11/15. Fatal water intoxication, schizophrenia, and diuretic therapy for systemic hypertension.Clinical and morphologic findings are described in a 37-year-old hypertensive man with chronic schizophrenia who had two well-documented episodes of water intoxication. The use of diuretics for control of systemic hypertension in the setting of chronic schizophrenia appears ill-advised.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
12/15. Idiopathic, sustained, inappropriate secretion of ADH with associated hypertension and thirst.A 15 year old girl presented with excessive thirst and hypertension (170/110 mm Hg). Biochemical investigations revealed serum sodium 118 meq/liter, serum osmolality 238 mosmol/liter, urine sodium 90 meq/liter, urine osmolality 700 mosmol/liter, persistenly elevated serum antidiuretic hormone (ADH) levels (5.8 to 11.9 pg/ml) and no obvious cause for the hypertension. The hypertension is, at least in part, volume-related, diminishing with fluid restriction. Features of gross water intoxication (e.g., confusion, coma) have not occurred. The etiology of the inappropriate secretion of ADH is not obvious but is not thought to be due to "resetting of osmoreceptors" as evidenced by failure to maximally dilute urine following a water load test and persistently elevated serum ADH levels. A similar patient described by Epstein and associates in 1962 is presently well with persistent features of inappropriate secretion of ADH.- - - - - - - - - - ranking = 0.2keywords = intoxication (Clic here for more details about this article) |
13/15. Subacute fluorosis: a consequence of abuse of an organofluoride anesthetic.A young woman presented with a novel multisystem disease: painful periostitis, osteosclerosis, hypertension, and renal dysfunction. The similarity of some of this clinical picture to fluoride intoxication led to the discovery of massively elevated fluoride levels in serum, urine, and bone. Although initially an enigma, the source of fluoride was later found to be the illicit use of an anesthetic agent, methoxyflurane. This agents is one of a class of organofluorides that, by virtue of biotransformation, is a known cause of inorganic fluoride exposure. Though the drug is potentially nephrotoxic as generally used, exposure to it is transient and has not previously led to discernible bone disease.- - - - - - - - - - ranking = 0.2keywords = intoxication (Clic here for more details about this article) |
14/15. Impaired elimination of atenolol in a nephropathic patient with self-medication overdose.A case of intoxication with atenolol (plasma concentration of 2.71 mg/L) caused by an improper self-medication combined with impaired renal function is presented. The patient was supported with atropine, isoproterenol, dopamine, and dobutamine, and a thorough pharmacokinetic monitoring of atenolol was conducted. As the serum creatinine concentration returned slowly to baseline with good diuresis, the concentration of atenolol decreased (biologic half-life = 2.95 days) and the blood pressure gradually recovered. The patient improved and was subsequently discharged in good health. Had pharmacokinetic monitoring of atenolol not been performed, hemodialysis would have been indicated.- - - - - - - - - - ranking = 0.2keywords = intoxication (Clic here for more details about this article) |
15/15. Carbon monoxide intoxication: a review of 14 patients.In 14 cases of carbon monoxide poisoning, medical records were available for retrospective review in which blood samples for carboxyhemoglobin (COHgb) were obtained. Twelve victims (86%) were overcome while at work. Correlation of the clinical picture and COHgb saturation was not always possible although hypertension was not uncommon initially. On follow-up only three patients were mildly hypertensive. skin or mucous membrane color changes were difficult to detect. Three cases are presented to illustrate factors in the diagnosis and possible sequelae.- - - - - - - - - - ranking = 0.8keywords = intoxication (Clic here for more details about this article) |
| <- Previous | |