1/6. A case of traumatic shock complicated by methamphetamine intoxication.A case of a 38-year-old male with traumatic shock complicated by methamphetamine intoxication is presented. The patient was involved in an assault which resulted in cardiac tamponade and right ventricular outflow laceration. pericardiocentesis was immediately performed. However, profound metabolic acidosis greatly in excess of that expected from the short duration of the shock was revealed by arterial blood gas analysis. Another cause of the metabolic acidosis was suspected. The patient subsequently admitted to intravenous use of methamphetamine. Following hemodynamic and metabolic stabilization by continuous pericardial drainage and intravenous administration of sodium bicarbonate, the patient underwent cardiac surgery. His postoperative course was uneventful. There is a substantial association between methamphetamine users and traumatic accidents. In such cases, early identification of drug use is important. Marked metabolic acidosis, which conflicts with the diagnosed cause of shock, may be a clinical clue to methamphetamine intoxication.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/6. death after excessive propofol abuse.Abuse of the anaesthetic agent propofol (2,6-diisopropylphenol) is rare, but we report a case of a 26-year-old male nurse in which the autopsy showed unspecific signs of intoxication and criminological evidence pointed towards propofol abuse and/or overdose. Intravenously administered propofol is a fast and short-acting narcotic agent, therefore it seemed questionable whether the deceased would have been able to self-administer a lethal overdose before losing consciousness. The blood and brain concentrations corresponded to those found 1-2 min after bolus administration of a narcotic standard dose of 2.5 mg propofol/kg body weight. Extremely high propofol concentrations were found in the urine indicating excessive abuse before death. However, due to the short half-life of propofol, the cumulative effects of repeated injections should not be relevant for toxicity, since this would result in a blood level increase of only 1-2 micrograms/ml. Furthermore, the detection and quantitation of propofol in three different hair segments indicated chronic propofol abuse by the deceased. The results of the investigation suggest that death was not caused by a propofol overdose but by respiratory depression resulting from overly rapid injection.- - - - - - - - - - ranking = 0.16666666666667keywords = intoxication (Clic here for more details about this article) |
3/6. mercury poisoning from intravenous injection: treatment by granuloma resection.Intravenous injection of mercury is a rare event. Mercury administered by this route may have several different consequences. In addition to elevated serum mercury levels, the diagnosis may be made by radiographic detection of metallic densities in the chest and at the sites of injection. death due to mercury intoxication is unusual. Impairment of renal and hepatic function may occur. Our patient presented with gingivitis and a dentoalveolar abscess. Dense granulomas occur at the sites of injection. Treatment for these patients should include granuloma excision as the benefit of chelating agents, for chronic mercury intoxication is questionable. skin and granuloma resection may leave vital structures exposed, necessitating flap coverage.- - - - - - - - - - ranking = 0.33333333333333keywords = intoxication (Clic here for more details about this article) |
4/6. Acute rhabdomyolysis associated with cocaine intoxication: a case report.Over thirty million Americans are estimated to have tried cocaine at least once and 5 million use it on a regular basis. Recent media attention to the widespread use of cocaine has revealed the growing life-threatening complications that accompany its use. The effects of cocaine on the cardiovascular, pulmonary and central nervous system have been well-described in medical literature, but the complications of acute renal failure secondary to cocaine-induced rhabdomyolysis only recently have been addressed. Presented in this article is a case involving cocaine-induced acute renal failure.- - - - - - - - - - ranking = 0.66666666666667keywords = intoxication (Clic here for more details about this article) |
5/6. naloxone--for intoxications with intravenous heroin and heroin mixtures--harmless or hazardous? A prospective clinical study.BACKGROUND: naloxone is standard medication for the treatment of heroin intoxications. No large-scale studies have yet been carried out to determine its toxicity in heroin intoxications. methods: We have undertaken an investigation as to the frequency, type and degree of severity of complications attributable to naloxone administration. Subjects treated between 1991 and 1993 with naloxone for intravenous drug intoxications were prospectively evaluated. MAIN OUTCOME MEASUREMENTS: Development of ventricular tachycardia or fibrillation; atrial fibrillation; asystole; pulmonary edema; convulsions; vomiting; and violent behavior within ten minutes after parenteral administration of naloxone. RESULTS: Six of 453 intoxicated subjects (1.3%; 95% confidence interval 0.4%-3%) suffered severe adverse effects within ten minutes after naloxone administration (one asystole; three generalized convulsions; one pulmonary edema; and one violent behavior). After the ten minute period, no further complications were observed. CONCLUSIONS: The short time between naloxone administration and the occurrence of complications, as well as the type of complications, are strong evidence of a causal link. In 1000 clinically diagnosed intoxications with heroin or heroin mixtures, from 4 to 30 serious complications can be expected. Such a high incidence of complications is unacceptable and could theoretically be reduced by artificial respiration with a bag valve device (hyperventilation) as well as by administering naloxone in minimal divided doses, injected slowly.- - - - - - - - - - ranking = 1.3333333333333keywords = intoxication (Clic here for more details about this article) |
6/6. Disturbance of consciousness due to methamphetamine abuse. A study of 2 patients.The present paper reports 2 cases of methamphetamine abuse. Following consecutive methamphetamine administration, the patients developed acute intoxication, during which time they showed a unique type of disturbance of consciousness: delirium and twilight state. In both cases, mental status changed, passing through three distinct stages: restlessness and insomnia, hallucinatory paranoid state, and disturbance of consciousness. A review of the literature suggests that disturbance of consciousness may occur occasionally during the course of amphetamine and methamphetamine intoxication, although these symptoms can be overlooked easily due to confounding symptomatology.- - - - - - - - - - ranking = 0.33333333333333keywords = intoxication (Clic here for more details about this article) |