Toxicology

2012 ◽  
pp. 179-218
Author(s):  
Jonathan P. Wyatt ◽  
Robin N. Illingworth ◽  
Colin A. Graham ◽  
Kerstin Hogg ◽  
Michael J. Clancy ◽  
...  
Keyword(s):  
Supportive Care ◽  
Tricyclic Antidepressant ◽  
Paracetamol Poisoning ◽  
Barbiturate Poisoning ◽  
Salicylate Poisoning

Poisons: general principles 180 Diagnosis of poisoning 182 Poisons: supportive care 183 Reducing absorption of poison 184 Antidotes for poisons 186 Opioid poisoning 188 Salicylate poisoning 189 Paracetamol poisoning 190 Tricyclic antidepressant poisoning 194 Benzodiazepine poisoning 196 Clomethiazole poisoning 196 Phenothiazine poisoning 196 Barbiturate poisoning ...

scholarly journals Clinical pharmacology and therapeutics

2016 ◽  
Keyword(s):  
Clinical Pharmacology ◽  
Carbon Monoxide Poisoning ◽  
Tricyclic Antidepressant ◽  
Lithium Toxicity ◽  
Basic Training ◽  
Paracetamol Poisoning ◽  
Drug Reactions ◽  
Ethylene Glycol Poisoning ◽  
Salicylate Poisoning ◽  
Special Circumstances

Chapter 5 covers the basic science and clinical topics relating to clinical pharmacology and therapeutics which trainees are required to learn as part of their basic training and demonstrate in the MRCP. It covers pharmacodynamics, pharmacokinetics, drug metabolism and prescribing in special circumstances, drug interactions, adverse drug reactions, drug development, paracetamol poisoning, salicylate poisoning, lithium toxicity, digoxin toxicity, carbon monoxide poisoning, ethylene glycol poisoning, and tricyclic antidepressant poisoning.

Toxicology

2013 ◽  
Author(s):  
Victoria Stacey
Keyword(s):  
Carbon Monoxide ◽  
Carbon Monoxide Poisoning ◽  
Tricyclic Antidepressant ◽  
Paracetamol Poisoning ◽  
Salicylate Poisoning

Introduction - General principles of poisoning management - Toxidromes - Paracetamol poisoning - Salicylate poisoning - Tricyclic antidepressant poisoning - Carbon monoxide poisoning - SAQs

Emergencies

2017 ◽  
pp. 778-851
Author(s):  
Ian B. Wilkinson ◽  
Tim Raine ◽  
Kate Wiles ◽  
Anna Goodhart ◽  
Catriona Hall ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Tension Pneumothorax ◽  
Acute Poisoning ◽  
Paracetamol Poisoning ◽  
Coronary Syndrome ◽  
Salicylate Poisoning ◽  
Acute Exacerbations ◽  
St Elevation ◽  
Broad Complex ◽  
Narrow Complex Tachycardia

This chapter explores cardiovascular, respiratory, gastrointestinal, neurological, and endocrinological emergencies, including headache, breathlessness, chest pain, coma, Glasgow Coma Scale (GCS), shock, sepsis, anaphylactic shock, acute coronary syndrome with ST-elevation, acute coronary syndrome without ST-elevation, severe pulmonary oedema, cardiogenic shock, broad complex tachycardia, narrow complex tachycardia, bradycardia, acute severe asthma, acute exacerbations of COPD, pneumothorax, tension pneumothorax, pneumonia, pulmonary embolism (PE), acute upper GI bleeding, meningitis, encephalitis, cerebral abscess, status epilepticus, head injury, raised intracranial pressure (ICP), diabetic ketoacidosis (DKA), diabetic emergencies, thyroid emergencies, Addisonian crisis, hypopituitary coma, phaeochromocytoma emergencies, acute poisoning, poisons and their antidotes, paracetamol poisoning, salicylate poisoning, burns, hypothermia, and major disasters

Improvements in the packaging of drugs and chemicals may reduce the likelihood of severe intentional poisonings in adults

2000 ◽  
Vol 19 (7) ◽  
pp. 387-391 ◽  
Author(s):  
T YK Chan
Keyword(s):  
Methyl Salicylate ◽  
Marked Decrease ◽  
Rapid Onset ◽  
Pulmonary Aspiration ◽  
Paracetamol Poisoning ◽  
Severe Liver ◽  
Salicylate Poisoning ◽  
Severe Liver Damage ◽  
Time Required ◽  
The Uk

