Management of Methomyl Poisoning

1990 ◽  
Vol 9 (4) ◽  
pp. 251-254 ◽  
Author(s):  
J. Martinez-Chuecos ◽  
F. Molinero-Somolinos ◽  
J. Solé-Violàn ◽  
R. Rubio-Sanz
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Total Dose ◽  
Activated Charcoal ◽  
Cholinesterase Activity ◽  
Gastric Lavage ◽  
Plasma Cholinesterase ◽  
Acute Stage ◽  
Plasma Cholinesterase Activity ◽  
Small Doses

Eleven patients who suffered methomyl poisoning were admitted to the intensive care unit. All of them showed cholinergic symptoms similar to that produced by organophosphate insecticides but of lesser intensity. Plasma cholinesterase activity was normal in four patients and moderately lower in the remainder (always above 32%). All of the patients showed miosis and none presented with bradycardia. No complications were detected in the acute stage or on further examination a month later. The treatment applied was: (1) gastric lavage or washing the skin; (2) the administration of activated charcoal; (3) small doses of atropine according to symptoms (average of total dose 4.3 mg). All of the patients recovered within 24-48 h. In conclusion, we can assume that methomyl poisoning does not produce serious complications if moderate surveillance is assumed. Only small doses of atropine are required to counteract symptoms.

Elevated amylase is related to the development of respiratory failure in organophosphate poisoning

1996 ◽  
Vol 15 (3) ◽  
pp. 250-253 ◽  
Author(s):  
N. Matsumiya ◽  
M. Tanaka ◽  
M. Iwai ◽  
T. Kondo ◽  
S. Takahashi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Respiratory Failure ◽  
Activated Charcoal ◽  
Gastric Lavage ◽  
Ventilatory Support ◽  
Organophosphate Poisoning ◽  
Amylase Level ◽  
Normal Range

1 A retrospective study of organophosphate(OP) poison ing in the intensive care unit was performed to analyze the incidence of respiratory failure. 2 The patients were treated initially with gastrointest inal decontamination including gastric lavage and the administration of activated charcoal with cathartic. Further management included intravenous pralidoxim and atropine and ventilatory support. 3 Of the 32 OP poisoning patients, 16 patients developed respiratory failure and received ventilatory support. 4 An increase in plasma amylase above the normal range on the day of admission was related to the development of respiratory failure. 5 In OP poisoning, the elevation of amylase level was predictive of the subsequent respiratory failure.

Potentiation of Mivacurium Blockade by Low Dose of Pancuronium

2003 ◽  
Vol 98 (5) ◽  
pp. 1057-1062 ◽  
Author(s):  
Cyrus Motamed ◽  
Riad Menad ◽  
Robert Farinotti ◽  
Krassen Kirov ◽  
Xavier Combes ◽  
...  
Keyword(s):  
Acetylcholine Receptors ◽  
Low Dose ◽  
Cholinesterase Activity ◽  
Plasma Concentrations ◽  
Orotracheal Intubation ◽  
Plasma Cholinesterase ◽  
Neuromuscular Blocking ◽  
Pharmacokinetic Analysis ◽  
Plasma Cholinesterase Activity ◽  
Before And After

Background Mivacurium is potentiated by pancuronium to a much greater extent than other relaxants. In a previous investigation we suggested that this potentiation could be due to the ability of pancuronium to inhibit plasma cholinesterase activity, but we did not measure plasma concentrations of mivacurium. In the current study we performed a pharmacokinetic analysis by measuring the plasma concentration of mivacurium when preceded by administration of a low dose of pancuronium. Methods After induction of general anesthesia with propofol and fentanyl and orotracheal intubation, 10 patients (pancuronium-mivacurium group) received 15 microg/kg pancuronium followed 3 min later by 0.1 mg/kg mivacurium, whereas 10 other patients (mivacurium group) received saline followed by 0.13 mg/kg mivacurium 3 min later. Plasma cholinesterase activity was measured before and 3 and 30 min after pancuronium dosing in the pancuronium-mivacurium group and was measured before and after administration of saline in the mivacurium group. Arterial plasma concentrations of mivacurium and its metabolites were measured at 0.5, 1, 1.5, 2, 4, 10, 20, and 30 min after injection. Neuromuscular blockade was assessed by mechanomyography. Results Plasma cholinesterase activity decreased by 26% in the pancuronium-mivacurium group 3 min after injection of pancuronium (P < 0.01) and returned to baseline values 30 min later; however, no significant variation was observed in the mivacurium group. The clearances of the two most active isomers (Cis-Trans and Trans-Trans) were lower in the pancuronium-mivacurium group (17.6 +/- 5.1, 14.7 +/- 5.3 ml. min-1. kg-1, respectively) than in the mivacurium group (32.4 +/- 20.2, 24.8 +/- 13.5 ml. min-1. kg-1; P < 0.05). Conclusions A subparalyzing dose of pancuronium decreased plasma cholinesterase activity and the clearance of the two most active isomers of mivacurium. Pancuronium potentiates mivacurium more than other neuromuscular blocking agents because, in addition to its occupancy of postsynaptic acetylcholine receptors, it slows down the hydrolysis of mivacurium.

