nader; Yazdian Anari, Pouria

    2016-01-01

    There are several reports in the literature indicating a great variety of pharmacological effects for peganum harmala or aspand such as sedative anti-bacterial, anti-fungal, antiviral and antiprotozoal. Some people believe that can be used for treatment of some organic or psychiatric disorders. We introduce a woman with history of long time constipation that was disappointed in novel medical treatment and decided to use comminuted Aspand to relieve her problem. Two hours after use, the intoxication symptoms manifested as blurred vision, phonophobia, floating feeling, and tinnitus ringing. Here we report the treatment process and outcome of this case.

  18. 36 CFR 520.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... narcotics. 520.8 Section 520.8 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... § 520.8 Intoxicating beverages and narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of...

  19. 36 CFR 520.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... narcotics. 520.8 Section 520.8 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... § 520.8 Intoxicating beverages and narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of...

  20. 36 CFR 520.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... narcotics. 520.8 Section 520.8 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... § 520.8 Intoxicating beverages and narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of...

  1. 36 CFR 520.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... narcotics. 520.8 Section 520.8 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... § 520.8 Intoxicating beverages and narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of...

  2. 36 CFR 520.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... narcotics. 520.8 Section 520.8 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... § 520.8 Intoxicating beverages and narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of...

  3. Problematic College Drinking Behaviors as a Function of First Intoxication.

    ERIC Educational Resources Information Center

    Dana, Robert Q.; And Others

    1993-01-01

    Surveyed undergraduate students (n=152) to examine whether there is a relationship between an early first intoxication experience and development of alcohol or drug problems in later college life. Results indicated that those students who reported earliest experiences of intoxication also reported greatest frequency of substance abuse problems.…

  4. A Methanol Intoxication Outbreak From Recreational Ingestion of Fracking Fluid.

    PubMed

    Collister, David; Duff, Graham; Palatnick, Wesley; Komenda, Paul; Tangri, Navdeep; Hingwala, Jay

    2017-01-19

    Single-patient methanol intoxications are a common clinical presentation, but outbreaks are rare and usually occur in settings in which there is limited access to ethanol and methanol is consumed as a substitute. In this case report, we describe an outbreak of methanol intoxications that was challenging from a public health perspective and discuss strategies for managing such an outbreak.

  5. Clinical presentation of intoxication due to synthetic cannabinoids.

    PubMed

    Cohen, Joanna; Morrison, Sephora; Greenberg, Jeffrey; Saidinejad, Mohsen

    2012-04-01

    Synthetic cannabinoids are relatively novel substances of abuse. The use of these compounds among adolescents and young adults has been increasing, making it important for pediatric providers to be familiar with the presenting signs and symptoms of intoxication. We describe three case presentations of reported synthetic cannabinoid intoxication and provide a brief discussion of these compounds.

  6. 32 CFR 1903.13 - Intoxicated on an Agency installation.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false Intoxicated on an Agency installation. 1903.13 Section 1903.13 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.13 Intoxicated on an Agency installation. Presence on...

  7. 32 CFR 1903.13 - Intoxicated on an Agency installation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 6 2014-07-01 2014-07-01 false Intoxicated on an Agency installation. 1903.13 Section 1903.13 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.13 Intoxicated on an Agency installation. Presence on...

  8. 32 CFR 1903.13 - Intoxicated on an Agency installation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false Intoxicated on an Agency installation. 1903.13 Section 1903.13 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.13 Intoxicated on an Agency installation. Presence on...

  9. 32 CFR 1903.13 - Intoxicated on an Agency installation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 6 2012-07-01 2012-07-01 false Intoxicated on an Agency installation. 1903.13 Section 1903.13 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.13 Intoxicated on an Agency installation. Presence on...

  10. Water intoxication by the oral route in an infant.

    PubMed Central

    Etzioni, A; Benderley, A; Levi, Y

    1979-01-01

    Symptomatic water intoxication is common when hypo-osmolar fluids are given therapeutically, usually intravenously, but it is rare after drinking voluntarily (Wynn and Rob, 1954). We report a case of water intoxication caused by voluntary drinking in an infant. PMID:485199

  11. 32 CFR 1903.13 - Intoxicated on an Agency installation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Intoxicated on an Agency installation. 1903.13 Section 1903.13 National Defense Other Regulations Relating to National Defense CENTRAL INTELLIGENCE AGENCY CONDUCT ON AGENCY INSTALLATIONS § 1903.13 Intoxicated on an Agency installation. Presence on...

  12. A case of methanol intoxication caused by methomyl pesticide ingestion.

    PubMed

    Gil, H W; Hong, J R; Song, H Y; Hong, S Y

    2012-12-01

    When clinicians treat patients with pesticide poisoning, they often pay attention only to the chief toxic agent and ignore the toxicity of the pesticide's additives or solvents. Occasionally, however, a solvent (e.g. methanol) may itself be the cause of poisoning. We report a case of acute methanol intoxication that occurred after ingestion of a methomyl pesticide that contained methanol as an additive. A 49-year-old man was brought to the emergency department in an unconscious state after ingestion of 20 ml of a carbamate pesticide (chief ingredient: methomyl; active ingredient: methanol). Upon arrival, he was semicomatose and did not breathe spontaneously; however, his cholinesterase level was within normal limits and cholinergic symptoms were not observed. High anion gap metabolic acidosis was present. His blood ethanol level was 74.8 mg/dL. The urine methanol level was 55.60 mg/dL, and urine ethanol level was 22.0 mg/dL. He was treated with hemodialysis; subsequently, his metabolic acidosis resolved and he returned to normal mental status. We guessed that methanol, as the solvent of the methomyl, had produced the symptoms. When treating pesticide-poisoned patients, clinicians should identify the solvent used in the pesticide, because solvents such as methanol may exacerbate the symptoms of poisoned patients.

  13. Propranolol and atropine do not alter choroidal blood flow regulation during isometric exercise in healthy humans.

    PubMed

    Polska, Elzbieta; Luksch, Alexandra; Schering, Joanne; Frank, Barbara; Imhof, Andrea; Fuchsjäger-Mayrl, Gabriele; Wolzt, Michael; Schmetterer, Leopold

    2003-01-01

    Recent studies indicate that the human choroid has a considerable capacity to keep blood flow constant despite exercise-induced increases in perfusion pressure. The mechanisms underlying this vasoconstrictor response remain unclear. We hypothesized that pharmacological modulation of the autonomic nervous system may alter the choroidal pressure/flow relationship during squatting. To test this hypothesis, we performed a randomized, double-masked, placebo-controlled, three-way crossover study in 15 healthy male volunteers. Subjects received, on different study days, intravenous infusions of the beta-adrenoceptor antagonist propranolol, the muscarinic receptor antagonist atropine, or placebo. During these infusions, subjects performed squatting for 6 min. Choroidal blood flow was assessed with laser Doppler flowmetry and ocular perfusion pressure (OPP) was calculated from mean arterial pressure and intraocular pressure. As expected, propranolol reduced basal pulse rate, whereas atropine increased pulse rate, indicating that the drugs were administered at systemically effective doses. None of the drugs altered the choroidal pressure/flow relationship during isometric exercise. These data indicate that the regulatory vasoconstrictor capacity of the choroid during exercise is not affected by systemic blockade of beta-adrenoceptors or muscarinic receptors.

  14. A conjugate of pyridine-4-aldoxime and atropine as a potential antidote against organophosphorus compounds poisoning.

    PubMed

    Lovrić, Jasna; Berend, Suzana; Lucić Vrdoljak, Ana; Radić, Božica; Katalinić, Maja; Kovarik, Zrinka; Želježić, Davor; Kopjar, Nevenka; Rast, Slavko; Mesić, Milan

    2011-01-01

    A conjugate of pyridine-4-aldoxime and atropine (ATR-4-OX) was synthesized and its antidotal efficiency was tested in vitro on tabun- or paraoxon-inhibited acetylcholinesterase (AChE) of human erythrocytes as well as in vivo using soman-, tabun- or paraoxon-poisoned mice. Its genotoxic profile was assessed on human lymphocytes in vitro and was found acceptable for further research. ATR-4-OX showed very weak antidotal activity, inadequate for soman or tabun poisoning. Conversely, it was effective against paraoxon poisoning both in vitro and in vivo. All animals treated with 5 % or 25 % LD(50) doses of the new oxime survived after administration of 10.0 or 16.0 LD(50) doses of paraoxon, respectively. Based on the persistence of toxicity symptoms in mice, the atropine moiety had questionable effects in attenuating such symptoms. It appears that ATR-4-OX has a therapeutic effect related to the reactivation of phosphylated AChE, but not to receptor antagonization.

  15. Pre-medication and renal pre-conditioning: a role for alprazolam, atropine, morphine and promethazine.

    PubMed

    Pazoki-Toroudi, Hamid Reza; Ajami, Marjan; Habibey, Rouhollah

    2010-04-01

    Four pre-medication drugs are used to relieve pain, allay anxiety, reduce secretion and enhance hypnosis, were evaluated for their effects on ischemia reperfusion (I/R) injury which is one of the major complications of vascular and transplantation surgery. Right kidney was removed from female rats (210-250 g) 3 weeks before surgical procedure. Different doses of morphine (0.5, 2 and 5 mg/kg), promethazine (1, 2 and 5 mg/kg), atropine (0.1, 0.3 and 0.5 mg/kg) and alprazolam (0.08, 0.32 and 0.64 mg/kg) were administered subcutaneously 30 min before left renal artery occlusion and 6 h reperfusion. Left kidneys were processed for histological evaluations. Creatinine and BUN were measured in serum samples. Morphine, promethazine, atropine and alprazolam at all evaluated doses significantly decreased serum creatinine and BUN levels and histopathological scores. The effects of promethazine (1 mg/kg) and all doses of alprazolam were more potent than other pre-medication drugs and doses. This study suggested a protective effect of these pre-medication drugs on I/R injury. Although obvious studies are required, these findings may lead to effective therapies against I/R injury.

  16. Hemolytic uremic syndrome associated with paraquat intoxication.

    PubMed

    Jang, Ha Nee; Bae, Eun Jin; Hwang, Kyungo; Kang, Yeojin; Yun, Seongeun; Cho, Hyun Seop; Chang, Se-Ho; Park, Dong Jun

    2014-06-01

    We report a case of a 66-year-old patient with paraquat intoxication resulting in the requirement for hemoperfusion, hemodialysis, and plasma exchange. His initial serum paraquat level was 0.24 µg/mL (0.0-0.1 µg/mL). Activated charcoal (50 g) was administered orally, and high-dose N-acetylcysteine (150 mg/kg) was administered intravenously. In addition, immediate 4 h hemoperfusion was also performed for three consecutive days after admission. Hemodialysis was started on the 4th day after admission because of uremia. On the 9th day after admission, laboratory findings demonstrated hemolytic uremic syndrome (HUS): microangiopathic hemolytic anemia (MAHA), thrombocytopenia, elevated reticulocyte count, and lactate dehydrogenase (LDH). Plasma exchange was performed three times consecutively. Anemia and thrombocytopenia were improved, and LDH was normalized after plasma exchange. Urine output increased to 2240 mL/day on the 18th day after admission, and hemodialysis was discontinued. He is currently being observed at our follow-up clinic without renal impairment or pulmonary dysfunction for 1.5 years since discharge. We should suspect paraquat-associated HUS when thrombocytopenia and anemia are maintained for a long time after paraquat intoxication.

  17. In Vivo Nanodetoxication for Acute Uranium Exposure.

    PubMed

    Guzmán, Luis; Durán-Lara, Esteban F; Donoso, Wendy; Nachtigall, Fabiane M; Santos, Leonardo S

    2015-06-15

    Accidental exposure to uranium is a matter of concern, as U(VI) is nephrotoxic in both human and animal models, and its toxicity is associated to chemical toxicity instead of radioactivity. We synthesized different PAMAM G4 and G5 derivatives in order to prove their interaction with uranium and their effect on the viability of red blood cells in vitro. Furthermore, we prove the effectiveness of the selected dendrimers in an animal model of acute uranium intoxication. The dendrimer PAMAM G4-Lys-Fmoc-Cbz demonstrated the ability to chelate the uranyl ion in vivo, improving the biochemical and histopathologic features caused by acute intoxication with uranium.

  18. Multi-drug intoxication fatality involving atorvastatin: A case report.

    PubMed

    Cibickova, Lubica; Caran, Tomas; Dobias, Martin; Ondra, Peter; Vorisek, Viktor; Cibicek, Norbert

    2015-12-01

    Mixed antihypertensive drug intoxication poses a significant risk for patient mortality. In tandem to antihypertensives, hypolipidemic medicines (especially statins) are often prescribed. Among their well-known adverse effects belongs rhabdomyolysis. We report a case of fatal multi-drug overdose in a 65-year-old female alcoholic. The patient was unconscious at admission. Empty blister packs indicated the abuse of 250 tablets of urapidil, 42 tablets of verapamil/trandolapril, 50 tablets of moxonidin, 80 tablets of atorvastatin and 80 tablets of diacerein. Standard measures (gastric lavage, activated charcoal, mechanical ventilation, massive doses of vasopressors, volume expansion, diuretics and alkalinization) failed to provide sufficient drug elimination and hemodynamic support and the sufferer deceased on the fourth day. Dramatic elevations of serum myoglobin (34,020 μg/L) and creatine kinase (219 μkat/L) were accompanied by rise in cardiac troponin I and creatinine. Gas chromatography revealed ethanol 1.17 g/kg (blood) and 2.81 g/kg (urine). Thin layer chromatography and gas chromatography of gastric content and urine verified verapamil, moxonidin and urapidil fragment (diacerein method was unavailable). Atorvastatin and trandolapril concentrations (LC-MS(n)) equaled 277.7 μg/L and 57.5 μg/L, resp. (serum) and 8.15 μg/L and 602.3 μg/L, resp. (urine). Histology confirmed precipitates of myoglobin with acute necrosis of proximal renal tubules in association with striated muscle rhabdomyolysis and myocardial dystrophy. Cardiogenic-distributive shock in conjunction with acute renal failure due to the combined self-poisoning with vasoactive agents and atorvastatin were determined to be this decedent's immediate cause of death. The manner of death was assigned to be suicidal.

  19. Chelation in metal intoxication XXI: chelation in lead intoxication during vitamin B complex deficiency

    SciTech Connect

    Not Available

    1986-09-01

    The vitamin B-complex deficiency increases the vulnerability to neuro- and systemic toxicity of Pb in young rats. Thus, the nutritional status of vitamins like that of protein or minerals seems to influence the etiology of Pb toxicity and may be expected to affect the response toward Pb chelators. 2,3 dimercaptosuccinic acid (DMSA) and N-(2-hydroxyethyl) ethylene-diamine triacetic acid (HEDTA) have been found to be effective antidotes to Pb intoxication. In the present study, these selective metal chelating agents were compared for their ability to reduce the body burden of Pb and restore the altered biochemical parameters in young developing Pb intoxicated rats maintained on normal or vitamin B-complex deficient diet. The investigation was aimed to suggest suitable prophylaxis of Pb poisoning prevalent among children who may also be suffering from vitamin deficiency in developing and poor countries.

  20. Antimuscarinic-induced convulsions in fasted animals after food intake: evaluation of the effects of levetiracetam, topiramate and different doses of atropine.

    PubMed

    Büget, Bahar; Türkmen, Aslı Zengin; Allahverdiyev, Oruc; Enginar, Nurhan

    2016-01-01

    This study evaluated the effects of different doses of atropine and new antiepileptics, levetiracetam and topiramate, on the development of convulsions triggered by food intake in antimuscarinic-treated fasted animals. Mice deprived of food for 24 h and treated i.p. with atropine at a dose of 2.4 or 24 mg/kg developed convulsions after being allowed to eat ad libitum. No convulsions were observed in fasted animals treated with 0.24 mg/kg atropine. There was no difference in the incidence of convulsions between the two atropine treatments, but latency to convulsions was longer in 24 mg/kg atropine treated animals. The lowest dose of atropine, 0.24 mg/kg, caused stage 1 and stage 2 activity, but did not provide the convulsive endpoint (stage 3, 4, 5 activity). Administration of levetiracetam (50 or 200 mg/kg) or topiramate (50 or 100 mg/kg) to another group of 24-h fasted mice was ineffective in reducing the incidence of convulsions developed in the animals after 2.4 mg/kg atropine treatment and food intake. However, the higher dose of levetiracetam prolonged the onset of convulsions. Present results demonstrated the efficacy of low and high doses of atropine on the development of convulsions in fasted animals and provided additional evidence for the ineffectiveness of antiepileptic treatment in these seizures.

  1. Determination of atropine sulfate using a novel sensitive DNA-biosensor based on its interaction on a modified pencil graphite electrode.

    PubMed

    Ensafi, Ali A; Nasr-Esfahani, Parisa; Heydari-Bafrooei, Esmaeil; Rezaei, B

    2015-01-01

    A novel, selective, rapid and simple electrochemical method is developed for the determination of atropine sulfate. UV-Vis and differential pulse voltammetry are used to study the interaction of atropine sulfate with salmon sperm ds-DNA on the surface of salmon sperm ds-DNA modified-pencil graphite electrode (PGE). For this purpose, a pencil graphite electrode (PGE) modified with multiwall carbon nanotubes (MWCNTs), titanium dioxide nanoparticles (TiO2NPs), and poly-dialyldimethylammonium chloride (PDDA) decorated with ds-DNA is tested for the determination of atropine sulfate. The electrochemical oxidation peak current of adenine and guanine bonded on the surface of ds-DNA/PDDA-TiO2NPs-MWCNTs/PGE is used to obtain the analytical signal. Decreases in the intensities of guanine and adenine oxidation signals after their interaction with atropine sulfate are used as indicator signals for the sensitive determination of atropine sulfate. Using ds-DNA/PDDA-TiO2NPs-MWCNTs/PGE and based on the guanine signal, linear calibration curves were obtained in the range of 0.6 to 30.0 μmol L(-1) and 30.0 to 600.0 μmol L(-1) atropine sulfate with low detection limits of 30.0 nmol L(-1). The biosensor shows a good selectivity for the determination of atropine sulfate. Finally, the applicability of the biosensor is evaluated by measuring atropine sulfate in real samples with good accuracy.

  2. Drugs of abuse: management of intoxication and antidotes.

    PubMed

    Montoya, Ivan D; McCann, David J

    2010-01-01

    Illicit drug intoxications are an increasing public health problem for which, in most cases, no antidotes are clinically available. The diagnosis and treatment of these intoxications requires a trained clinician with experience in recognizing the specific signs and symptoms of intoxications to individual drugs as well as polydrug intoxications, which are more the rule than the exception. To make the diagnosis, the clinical observation and a urine toxicology test are often enough. Evaluating the blood levels of drugs is frequently not practical because the tests can be expensive and results may be delayed and unavailable to guide the establishment of a treatment plan. Other laboratory tests may be useful depending on the drug or drugs ingested and the presence of other medical complications. The treatment should be provided in a quiet, safe and reassuring environment. Vital signs should be closely monitored. Changes in blood pressure, respiratory frequency and temperature should be promptly treated, particularly respiratory depression (in cases of opiate intoxication) or hyperthermia (in cases of cocaine or amphetamine intoxication). Intravenous fluids should be administered as soon as possible. Other psychiatric and medical complication should receive appropriate symptomatic treatment. Research on immunotherapies, including vaccines, monoclonal and catalytic antibodies, seems to be a promising approach that may yield specific antidotes for drugs of abuse, helping to ameliorate the morbidity and mortality associated with illicit drug intoxications.