Because of the inconvenience and longer time required to punch out the tablets, strip packaging may reduce the number of tablets that can be readily swallowed by adults with self-poisonings. In fact, hospital-based studies of paracetamol poisoning in the U.K. and Hong Kong have shown that blister packs were associated with fewer tablets being ingested and large overdoses were mostly from loose preparations. In Australia, following the change in packa-ging for carbamazepine from bottles of tablets to blister packs, a marked decrease in the reported number of tablets ingested by patients was seen. Reducing the maximum number of tablets that can be available in individual preparations or prescriptions may also reduce the likelihood of severe poisonings. In France, but not in the UK, the content of each pack of paracetamol has been legally limited to 8 g. This was thought to be one reason why severe liver damage and deaths after paracetamol poisonings are less common in France than in the UK. Medicated oils containing methyl salicylate pose the threat of rapid-onset, severe salicylate poisoning if swallowed. To reduce the amount of methyl salicylate that can be readily swallowed, the methyl salicylate content and the size of the bottle and its opening should be restricted. In adults with Dettol poisoning, serious complications such as pulmonary aspiration are more likely if a large amount is ingested. Similarly, the risk may be reduced by restricting the size of bottle and its opening.

Activated Charcoal in Tricyclic Antidepressant Poisoning: Pilot Controlled Clinical Trial

1983 ◽  
Vol 2 (2) ◽  
pp. 205-209 ◽  
Author(s):  
P. Crome ◽  
R. Adams ◽  
C. Ali ◽  
V. Dallos ◽  
S. Dawling
Keyword(s):  
Clinical Trial ◽  
Side Effects ◽  
Supportive Care ◽  
Drug Screening ◽  
Activated Charcoal ◽  
Tricyclic Antidepressants ◽  
Randomised Clinical Trial ◽  
Tricyclic Antidepressant ◽  
Controlled Clinical Trial

1 A randomised clinical trial was carried out to assess the effects of activated charcoal in the management of suspected tricyclic antidepressant poisoning. 2 Forty-eight patients entered the study, twenty receiving supportive care plus activated charcoal (10 g) and twenty-eight supportive care alone. 3 Drug screening showed that only seventeen patients had taken tricyclic antidepressants alone. 4 Activated charcoal had no effect on either the rate of lightening of coma or the fall in plasma antidepressant concentrations in the 'pure' tricyclic antidepressant poisoning group. 5 No serious side-effects of activated charcoal were reported.

Cholangiokarzinome

Praxis ◽  
2002 ◽  
Vol 91 (34) ◽  
pp. 1352-1356
Author(s):  
Harder ◽  
Blum
Keyword(s):  
Supportive Care ◽  
Evidence Based Medicine ◽  
Best Supportive Care ◽  
Evidence Based ◽  
Systemische Chemotherapie ◽  
Chirurgische Resektion ◽  
Multimodale Therapiekonzepte ◽  
Based Medicine

Cholangiokarzinome oder cholangiozelluläre Karzinome (CCC) sind seltene Tumoren des biliären Systems mit einer Inzidenz von 2–4/100000 pro Jahr. Zu ihnen zählen die perihilären Gallengangskarzinome (Klatskin-Tumore), mit ca. 60% das häufigste CCC, die peripheren (intrahepatischen) Cholangiokarzinome, das Gallenblasenkarzinom, die Karzinome der extrahepatischen Gallengänge und das periampulläre Karzinom. Zum Zeitpunkt der Diagnose ist nur bei etwa 20% eine chirurgische Resektion als einzige kurative Therapieoption möglich. Die Lebertransplantation ist wegen der hohen Rezidivrate derzeit nicht indiziert. Die Prognose von nicht resektablen Cholangiokarzinomen ist mit einer mittleren Überlebenszeit von sechs bis acht Monaten schlecht. Eine wirksame Therapie zur Verlängerung der Überlebenszeit existiert aktuell nicht. Die wichtigste Massnahme im Rahmen der «best supportive care» ist die Beseitigung der Cholestase (endoskopisch, perkutan oder chirurgisch), um einer Cholangitis oder Cholangiosepsis vorzubeugen. Durch eine systemische Chemotherapie lassen sich Ansprechraten von ca. 20% erreichen. 5-FU und Gemcitabine sind die derzeit am häufigsten eingesetzten Substanzen, die mit einer perkutanen oder endoluminalen Bestrahlung kombiniert werden können. Multimodale Therapiekonzepte können im Einzellfall erfolgreich sein, müssen jedoch erst in Evidence-Based-Medicine-gerechten Studien evaluiert werden, bevor Therapieempfehlungen für die Praxis formuliert werden können.

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