scholarly journals Topical Ophthalmic Cyclosporine in the Treatment of Toxic Epidermal Necrolysis

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Zafer Onaran ◽  
Gülşah Usta ◽  
Mukadder Koçak ◽  
Kemal Örnek ◽  
Ünase Büyükkoçak
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Toxic Epidermal Necrolysis ◽  
Ocular Surface ◽  
Acute Stage ◽  
Ocular Involvement ◽  
Pathologic Finding ◽  
Ocular Complication ◽  
Case Presentation ◽  
Intravenous Corticosteroid

Aim. To describe a case of toxic epidermal necrolysis (TEN) with ocular involvement treated with topical ophthalmic cyclosporine.Case Presentation. A 20-year-old woman developed TEN following administration of carbamazepine that was prescribed for epilepsy. Ophthalmic examination revealed bilateral pseudomembranous conjunctivitis. She was hospitalized in the intensive care unit and treated with intravenous corticosteroid and immunoglobulin. Topical cyclosporine was used in combination with topical corticosteroids for ocular surface disease. Following two months of ocular treatment, she recovered without any severe ocular complication. Ocular examination at the four-month followup showed a 2 mm of symblepharon in the lower fornix as the sole pathologic finding.Conclusion. Topical ophthalmic cyclosporine may contribute to decrease the ophthalmic complications of TEN and should be considered in the acute stage of the disease.

scholarly journals Use of high-flow nasal cannula and intravenous propofol sedation while performing flexible video bronchoscopy in the intensive care unit: Case reports

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110619
Author(s):  
Killen H Briones-Claudett ◽  
Mónica H Briones-Claudett ◽  
Bertha López Briones ◽  
Killen H Briones Zamora ◽  
Diana C Briones Marquez ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Total Dose ◽  
Male Patient ◽  
Flow System ◽  
High Flow ◽  
Nasal Cannula ◽  
Lung Field ◽  
High Flow Nasal Cannula ◽  
Propofol Sedation

Flexible video bronchoscopy is a procedure that plays an important role in diagnosing various types of pulmonary lesions and abnormalities. Case 1 is a 68-year-old male patient with a lesion in the right lung apex of approximately 4 mm × 28 mm with atelectasis bands due to a crash injury. High-flow system with 35 L/min and fraction of inspired oxygen (FiO2) 0.45 and temperature of 34 °C was installed prior to the video bronchoscopy. SpO2 was maintained at 98%–100%. The total dose of sedative was 50 mg of propofol. In Case 2, a 64-year-old male patient with bronchiectasis, cystic lesions and pulmonary fibrosis of the left lung field was placed on a high-flow system with 45 L/min and 0.35 FiO2 at a temperature of 34 °C. SpO2 was maintained at 100%. The total duration of the procedure was 25 min; SpO2 of 100% was sustained with oxygenation during maintenance time with the flexible bronchoscope within the airway. The total dose of propofol to reach the degree of desired sedation was 0.5–1 mg/kg. Both patients presented hypotension. For the patient of case 1, a vasopressor (norepinephrine at doses of 0.04 µg/kg/min) was given, and for the patient of case 2, only saline volume expansion was used. The video bronchoscopy with propofol sedation and high-flow nasal cannula allows adequate oxygenation during procedure in the intensive care unit.

Acceleration of Plasma Cholinesterase Activity by Quaternary Ammonium Salts

Science ◽  
1958 ◽  
Vol 128 (3315) ◽  
pp. 92-93 ◽  
Author(s):  
E. G. ERDOS ◽  
F. F. FOLDES ◽  
E. K. ZSIGMOND ◽  
N. BAART ◽  
J. A. ZWARTZ
Keyword(s):  
Quaternary Ammonium ◽  
Cholinesterase Activity ◽  
Plasma Cholinesterase ◽  
Quaternary Ammonium Salts ◽  
Ammonium Salts ◽  
Plasma Cholinesterase Activity
Sign in / Sign up

Export Citation Format

Share Document