  3. [Effect of the chelator Zn-DTPA on the excretion of lead in lead intoxication mice detected with ICP-MS].

    PubMed

    Li, Chen; Lu, Kai-zhi; Zhou, Qi; Wang, Qiong; Zeng, Yu-liang; Yin, Hong-jun; He, Xuan-hui; Tian, Ying; Dong, Jun-Xing

    2014-11-01

    To study the lead excretion effect of the chelator Zn-DTPA on the lead intoxication mice, inductively coupled plasma mass spectrometry (ICP-MS) was applied to detect the lead content of biological samples. The acute lead intoxication mice model was established by injecting lead acetate intraperitoneally with the dose of 1 mg. Zn-DTPA was administered intraperitoneally to mice once daily for five consecutive days 4 h after intoxication. Control group, model group, combination of Zn-DTPA and Ca-DTPA group were evaluated at the same time. The urine was collected every day. The mice were sacrificed in batches in the 2rd, 4th, 6th day. Biological samples including urine, whole blood, femur and brain were prepared and nitrated. Lead concentration was detected by ICP-MS. The result showed that Zn-DTPA could increase lead content in urine markedly and reduce lead content in blood, femur and brain.

  4. Methylbromide intoxication: a clinical case study.

    PubMed

    Breeman, Wim

    2009-01-01

    The port of Rotterdam, The Netherlands, is the world's largest container port. In 2006, one of these containers caused a chemical incident. Methylbromide is used in some countries as a pesticide for the fumigation of maritime containers. Because of an insufficiently performed detoxification, this insecticide intoxicated several employees and some of the ambulance crew and Mobile Medical Team (MMT). The victims displayed symptoms of sore throat, irritated eyes, and hypersalivation. One of the victims suffered from multiple epileptic seizures. Two victims were admitted to the intensive care unit for respiratory support. Three other employees showed milder symptoms and received supportive care but were not admitted to the hospital. This complicated case shows that the safety of the ambulance crew and MMT must be guaranteed. It also demonstrates that healthcare providers cannot always oversee the accident scene and that there are some pitfalls that are almost impossible to prevent.

  5. Polytetrafluoroethylene gas intoxication in broiler chickens.

    PubMed

    Boucher, M; Ehmler, T J; Bermudez, A J

    2000-01-01

    A poultry research facility that housed 2400 Peterson x Hubbard cross broilers (48 pens of 50 chicks each) experienced 4% mortality within 24 hr of chick placement. Mortality started within 4 hr of placement, and within 72 hr, cumulative mortality had reached 52%. Mild dyspnea was the only clinical sign noted in some chicks prior to death. The primary gross lesion noted in the chicks submitted was moderate to severe pulmonary congestion. The lungs of four of these chicks sank in formalin, and blood-tinged fluid was noted in the mouth and nares of two chicks. The microscopic lesions noted in the affected chicks were moderate to severe pulmonary edema and congestion. The diagnosis indicated to the submitter was that pulmonary edema caused by exposure to an unidentified noxious gas caused the death of the chicks. The poultry house environment was tested for sulfur dioxide, oxides of nitrogen, carbon monoxide, carbon dioxide, and volatile organic compounds (as produced by combustion engines); all tests were negative for significant levels of these compounds. A second broiler flock was placed in the same facility and the mortality at 6 wk was 11%, which was greater than the 2.5%-4.7% mortality seen in the previous four flocks on the farm. Further investigation revealed that the only change in management practice in this facility prior to the onset of the severe mortality problem was the replacement of 48 heat lamp bulbs (one for each pen). The new heat lamp bulbs were polytetrafluoroethylene (PTFE) coated. PTFE gas intoxication has been reported in several exotic avian species, but this intoxication has not been previously reported in a poultry flock.

  6. Salt wastage, plasma volume contraction and hypokalemic paralysis in self-induced water intoxication.

    PubMed

    Tanneau, R S; Pennec, Y L; Morin, J F; Codet, J P; Bourbigot, B; Garre, M; Le Menn, G

    1993-01-01

    Eleven episodes of severe hyponatremia secondary to hiccup-induced potomania were recorded in 3 years in a man who had essential hypertension, a low protein intake and a normal diluting ability. Paradoxical increase in hematocrit and plasma protein with acute extensive natriuresis was associated as well as urine potassium loss and hypokalemia producing paralysis in 1 episode. During a chronic water loading test, the defect in water excretion was related to a low urine solute delivery which was partially reverted by the natriuretic response to plasma volume expansion, promoting water diuresis. In acute water intoxication, this natriuretic response was exaggerated, producing a brisk water diuresis. Plasma volume was rapidly normalized but without any improvement in plasma sodium due to the concomitant negative sodium balance. Thus, water diuresis persisted until plasma volume was significantly contracted. Potassium loss appeared to be related to sodium excretion. Metabolic disturbances have not reoccurred despite persistent hiccup and potomania during 2 years of urea therapy.

  7. Atropine, sodium cromoglycate, and thymoxamine in PGF2 alpha-induced bronchoconstriction in extrinsic asthma.

    PubMed Central

    Patel, K R

    1975-01-01

    In six patients with extrinsic bronchial asthma the inhalation of prostaglandin (PG) F2 alpha in a small dosage produced significant bronchoconstriction, whereas PGE2 produced bronchodilatation. In these patients cholinergic blockade with atropine partially inhibited the PGF2 alpha-induced bronchoconstriction, but the alpha-receptor-blocking drug thymoxamine and sodium cromoglycate did not. These results suggest that the effect of PGF2 alpha is mediated through cholinergic receptors in the airways, and this effect is grossly exaggerated in asthma. The failure to inhibit PGF2 alpha-induced bronchoconstriction with sodium cromoglycate and the observation of an inhibitory effect of sodium cromoglycate in both allergic and exercise asthma suggest that locally formed PGF2 alpha may not be the main factor in the pathogenesis of bronchial asthma. PMID:124195

  8. Effects of atropine and propranolol on lung inflammation in experimental envenomation: comparison of two buthidae venoms

    PubMed Central

    2013-01-01

    Background Previous works had shown that scorpion venom induced neurotransmitter elevation and an inflammatory response associated with various anatomo-pathological modifications. The most dangerous scorpions species in Algeria responsible for these effects are Androctonus australis hector (Aah) and Androctonus amoreuxi (Aam). Results Comparison of the physiopathological effects induced by the two venoms showed differences in the kinetic of cytokine release and in lung injury. The lung edema was only observed in response to Aah venom and it was correlated with cell infiltration. In order to better understand the involved mechanism in inflammatory response, we used two antagonists, atropine (non-selective muscarinic antagonist) and propranolol (β adrenergic antagonist), which lead to a decrease of cell infiltration but has no effect on edema forming. Conclusion These results suggest another pathway in the development of lung injury following envenomation with Aam or Aah venom. PMID:23849182

  9. Quantitative proton nuclear magnetic resonance for the structural and quantitative analysis of atropine sulfate.

    PubMed

    Shen, Shi; Yao, Jing; Shi, Yaqin

    2014-02-01

    This study assessed a general method of quantitative nuclear magnetic resonance (qNMR) for the calibration of atropine sulfate (Active Pharmaceutical Ingredient, API) as reference standard. The spectra were acquired in D2O using maleic acid as the internal standard. Conformational behaviors of tropane ring were observed and studied by means of NMR and ROESY experiments at different temperature, which showed that the azine methyl group was at equilibrium for axial and equatorial conformations at room temperature. Signal delay and monitor signals of qNMR experimentation were optimized for quantification. The study reported here validated the method's linearity, range, limit of quantification, stability and precision. The results were consistent with the results obtained from mass balance approach.

  10. Acute severe organophosphate poisoning in a child who was successfully treated with therapeutic plasma exchange, high-volume hemodiafiltration, and lipid infusion.

    PubMed

    Yesilbas, Osman; Kihtir, Hasan S; Altiti, Mohammad; Petmezci, Mey Talip; Balkaya, Seda; Bursal Duramaz, Burcu; Ersoy, Melike; Sevketoglu, Esra

    2016-10-01

    Acute severe organophosphate poisoning is a serious complication seen in developing and agricultural countries. Pralidoxime and high dose atropine are the standard treatments. There is no consensus about acute severe organophosphate poisonings that are unresponsive to pralidoxime, atropine, and supportive therapies. We report a case of acute severe organophosphate poisoning that was unresponsive to standard treatments and successfully treated with high-volume continuous venovenous hemodiafiltration and therapeutic plasma exchange combined with lipid infusion. J. Clin. Apheresis 31:467-469, 2016. © 2015 Wiley Periodicals, Inc.

  11. In Vitro Acaricidal Activity of Atropa belladonna and Its Components, Scopolamine and Atropine, against Rhipicephalus (Boophilus) microplus

    PubMed Central

    Godara, R.; Katoch, M.; Yadav, Anish; Parveen, S.; Vij, Bhavna; Khajuria, Varun; Singh, G.; Singh, Nirbhay K.

    2014-01-01

    In vitro efficacy of methanolic extract of Atropa belladonna and its components scopolamine and atropine was assessed against Rhipicephalus (Boophilus) microplus. Five concentrations of the extract (1.25%, 2.5%, 5%, 10%, and 20%) were used whereas scopolamine and atropine were each tested at 0.1%. In adult immersion test, the extract was lethal to ticks at 20% concentration. The LC50 and LC95 values were determined as 6.875% and 17.306%, respectively. The extract caused a significant reduction (P < 0.05) in egg mass production at 10% concentration. In larval packet test, the extract was lethal to larvae in the concentrations of 10% and 20% after 24 h, with LC50 and LC95 values of 1.321% and 4.935%, respectively. Scopolamine and atropine showed 93.3% and 60.0% mortality of adult ticks, respectively, but they caused complete (100%) blocking of hatching as well as 100% larval mortality. Scopolamine and atropine were observed to be more potent than the crude extract at an equivalent concentration in both the bioassays. PMID:25516877

  12. Effect of atropine-dobutamine stress test on left ventricular echocardiographic parameters in untrained warmblood horses.

    PubMed

    Sandersen, Charlotte F; Detilleux, Johanne; de Moffarts, Brieuc; Van Loon, Gunther; Amory, Hélène

    2006-01-01

    The aim of this study was to investigate the effect of combined atropine low-dose dobutamine stress test on left ventricular parameters in adult warmblood horses, to establish a potential protocol for pharmacological stress echocardiography. Seven healthy untrained warmblood horses aged 9 to 22 years were used. Heart rate (HR) and left ventricular B- and M-mode dimensions were recorded at baseline and during stress testing with 35 microg/kg atropine IV followed by incremental dobutamine infusion of 2 to 6 microg/kg/min. HR increased significantly (P < .05) during the pharmacological challenge, and a maximal HR of 156.6 +/- 12.5 bpm was reached at maximal dobutamine infusion rate. Systolic and diastolic interventricular septum thickness, systolic and diastolic left ventricular free wall thickness, and fractional shortening increased significantly and reached a maximum at the highest infusion rate (mean +/- SD: 4.51 +/- 0.27 versus 5.65 +/- 0.31 cm, 2.89 +/- 0.19 versus 3.78 +/- 0.10 cm, 3.72 +/- 0.34 versus 4.77 +/- 0.18 cm, 2.44 +/- 0.28 versus 3.11 +/- 0.34 cm, 34.98 +/- 3.82 versus 50.56 +/- 3.42%, respectively). Systolic and diastolic left ventricular internal diameter decreased significantly during dobutamine infusion. Left ventricular external and internal area were significantly lower at a dobutamine infusion rate of 2 microg/kg/min but no further decrease was observed during the subsequent steps. Systolic and diastolic myocardial area was significantly lower after the administration of dobutamine but not significantly different during dobutamine infusion, when compared to baseline values. This pharmacological stress test induced significant changes in left ventricular echocardiographic parameters in adult warmblood horses. Additional research should evaluate the value of this stress test in horses suffering from cardiac disease.

  13. Comparative Study of Atropine Combined with Sodium Nitroprusside Pretreatment to Prevent Trigemino Cardiac Reflex after Trigeminal Ganglion Compression

    PubMed Central

    Guan, Zhan-Ying; Cai, Chang-Hua; Zhang, Jing; Wang, Rong-Wei; Pang, Qing-Gui; Liu, Hui

    2016-01-01

    Introduction Manipulation of percutaneous compression of the trigeminal ganglion (PCTG) for trigeminal neuralgia (TN) can lead to significant haemodynamic changes, which were termed trigemino cardiac reflex (TCR). Nevertheless, many studies indicated that atropine pretreatment can reduce the incidence of bradycardia and cardiac arrest, but do not take precautions against abrupt rise of blood pressure. Aim The purpose of our study was to compare control group {patients receiving Sodium Nitro-Prusside (SNP) pretreatment before PCTG} with study groups (patients receiving different doses of atropine combined with SNP pretreatment before PCTG) in cardiovascular parameters {Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR)} at 5 periods during Total Intravenous Anaesthesia (TIVA). Materials and Methods In total, 120 patients, who underwent PTCG, were enrolled and randomly assigned into control group {group A (SNP pretreatment before PCTG, n=29)} and study groups {group B (0.002mg /kg atropine combined with SNP pretreatment before PCTG, n=30), C (0.004mg/kg atropine pretreatment before PCTG, n=31) and D (0.006mg/kg atropine combined with SNP pretreatment before PCTG, n=30)}, the relationship between haemodynamic changes and using atropine pretreatment or not was compared. Cardiovascular parameters were measured at five periods: preoperative (T0); before puncture (T1); during compression (T2); 1 min after the compression ended (T3); and 1 min after the procedure ended (T4). Multivariate analysis of variance (MANOVA) and Pearson’s χ2 test were used, and a value of p < 0.05 was considered statistically significant. Results Compared with the group A, means of SBP and DBP in the study groups (group B, C and D) were not observed significant differences at all time points (p>0.05), the mean values of HR showed significant differences, when compared to group C and group D at T2 and T3 (p<0.001). Meanwhile, means of SBP, DBP and HR comparison in

  14. Carbon dioxide poisoning: a literature review of an often forgotten cause of intoxication in the emergency department.

    PubMed

    Permentier, Kris; Vercammen, Steven; Soetaert, Sylvia; Schellemans, Christian

    2017-12-01

    The goal of this article was to provide an overview of the literature available on carbon dioxide intoxication. Articles were included based on their focus on medical or physiological effects of carbon dioxide. Studies related to decompression sickness were excluded. Mechanisms of carbon dioxide poising (both as an asphyxiant and as a toxicant) were described. Our review suggested that precautions are needed when handling dry ice or while working in confined spaces. Pre-hospital responders also need to pay attention for the possible diagnosis of CO2 intoxication for their own safety. When confronted with a victim, he/she should be removed from the dangerous area as fast as possible and oxygen should be administered. Without adequate treatment, victims may show acute reduced cognitive performance, respiratory failure, and circulatory arrest. Therefore, carbon dioxide poisoning is a rare but not to miss diagnosis in the emergency department.

  15. Isolation and identification of trichothecenes from Fusarium compactum suspected in the aetiology of a major intoxication of sandhill cranes.

    USGS Publications Warehouse

    Cole, Richard J.; Dorner, Joe W.; Gilbert, John; Mortimer, David N.; Crews, Colin; Mitchell, J.C.; Windingstad, Ronald M.; Nelson, Paul E.; Cutler, Horace G.

    1988-01-01

    Isoneosolaniol (4,8-diacetoxy-12,13-epoxytrichothec-9-ene-3,15-diol) and other unidentified trichothecene mycotoxins were isolated from culture extracts of two highly toxigenic strains of Fusarium compactum cultured from waste peanuts involved in an acute intoxication of sandhill cranes (Grus canadensis). Neosolaniol and other unidentified trichothecenes were detected in waste peanuts collected from affected areas. The structure of isoneosolaniol was determined by 1H and 13C NMR analyses and by high-resolution mass spectometry. Isoneosolaniol was hightly toxic to 1-day-old chickens and to a HEp2 cell culture assay. It was concluded that the most logical cause of the sandhill crane intoxication was Fusarium spp. Contaminated peanuts and various trichothecene mycotoxins acting alone or in conjunction with other Fusarium mycotoxins.

  16. Determination of tropane alkaloids atropine and scopolamine by liquid chromatography-mass spectrometry in plant organs of Datura species.

    PubMed

    Jakabová, Silvia; Vincze, Lajos; Farkas, Agnes; Kilár, Ferenc; Boros, Borbála; Felinger, Attila

    2012-04-06

    Hyoscyamine (atropine) and scopolamine are the predominant tropane alkaloids in the Datura genus, occurring in all plant organs. The assessment of the alkaloid content of various plant parts is essential from the viewpoint of medical use, but also as a potential risk of toxicity for humans and animals. Therefore, a reliable method for the determination of tropane alkaloid content is of high importance. The present work aimed at the elaboration of a rapid method for determination of the most abundant Datura alkaloids by LC-MS technique using a new generation of core-shell particle packed column. Tropane alkaloid content was investigated in various plant organs of four Datura taxa (D. innoxia, D. metel, D. stramonium, and D. stramonium var. tatula), grown under the same conditions, in two developmental stages. We have developed a rapid LC-MS method for the quantitative determination of atropine and scopolamine, which was successfully applied to quantify the alkaloids in different plant organs (leaves, flowers, stems, seeds) of thorn apples after a simple sample preparation step. Elaboration and validation of the method and analysis of plant extracts were done by UFLC-MS technique, employing an Ascentis Express C18 column. Detection was done in positive ionization mode (ESI+) and the method suitability was evaluated by several validation characteristics. Quantitation limits are 333 and 167 pgmL(-1) for scopolamine and atropine, respectively, and the method shows very good repeatability. The analysis of Datura extracts revealed significant differences depending on the species, the organ and the sampling period. Atropine was found to be dominant over scopolamine in three out of the four taxa investigated. D. innoxia showed the highest concentrations of scopolamine in all organs examined, whereas D. metel accumulated the lowest scopolamine levels. Hyoscyamine, measured as atropine, was the highest in D. stramonium var. tatula, and the lowest in D. innoxia. Samples

  17. Task 89-06: Determination of the Bioequivalence of HI-6 and Atropine When Delivered by Wet/Dry Autoinjector or Syringe in Sheep: A Pharmacokinetic and Efficacy Evaluation

    DTIC Science & Technology

    1991-04-01

    available atropine sulfate injectable solution (Atropine L.A., Sutler, Columbus, ON) was purchased locally for use as supplmental atropine in efficacy...mL of phosphate buffer (a), add 0.20-g magnesium chlorid3 (MgCI 2) (0.01 M), 0.01-g bovine serum albumin, Revised April 11, 1990 ] -1 MREF SOP-88-46

  18. Intralipid emulsion treatment as an antidote in lipophilic drug intoxications.

    PubMed

    Eren Cevik, Sebnem; Tasyurek, Tanju; Guneysel, Ozlem

    2014-09-01

    Intravenous lipid emulsion (ILE) is a lifesaving treatment of lipophilic drug intoxications. Not only does ILE have demonstrable efficacy as an antidote to local anesthetic toxicity, it is also effective in lipophilic drug intoxications. Our case series involved 10 patients with ingestion of different types of lipophilic drugs. Intravenous lipid emulsion treatment improved Glasgow Coma Scale or blood pressure and pulse rate or both according to the drug type. Complications were observed in 2 patients (minimal change pancreatitis and probable ILE treatment-related fat infiltration in lungs). In our case series, ILE was used for different lipophilic drug intoxications to improve cardiovascular and neurologic symptoms. According to the results, it was found that ILE treatment is a lifesaving agent in lipophilic drug intoxications and it can be used in unconscious patients who have cardiac and/or neurologic symptoms but no history of a specific drug ingestion.

