1/29. Hospital-acquired salicylate intoxication. report of a case with psychosis, acidosis, and coma.A case of salicylate intoxication from repeated therapeutic doses of aspirin is reported in an adult with impairment of salicylate elimination. Evolution of acid-base disturbance from respiratory alkalosis to metablic acidosis is documented. serum salicylate levels during several years of therapy demonstrate the acquisition of impaired elimination of the drug. This case illustrates the practical importance of special features of salicylate accumulation kinetics emphasized in a recent review.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/29. Three cases of angel's trumpet tea-induced psychosis in adolescent substance abusers.An increase of intoxications in persons using alkaloid-containing ornamental plants (mainly angel's trumpet) for their hallucinogenic effects and easy and cheap availability is registered. It is mainly adolescents who are experimenting with these plants. In addition to severe vegetative anticholinergic symptoms, the clinical picture is often dominated by a toxic psychosis with hallucinations, disturbances of orientation, and psychomotoric agitation, aggression, or anxiety. Three cases of severe psychotic pictures with only mild or completely missing vegetative symptoms after ingestion of angel's trumpet tea are reported. Caused by the increasing spreading of angel's trumpet shrubberies in europe and north america, intoxications with large numbers of fatalities have to be expected in the future. The taxonomical, pharmacological, and clinical aspects of angel's trumpet-induced disorders are discussed. knowledge of the clinical picture is important for correct diagnosis and treatment. Prevention by mass media should mainly focus on the medical fatalities of abuse and not emphasize the hallucinogenic effects, presumably increasing unwanted interest for these plants among youths.- - - - - - - - - - ranking = 0.4keywords = intoxication (Clic here for more details about this article) |
3/29. Treatable aspects of the dementia syndrome.With attentive medical management, the elderly demented patient can live in greater comfort, dignity and independence. Errors in supervision can result in a drug intoxication, misdiagnoses, and personal neglect. Many of the elderly have a chronic dementing illness, and disability often is accelerated by complications. However, some of these complications are treatable. Case histories are presented to illustrate pitfalls in the care of such patients.- - - - - - - - - - ranking = 0.2keywords = intoxication (Clic here for more details about this article) |
4/29. Sudden death during arrest and phencyclidine intoxication.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.- - - - - - - - - - ranking = 1.2keywords = intoxication (Clic here for more details about this article) |
5/29. Efavirenz intoxication due to slow hepatic metabolism.We describe a human immunodeficiency virus-positive woman who presented with severe psychosis while she was receiving therapy with efavirenz. Her plasma efavirenz level was excessively high. Genetic investigation showed that she was homozygous for the CYP2B6 G516T allele, resulting in slow hepatic metabolism. After the dosage of efavirenz was lowered, all neuropsychiatric symptoms subsided.- - - - - - - - - - ranking = 0.8keywords = intoxication (Clic here for more details about this article) |
6/29. Low cost, high risk: accidental nutmeg intoxication.Nutmeg poisoning is rare but probably underreported and should be considered in recreational substance users with acute psychotic symptoms as well as central nervous system neuromodulatory signs that may mimic in part an anticholinergic hyperstimulation.- - - - - - - - - - ranking = 0.8keywords = intoxication (Clic here for more details about this article) |
7/29. dextromethorphan psychosis, dependence and physical withdrawal.As part of a synthesis of evidence regarding the abuse and addiction liability of dextromethorphan (DM), an over-the-counter cough medicine available in over 140 preparations, an uncommonly published case of dextromethorphan dependence (addiction) is described, with specific, rarely published complications. The individual was interviewed and several medical databases were also reviewed (medline, 1966-present; pubmed) for all content relating to the Keywords: dextromethorphan, abuse, dependence, cough medicine, addiction, withdrawal, psychosis. The patient evidenced history suggesting substance dependence, substance-induced psychosis and substance withdrawal in relation to DM. A literature review revealed that DM has specific serotonergic and sigma-1 opioidergic properties. dextrorphan (DOR), the active metabolite of DM, has similar properties; however, DOR is a weaker sigma opioid receptor agonist, and a stronger NMDA receptor antagonist. DM and DOR display specific biological features of addiction, and are capable of inducing specific psychiatric sequelae. A specific, reproducible toxidrome with significant psychiatric effects occurred, when DM was abused at greater than indicated doses, with more profound and potentially life-threatening effects at even higher doses. DM withdrawal appears evident. DM's active metabolite, DOR, has pharmacodynamic properties and intoxication effects similar to dissociatives, and may be more responsible for the dissociative effect that this DM abuser sought. However, it is this same metabolite that may be fraught with the potentially life-threatening psychoses and dissociative-induced accidents, as well as addiction. While DM has been hypothesized as the most commonly abused dissociative, health-care providers seem largely unaware of its toxidrome and addiction liability.- - - - - - - - - - ranking = 0.2keywords = intoxication (Clic here for more details about this article) |
8/29. central nervous system toxicity from nebulized atropine sulfate.Central anticholinergic intoxication can result from iatrogenic sources. We report the occurrence of a central anticholinergic syndrome in a patient treated with aerosolized atropine.- - - - - - - - - - ranking = 0.2keywords = intoxication (Clic here for more details about this article) |
9/29. Acute respiratory failure following severe arsenic poisoning.A 47-year-old man had an episode of severe respiratory failure after acute intoxication with arsenic. Features of the initial clinical presentation included nausea, vomiting, and diarrhea, acute psychosis, diffuse skin rash, and marked pancytopenia. A peripheral neuropathy then developed which resulted in severe weakness of all muscles of the limbs, the shoulder and pelvis girdles, and the trunk. The neuropathy continued to progress despite treatment with dimercaprol (BAL in oil). Five weeks after the initial exposure, the patient was no longer able to maintain adquate ventilation and required mechanical ventilatory support. Improvement in the patient's neuromuscular status permitted successful weaning from the ventilator after one month of mechanical ventilation. Long-term follow-up revealed no further respiratory difficulty and slow improvement in the strength of the peripheral muscles.- - - - - - - - - - ranking = 0.2keywords = intoxication (Clic here for more details about this article) |
10/29. Bromide intoxication secondary to pyridostigmine bromide therapy.The diagnosis of bromide intoxication is often aided by the detection of a low or negative anion gap due to the laboratory detection of bromide as chloride. A 59-year-old woman with myasthenia gravis who received a large dose of pyridostigmine bromide developed postoperative psychosis and was diagnosed as having bromide intoxication. The diagnosis was suspected in the setting of a negative anion gap and only later confirmed by direct measurement of the serum bromide level. To our knowledge , this is the first reported case of bromide intoxication due to pyridostigmine bromide administration.- - - - - - - - - - ranking = 1.4keywords = intoxication (Clic here for more details about this article) |
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