  19. Severe childhood amitriptyline intoxication and plasmapheresis: a case report.

    PubMed

    Karacı, Mehmet; Özçetin, Mustafa; Dilsiz, Günter; Güçlü-Songür, Yaşar Gözde

    2013-01-01

    Tricyclic antidepressant intoxication is one of the most frequently encountered and life-threatening causes of intoxication among referrals to emergency departments due to drug intoxication. There is no known antidote against any of the tricyclic antidepressants. The American Society for Apheresis (ASFA) recommends plasmapheresis to support primary treatment in this type of drug poisoning, which does not respond to certain and traditional treatments. We present a 15-year-old girl who ingested amitriptyline with suicidal intent. On admission, she was in a comatose state (Glasgow Coma Scale score: 5), with no spontaneous respiration and presence of pathological reflexes. Due to the intake history of lethal doses and the severe clinical picture, plasmapheresis was performed. She was discharged on her fifth day of hospitalization.Due to the high plasma protein binding property of amitriptyline, plasma exchange therapy should be considered in cases of severe amitriptyline intoxication as a life-saving therapeutic modality.

  20. [Sudden unilateral sensorineural hearing loss after carbon monoxide intoxication].

    PubMed

    Michalska-Piechowiak, Teresa; Miarzyńska, Maria; Perlik-Gattner, Irena

    2004-01-01

    A case of unilateral sensorineural hearing loss of the left ear after carbon monoxide intoxication was presented. The diagnosis was based upon an interview, medical examinations and audiometric investigations. Results of diagnostic evaluations, clinical presentation and treatment were discussed. Hearing improvement was obtained after 6 days of treatment and normal hearing returned after 14 days. Patients who suffer from CO intoxication are at risk of hearing impairment, therefore, there is a need for audiometric follow up in these patients.

  1. Computer-Assisted Communication Device for Botulinum-Intoxicated Patients

    DTIC Science & Technology

    2008-01-01

    2006; Kubler et al., 2001), while most BoNT-intoxicated patients recover speech within three months of hospitalisation (Sobel, 2005... Kubler et al., 2001), whereas vision is invariably compromised in BoNT-intoxicated patients (Penas et al., 2005). • In the event of a large-scale...Infect. Dis., Vol. 56, pp.73–74. Kubler , A., Neumann, N., Kaiser, J., Kotchoubey, B., Hinterberger, T. and Birbaumer, N.P. (2001) ‘Brain-computer

  2. Colchicine intoxication: a report of two suicide cases

    PubMed Central

    Erden, Abdulsamet; Karagoz, Hatice; Gümüscü, Hasan Hüseyin; Karahan, Samet; Basak, Mustafa; Aykas, Fatma; Bulut, Kadir; Cetinkaya, Ali; Avci, Deniz; Poyrazoglu, Orhan Kürsat

    2013-01-01

    Colchicine, an old and well-known drug, is an alkaloid extracted from Colchicum autumnale and related species. Colchicine inhibits the deposition of uric acid crystals and is an inhibitor of mitosis. Nausea, vomiting, abdominal pain, and diarrhea, with a massive loss of fluid and electrolytes are the first clinical symptoms of colchicine poisoning. Stomach lavage and rapid gastric decontamination with activated charcoal are crucial. An acute dose of about 0.8 mg/kg of colchicine is presumed to be fatal. We report the clinical outcomes of two different cases of colchicine intoxication for attempted suicide. The dose required for morbidity or mortality varies significantly. The dose of 1 mg/kg in the first case was directly related with mortality, while the dose of 0.2 mg/kg in the second was related with survival. The other difference between the patients was the time of arrival to hospital after ingestion. This period was 4 hours for case 1 and only 1, hour for case 2. The initiation of treatment later than 2 hours after ingestion of colchicine may significantly impair treatment because the absorption time for colchicine after oral administration is about 30–120 minutes. The rising lactate level and high anion gap metabolic acidosis in our patient (case 1) were attributed to lactic acidosis, so hemodialysis was performed, and the duration of hemodialysis was prolonged. Lactic acidosis in the first case was one of the reasons for mortality. The most important parameters which define the chance of survival are the dose of ingested drugs and the arrival time to hospital after ingestion. The patients must be monitored closely for lactic acidosis and the decision to start hemodialysis must be made promptly for patients who develop lactic acidosis. PMID:24353429

  3. Diphenyl Ditelluride Intoxication Triggers Histological Changes in Liver, Kidney, and Lung of Mice

    PubMed Central

    da Luz, Sônia Cristina Almeida; Daubermann, Melissa Falster; Thomé, Gustavo Roberto; dos Santos, Matheus Mülling; Ramos, Angelica; Torres Salazar, Gerson; da Rocha, João Batista Teixeira; Barbosa, Nilda Vargas

    2015-01-01

    Tellurium compounds may be cytotoxic to different cells types. Thus, this work evaluated the effect of diphenyl ditelluride ((PhTe)2), an organotellurium commonly used in organic synthesis, on the morphology of liver, kidney, and lung. Adult mice were acutely (a subcutaneous single dose: 250 μmol/kg) or subchronically (one daily subcutaneous dose: 10 or 50 μmol/kg for 7 and 14 days) exposed to (PhTe)2. Afterwards, the histological analyses of liver, kidney, and lungs were performed. Liver histology revealed that the hepatocytes of mice subchronically exposed to (PhTe)2 presented cytoplasmic vacuolization, hydropic degeneration, and hyperchromatic nuclei. Subchronic exposure to 50 μmol/kg (PhTe)2 also caused hepatic necrosis. Microvesicular and macrovesicular steatosis were identified in liver of mice acutely exposed to (PhTe)2. Acute and subchronic intoxication with (PhTe)2 induced changes on epithelial cells of renal tubules, namely, loss of brush border and cytoplasmatic vacuolization. Atrophy and hypertrophy, cast proteinaceous formation, and acute tubular necrosis were also identified in renal tissue. Mice subchronically exposed to 50 μmol/kg (PhTe)2 developed intra-alveolar edema and alveolar wall congestion in some areas of lungs. Acute exposure to (PhTe)2 did not cause histological changes in lungs. Our data show that (PhTe)2 may be considered a histotoxic agent for liver, kidney, and lung. PMID:26236579

  4. Diphenyl ditelluride intoxication triggers histological changes in liver, kidney, and lung of mice.

    PubMed

    da Luz, Sônia Cristina Almeida; Daubermann, Melissa Falster; Thomé, Gustavo Roberto; Dos Santos, Matheus Mülling; Ramos, Angelica; Torres Salazar, Gerson; da Rocha, João Batista Teixeira; Barbosa, Nilda Vargas

    2015-01-01

    Tellurium compounds may be cytotoxic to different cells types. Thus, this work evaluated the effect of diphenyl ditelluride ((PhTe)2), an organotellurium commonly used in organic synthesis, on the morphology of liver, kidney, and lung. Adult mice were acutely (a subcutaneous single dose: 250 μmol/kg) or subchronically (one daily subcutaneous dose: 10 or 50 μmol/kg for 7 and 14 days) exposed to (PhTe)2. Afterwards, the histological analyses of liver, kidney, and lungs were performed. Liver histology revealed that the hepatocytes of mice subchronically exposed to (PhTe)2 presented cytoplasmic vacuolization, hydropic degeneration, and hyperchromatic nuclei. Subchronic exposure to 50 μmol/kg (PhTe)2 also caused hepatic necrosis. Microvesicular and macrovesicular steatosis were identified in liver of mice acutely exposed to (PhTe)2. Acute and subchronic intoxication with (PhTe)2 induced changes on epithelial cells of renal tubules, namely, loss of brush border and cytoplasmatic vacuolization. Atrophy and hypertrophy, cast proteinaceous formation, and acute tubular necrosis were also identified in renal tissue. Mice subchronically exposed to 50 μmol/kg (PhTe)2 developed intra-alveolar edema and alveolar wall congestion in some areas of lungs. Acute exposure to (PhTe)2 did not cause histological changes in lungs. Our data show that (PhTe)2 may be considered a histotoxic agent for liver, kidney, and lung.

  5. Chlorpromazine and ethanol intoxication: an underlying mechanism.

    PubMed

    Messiha, F S

    1985-01-01

    The in vitro effect of chlorpromazine on hepatic alcohol dehydrogenase (L-ADH) was studied as a function of sex and species. The presence of chlorpromazine, 50 muMol, in reaction mixture noncompetitively inhibited rat L-ADH in a dose dependent fashion in the concentration range between 5 X 10(-5) Mol and 10(-4) Mol. This drug concentration also inhibited L-ADH of albino mice of both sexes, but chlorpromazine-produced a decrease in Km which was greater in the female than in the male mouse. Likewise, chlorpromazine, 50 muMol, noncompetitively inhibited mouse L-ADH of C57BL/6J, a mouse strain with ethanol preference, but without a concomitant change in the apparent Km. The KI50 determination indicates 3.5 fold lower concentration requirement of the drug in the C57BL mouse strain compared to that of the albino rat liver preparation. The results suggest that the inhibitory action of the drug on L-ADH and the genetic factor involved may influence the legal limit of serum ethanol concentration during alcohol intoxication in subjects under psychotropic medications. A medical forensic implication is suggested.

  6. Involvement of GABA transporters in atropine-treated myopic retina as revealed by iTRAQ quantitative proteomics.

    PubMed

    Barathi, Veluchamy A; Chaurasia, Shyam S; Poidinger, Michael; Koh, Siew Kwan; Tian, Dechao; Ho, Candice; Iuvone, P Michael; Beuerman, Roger W; Zhou, Lei

    2014-11-07

    Atropine, a muscarinic antagonist, is known to inhibit myopia progression in several animal models and humans. However, the mode of action is not established yet. In this study, we compared quantitative iTRAQ proteomic analysis in the retinas collected from control and lens-induced myopic (LIM) mouse eyes treated with atropine. The myopic group received a (-15D) spectacle lens over the right eye on postnatal day 10 with or without atropine eye drops starting on postnatal day 24. Axial length was measured by optical low coherence interferometry (OLCI), AC-Master, and refraction was measured by automated infrared photorefractor at postnatal 24, 38, and 52 days. Retinal tissue samples were pooled from six eyes for each group. The experiments were repeated twice, and technical replicates were also performed for liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. MetaCore was used to perform protein profiling for pathway analysis. We identified a total of 3882 unique proteins with <1% FDR by analyzing the samples in replicates for two independent experiments. This is the largest number of mouse retina proteome reported to date. Thirty proteins were found to be up-regulated (ratio for myopia/control > global mean ratio + 1 standard deviation), and 28 proteins were down-regulated (ratio for myopia/control < global mean ratio - 1 standard deviation) in myopic eyes as compared with control retinas. Pathway analysis using MetaCore revealed regulation of γ-aminobutyric acid (GABA) levels in the myopic eyes. Detailed analysis of the quantitative proteomics data showed that the levels of GABA transporter 1 (GAT-1) were elevated in myopic retina and significantly reduced after atropine treatment. These results were further validated with immunohistochemistry and Western blot analysis. In conclusion, this study provides a comprehensive quantitative proteomic analysis of atropine-treated mouse retina and suggests the involvement of GABAergic signaling in the

  7. Involvement of GABA Transporters in Atropine-Treated Myopic Retina As Revealed by iTRAQ Quantitative Proteomics

    PubMed Central

    2015-01-01

    Atropine, a muscarinic antagonist, is known to inhibit myopia progression in several animal models and humans. However, the mode of action is not established yet. In this study, we compared quantitative iTRAQ proteomic analysis in the retinas collected from control and lens-induced myopic (LIM) mouse eyes treated with atropine. The myopic group received a (−15D) spectacle lens over the right eye on postnatal day 10 with or without atropine eye drops starting on postnatal day 24. Axial length was measured by optical low coherence interferometry (OLCI), AC-Master, and refraction was measured by automated infrared photorefractor at postnatal 24, 38, and 52 days. Retinal tissue samples were pooled from six eyes for each group. The experiments were repeated twice, and technical replicates were also performed for liquid chromatography–tandem mass spectrometry (LC–MS/MS) analysis. MetaCore was used to perform protein profiling for pathway analysis. We identified a total of 3882 unique proteins with <1% FDR by analyzing the samples in replicates for two independent experiments. This is the largest number of mouse retina proteome reported to date. Thirty proteins were found to be up-regulated (ratio for myopia/control > global mean ratio + 1 standard deviation), and 28 proteins were down-regulated (ratio for myopia/control < global mean ratio - 1 standard deviation) in myopic eyes as compared with control retinas. Pathway analysis using MetaCore revealed regulation of γ-aminobutyric acid (GABA) levels in the myopic eyes. Detailed analysis of the quantitative proteomics data showed that the levels of GABA transporter 1 (GAT-1) were elevated in myopic retina and significantly reduced after atropine treatment. These results were further validated with immunohistochemistry and Western blot analysis. In conclusion, this study provides a comprehensive quantitative proteomic analysis of atropine-treated mouse retina and suggests the involvement of GABAergic signaling in the

  8. Safety and feasibility of dobutamine-atropine stress testing in hypertensive patients.

    PubMed

    Elhendy, A; van Domburg, R T; Roelandt, J R; Geleijnse, M L; Ibrahim, M M; Fioretti, P M

    1997-06-01

    Dobutamine stress testing is increasingly used for the diagnosis and functional evaluation of coronary artery disease. The aim of this study was to assess the hemodynamic profile, safety, and feasibility of dobutamine stress testing in hypertensive patients. Dobutamine (up to 40 micrograms/kg per minute)-atropine (up to 1 mg) stress echocardiography was performed for the detection of myocardial ischemia in 1164 patients with limited exercise capacity (age, 60 +/- 12 years; 761 men); 446 patients were known to have hypertension. The test was considered feasible when 85% of the maximal heart rate and/or an ischemic end point (new or worsened wall motion abnormalities, ST segment depression, or angina) was achieved. No myocardial infarction or death occurred during the test. Dobutamine induced a significant increase of heart rate in patients with and without hypertension (59 +/- 25 and 63 +/- 23 beats per minute, respectively). Peak rate pressure product was similar in patients with and without hypertension (18,566 +/- 4584 and 18,230 +/- 4508). Hypotension (systolic pressure drop > 40 mm Hg) during the test was more frequent in hypertensive patients (7% versus 4% in normotensive, P < .05). Independent predictors of hypotension were baseline systolic pressure greater than 140 mm Hg (odds ratio, 6.9; 95% confidence interval, 3.4 to 14), older age (odds ratio, 1.04; 95% confidence interval, 1.01 to 1.07), and medication with calcium channel blockers (odds ratio, 1.8; 95% confidence interval, 1.1 to 3.5). The prevalence of ventricular tachycardia was similar (4.1%) in both groups. Episodes of 10 beats or more (0.06% of patients) were terminated promptly by intravenous metoprolol administration. Dobutamine stress testing was considered feasible in 91% of patients with and 92% of patients without hypertension. Dobutamine-atropine stress echocardiography is a safe and feasible method for the assessment of hypertensive patients referred for evaluation of myocardial ischemia

  9. Paraquat intoxication and associated pathological findings in three dogs in South Africa.

    PubMed

    Williams, June H; Whitehead, Zandri; Van Wilpe, Erna

    2016-11-09

    Paraquat is a bipyridylium non-selective contact herbicide commonly used worldwide. When ingestion occurs by humans and animals either accidentally, intentionally or maliciously, paraquat selectively accumulates in the lungs resulting in the production of oxygen-free radicals, causing membrane damage and cell death. Intoxicated subjects typically show progressive and fatal pulmonary haemorrhage, collapse and oedema. In individuals surviving the acute phase, pulmonary fibrosis develops. Gastrointestinal-, renal- and central nervous system clinical signs may also occur. Owing to the lack of effective treatment and absence of an antidote, the prognosis is poor. The clinical presentation, clinicopathological findings and treatment are briefly described of three dogs from one South African household, intoxicated with paraquat. Macroscopic and microscopic lesions in one dog that was necropsied, as well as pulmonary ultrastructure are detailed and illustrated for academic reference. All dogs presented with tachypnoea and dyspnoea 2-3 days after accidental paraquat ingestion. Treatment was aimed at reducing gastrointestinal absorption, enhancing elimination by diuresis and avoiding further oxidative damage by administration of antioxidants. All dogs, however, became progressively hypoxic despite treatment and were euthanised. Paraquat toxicity should be a differential diagnosis in dogs with unexplained progressive respiratory and gastrointestinal signs and renal failure. The local veterinary profession should be aware of accidental or intentional paraquat toxicity of animals. Existing literature, variations possible in canine clinical signs, measured parameters, lesions, as well as possible treatments, promising experimental antidotes and management options are discussed.

  10. [Prolonged convulsion after intoxication of alachlor herbicide (Lasso): a case report].

    PubMed

    Naito, Hiromichi; Nagae, Masaharu; Okahara, Shuji; Maeyama, Hiroki; Okada, Daisuke; Hagioka, Shingo; Morimoto, Naoki

    2011-03-01

    We experienced a case of alachlor herbicide (Lasso) intoxication. A 57-year-old man was transported to our hospital by ambulance after ingesting 450 mL of Lasso. He was unconscious and had difficulty in breathing. Gastric lavage was performed after tracheal intubation and the patient was placed on mechanical ventilation. Activated charcoal and laxative were administrated. Even after admission, disturbance of consciousness persisted. He had liver and kidney disorders but these did not progress to multiple organ failure. He experienced convulsions from day 4 and was administered anticonvulsants. Convulsion was intractable and needed long-term treatment. His general condition improved until discharge. He was weaned from mechanical ventilation and recovered consciousness, but he still displayed tremors. The herbicide (Lasso) is a combination of alachlor and monochlorobenzene. Studies have shown that alachlor is neurotoxic and monochlorobenzene accumulates in the brain. In case of intoxication with the herbicide Lasso, treatment is required for ameliorating neurotoxic effects and intractable convulsion as well as liver and kidney disorders, gastrointestinal mucosal damage, hematopoietic disorder, and acute circulatory failure.

  11. GM1 ganglioside reduces ethanol intoxication and the development of ethanol dependence.

    PubMed

    Wallis, C J; Rezazadeh, S M; Lal, H

    1995-01-01

    The monosialoganglioside, GM1, protects the nervous system against a variety of insults. In this study, we evaluated the protective properties of GM1 on ethanol intoxication and development of dependence. GM1 (20-40 mg/kg, IP) reduced the extent and duration of ataxia produced by ethanol (2 g/kg, IP, 15-95 min), and delayed the onset of loss and reduced the duration of the righting reflex (LORR) produced by ethanol (4.2 g/kg, IP). GM1 did not alter ethanol-induced hypothermia or the rate of ethanol clearance. Rather, GM1 increased the waking blood ethanol concentration. In animals fed a complete liquid diet containing 4.5% ethanol, concurrent administration of GM1 (40 mg/kg/day) blocked the tremors, hypolocomotion, and anxiety-like behavior associated with ethanol withdrawal. These findings demonstrate that GM1 reduces both ethanol's acute intoxication and the signs and symptoms of ethanol withdrawal by a mechanism not related to ethanol pharmacokinetics.

  12. Anticonvulsant Treatment of Nerve Agent Seizures: Anticholinergics versus Diazepam in Soman-Intoxicated Guinea Pigs

    DTIC Science & Technology

    2000-01-01

    8 June 1999 Abstract A total of eight anticholinergic drugs (aprophen, atropine, azaprophen, benactyzine, biperiden , procyclidine, scopolamine...procyclidine and aprophen terminated seizures most rapidly while scopolamine, trihexyphenidyl, biperiden , and diazepam were significantly slower. When...given 40 min after seizure onset, diazepam was the most potent compound tested, followed by scopolamine, benactyzine and biperiden ; atropine was not

  13. Animal Models That Best Reproduce the Clinical Manifestations of Human Intoxication with Organophosphorus Compounds

    PubMed Central

    Pereira, Edna F. R.; Aracava, Yasco; DeTolla, Louis J.; Beecham, E. Jeffrey; Basinger, G. William; Wakayama, Edgar J.

    2014-01-01

    The translational capacity of data generated in preclinical toxicological studies is contingent upon several factors, including the appropriateness of the animal model. The primary objectives of this article are: 1) to analyze the natural history of acute and delayed signs and symptoms that develop following an acute exposure of humans to organophosphorus (OP) compounds, with an emphasis on nerve agents; 2) to identify animal models of the clinical manifestations of human exposure to OPs; and 3) to review the mechanisms that contribute to the immediate and delayed OP neurotoxicity. As discussed in this study, clinical manifestations of an acute exposure of humans to OP compounds can be faithfully reproduced in rodents and nonhuman primates. These manifestations include an acute cholinergic crisis in addition to signs of neurotoxicity that develop long after the OP exposure, particularly chronic neurologic deficits consisting of anxiety-related behavior and cognitive deficits, structural brain damage, and increased slow electroencephalographic frequencies. Because guinea pigs and nonhuman primates, like humans, have low levels of circulating carboxylesterases—the enzymes that metabolize and inactivate OP compounds—they stand out as appropriate animal models for studies of OP intoxication. These are critical points for the development of safe and effective therapeutic interventions against OP poisoning because approval of such therapies by the Food and Drug Administration is likely to rely on the Animal Efficacy Rule, which allows exclusive use of animal data as evidence of the effectiveness of a drug against pathologic conditions that cannot be ethically or feasibly tested in humans. PMID:24907067

  14. [An atypical case of acute zinc poisoning].

    PubMed

    Andrzejak, R; Antonowicz, J; Andreasik, Z

    1992-01-01

    The paper discussed a case of acute zinc intoxication in a 48-year old welder, after four days of cutting zinc-plated pipes with an oxy-acetylene torch, in poorly ventilated places. The zinc fever has been diagnosed on the basis of the symptoms and confirmed by laboratory findings: high zinc blood and erythrocyte concentration and increased urinary excretion of zinc. One year the intoxication the manifestations of the psycho-organic syndrome with predilection to pseudoneurotic reactions were still present. The non-standard factor in this case is the very short time of exposure to zinc oxide and the occurrence of chronic encephalopathy is also singular.

  15. Reducing intoxication among bar patrons: some lessons from prevention of drinking and driving.

    PubMed

    Graham, Kathryn; Miller, Peter; Chikritzhs, Tanya; Bellis, Mark A; Clapp, John D; Hughes, Karen; Toomey, Traci L; Wells, Samantha

    2014-05-01

    Intoxication in and around licensed premises continues to be common, despite widespread training in the responsible service of alcohol and laws prohibiting service to intoxicated individuals. However, research suggests that training and the existence of laws are unlikely to have an impact on intoxication without enforcement, and evidence from a number of countries indicates that laws prohibiting service to intoxicated individuals are rarely enforced. Enforcement is currently hampered by the lack of a standardized validated measure for defining intoxication clearly, a systematic approach to enforcement and the political will to address intoxication. We argue that adoption of key principles from successful interventions to prevent driving while intoxicated could be used to develop a model of consistent and sustainable enforcement. These principles include: applying validated and widely accepted criteria for defining when a person is 'intoxicated'; adopting a structure of enforceable consequences for violations; implementing procedures of unbiased enforcement; using publicity to ensure that there is a perceived high risk of being caught and punished; and developing the political will to support ongoing enforcement. Research can play a critical role in this process by: developing and validating criteria for defining intoxication based on observable behaviour; documenting the harms arising from intoxication, including risk curves associated with different levels of intoxication; estimating the policing, medical and social costs from intoxicated bar patrons; and conducting studies of the cost-effectiveness of different interventions to reduce intoxication.

  16. Neuronal Death Following Soman Intoxication: Necrosis or Apoptosis?

    DTIC Science & Technology

    2006-05-01

    ORGANIZATION NAME(S) AND ADDRESS(ES) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER US Army Medical Research Institute of...MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) US Army Medical Research Institute of Chemical Defense Aberdeen Proving...40 min after onset of seizures, the anticholinergic drugs scopolamine and atropine failed to block soman-induced seizures, but diazepam and MK-801

  17. Hawthorn (Crataegus monogyna Jacq.) extract exhibits atropine-sensitive activity in a cultured cardiomyocyte assay.

    PubMed

    Salehi, Satin; Long, Shannon R; Proteau, Philip J; Filtz, Theresa M

    2009-01-01

    Hawthorn (Crataegus spp.) plant extract is used as a herbal alternative medicine for the prevention and treatment of various cardiovascular diseases. Recently, it was shown that hawthorn extract preparations caused negative chronotropic effects in a cultured neonatal murine cardiomyocyte assay, independent of beta-adrenergic receptor blockade. The aim of this study was to further characterize the effect of hawthorn extract to decrease the contraction rate of cultured cardiomyocytes. To test the hypothesis that hawthorn is acting via muscarinic receptors, the effect of hawthorn extract on atrial versus ventricular cardiomyocytes in culture was evaluated. As would be expected for activation of muscarinic receptors, hawthorn extract had a greater effect in atrial cells. Atrial and/or ventricular cardiomyocytes were then treated with hawthorn extract in the presence of atropine or himbacine. Changes in the contraction rate of cultured cardiomyocytes revealed that both muscarinic antagonists significantly attenuated the negative chronotropic activity of hawthorn extract. Using quinuclidinyl benzilate, L-[benzylic-4,4'-(3)H] ([(3)H]-QNB) as a radioligand antagonist, the effect of a partially purified hawthorn extract fraction to inhibit muscarinic receptor binding was quantified. Hawthorn extract fraction 3 dose-dependently inhibited [(3)H]-QNB binding to mouse heart membranes. Taken together, these findings suggest that decreased contraction frequency by hawthorn extracts in neonatal murine cardiomyocytes may be mediated via muscarinic receptor activation.

  18. Intravenous and inhalation toxicokinetics of sarin stereoisomers in atropinized guinea pigs.

    PubMed

    Spruit, H E; Langenberg, J P; Trap, H C; van der Wiel, H J; Helmich, R B; van Helden, H P; Benschop, H P

    2000-12-15

    We report the first toxicokinetic studies of (+/-)-sarin. The toxicokinetics of the stereoisomers of this nerve agent were studied in anesthetized, atropinized, and restrained guinea pigs after intravenous bolus administration of a dose corresponding to 0.8 LD50 and after nose-only exposure to vapor concentrations yielding 0.4 and 0.8 LCt50 in an 8-min exposure time. During exposure the respiratory minute volume and frequency were monitored. Blood samples were taken for gas chromatographic analysis of the nerve agent stereoisomers and for measurement of the activity of blood acetylcholinesterase (AChE). In all experiments, the concentration of (+)-sarin was below the detection limit (<5 pg/ml). The concentration-time profile of the toxic isomer, i.e., (-)-sarin, after an intravenous bolus was adequately described with a two-exponential equation. (-)-Sarin is distributed ca. 10-fold faster than C(-)P(-)-soman, whereas its elimination proceeds almost 10-fold slower. During nose-only exposure to 0.4 and 0.8 LCt50 of (+/-)-sarin in 8 min, (-)-sarin appeared to be rapidly absorbed. The blood AChE activity decreased during the exposure period to ca. 15 and 70% of control activity, respectively. There were no effects on the respiratory parameters. A significant nonlinearity of the toxicokinetics with dose was observed for the respiratory experiments.

  19. Percutaneous exposure to the nerve agent VX: Efficacy of combined atropine, obidoxime and diazepam treatment.

    PubMed

    Joosen, Marloes J A; van der Schans, Marcel J; van Helden, Herman P M

    2010-10-06

    The nerve agent VX is most likely to enter the body via liquid contamination of the skin. After percutaneous exposure, the slow uptake into the blood, and its slow elimination result in toxic levels in plasma for a period of several hours. Consequently, this has implications for the development of toxic signs and for treatment onset. In the present study, clinical signs, toxicokinetics and effects on respiration, electroencephalogram and heart rate were investigated in hairless guinea pigs after percutaneous exposure to 500 microg/kg VX. We found that full inhibition of AChE and partial inhibition of BuChE in blood were accompanied by the onset of clinical signs, reflected by a decline in respiratory minute volume, bronchoconstriction and a decrease in heart rate. Furthermore, we investigated the therapeutic efficacy of a single dose of atropine, obidoxime and diazepam, administered at appearance of first clinical signs, versus that of repetitive dosing of these drugs on the reappearance of signs. A single shot treatment extended the period to detrimental physiological decline and death for several hours, whereas repetitive administration remained effective as long as treatment was continued. In conclusion, percutaneous VX poisoning showed to be effectively treatable when diagnosed on time and when continued over the entire period of time during which VX, in case of ineffective decontamination, penetrates the skin.

  20. Isolation of atropine and scopolamine from plant material using liquid-liquid extraction and EXtrelut(®) columns.

    PubMed

    Śramska, Paula; Maciejka, Artur; Topolewska, Anna; Stepnowski, Piotr; Haliński, Łukasz P

    2017-02-01

    Tropane alkaloids are toxic secondary metabolites produced by Solanaceae plants. Among them, plants from Datura genus produce significant amounts of scopolamine and hyoscyamine; the latter undergoes racemization to atropine during isolation. Because of their biological importance, toxic properties and commonly reported food and animal feed contamination by different Datura sp. organs, there is a constant need for reliable methods for the analysis of tropane alkaloids in many matrices. In the current study, three extraction and sample-clean up procedures for the determination of scopolamine and atropine in plant material were compared in terms of their effectiveness and repeatability. Standard liquid-liquid extraction (LLE) and EXtrelut(®) NT 3 columns were used for the sample clean-up. Combined ultrasound-assisted extraction and 24h static extraction using ethyl acetate, followed by multiple LLE steps was found the most effective separation method among tested. However, absolute extraction recovery was relatively low and reached 45-67% for atropine and 52-73% for scopolamine, depending on the compound concentration. The same method was also the most effective one for the isolation of target compounds from Datura stramonium leaves. EXtrelut(®) columns, on the other hand, displayed relatively low effectiveness in isolating atropine and scopolamine from such a complex matrix and hence could not be recommended. The most effective method was also applied to the extraction of alkaloids from roots and stems of D. stramonium. Quantitative analyses were performed using validated method based on gas chromatography with flame ionization detector (GC-FID). Based on the results, the importance of the proper selection of internal standards in the analysis of tropane alkaloids was stressed out.

  1. Comparison of safety and efficacy of the early injection of atropine during dobutamine stress echocardiography with the conventional protocol.

    PubMed

    Tsutsui, Jeane M; Osório, Altamiro F F; Lario, F Abio C; Fernandes, Daniela R A; Sodre, Gustavo; Andrade, José L; Ramires, José A F; Mathias, Wilson

    2004-12-01

    Although dobutamine-atropine stress echocardiography (DASE) is an established method for evaluating patients who have coronary artery disease (CAD), it can increase test duration and a patient's exposure to large doses of dobutamine. New protocols, including the early injection of atropine during dobutamine stress echocardiography (EA-DSE), have been proposed to decrease test duration. This study compared the safety, efficacy, and accuracy of EA-DSE with those of DASE. We retrospectively evaluated 3,163 patients who underwent DASE and 1,664 patients who underwent EA-DSE over a period of 12 years. In EA-DSE, atropine at a dose 50% stenosis) was assessed in patients who underwent quantitative angiography atropine dose was larger (0.8 +/- 0.5 vs 0.5 +/- 0.25 mg, p <0.0001). EA-DSE resulted in a significantly shorter duration of dobutamine infusion (12.4 +/- 2.0 vs 14.6 +/- 2.5 minutes, p <0.0001), more diagnostic studies (88% vs 81%, p <0.0001), and a lower incidence of minor adverse effects than did DASE. The rate of major adverse effects was similar in the 2 protocols. Sensitivities, specificities, positive predictive values, negative predictive values, and accuracies for detecting CAD were 84%, 90%, 93%, 76%, and 86% for EA-DSE and 86%, 78%, 84%, 79%, and 82% for DASE, respectively (p = NS). Therefore, EA-DSE is a safe and effective alternative to DASE and had a similar accuracy for the detection of CAD.

  2. Attention to advertising and memory for brands under alcohol intoxication

    PubMed Central

    Orquin, Jacob L.; Jeppesen, Heine B.; Scholderer, Joachim; Haugtvedt, Curtis

    2014-01-01

    In an attempt to discover new possibilities for advertising in uncluttered environments marketers have recently begun using ambient advertising in, for instance, bars and pubs. However, advertising in such licensed premises have to deal with the fact that many consumers are under the influence of alcohol while viewing the ad. This paper examines the effect of alcohol intoxication on attention to and memory for advertisements in two experiments. Study 1 used a forced exposure manipulation and revealed increased attention to logos under alcohol intoxication consistent with the psychopharmacological prediction that alcohol intoxication narrows attention to the more salient features in the visual environment. Study 2 used a voluntary exposure manipulation in which ads were embedded in a magazine. The experiment revealed that alcohol intoxication reduces voluntary attention to ads and leads to a significant reduction in memory for the viewed ads. In popular terms consuming one or two beers reduces brand recall from 40 to 36% while being heavily intoxicated further reduces brand recall to 17%. PMID:24723899

  3. Morphological changes in the liver of rats intoxicated with methanol.

    PubMed

    Kasacka, I; Skrzydlewska, E

    1999-01-01

    On the basis of morphological examinations in light and electron microscope, the evaluation of methanol influence on the liver of rats was conducted. The examination was carried out in the group of 36 rats that were given a single dose of methanol (1.5 g/kg b.w.) into the stomach through a gastric tube. The liver was taken from rats under the ether anaesthesia after 6, 12, and 24 hours as well as after 2, 5, and 7 days of methanol administration. Results showed that methanol intoxication caused visible changes in the examined organ. Only 6 h after intoxication, lobular peripheral hepatocytes presented characteristic features of vacuolar degradation persisting up to 48 h. Since the second day of intoxication, many cells with double nuclei were found more frequently than in controls. Single hepatocytes or small hepatocytic clusters with the features of deliquescent necrosis could be seen after 5 and 7 days of examination. All animals intoxicated with methanol showed distinct weakness of glycogen reaction. The loss of glycogen resources was highest at 24 h after methanol administration. The results indicate, that methanol causes morphological changes in the rat liver and that intensification of these changes depends on the time after intoxication.

  4. Attention to advertising and memory for brands under alcohol intoxication.

    PubMed

    Orquin, Jacob L; Jeppesen, Heine B; Scholderer, Joachim; Haugtvedt, Curtis

    2014-01-01

    In an attempt to discover new possibilities for advertising in uncluttered environments marketers have recently begun using ambient advertising in, for instance, bars and pubs. However, advertising in such licensed premises have to deal with the fact that many consumers are under the influence of alcohol while viewing the ad. This paper examines the effect of alcohol intoxication on attention to and memory for advertisements in two experiments. Study 1 used a forced exposure manipulation and revealed increased attention to logos under alcohol intoxication consistent with the psychopharmacological prediction that alcohol intoxication narrows attention to the more salient features in the visual environment. Study 2 used a voluntary exposure manipulation in which ads were embedded in a magazine. The experiment revealed that alcohol intoxication reduces voluntary attention to ads and leads to a significant reduction in memory for the viewed ads. In popular terms consuming one or two beers reduces brand recall from 40 to 36% while being heavily intoxicated further reduces brand recall to 17%.

  5. Sexual abuse history, alcohol intoxication, and women's sexual risk behavior.

    PubMed

    Schacht, Rebecca L; George, William H; Davis, Kelly Cue; Heiman, Julia R; Norris, Jeanette; Stoner, Susan A; Kajumulo, Kelly F

    2010-08-01

    We examined potential differences in women's likelihood of sexual risk taking in a laboratory setting based on alcohol intoxication and sexual abuse history. Participants (n = 64) were classified as non-sexually abused (NSA) or as having experienced sexual abuse in childhood only (CSA) or adulthood only (ASA) and randomly assigned to consume alcoholic (.06, .08, or .10% target blood alcohol content) or non-alcoholic drinks, after which participants read and responded to a risky sex vignette. Dependent measures included vaginal pulse amplitude, self-reported sexual arousal, likelihood of engaging in condom use and risky sexual behaviors described in the vignette, and mood. NSA and ASA women did not differ significantly on any dependent measures. CSA women reported significantly lower likelihood of condom use and unprotected intercourse relative to NSA and ASA women. Intoxicated women reported significantly greater sexual arousal, positive mood, and likelihood of risky sex relative to sober women. Intoxicated CSA women reported significantly more likelihood of unprotected oral sex and less likelihood of condom use relative to intoxicated NSA and ASA and sober CSA women. CSA women's increased risk of sexually transmitted infections (STIs) may be driven by non-condom use and behavioral changes while intoxicated. These findings provide preliminary insight into situational influences affecting CSA women's increased STI risk.

  6. Alcohol consumption and escalatory aggression in intoxicated and sober dyads.

    PubMed

    Leonard, K E

    1984-01-01

    It has been suggested that alcohol ingestion facilitates escalatory processes in aggressive interactions. The present study examined interaction patterns in intoxicated, sober and mixed dyads. Thirty pairs of men college students were randomly assigned to these conditions. Subjects who received alcohol received .964 g of absolute alcohol per kg of body weight. At the beginning of each trial in a reaction-time competition, each member of the dyad selected the shock level that he wanted his opponent to receive if the opponent was slower on the trial. Further, each member was informed by feedback lights of the shock level that his opponent had selected for him. The results indicated that the intoxicated dyads selected higher shock levels than did the sober dyads. Mixed dyads tended to select lower shock levels than intoxicated dyads but higher shock levels than sober dyads. However, these differences were not statistically significant. Additionally, intoxicated dyads escalated in aggression over the first block of six trials, whereas neither sober nor mixed dyads evidenced such an escalation. One interpretation of these findings is that the cognitive disruption caused by the alcohol interfered with the subjects' ability to evaluate the consequences of their behavior and to interpret the behavior of their opponents. A second interpretation is that, because of the expectancy effects associated with alcohol consumption, intoxicated dyads did not feel constrained to a nonaggressive stance. Finally, the value of the dyadic-interaction paradigm in the study of alcohol-related violence was discussed.

  7. [3,5-dimethoxyfenol--marker intoxication with Taxus baccata].

    PubMed

    Stríbrný, J; Dogosi, M; Snupárek, Z; Toupalík, P; Baláz, P; Bartos, P

    2010-07-01

    Autopsy findings of fatal intoxication with yew (Taxus baccata) are nonspecific. A presence of plant residues in the digestive tract can signalize yew intoxication. If yew decoction is consumed, plant residues are not found. In such a case the intoxication can be signalized by the presence of 3,5-dimethoxyphenol in biological material. Authors of this article describe the proof and quantification of the 3,5-dimethoxyphenol in two cases of fatal intoxication with yew. In both cases the liquid/liquid extraction and solid phase extraction was used. Extracts obtained from the acidic and basic environment were analysed. Extracts from the acidic environment were methylated and the extracts from the basic environment were acetylated. The analyses were carried out by gas chromatography/mass spectrometry. In the blood of both intoxicated persons the presence of 3,5-dimethoxyphenol was proved and its concentration 82 ng/ml and 417 ng/ml was quantificated. In both cases the presence of 3,5-dimethoxyphenol was also proved in the gastric contents and urine.

  8. Evaluation of antidotes against the acute cardiovascular toxicity of propranolol.

    PubMed

    Strubelt, O

    1984-06-01

    Rats anesthetized with pentobarbital and ventilated artificially were intoxicated with 1 mg/kg X min propranolol i.v. After 30 min heart rate, mean arterial blood pressure and peripheral resistance had dropped by about 50% and cardiac output by about 25% and were stable for up to 120 min. Isoprenaline proved to be the best antidote for the treatment of propranolol intoxication antagonizing the bradycardia by 76% and the hypotension completely. The antagonistic activities of orciprenaline and prenalterol were lower than those of isoprenaline. Dopamine, adrenaline and noradrenaline antagonized propranolol-induced hypotension but did not considerably influence the bradycardia whereas dobutamine was nearly ineffective in both respects. Glucagon and aminophylline displayed some chronotropic activity without influencing propranolol-induced hypotension. Calcium chloride, on the other hand, produced a moderate elevation of blood pressure but only a small chronotropic activity, and atropine was inactive in both respects. Isoprenaline also restored the cardiac function of propranolol-poisoned rats if administered by infusion and, furthermore, increased the lethal dose of propranolol from 77 to 165 mg/kg. The strong antagonistic activity of isoprenaline against propranolol-induced cardiovascular depression was also confirmed by experiments in pigs. In conclusion, isoprenaline is the most active antidote for the treatment of propranolol intoxication in the rat though the administration of massive doses are required. The vasodilatory effect of isoprenaline can be overcome by the additional administration of a vasoconstricting agent like dopamine.

  9. Accidental choke-cherry poisoning: early symptoms and neurological sequelae of an unusual case of cyanide intoxication.

    PubMed

    Pentore, R; Venneri, A; Nichelli, P

    1996-06-01

    We report the case of a 56-year-old woman who was accidentally poisoned when she ingested choke cherries whose pulp contained cyanide, and describe the acute clinical picture, the neurological sequelae and the neuroradiological findings. After recovery from coma, the patient showed signs of a parkinsonian syndrome, retrobulbar neuritis and sensory-motor neuropathy. MRI showed abnormal signal intensities involving the basal ganglia. Since no memory deficits were observed, we argue that the parkinsonian syndrome was caused by cyanide intoxication rather than by subcortical damage due to hypoxia.

  10. [Forensic medical diagnostics of intoxication with certain poisonous mushrooms in the case of the lethal outcome in a hospital].

    PubMed

    Zaraf'aynts, G N

    2016-01-01

    The present study was undertaken with a view to improving forensic medical diagnostics of intoxication with poisonous mushrooms in the cases of patients' death in a hospital. A total of 15 protocols of forensic medical examination of the corpses of the people who had died from acute poisoning were available for the analysis. The deathly toxins were amanitin and muscarine contained in various combinations in the death cap (Amanita phalloides) and the early false morels (Gyromitra esculenta and G. gigas). The main poisoning season in the former case was May and in the latter case August and September (93.4%). The mortality rate in the case of group intoxication (such cases accounted for 40% of the total) amounted to 28.6%. 40% of the deceased subjects consumed mushrooms together with alcohol. The poisoning caused the development of either phalloidin- or gyromitrin-intoxication syndromes (after consumption of Amanita phalloides and Gyromitra esculenta respectively). It is emphasized that the forensic medical experts must substantiate the diagnosis of poisoning with mushroom toxins based on the results of the chemical-toxicological and/or forensic chemical investigations. The relevant materials taken from the victim or the corpse should be dispatched for analysis not only within the first day but also on days 2-4 after intoxication. The mycological and genetic analysis must include the detection and identification of mushroom microparticles and spores in the smears from the oral cavity, vomiting matter, wash water, gastric and intestinal contents. In addition, the macro- and microscopic morphological signs, clinical data (major syndromes, results of laboratory studies, methods of treatment) should be taken into consideration as well as the time (season) of mushroom gathering, simultaneous poisoning in a group of people, and other pertinent information.

  11. Solvent extraction coupled on-line to a reversed micellar mediated chemiluminescence detection system for trace-level determination of atropine.

    PubMed

    Fujiwara, T; Mohammadzai, I U; Murayama, K; Kumamaru, T

    2000-04-01

    A fast and sensitive method for the determination of atropine, an alkaloid closely related to cocaine, is proposed. The principles of on-line ion-pair formation of alkaloid-metal complexes and liquid-liquid extraction are applied to the chemiluminescence determination of atropine. On mixing with a reversed micellar medium of cetyltrimethylammonium chloride in dichloromethane-cyclohexane (1:1 v/v)-water (0.3 M Na2CO3) containing luminol, the ion-pair complex of tetrachloroaurate(III) with atropinium produced an analytical chemiluminescence signal when it entered the reversed micellar water pool. Using the reverse-flow injection and chemical conditions optimized for atropine in aqueous samples, a detection limit of 1 ng/mL was achieved and a linear calibration graph was obtained with a wide dynamic range from 10 ng/mL to 100 micrograms/mL. The proposed method is simple and provides a good precision with a relative standard deviation (n = 6) of ca. 3% at the atropine concentration of 100 ng/mL. After a preliminary study involving the potential interference from species of organic, inorganic, and metallic nature, the method was applied to the determination of atropine in artificial urine samples and of atropine and scopolamine in pharmaceutical formulations.

  12. Methyltin intoxication in six men; toxicologic and clinical aspects

    SciTech Connect

    Rey, C.; Reinecke, H.J.; Besser, R.

    1984-04-01

    Neurologic and psychiatric symptoms such as headache, tinnitus, defective hearing, changing desorientation and aggressiveness are initial symptoms of methyltin chloride intoxication. Some patients also developed epileptic equivalents, such as dreamy attacks and central ventilation transaminases. Laboratory findings included low levels of serum potassium, leucocytosis and elevated transaminases. The excretion rate of tin in the urine correlated with the severity of the intoxication. There was no measurable effect of plasma separation or d-penicillamine therapy on tin excretion in the urine or on the clinical picture. The long-term prognosis of severely intoxicated persons is poor. To prevent such events workers need to be warned of the risk and dangers of working with organo-metallic compounds. The effectiveness of protective clothes and gas masks should be checked. In exposed workers regular testing is advised of tin concentrations in the urine.

  13. Fatal water intoxication during olanzapine treatment: a case report.

    PubMed

    Nagasawa, Sayaka; Yajima, Daisuke; Torimitsu, Suguru; Abe, Hiroko; Iwase, Hirotaro

    2014-03-01

    A man in his twenties was diagnosed with schizophrenia in his late teens. The night before his death, his family reported he drank a large amount of water, vomited, collapsed, and snored loudly while sleeping, but they did not view the event seriously as he did it routinely. The following morning, he was found dead. Autopsy revealed hyponatremia by water intoxication as the cause of death. Water intoxication has various causes. In this case, 610 ng/mL olanzapine was detected in serum samples. Although this concentration is not as high as the fatal concentrations reported in past studies, it might have caused some adverse effects. Furthermore, the observation that excessive drinking behavior started after the dose of olanzapine was increased suggests a possibility that olanzapine aggravated water intoxication.

  14. Effects of alcohol intoxication on anger experience and expression among partner assaultive men.

    PubMed

    Eckhardt, Christopher I

    2007-02-01

    The author investigated the acute effects of alcohol intoxication on anger experience and expression among 46 maritally violent (MV) and 56 maritally nonviolent (NV) men randomly assigned to receive alcohol, placebo, or no alcohol. Participants completed an anger-arousing articulated thoughts in simulated situations (ATSS) paradigm and imagined marital conflict scenarios. Anger experience was operationalized as subjective ratings of anger experienced during ATSS, and anger expression was measured as ATSS anger statements and aggression verbalizations. MV men given alcohol articulated significantly more aggressive verbalizations than all other groups, with high trait anger and increased anger experience predicting more aggressive verbalizations. Thus, alcohol may exert proximal effects on abusive behavior among individuals already prone to respond to conflict with increased anger.

  15. The effect of alcohol intoxication on primary and secondary processes in male social drinkers.

    PubMed

    Gustafson, R; Källmén, H

    1989-12-01

    The acute effects of alcohol intoxication on cognitive style and on locus of control was investigated in an experimental setting. Sixty male subjects were randomly assigned to either an Alcohol, a Placebo, or a Control group. The alcohol dose was 1.0 ml of 100% alcohol/kg body weight. Subjects filled out a modified version of Rotter's locus of control scale and reported their perceptions to Street's Gestalt Completion Test. The latter test was scored in a standardized way for stimulus closeness, indicating a reality oriented and rational functioning, and stimulus distance, indicating a more primitive, irrational and pleasure oriented functioning. Alcohol made subjects less internally controlled and decreased the reality oriented functioning while the pleasure oriented functioning was not affected. Results were discussed in terms of pharmacological mechanisms, disinhibition, and creativity.

  16. When plenty is too much: water intoxication in a patient with a simple urinary tract infection.

    PubMed

    Lee, Laura Christine; Noronha, Maryann

    2016-11-01

    Healthcare professionals frequently advise patients with simple infective illness to drink more fluids. Here, a 59-year-old woman with a urinary tract infection followed such advice resulting in hospital admission with symptomatic acute hyponatraemia. Water intoxication is well recognised as a cause of symptomatic hyponatraemia in endurance sports, MDMA use and psychogenic polydipsia. It has rarely been described outside of these circumstances. With normal renal function, it is difficult to overwhelm the excretory capacity for water. However, in infective illness, increased levels of antidiuretic hormones (which may be secreted both appropriately to correct volume status and inappropriately as a feature of disease) reduce renal excretion of water. In this scenario, could increased administration of oral hypotonic fluids lead to hyponatraemia, with associated morbidity and mortality, than has previously been recognised? There is a need for more research to qualify our oft-given advise to drink more fluids.

  17. Intoxication and biochemical responses of freshwater snail Bellamya aeruginosa to ethylbenzene.

    PubMed

    Zheng, Shimei; Zhou, Qixing

    2017-01-01

    No acute toxic data of ethylbenzene on gastropod is available in literature. In the present study, the acute toxicity of ethylbenzene was assessed on a freshwater snail Bellamya aeruginosa, which was exposed to ethylbenzene concentration from 1 to 100 mg/L for 96 h. No mortality occurred, but a manifestation of intoxication (distress syndrome) was observed in part of exposed snails, and meanwhile, another part was moved normally. The distress syndrome showed clear dose- and time-dependent effects, and the 96-h EC50 value for distress syndrome was 13.3 mg/L in snail. The biochemical responses induced by ethylbenzene to the snail, including acetylcholinesterase (AChE) in the whole body and superoxide dismutase (SOD), catalase (CAT), glutathione S-transferases (GST), and reduced glutathione (GSH) in the hepatopancreas, were evaluated both for distressed snail and moved snail. The AChE activity of distressed snail was all inhibited more than 45 %, and the inhibition of AChE activity in the moved snail was all less than 30 % and more than 20 %, demonstrating that ethylbenzene exerted nervous toxicity to both distressed snail and moved snail. Meanwhile, the difference for AChE activity between the two different response snails was significant. Among the antioxidant biomarkers (SOD, CAT, GST, and GSH), only GST displayed significant difference between the distressed snail and moved snail. However, the activities of enzymes (SOD, CAT, and GST) in the moved snail were greater than those in the distressed snail, no matter significantly or insignificantly, which indicated that the ability of antioxidant defense in the distressed snail was weaker than that in the moved snail. The findings here reported manifest that ethylbenzene exerted nervous toxicity to snail, and the snail with intoxication response (distress syndrome) presented larger inhibition on AChE activity and weaker antioxidant ability in comparison with the moved snail.

  18. A novel role for PSD-95 in mediating ethanol intoxication, drinking and place preference.

    PubMed

    Camp, Marguerite C; Feyder, Michael; Ihne, Jessica; Palachick, Benjamin; Hurd, Benita; Karlsson, Rose-Marie; Noronha, Bianca; Chen, Yi-Chyan; Coba, Marcelo P; Grant, Seth G N; Holmes, Andrew

    2011-07-01

    The synaptic signaling mechanisms mediating the behavioral effects of ethanol (EtOH) remain poorly understood. Post-synaptic density 95 (PSD-95, SAP-90, Dlg4) is a key orchestrator of N-methyl-D-aspartate receptors (NMDAR) and glutamatergic synapses, which are known to be major sites of EtOH's behavioral actions. However, the potential contribution of PSD-95 to EtOH-related behaviors has not been established. Here, we evaluated knockout (KO) mice lacking PSD-95 for multiple measures of sensitivity to the acute intoxicating effects of EtOH (ataxia, hypothermia, sedation/hypnosis), EtOH drinking under conditions of free access and following deprivation, acquisition and long-term retention of EtOH conditioned place preference (CPP) (and lithium chloride-induced conditioned taste aversion), and intoxication-potentiating responses to NMDAR antagonism. PSD-95 KO exhibited increased sensitivity to the sedative/hypnotic, but not ataxic or hypothermic, effects of acute EtOH relative to wild-type controls (WT). PSD-95 KO consumed less EtOH than WT, particularly at higher EtOH concentrations, although increases in KO drinking could be induced by concentration-fading and deprivation. PSD-95 KO showed normal EtOH CPP 1 day after conditioning, but showed significant aversion 2 weeks later. Lithium chloride-induced taste aversion was impaired in PSD-95 KO at both time points. Finally, the EtOH-potentiating effects of the NMDAR antagonist MK-801 were intact in PSD-95 KO at the dose tested. These data reveal a major, novel role for PSD-95 in mediating EtOH behaviors, and add to growing evidence that PSD-95 is a key mediator of the effects of multiple abused drugs.

  19. [Acetaldehyde and some biochemical parameters in alcoholic intoxications].

    PubMed

    Vasil'eva, E V; Morozov, Iu E; Lopatkin, O N; Zarubin, V V; Mamedov, V K

    2004-01-01

    The need in comprehensive gas chromatography and biochemistry examinations is grounded for cadaver expertise in order to cope with issues related with alcoholic intoxication. Descriptions of 3 examination methods of biological fluids are elucidated, i.e. gas chromatography, electrophoresis and fixing of a degree of endogenous intoxication. The concentration of acetaldehyde in 3 body media (blood, urine and liquor) are analyzed in detail; the isoenzyme spectra of lactate-, alcohol- and aldehyde dehydrogenase as well as the contents of medium molecules in death of alcohol poisonings and due to mechanical trauma are also in the focus of attention.

  20. Prolonged neuropsychiatric effects following management of chloroquine intoxication with psychotropic polypharmacy

    PubMed Central

    Maxwell, Nicole M; Nevin, Remington L; Stahl, Stephen; Block, Jerald; Shugarts, Sarah; Wu, Alan H B; Dominy, Stephen; Solano-Blanco, Miguel Alonso; Kappelman-Culver, Sharon; Lee-Messer, Christopher; Maldonado, Jose; Maxwell, Andrew J

    2015-01-01

    Key Clinical Message Susceptibility to quinoline antimalarial intoxication may reflect individual genetic and drug-induced variation in neuropharmacokinetics. In this report, we describe a case of chloroquine intoxication that appeared to be prolonged by subsequent use of multiple psychotropic medications. This case highlights important new considerations for the management of quinoline antimalarial intoxication. PMID:26185633

  1. Hyperbaric oxygen therapy or hydroxycobalamin attenuates surges in brain interstitial lactate and glucose; and hyperbaric oxygen improves respiratory status in cyanide-intoxicated rats.

    PubMed

    Lawson-Smith, P; Olsen, N V; Hyldegaard, O

    2011-01-01

    Cyanide (CN) intoxication inhibits cellular oxidative metabolism and may result in brain damage. Hydroxycobalamin (OHCob) is one among other antidotes that may be used following intoxication with CN. Hyperbaric oxygen (HBO2) is recommended when supportive measures or antidotes fail. However, the effect of hydroxycobalamin or HBO2 on brain lactate and glucose concentrations during CN intoxication is unknown. We used intracerebral microdialysis to study the in vivo effect of hydroxycobalamin or HBO2 treatment on acute CN-induced deterioration in brain metabolism. Anesthetized rats were allocated to four groups receiving potassium CN (KCN) 5.4 mg/kg or vehicle intra-arterially: 1) vehicle-treated control rats; 2) KCN-poisoned rats; 3) KCN-poisoned rats receiving hydroxycobalamin (25 mg); and 4) KCN-poisoned rats treated with HBO2 (284 kPa for 90 minutes). KCN alone caused a prompt increase in interstitial brain lactate and glucose concentrations peaking at 60 minutes. Both hydroxycobalamin and HBO2 abolished KCN-induced increases in brain lactate and glucose concentration. However, whereas HBO2 treatment increased cerebral PtO2 and reduced respiratory distress and cyanosis, OHCob did not have this beneficial effect. In conclusion, CN intoxication in anesthetized rats produces specific uncoupling of cerebral oxidative metabolism resulting in interstitial lactate and glucose surges that may be ameliorated by treatment with either hydroxycobalamin or HBO2.

  2. The muscarinic antagonists scopolamine and atropine are competitive antagonists at 5-HT3 receptors.

    PubMed

    Lochner, Martin; Thompson, Andrew J

    2016-09-01

    Scopolamine is a high affinity muscarinic antagonist that is used for the prevention of post-operative nausea and vomiting. 5-HT3 receptor antagonists are used for the same purpose and are structurally related to scopolamine. To examine whether 5-HT3 receptors are affected by scopolamine we examined the effects of this drug on the electrophysiological and ligand binding properties of 5-HT3A receptors expressed in Xenopus oocytes and HEK293 cells, respectively. 5-HT3 receptor-responses were reversibly inhibited by scopolamine with an IC50 of 2.09 μM. Competitive antagonism was shown by Schild plot (pA2 = 5.02) and by competition with the 5-HT3 receptor antagonists [(3)H]granisetron (Ki = 6.76 μM) and G-FL (Ki = 4.90 μM). The related molecule, atropine, similarly inhibited 5-HT evoked responses in oocytes with an IC50 of 1.74 μM, and competed with G-FL with a Ki of 7.94 μM. The reverse experiment revealed that granisetron also competitively bound to muscarinic receptors (Ki = 6.5 μM). In behavioural studies scopolamine is used to block muscarinic receptors and induce a cognitive deficit, and centrally administered concentrations can exceed the IC50 values found here. It is therefore possible that 5-HT3 receptors are also inhibited. Studies that utilise higher concentrations of scopolamine should be mindful of these potential off-target effects.

  3. Atropine-resistant depolarization in the guinea-pig small intestine.

    PubMed

    Bywater, R A; Holman, M E; Taylor, G S

    1981-07-01

    1. Junction potentials were recorded from the circular muscle cells of the guinea-pig ileum following transmural stimulation in the presence of atropine at 30 degrees C.2. Single stimuli produced a transient hyperpolarization, the inhibitory junction potential (i.j.p.). At high stimulus strengths the i.j.p. was followed by a post-stimulus depolarization (PSD).3. During repetitive stimulation the magnitude of the hyperpolarization decreased; however, at the end of the stimulus period the PSD was enhanced and often reached threshold for the generation of action potentials. Thus, the size of the PSD was not directly related to the degree of the preceding hyperpolarization.4. Hyperpolarization of the circular muscle cells was produced by the application of anodal current using large external electrodes. Rapid cessation of the applied current produced a transient after-depolarization which was shorter in time course than the PSD following the i.j.p. If the applied anodal current was reduced slowly (at a rate which mimicked the decrease in the hyperpolarization during repetitive nerve stimulation) no after-depolarization was observed.5. Conditioning hyperpolarization of the circular muscle cells reduced the amplitude of the i.j.p. The i.j.p. was reversed at membrane potentials greater than approximately -90 mV.6. The PSD did not appear to be due to the extracellular accumulation of potassium ions following the i.j.p. since the PSD persisted even when the i.j.p. was reversed.7. The neurotoxin apamin reversibly abolished the i.j.p. and unmasked a transient excitatory junction potential (e.j.p.) with a variable latency (350-900 ms).

  4. Transesophageal dobutamine-atropine stress echocardiography: diagnostic accuracy for coronary stenosis detection and localization.

    PubMed

    Shahi, M; Radhakrishnan, S; Sinha, N; Shrivastava, S

    1996-10-11

    Transesophageal echocardiography with dobutamine-atropine stress (TE-DASE) is a recently described technique for evaluation of coronary artery disease (CAD). We undertook this study prospectively to determine the feasibility, reliability and safety of this procedure in patients with known CAD and to evaluate its diagnostic accuracy for coronary stenoses of varying severity. Thirty-seven patients who underwent coronary arteriography (CART) and TE-DASE within a 3-month interval without intervening ischemic events or revascularisation were included in the study CART and stress echograms were independently evaluated by different observers. Stenosis was measured with calipers and a > or = 50% lumen diameter stenosis was considered significant. A reduction or lack of endocardial motion and/or wall thickening on progressive incremental stress was considered an abnormal response. TE-DASE could be successfully completed in 33/37 (90%) patients. Using a modified 16-segment model of the left ventricle (LV), 15.2 +/- 0.8 segments/patient and 501/528 (95%) segments overall could be optimally evaluated. Inter-observer concordance for an abnormal response was 94%. Predictive accuracies for one-vessel disease (1-VD), two-vessel disease (2-VD) and three-vessel disease (3-VD) were 88, 58 and 23% respectively. Overall sensitivity for detection of a significant (> or = 50%) stenosis was 72% (32% for moderate (50-69%), 90% for severe (> or = 70%) stenosis) and specificity was 96%. Diagnostic accuracy for localisation of significant stenosis was 95% for the left anterior descending artery (LAD), 86% for the left circumflex artery (LCX) and 88% for the right coronary artery (RCA). There were no major complications. We conclude that TE-DASE is a safe, reliable and easily-performed procedure and provides excellent visualisation of myocardial segments. Diagnostic accuracy for detection of severe stenosis and its localisation is excellent.

  5. The cardiovascular sparing effect of fentanyl and atropine, administered to enflurane anesthetized dogs.

    PubMed Central

    Ilkiw, J E; Pascoe, P J; Haskins, S C; Patz, J D; Jaffe, R

    1994-01-01

    Cardiovascular effects of high dose opioid together with low dose inhalant were compared with inhalant alone to determine whether opioid/inhalant techniques were less depressant on the cardiovascular system. The effects of positive pressure ventilation and increasing heart rate to a more physiological level were also studied. Cardiovascular measurements recorded during administration of enflurane at 1.3 minimum alveolar concentration (MAC; 2.89 +/- 0.02%) to spontaneously breathing dogs (time 1) and during controlled ventilation [arterial carbon dioxide tension at 40 +/- 3 mmHg (time 2)] were similar. At time 2, mixed venous oxygen tension and arterial and mixed venous carbon dioxide tensions were significantly decreased, while arterial and mixed venous pH were significantly increased compared to measurements at time 1. After administration of fentanyl to achieve plasma fentanyl concentration of 71.7 +/- 14.4 ng/mL and reduction of enflurane concentration to yield 1.3 MAC multiple (0.99 +/- 0.01%), heart rate significantly decreased, while mean arterial pressure, central venous pressure, stroke index, and systemic vascular resistance index increased compared to measurements taken at times 1 and 2. Pulmonary arterial occlusion pressure was significantly increased compared to measurements taken at time 2. After administration of atropine until heart rate was 93 +/- 5 beats/min (plasma fentanyl concentration 64.5 +/- 13.5 ng/mL) heart rate, mean arterial pressure, cardiac index, oxygen delivery index, and venous admixture increased significantly compared to values obtained at all other times.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7889455

  6. Cannabis and tolerance: acute drug impairment as a function of cannabis use history

    PubMed Central

    Ramaekers, J. G.; van Wel, J. H.; Spronk, D. B.; Toennes, S. W.; Kuypers, K. P. C.; Theunissen, E. L.; Verkes, R. J.

    2016-01-01

    Cannabis use history as predictor of neurocognitive response to cannabis intoxication remains subject to scientific and policy debates. The present study assessed the influence of cannabis on neurocognition in cannabis users whose cannabis use history ranged from infrequent to daily use. Drug users (N = 122) received acute doses of cannabis (300 μg/kg THC), cocaine HCl (300 mg) and placebo. Cocaine served as active control for demonstrating neurocognitive test sensitivity. Executive function, impulse control, attention, psychomotor function and subjective intoxication were significantly worse after cannabis administration relative to placebo. Cocaine improved psychomotor function and attention, impaired impulse control and increased feelings of intoxication. Acute effects of cannabis and cocaine on neurocognitive performance were similar across cannabis users irrespective of their cannabis use history. Absence of tolerance implies that that frequent cannabis use and intoxication can be expected to interfere with neurocognitive performance in many daily environments such as school, work or traffic. PMID:27225696

  7. Cannabis and tolerance: acute drug impairment as a function of cannabis use history.

    PubMed

    Ramaekers, J G; van Wel, J H; Spronk, D B; Toennes, S W; Kuypers, K P C; Theunissen, E L; Verkes, R J

    2016-05-26

    Cannabis use history as predictor of neurocognitive response to cannabis intoxication remains subject to scientific and policy debates. The present study assessed the influence of cannabis on neurocognition in cannabis users whose cannabis use history ranged from infrequent to daily use. Drug users (N = 122) received acute doses of cannabis (300 μg/kg THC), cocaine HCl (300 mg) and placebo. Cocaine served as active control for demonstrating neurocognitive test sensitivity. Executive function, impulse control, attention, psychomotor function and subjective intoxication were significantly worse after cannabis administration relative to placebo. Cocaine improved psychomotor function and attention, impaired impulse control and increased feelings of intoxication. Acute effects of cannabis and cocaine on neurocognitive performance were similar across cannabis users irrespective of their cannabis use history. Absence of tolerance implies that that frequent cannabis use and intoxication can be expected to interfere with neurocognitive performance in many daily environments such as school, work or traffic.

  8. Chronic Vitamin D Intoxication in Captive Iberian Lynx (Lynx pardinus).

    PubMed

    Lopez, Ignacio; Pineda, Carmen; Muñoz, Luis; Raya, Ana; Lopez, Guillermo; Aguilera-Tejero, Escolástico

    2016-01-01

    To document the biochemical and pathologic features of vitamin D intoxication in lynx and to characterize mineral metabolism in healthy lynx, blood samples were obtained from 40 captive lynx that had been receiving excessive (approximately 30 times the recommended dose) vitamin D3 in the diet, and from 29 healthy free ranging lynx. Tissue samples (kidney, stomach, lung, heart and aorta) were collected from 13 captive lynx that died as a result of renal disease and from 3 controls. Vitamin D intoxication resulted in renal failure in most lynx (n = 28), and widespread extraskeletal calcification was most severe in the kidneys and less prominent in cardiovascular tissues. Blood minerals and calciotropic hormones in healthy lynx were similar to values reported in domestic cats except for calcitriol which was higher in healthy lynx. Changes in mineral metabolism after vitamin D intoxication included hypercalcemia (12.0 ± 0.3 mg/dL), hyperphosphatemia (6.3 ± 0.4 mg/dL), increased plasma calcidiol (381.5 ± 28.2 ng/mL) and decreased plasma parathyroid hormone (1.2 ± 0.7 pg/mL). Hypercalcemia and, particularly, hyperphosphatemia were of lower magnitude that what has been previously reported in the course of vitamin D intoxication in other species. However, extraskeletal calcifications were severe. The data suggest that lynx are sensitive to excessive vitamin D and extreme care should be taken when supplementing this vitamin in captive lynx diets.

  9. Chronic Vitamin D Intoxication in Captive Iberian Lynx (Lynx pardinus)

    PubMed Central

    Muñoz, Luis; Raya, Ana; Lopez, Guillermo; Aguilera-Tejero, Escolástico

    2016-01-01

    To document the biochemical and pathologic features of vitamin D intoxication in lynx and to characterize mineral metabolism in healthy lynx, blood samples were obtained from 40 captive lynx that had been receiving excessive (approximately 30 times the recommended dose) vitamin D3 in the diet, and from 29 healthy free ranging lynx. Tissue samples (kidney, stomach, lung, heart and aorta) were collected from 13 captive lynx that died as a result of renal disease and from 3 controls. Vitamin D intoxication resulted in renal failure in most lynx (n = 28), and widespread extraskeletal calcification was most severe in the kidneys and less prominent in cardiovascular tissues. Blood minerals and calciotropic hormones in healthy lynx were similar to values reported in domestic cats except for calcitriol which was higher in healthy lynx. Changes in mineral metabolism after vitamin D intoxication included hypercalcemia (12.0 ± 0.3 mg/dL), hyperphosphatemia (6.3 ± 0.4 mg/dL), increased plasma calcidiol (381.5 ± 28.2 ng/mL) and decreased plasma parathyroid hormone (1.2 ± 0.7 pg/mL). Hypercalcemia and, particularly, hyperphosphatemia were of lower magnitude that what has been previously reported in the course of vitamin D intoxication in other species. However, extraskeletal calcifications were severe. The data suggest that lynx are sensitive to excessive vitamin D and extreme care should be taken when supplementing this vitamin in captive lynx diets. PMID:27243456

  10. 36 CFR 504.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... narcotics. 504.7 Section 504.7 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of such drug in or on the premises...

  11. 36 CFR 504.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... narcotics. 504.7 Section 504.7 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of such drug in or on the premises...

  12. 36 CFR 504.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... narcotics. 504.7 Section 504.7 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of such drug in or on the premises...

  13. 36 CFR 504.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... narcotics. 504.7 Section 504.7 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of such drug in or on the premises...

  14. 36 CFR 504.7 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... narcotics. 504.7 Section 504.7 Parks, Forests, and Public Property SMITHSONIAN INSTITUTION RULES AND... narcotics. Entering the premises or the operating of a motor vehicle thereon by a person under the influence of any intoxicating beverage or narcotic drug or the use of such drug in or on the premises...

  15. A Systematic Review of Intervening to Prevent Driving While Intoxicated

    PubMed Central

    Chapman, Rebekah L; Lewis, Ioni

    2016-01-01

    Background Driving while intoxicated (DWI) is a significant public health issue. The likelihood someone will intervene to prevent driving while intoxicated is affected by the characteristics of the individuals and the context of the potential driving scenario. Understanding such contexts may help tailor public health messages to promote intervening from those who are nearby to an intoxicated driver. Objective This systematic review investigates the behavior of those close to an intoxicated driver and factors associated with increasing the likelihood they will intervene in situations where driving while impaired may be likely. The review of the literature is guided by an orienting framework, namely the classic social psychology theory of decision-making proposed by Latané and Darley. Results Drawing upon this framework, the review examines the extent to which research has focused on factors which influence whether or not an individual identifies a need to intervene and identifies a serious/dangerous situation. In addition, consideration is given to perceived personal responsibility. The final two components of the model are then discussed; the perceived skill an individual who may intervene has (in their ability to intervene) and their actual enactment of the intervening behavior. Conclusions/Importance Drawing upon such a well-considered theoretical framework, this review provides guidance on key components likely to assist in the development of targeted, more effective public education messages/campaigns that dissuade individuals from drinking and then driving. PMID:26757349

  16. [Intentional Datura stramonium intoxication: an unknown etiology of mydriasis].

    PubMed

    Montcriol, A; Kenane, N; Delort, G; Asencio, Y; Palmier, B

    2007-09-01

    Two case reports of Datura stramonium intoxications are presented. The first one was a self poisoning, with a moderate anticholinergic syndrome and a spontaneous improvement. The second one was a recreational use of Datura stramonium for its hallucinogenic properties. The anticholinergic syndrome was marked and the improvement required orotracheal intubation, mechanical ventilation, intraveinous rehydratation, and active cooling to prevent organ failure.

  17. Are Reactive Oxygen Species Involved in Microcystin-LR Intoxication?

    DTIC Science & Technology

    1988-05-12

    peroxidation in paracetamol intoxication, did not alter the effect of BHA pretreatment., -- 2-A 4" 4 2 - INTRODUCTION The toxic cyclic heptapeptide...that paracetamol induces dose-dependant lipid peroxidation in starved, but not in fed mice (WENDEL et a’.., 1979). This fact, and the trends

  18. DWI [Driving While Intoxicated] Law Enforcement Training Project: Instructor's Manual.

    ERIC Educational Resources Information Center

    Carnahan, James E.; And Others

    The Driving While Intoxicated (DWI) Law Enforcement Training Program has been developed to provide the alcohol enforcement officer trainee with working knowledge and skills which will enable him to effectively carry out his alcohol enforcement tasks. The instructor's manual has been prepared to serve as a text to assist the instructor in…

  19. DWI [Driving While Intoxicated] Law Enforcement Training Project: Student Manual.

    ERIC Educational Resources Information Center

    Carnahan, James E.; And Others

    The student manual has been prepared to serve as a workbook to assist the student officer in successfully completing the Driving While Intoxicated (DWI) Law Enforcement Training Course. It is organized under 16 subject headings (orientation, alcohol and highway safety, preparation for alcohol enforcement task, detection of the drinking…

  20. 7 CFR 503.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Intoxicating beverages and narcotics. 503.8 Section 503.8 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.8...

  1. 7 CFR 503.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Intoxicating beverages and narcotics. 503.8 Section 503.8 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.8...

  2. 7 CFR 503.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Intoxicating beverages and narcotics. 503.8 Section 503.8 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.8...

  3. 7 CFR 503.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Intoxicating beverages and narcotics. 503.8 Section 503.8 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.8...

  4. 7 CFR 503.8 - Intoxicating beverages and narcotics.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Intoxicating beverages and narcotics. 503.8 Section 503.8 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.8...

  5. Celebratory Drinking and Intoxication: A Contextual Influence on Alcohol Consumption

    ERIC Educational Resources Information Center

    Glindemann, Kent E.; Wiegand, Douglas M.; Geller, E. Scott

    2007-01-01

    Two field studies measured college students' actual intoxication levels using handheld breathalyzers on Halloween and St. Patrick's Day and compared these celebration days to typical nights surrounding these events. In addition, across all nights of Study 2, participants were asked if they were celebrating any occasion or event that night, and…

  6. Korean Patients with Superwarfarin Intoxication and Their Outcome

    PubMed Central

    Hong, Junshik; Yhim, Ho-Young; Bae, Sung Hwa; Yuh, Young Jin; Yoon, Sung-Soo; Yoon, Hwi-Joong; Kim, Seung Taik; Chi, Hyun-Sook

    2010-01-01

    This observational study aimed at evaluating recent superwarfarin intoxication of Korean patients. Ten patients were diagnosed as or highly suspicious for superwarfarin intoxication. Case report forms described by attending hematologists of the patients were collected and analyzed. Bleeding symptoms were varied among the patients. Patients uniformly showed prolonged prothrombin time (PT) and activated thromboplastin time (aPTT) with decreased activity of vitamin K dependent coagulation factors. Positive serum brodifacoum test results in 4 of 5 requested patients contributed to confirmatory diagnosis. Psychiatric interview revealed an attempted ingestion in one patient. High dose vitamin K1 therapy promptly corrected prolonged PT and aPTT, but hasty discontinuation caused repeated bleeding diathesis in 6 patients. Route of intoxication was unknown or not definite among 8 of 10 patients. Three patients had a possibility of environmental exposure considering their occupations: there might be intoxication by transdermal absorption or inhalation. Therefore, high dose and prolonged use of vitamin K1 therapy is necessary for effective detoxification. Further detailed investigation on environmental exposure and efforts to improve availability of the blood level test in clinic are requested. PMID:21165290

  7. DWI [Driving While Intoxicated] Law Enforcement Training Project: Course Guide.

    ERIC Educational Resources Information Center

    Carnahan, James E.

    The course guide has been designed as the basic planning document for the program director and instructional personnel in the organization and administration of a Driving While Intoxicated (DWI) Law Enforcement Training Course. It contains an explanation of the developmental effort of the DWI Law Enforcement Training Project and detailed…

  8. Fatal carbon monoxide intoxication after acetylene gas welding of pipes.

    PubMed

    Antonsson, Ann-Beth; Christensson, Bengt; Berge, Johan; Sjögren, Bengt

    2013-06-01

    Acetylene gas welding of district heating pipes can result in exposure to high concentrations of carbon monoxide. A fatal case due to intoxication is described. Measurements of carbon monoxide revealed high levels when gas welding a pipe with closed ends. This fatality and these measurements highlight a new hazard, which must be promptly prevented.

  9. Korean patients with superwarfarin intoxication and their outcome.

    PubMed

    Hong, Junshik; Yhim, Ho-Young; Bang, Soo-Mee; Bae, Sung Hwa; Yuh, Young Jin; Yoon, Sung-Soo; Yoon, Hwi-Joong; Kim, Seung Taik; Chi, Hyun-Sook

    2010-12-01

    This observational study aimed at evaluating recent superwarfarin intoxication of Korean patients. Ten patients were diagnosed as or highly suspicious for superwarfarin intoxication. Case report forms described by attending hematologists of the patients were collected and analyzed. Bleeding symptoms were varied among the patients. Patients uniformly showed prolonged prothrombin time (PT) and activated thromboplastin time (aPTT) with decreased activity of vitamin K dependent coagulation factors. Positive serum brodifacoum test results in 4 of 5 requested patients contributed to confirmatory diagnosis. Psychiatric interview revealed an attempted ingestion in one patient. High dose vitamin K1 therapy promptly corrected prolonged PT and aPTT, but hasty discontinuation caused repeated bleeding diathesis in 6 patients. Route of intoxication was unknown or not definite among 8 of 10 patients. Three patients had a possibility of environmental exposure considering their occupations: there might be intoxication by transdermal absorption or inhalation. Therefore, high dose and prolonged use of vitamin K1 therapy is necessary for effective detoxification. Further detailed investigation on environmental exposure and efforts to improve availability of the blood level test in clinic are requested.

  10. Superwarfarin intoxication: hematuria is a major clinical manifestation.

    PubMed

    Wu, Yi-Feng; Chang, Cheng-Shyong; Chung, Chih-Yuan; Lin, Hsuan-Yu; Wang, Chuan-Cheng; Shen, Ming-Ching

    2009-09-01

    Since superwarfarin is popular and readily available in stores, it may cause intoxication or overexposure, which can result in coagulopathy or abnormal bleeding in humans and, thus, is an important public health problem. We report our clinical experience with superwarfarin intoxication. Nine patients, including eight patients who had histories of ingesting superwarfarin, were studied. Of the patients, hematuria occurred in eight. Laboratory tests among the nine patients showed extremely prolonged prothrombin times and activated partial thromboplastin times, which could be corrected to normal by mixing 1:1 with normal pooled plasma; they also had very low functional levels of factor II, VII, IX, X, and proteins C and S, but normal functional levels of factors V, VIII, fibrinogen, and anti-thrombin III. Large doses of vitamin K1 were needed for 3 months or more to treat and correct the coagulopathy among the patients. The majority of the patients presented with gross hematuria, suggesting that hematuria is probably a major clinical manifestation of superwarfarin intoxication. Prolonged use of large doses of vitamin K1 is needed for the treatment of superwarfarin intoxication.

  11. The Impact of Behavioral Signs of Intoxication on Bartender Service

    ERIC Educational Resources Information Center

    Goodsite, Billie; Klear, Lacey; Rosenberg, Harold

    2008-01-01

    Objective: The present study was designed to assess whether the serving practices of a sample of bartenders in an American university town would vary as a function of the number of behavioral cues of intoxication displayed by apparently real patrons (who were actually experimental confederates). Method: We trained two male and three female…

  12. Self-induced water intoxication in a schizophrenic patient.

    PubMed Central

    Rae, J.

    1976-01-01

    Water intoxication occurred in a 53-year-old woman with chronic simple schizophrenia and poorly controlled diabetes. For several years she had had a compulsive habit of drinking excessive amounts of water. Coma, fever, convulsions and other neurologic signs appeared suddenly, and she had severe hyponatremia. Her condition improved rapidly when the electrolyte abnormality was corrected. PMID:943225

  13. Technetium-99m pyrophosphate imaging in acute renal failure associated with nontraumatic rhabdomyolysis

    SciTech Connect

    Patel, R.; Mishkin, F.S.

    1986-10-01

    Technetium-99m pyrophosphate (Tc-PYP) imaging was performed in five patients with acute renal failure associated with nontraumatic rhabdomyolysis. Four patients had phencyclidine intoxication and one had viral pneumonia. During the acute phase, marked uptake of pyrophosphate was seen in all patients in several muscle groups, but always in the thigh adductors. The results show that phencyclidine intoxication can result in diffuse muscle uptake of Tc-PYP without overt evidence of muscle injury. Tc-PYP imaging may provide a clue to the cause of acute renal failure in patients with suspected rhabdomyolysis in whom elevations of serum creatine phosphokinase concentrations are equivocal.

  14. Portrayal of Alcohol Intoxication on YouTube

    PubMed Central

    Primack, Brian A.; Colditz, Jason B.; Pang, Kevin C.; Jackson, Kristina M.

    2015-01-01

    Background We aimed to characterize the content of leading YouTube videos related to alcohol intoxication and to examine factors associated with alcohol intoxication in videos that were assessed positively by viewers. Methods We systematically captured the 70 most relevant and popular videos on YouTube related to alcohol intoxication. We employed an iterative process to codebook development which resulted in 42 codes in 6 categories: video characteristics, character socio-demographics, alcohol depiction, degree of alcohol use, characteristics associated with alcohol, and consequences of alcohol. Results There were a total of 333,246,875 views for all videos combined. While 89% of videos involved males, only 49% involved females. The videos had a median of 1646 (IQR 300-22,969) “like” designations and 33 (IQR 14-1,261) “dislike” designations each. Liquor was most frequently represented, followed by beer and then wine/champagne. Nearly one-half (44%) of videos contained a brand reference. Humor was juxtaposed with alcohol use in 79% of videos, and motor vehicle use was present in 24%. There were significantly more likes per dislike, indicating more positive sentiment, when there was representation of liquor (29.1 vs. 11.4, p = .008), brand references (32.1 vs. 19.2, p = .04), and/or physical attractiveness (67.5 vs. 17.8, p < .001). Conclusions Internet videos depicting alcohol intoxication are heavily viewed. Nearly half of these videos involve a brand-name reference. While these videos commonly juxtapose alcohol intoxication with characteristics such as humor and attractiveness, they infrequently depict negative clinical outcomes. The popularity of this site may provide an opportunity for public health intervention. PMID:25703135

  15. Efficacy of chelation therapy to remove aluminium intoxication.

    PubMed

    Fulgenzi, Alessandro; De Giuseppe, Rachele; Bamonti, Fabrizia; Vietti, Daniele; Ferrero, Maria Elena

    2015-11-01

    There is a distinct correlation between aluminium (Al) intoxication and neurodegenerative diseases (ND). We demonstrated how patients affected by ND showing Al intoxication benefit from short-term treatment with calcium disodium ethylene diamine tetraacetic acid (EDTA) (chelation therapy). Such therapy further improved through daily treatment with the antioxidant Cellfood. In the present study we examined the efficacy of long-term treatment, using both EDTA and Cellfood. Slow intravenous treatment with the chelating agent EDTA (2 g/10 mL diluted in 500 mL physiological saline administered in 2 h) (chelation test) removed Al, which was detected (using inductively coupled plasma mass spectrometry) in urine samples collected from patients over 12 h. Patients that revealed Al intoxication (expressed in μg per g creatinine) underwent EDTA chelation therapy once a week for ten weeks, then once every two weeks for a further six or twelve months. At the end of treatment (a total of 22 or 34 chelation therapies, respectively), associated with daily assumption of Cellfood, Al levels in the urine samples were analysed. In addition, the following blood parameters were determined: homocysteine, vitamin B12, and folate, as well as the oxidative status e.g. reactive oxygen species (ROS), total antioxidant capacity (TAC), oxidized LDL (oxLDL), and glutathione. Our results showed that Al intoxication reduced significantly following EDTA and Cellfood treatment, and clinical symptoms improved. After treatment, ROS, oxLDL, and homocysteine decreased significantly, whereas vitamin B12, folate and TAC improved significantly. In conclusion, our data show the efficacy of chelation therapy associated with Cellfood in subjects affected by Al intoxication who have developed ND.

  16. The clinical experience of acute cyanide poisoning.

    PubMed

    Yen, D; Tsai, J; Wang, L M; Kao, W F; Hu, S C; Lee, C H; Deng, J F

    1995-09-01

    The authors reviewed the clinical manifestations, complications, and the prognosis affected by Lilly Cyanide Antidote in 21 victims of acute cyanide poisoning over a 10-year period. The clinical signs and symptoms in cyanide poisoning are variable. Among 21 cases, loss of consciousness (15), metabolic acidosis (14), and cardiopulmonary failure (9) were the three leading manifestations of cyanide intoxication. Anoxic encephalopathy (6) was not uncommon in the severely intoxicated victims. Diabetes insipidus (1) or clinical signs and symptoms mimicking diabetes insipidus (3) may be an ominous sign to encephalopathy victims. The major cause of fatal cyanide poisoning is the intentional ingestion of cyanide compounds as part of a suicide attempt. Decrease of arteriovenous difference of O2 partial pressure may be a clue for the suspicion of cyanide intoxication. Although the authors cannot show a statistically significant difference (P = .47) for the Lilly cyanide antidote kit in terms of improving the survival rate for victims of cyanide poisoning, the antidote kit was always mandatory in our study in the cases of severely intoxicated victims who survived. Early diagnosis, prompt, intensive therapy with antidote, and supportive care are still the golden rules for the treatment of acute cyanide poisoning, whether in the ED or on the scene.

  17. Comparative study on pharmacokinetics of a series of anticholinergics, atropine, anisodamine, anisodine, scopolamine and tiotropium in rats.

    PubMed

    Tian, Fengjie; Li, Cuiyun; Wang, Xin; Ren, Shuangxia; Li, Ning; Liu, Qi; Zhou, Sufeng; Lu, Yang; Zhao, Di; Chen, Xijing

    2015-09-01

    The compound series of traditional anticholinergics [atropine (Atr), anisodamine (Ani), anisodine (AT3), and scopolamine (Sco)], naturally occurring belladonna alkaloid, have been approved for numerous therapeutic uses since 1970s. Tiotropium, a novel M receptor antagonist for the treatment of chronic obstructive pulmonary disease, was structurally modified based on atropine-like drugs. Clinical phenomena suggested that the changes of substituent group were related to the pharmacokinetic and pharmacodynamic characteristics of the agents. In an attempt to compare the pharmacokinetics of the series of anticholinergics and investigate the subsets motivating selective anticholinergic potencies, a sensitive LC-MS/MS method was established to analyze the differences of pharmacokinetic parameters. In this paper, we determined the pharmacokinetics of atropine, anisodamine, anisodine, scopolamine, and tiotropium after i.v. and i.g. single dose administration. After i.v. administration, the maximum drug plasma concentrations (C max) of Atr, Ani, AT3, and Sco were 274.25 ± 53.66, 267.50 ± 33.16, 340.50 ± 44.52, and 483.75 ± 78.13 ng/mL. Tiotropium had a slightly higher area under the curve with a significant increase of C max value. Because of their partial solubility, Atr, Ani, AT3, and Sco had different bioavailability in rats of 21.62, 10.78, 80.45 and 2.52 %, respectively. Following i.g. administration of tiotropium, the C max value below 20 ng/mL revealed the very low oral absorption. The urinary excretion rates of Atr, Ani, AT3, Sco and tiotropium were 11.33, 54.86, 32.67, 8.69 and 73.91 %. This work provided relatively comprehensive preclinical data on the series of anticholinergics, which may be used to explain the clinical adverse effects and applications.

  18. A Randomized Trial of Atropine versus Patching for Treatment of Moderate Amblyopia: Follow-up at 10 Years of Age

    PubMed Central

    2008-01-01

    Objectives To determine the visual acuity outcome at 10 years of age for children less than 7 years of age when enrolled in a treatment trial for moderate amblyopia. Methods In a multi-center clinical trial, 419 children with amblyopia (20/40 to 20/100) were randomized to patching or atropine eye drops for 6 months. Two years after enrollment, a subgroup of 188 children entered long-term follow-up. Treatment after 6 months was at the discretion of the investigator; 89% of children were treated. Main outcome measure Visual acuity at age 10 years with the electronic ETDRS test. Results The mean amblyopic eye acuity, measured in 169 patients, at age 10 years was 0.17 logMAR (approximately 20/32) and 46% of amblyopic eyes were 20/25 or better. Age < 5 years at the time of entry into the randomized trial was associated with a better visual acuity outcome (P<0.001). Mean amblyopic and sound eye visual acuities at age 10 years were similar in the original treatment groups (P= 0.56 and 0.80, respectively). Conclusion At age 10 years the improvement of the amblyopic eye is maintained, although residual amblyopia is common following treatment initiated at 3 to <7 years of age. The outcome is similar regardless of initial treatment with atropine or patching. Application to Clinical Practice Patching and atropine eye drops produce comparable improvement in visual acuity that is maintained through age 10 years. Trial Registry Name Amblyopia Treatment Study: Occlusion Versus Pharmacologic Therapy for Moderate Amblyopia Registration Number NCT00000170 URL http://clinicaltrials.gov/show/NCT00000170 PMID:18695096

  19. Effectiveness of Oral Ketamine, Midazolam, and Atropine Cocktail Versus Oral Diphenhydramine for Pediatric Sedation in the Emergency Department

    PubMed Central

    Soleimanpour, Hassan; Mahmoodpoor, Ata; Eftekhari Milani, Farid; Shahsavari Nia, Kavous; Mehdizadeh Esfanjani, Robab; Safari, Saeid

    2014-01-01

    Background: Sedation is a condition of reduced level of consciousness (LOC) for a patient that is created to decrease irritability, anxiety, and restlessness. Objectives: In this study, we compared the sedative effect of oral administration of ketamine, midazolam, and atropine cocktail with diphenhydramine in the referent children to the emergency department. Patients and Methods: Based on the double-blind randomized clinical trial in this investigation, 80 children, who needed to repair their wounds with suture were randomly divided into two groups: group 1 and group 2, who have received oral diphenhydramine and oral ketamine, midazolam, and atropine cocktail, respectively. Behavioral changes were collected and recorded before, during intervention and two weeks after intervention. Statistical data were analyzed by SPSS-16 software and chi-square and Mann-Whitney U tests were employed to study the relations among variables. P < 0.05 was considered statistically significant. Results: There was no significant difference between two groups in terms of drug acceptance and anxiety degree in children before intervention. Group 2 had achieved better and deeper sedation than group 1 during 45-minute post-medication (P < 0.05, P = 0.01). Regarding pediatric general behavior such as crying or interruptive moves, there was also a significant statistical difference between group 2 and group 1 (P = 0.009) based on Houpt Classification. The mean recovery times in groups 1 and 2 were 34.37 ± 14.23 min and 27.25 ± 5.14 min, respectively (P = 0.003). In terms of behavioral changes, the rate of cumulative frequency was computed for behavioral changes two weeks after the discharge from emergency department in which there were less behavioral changes in group 2 than in group 1 (P = 0.04). Conclusions: Oral administration of ketamine, midazolam, and atropine cocktail induces better sedation than diphenhydramine with respect to its limited mood changes in children, who need a medical

  20. Visual hallucinations on eye closure associated with atropine toxicity. A neurological analysis and comparison with other visual hallucinations.

    PubMed

    Fisher, C M

    1991-02-01

    Visual hallucinations of remarkable intensity began shortly after intravenous atropine and persisted for 11 days. They were present only when the eyes were closed and were associated with heightened dreaming and disturbed sleep. The patient remained lucid and described his experiences to his attendants. Our patient's hallucinations bore some resemblance to hypnagogic hallucinations and this became the basis for the hypothesis that the hallucinations originated in the sleep-dream system of the brain stem. It is speculated that a similar site--a metabolic locus minoris resistentiae may play a part in other types of visual hallucinations and in delirium.

  1. Non-lethal, repeated testing, anesthetized canine model for the evaluation of effectiveness of new forms of prophylaxis and therapy for cyanide intoxication

    SciTech Connect

    Von Bredow, J.; Vick, J.; Kaminskis, A.; Brewer, T.

    1993-05-13

    Acute cyanide intoxication has most often been modeled through the bolos intravenous administration of a lethal amount of sodium or potassium cyanide which provides reproducible effects and represents the most severe challenge to any new form of prophylaxis and therapy. Inhalation of cyanide leads to a similar acute onset of toxic signs which is controlled by the rate and depth of respiration. The cyanide induced halt in respiration also halts the continued absorption of cyanide leading to a well defined, consistent end point of the amount of cyanide absorbed. Regardless of the abundance of cyanide in the ambient air, the casualty can only absorb cyanide during respiration. A slow intravenous infusion of cyanide which is continued only until respiratory arrest is achieved should define the same limit of cyanide intoxication. Cyanide intoxication defined by the amount of sodium cyanide infused to induce respiratory arrest (RA) in pentobarbital anesthetized dogs provides the basis for the development of a useful repeated testing animal model. Utilization of the RA yields a surrogate endpoint in the anesthetized dog model and provides a non-traumatic, reproducible procedure to estimate the lethal level of CN in each dog as well defining the protective effect of pretreatments and antidotes.

  2. Neuroprotection against diisopropylfluorophosphate in acute hippocampal slices

    PubMed Central

    Ferchmin, P. A.; Pérez, Dinely; Cuadrado, Brenda L.; Carrasco, Marimée; Martins, Antonio H.; Eterović, Vesna A.

    2015-01-01

    Diisopropylfluorophosphate (DFP) is an irreversible inhibitor of acetylcholine esterase (AChE) and a surrogate of the organophosphorus (OP) nerve agent sarin. The neurotoxicity of DFP was assessed as a reduction of population spike (PS) area elicited by synaptic stimulation in acute hippocampal slices. Two classical antidotes, atropine, and pralidoxime, and two novel antidotes, 4R-cembranotriene-diol (4R) and a caspase 9 inhibitor, were tested. Atropine, pralidoxime, and 4R significantly protected when applied 30 min after DFP. The caspase inhibitor was neuroprotective when applied 5–10 min before or after DFP, suggesting that early synaptic apoptosis is responsible for the loss of PSs. It is likely that apoptosis starts at the synapses and, if antidotes are not applied, descends to the cell bodies, causing death. The acute slice is a reliable tool for mechanistic studies, and the assessment of neurotoxicity and neuroprotection with PS areas is, in general, pharmacologically congruent with in vivo results and predicts the effect of drugs in vivo. 4R was first found to be neuroprotective in slices and later we demonstrated that 4R is neuroprotective in vivo. The mechanism of neurotoxicity of OPs is not well understood, and there is a need for novel antidotes that could be discovered using acute slices. PMID:26438150

  3. Prognostic Factors in Emergency Department Patients with Glyphosate Surfactant Intoxication: Point-of-Care Lactate Testing.

    PubMed

    Kim, Yong Hwan; Lee, Jun Ho; Cho, Kwang Won; Lee, Dong Woo; Kang, Mun Ju; Lee, Kyoung Yul; Lee, Young Hwan; Hwang, Seong Youn; Lee, Na Kyoung

    2016-12-01

    An increasing number of suicide attempts involve the ingestion of glyphosate surfactant; hence, clinical toxicologists may encounter severe cases of glyphosate surfactant intoxication. In several other clinical conditions, serum lactate is used to predict outcome. We investigated the relationship between lactate levels and 30-day mortality from glyphosate surfactant poisoning. This retrospective analysis involved 232 patients who were admitted to the emergency department after acute glyphosate surfactant poisoning between January 2004 and June 2014. We used a receiver operating characteristic (ROC) curve to define the optimal cut-off point for lactate levels. A Kaplan-Meier 30-day survival curve was then analysed in terms of the defined cut-off level. We used multi-variate Cox proportional hazards regression analysis to determine the risk factors for 30-day mortality. Of the 232 patients, 29 died, yielding a case fatality rate of 12.5%. Lactate was significantly higher in non-survivors (6.5 ± 3.1 mmol/L) than in survivors (3.3 ± 2.2 mmol/L; p < 0.001), and elevated lactate was significantly associated with 30-day mortality. The area under the ROC curve of lactate levels was 0.836 [95% confidence interval (CI): 0.716-0.869]. Lactate levels higher than 4.7 mmol/L were associated with increased mortality in multi-variable analysis (hazard ratio: 3.2; 95% CI: 1.1-8.7). Besides lactate, age >59 years, corrected QT interval >495 ms and potassium >5.5 mmol/L were independent risk factors for 30-day mortality. Lactate is an independent predictor of 30-day mortality in patients with glyphosate surfactant poisoning. Early measurement of lactate levels may be a simple and practical way to assess the severity of intoxication.

  4. [Vibrio parahaemolyticus infections and algal intoxications as emergent public health problems in Chile].

    PubMed

    Hernández, Cristina; Ulloa, Juanita; Vergara, José Antonio; Espejo, Romilio; Cabello, Felipe

    2005-09-01

    There is interest in the paradigm that relates environmental sea changes to the emergence of diseases that affect both aquatic organisms in the sea and human beings. The emergence of Vibrio parahaemolyticus as an important cause of epidemic summer diarrhea in 2004 and 2005, confined mainly to the tenth region in Chile, could be a manifestation of this trend. This and other areas of the country have also experienced several outbreaks of paralytic shellfish poisoning (PSP), diarrheal shellfish poisoning (DSP) and amnesic shellfish poisoning (ASP) caused by harmful algal blooms (HAB) of Alexandrium catenella, Dinophysis acuta and Pseudonitzchia species, respectively. The short historical record of these pathological phenomena in Chile suggests that they are increasing in frequency and expanding their geographical range. The V parahaemolyticus isolates responsible for the Chilean outbreaks correspond mainly to the pandemic strain O3:K6. HAB found in Chile and the intoxications caused by them have similar biological characteristics to those described in other areas of the world. The tenth region, the area where these problems are emerging, produces approximately 80-90% of the shellfish consumed in Chile and a large proportion of the shellfish that is exported. Prevention of these public health problems can be attained by developing policies that increase environmental surveillance for Vibrios and toxic algae, improve the epidemiological surveillance of acute diarrhea and algal intoxications after the ingestion of raw bivalves, and educate the population on the mode of transmission of these diseases. Scientific capacity and laboratories need to be developed to widen the limited knowledge of the biology of Vibrio and toxic algae and the environmental factors that favor their emergence as public health and economic problems in Chile.

  5. [Polonium-210 acute and chronic pathomorphology and pathogenesis].

    PubMed

    Kvacheva, Yu E

    2015-01-01

    In the present review, the data on the pathology of acute and chronic polonium injuries available from the an open-access domestic and foreign literature are primarily systemized and analyzed. The historical background of the research is presented in brief. On the basis of clinical and experimental generalizations, the current concept regarding the pathogenesis of polonium intoxication has been developed.

  6. Optimizing the Treatment of Acute Duct-Destructive Pancreatitis

    ERIC Educational Resources Information Center

    Zhakiev, Bazylbek S.; Karsakbayev, Uteugali G.; Kelimberdiev, Mersaid S.; ?uhamedgalieva, Bodagoz M.; K?nonenko, Aleksander F.

    2016-01-01

    The search for new methods for treating duct-destructive pancreatitis is a relevant problem. Endogenous intoxication and oxidative stress that accompany acute pancreatitis often progress even after surgery, which forces one to search for additional possibilities of preventing these severe consequences. This research studied the effect of small…

  7. Sodium cromoglycate and atropine block the fall in FEV1 but not the cough induced by hypotonic mist.

    PubMed Central

    Fuller, R W; Collier, J G

    1984-01-01

    In a group of patients with mild asthma the inhalation of mist derived from ultrasonically nebulised distilled water caused an increase in cough and a fall in FEV1. Double blind administration for five minutes of sodium cromoglycate (from an original solution containing 30 mg/ml) or atropine (2 mg/ml) by inhalation from a Minineb nebuliser, 30 minutes before the mist challenge, caused a significant reduction in the fall in FEV1 (p less than 0.05), but not in cough, by comparison with the protection afforded by placebo (saline). In a second study the fall in FEV1 caused by the inhalation of distilled water was not significantly different from that seen in response to hypotonic sodium chloride (1.7 g/l, 58 mmol/l), but both produced a significantly greater fall than did a similar mist containing sodium cromoglycate at an original concentration of 10 mg/ml (58 mmol/l). The results show that both atropine and sodium cromoglycate can block the fall in FEV1 due to mist and that protection by sodium cromoglycate is immediate. These results suggest that sodium cromoglycate blocks the nervous reflexes concerned in the response to mist, probably in the afferent limb of the reflex. PMID:6437001

  8. Safety and tolerability of dobutamine-atropine stress echocardiography: a prospective, multicentre study. Echo Dobutamine International Cooperative Study Group.

    PubMed

    Picano, E; Mathias, W; Pingitore, A; Bigi, R; Previtali, M

    1994-10-29

    Diagnostic tests that are hazardous or infeasible, or both, may become accepted before inadequacies are recognised; only multicentre trials can provide the necessary information for an unrestricted acceptance of any new diagnostic procedure. We prospectively studied the results obtained in 24 experienced echocardiography laboratories. 2949 tests were done in 2799 patients. In 341 tests (12% of the overall population, 21% of the negative tests) the test could not be completed because of complex ventricular tachyarrhythmias (134, 38% of all submaximal studies); nausea and/or headache (71, 20%); hypotension and/or bradycardia (62, 17%); supraventricular tachyarrhythmias (44, 12%); hypertension (24, 7%); and others (20, 6%). Dangerous events (life-threatening complications or side-effects requiring specific treatment and lasting more than 3 hours, or new hospital admission) occurred in 14 cases (1 every 210 tests)--9 cardiac (3 ventricular tachycardias; 2 ventricular fibrillations; 2 myocardial infarctions; 1 prolonged antidote-resistant myocardial ischaemia; 1 severe, persistent hypotension) and 5 extracardiac (atropine poisoning with hallucinations lasting several hours in the absence of either myocardial ischaemia or hypotension). Life-threatening and/or longlasting complications may occur during dobutamine/atropine stress echocardiography. The test is generally well tolerated, although may be interrupted by minor, self-limiting, usually symptomless side-effects.

  9. Effect of chronic lead intoxication on the distribution and elimination of amoxicillin in goats.

    PubMed

    Soliman, Ahmed M; Abu-Basha, Ehab A; Youssef, Salah A H; Amer, Aziza M; Murphy, Patricia A; Hauck, Catherine C; Gehring, Ronette; Hsu, Walter H

    2013-01-01

    A study of amoxicillin pharmacokinetics was conducted in healthy goats and goats with chronic lead intoxication. The intoxicated goats had increased serum concentrations of liver enzymes (alanine aminotransferase and γ-glutamyl transferase), blood urea nitrogen, and reactivated δ-aminolevulinic acid dehydratase compared to the controls. Following intravenous amoxicillin (10 mg/kg bw) in control and lead-intoxicated goats, elimination half-lives were 4.14 and 1.26 h, respectively. The volumes of distribution based on the terminal phase were 1.19 and 0.38 L/kg, respectively, and those at steady-state were 0.54 and 0.18 L/kg, respectively. After intramuscular (IM) amoxicillin (10 mg/kg bw) in lead-intoxicated goats and control animals, the absorption, distribution, and elimination of the drug were more rapid in lead-intoxicated goats than the controls. Peak serum concentrations of 21.89 and 12.19 μg/mL were achieved at 1 h and 2 h, respectively, in lead-intoxicated and control goats. Amoxicillin bioavailability in the lead-intoxicated goats decreased 20% compared to the controls. After amoxicillin, more of the drug was excreted in the urine from lead-intoxicated goats than the controls. Our results suggested that lead intoxication in goats increases the rate of amoxicillin absorption after IM administration and distribution and elimination. Thus, lead intoxication may impair the therapeutic effectiveness of amoxicillin.

  10. Gender Differences in Natural Language Factors of Subjective Intoxication in College Students: An Experimental Vignette Study

    PubMed Central

    Levitt, Ash; Schlauch, Robert C.; Bartholow, Bruce D.; Sher, Kenneth J.

    2013-01-01

    Background Examining the natural language college students use to describe various levels of intoxication can provide important insight into subjective perceptions of college alcohol use. Previous research (Levitt et al., 2009) has shown that intoxication terms reflect moderate and heavy levels of intoxication, and that self-use of these terms differs by gender among college students. However, it is still unknown whether these terms similarly apply to other individuals and, if so, whether similar gender differences exist. Method To address these issues, the current study examined the application of intoxication terms to characters in experimentally manipulated vignettes of naturalistic drinking situations within a sample of university undergraduates (N = 145). Results Findings supported and extended previous research by showing that other-directed applications of intoxication terms are similar to self-directed applications, and depend on the gender of both the target and the user. Specifically, moderate intoxication terms were applied to and from women more than men, even when the character was heavily intoxicated, whereas heavy intoxication terms were applied to and from men more than women. Conclusions The findings suggest that gender differences in the application of intoxication terms are other-directed as well as self-directed, and that intoxication language can inform gender-specific prevention and intervention efforts targeting problematic alcohol use among college students. PMID:23841828

  11. Hemorheological changes and hematometric erythrocyte characteristics in rats after sodium nitrite intoxication

    NASA Astrophysics Data System (ADS)

    Ivanov, Ivan; Gluhcheva, Yordanka; Petrova, Emilia; Antonova, Nadia

    2014-05-01

    Sodium nitrite (NaNO2) is a precursor to a variety of organic compounds (pharmaceuticals, dyes and pesticides), but it is best known as a food additive. The aim of the study is to investigate the influence of acute (i.p.) treatment of Wistar rats with NaNO2 (at the dose of 50 mg/kg b.w.) on the blood rheological properties and erythrocyte hematometric indices (Hb, HCT, RBC, MCV, RDW, MCH, MCHC). The significant differences were not found in the whole blood viscosity (WBV) values of the control and NaNO2-treated groups. The changes in the erythrocyte hematometric indices were statistically significant for RDW, MCHC and MCH at the 1st hour, five- and ten days after NaNO2 administration. Interestingly, at the day 5th of the NaNO2 treatment we obtained statistically significant lower values for the RBC count, Hb, HCT, RDW, as well as elevated indices MCV (no statistically significant), MCH, MCHC. The results obtained indicate that hemorheological and hematometric parameters examined should be monitored in cases of acute exposure to nitrites — for the purposes of clinical toxicology. The quantitative values of hematometric indices reported in our experimental model could be suitable for predicting NaNO2 intoxication and methemoglobinemia in animals and humans.

  12. Central respiratory failure during acute organophosphate poisoning.

    PubMed

    Carey, Jennifer L; Dunn, Courtney; Gaspari, Romolo J

    2013-11-01

    Organophosphate (OP) pesticide poisoning is a global health problem with over 250,000 deaths per year. OPs affect neuronal signaling through acetylcholine (Ach) neurotransmission via inhibition of acetylcholinesterase (AChE), leading to accumulation of Ach at the synaptic cleft and excessive stimulation at post-synaptic receptors. Mortality due to OP agents is attributed to respiratory dysfunction, including central apnea. Cholinergic circuits are integral to many aspects of the central control of respiration, however it is unclear which mechanisms predominate during acute OP intoxication. A more complete understanding of the cholinergic aspects of both respiratory control as well as neural modification of pulmonary function is needed to better understand OP-induced respiratory dysfunction. In this article, we review the physiologic mechanisms of acute OP exposure in the context of the known cholinergic contributions to the central control of respiration. We also discuss the potential central cholinergic contributions to the known peripheral physiologic effects of OP intoxication.

  13. The role of therapeutic plasma exchange in poisonings and intoxications.

    PubMed

    Schutt, Robert Clark; Ronco, Claudio; Rosner, Mitchell H

    2012-01-01

    Poisonings, intoxications, and drug overdoses are common occurrences and rapid lowering of the toxin level is a cornerstone of all effective therapies. Therapeutic plasma exchange (TPE) has several unique characteristics that allow it to be a potentially effective therapy in rapidly achieving this goal. Specifically, TPE allows for the removal of large molecular weight, protein-bound molecules that have a small volume of distribution. Due to the nature of poisonings, intoxications, and drug overdoses, no randomized controlled trials studying the efficacy of TPE in these situations exist. Thus, careful interpretation and analysis of case reports and series are required to assess the potential efficacy of this therapy. Recent data suggest that TPE may also be effective in the therapy of patients receiving biologic treatments who develop life-threatening complications due to therapy.

  14. [Case report of butane intoxication with fatal outcome].

    PubMed

    Kirichek, A V; Rassinskaia, L A; Shirokova, L V; Simonov, E A

    2009-01-01

    Forensic medical examiners know numerous cases of non-occupational intoxication (e.g. suicide, drug intoxication, household poisoning) but rarely encounter cases of occupational poisoning with household gases. Collection of forensic chemical facts testifying to the presence of saturated hydrocarbons in blood and other tissues is a challenging task. It hampers evaluation of their toxic effect on human brain for the purpose of forensic medical examination. A method is proposed for the analysis of biological materials allowing for the detection of natural alkanes, such as butane, along with recommendations on taking samples for chemical analysis in suspected cases of poisoning with household gases. The method is designed to be employed in combination with up-to-date analytical techniques, such as capillary gas chromatography and mass spectrometry.

  15. The case of intoxicated cells-an epidemiologic note.

    PubMed

    Cohen, D; Wanner, R G

    1981-03-01

    An episode is described in which tissue culture in a laboratory could have become intoxicated due to the recirculation of toxic exhaust fumes extruded from the roof of a research institution. A route of entry was found whereby a portion of fume hood exhaust was reintroduced into the building by means of large intake fans located on the roof near the exhaust ducts used to cool the elevator cables and motors at the top of the elevator shafts. The descending action of the elevator created a suction which pulled the polluted air down the elevated shafts and into the corridors. Such mechanisms for cooling elevator shafts are widely used in the modern architecture of commercial, industrial and laboratory buildings, and they should therefore be considered in epidemiologic investigations of airborne infections or intoxications of undetermined origin.

  16. Plumbism or Lead Intoxication Mimicking an Abdominal Tumor

    PubMed Central

    Dedeken, Peter; Louw, Vernon; Vandooren, Ann-Karolien; Geert, Verstegen; Goossens, Willy; Dubois, Bénédicte

    2006-01-01

    The clinical presentation of lead intoxication may vary widely and in the absence of a high clinical index of suspicion, the diagnosis may be missed. The effects of lead on mitochondrial oxidative phosphorylation and its interaction with calcium-mediated processes explain the heterogenous presentation. In this case report, the diagnosis was finally made when bilateral wrist drop developed on top of abdominal cramps and anemia. Before, ascites raised the suspicion of a tumor. Therefore, each element of the triad of unexplained anemia, abdominal cramps, and bilateral wrist (or foot) drop should lead any physician to consider the diagnosis of lead intoxication. This case also illustrates the importance of a careful and meticulous social history in patient management. PMID:16808730

  17. Pseudolaminar necrosis in cyanide intoxication: a neuropathology case report.

    PubMed

    Riudavets, Miguel Angel; Aronica-Pollak, Patricia; Troncoso, Juan C

    2005-06-01

    We describe the gross and microscopic neuropathological changes in the brain of a 17-year-old male who died 4 days after being poisoned with cyanide. Previous reports indicate that following cyanide intoxication, the brain develops diffuse hypoxic/ischemic changes, predominantly of the basal ganglia. The case we describe here had similar features but in addition showed striking laminar necrosis of the cerebral cortex. This finding in cyanide poisoning has been previously demonstrated by neuroimaging, but not pathologically.

  18. Alcohol Intoxication Impact on Outcome from Traumatic Injury

    DTIC Science & Technology

    2007-05-01

    response to an intratracheal challenge with Streptococcus pneumoniae (39). The differential response FIG 5. Top, Lung MPO activity in rodent model of...as well as following an intratracheal challenge with Streptococcus pneumoniae during alcohol intoxication alone (Boe et al., 2001). Thus, while no...suppresses lung chemokine production following infection with Streptococcus pneumoniae . J Infect Dis 184:1134–1142. Boe DM, Nelson S, Zhang P, Quinton L

  19. Drug Intoxicated Irregular Fighters: Complications, Dangers, and Responses

    DTIC Science & Technology

    2008-03-01

    norms offer that chance. Outside agencies, NGOs and the UN Office of the High Commissioner for Refugees ( UNHCR ) should begin to put such...has argued, the desire to seek intoxication may be a “fourth drive” in human beings after hunger, thirst, and sex .2 Such a drive appears to have an...regional stability. For example, carnival activities in Yugoslavia sent waves of refugees throughout Europe and eventually led to a Western military

  20. Deleterious effects of magnesium intoxication upon the domestic broiler chick

    SciTech Connect

    Lee, S.R.

    1984-01-01

    Dietary levels of 0.6 to 0.8% magnesium in a corn-soy basal were rachitogenic. These rickets appeared most like phosphorus deficiency. Bone Ca/P ratios were numerically quite low implying a lack of transformation from amorphous calcium phosphate to hydroxyapatite. Bone alkaline phosphatase activity was elevated. Additional dietary phosphorus ameliorated, but could not overcome the rachitogenic effects of magnesium. Tibial dyschondroplasia (TD), induced by elevated dietary P, was decreased by high levels of dietary Mg, but with no decrease in plasma phosphorus. Anticoccidial ionophores fed in conjunction with a moderate dietary challenge of Mg (0.48%) produced no clear changes in plasma calcium or Mg, but did interact to reduce body weight. The diarrhea caused by magnesium intoxication is not due to hyperosmotic loads of Mg per se. Rather, Cl was observed to be the major ionic constituent of the gut osmotic load implying different gut ionic fluxes in control versus magnesium intoxicated chicks. These data imply that the cathartic action of Mg is due to hypersecretion of the gut. Effects mediated or modified by the CNS changed in magnesium intoxicated chicks. Such chicks appeared cold and stayed near the heat. When startled, they exhibited extreme avoidance behavior and seizures similar to epilepsy and/or Cl deficiency. Brain tissue Mg content did not concomitantly increase. Whether these effects are due to central signals is unclear.