Toxic Effects of Disulfiram Therapy. With Two Case Reports

AbstractThe aim of this systematic review was to perform qualitative and quantitative analysis on the toxic effects of chloroquine (CQ) and hydroxychloroquine (HCQ) on skeletal muscles. We designed the study according to PRISMA guidelines. Studies for qualitative and quantitative analyses were selected according to the following inclusion criteria: English language; size of sample (> 5 patients), adult (> age of 18) patients, treated with CQ/HCQ for inflammatory diseases, and presenting and not presenting with toxic effects on skeletal muscles. We collected data published from 1990 to April 2020 using PubMed, Cochrane Library, EMBASE, and SciELO. Risk of bias for observational studies was assessed regarding the ROBIN-I scale. Studies with less than five patients (case reports) were selected for an additional qualitative analysis. We used the software Comprehensive Meta-Analysis at the confidence level of 0.05. We identified 23 studies for qualitative analysis (17 case-reports), and five studies were eligible for quantitative analysis. From case reports, 21 patients presented muscle weakness and confirmatory biopsy for CQ/HCQ induced myopathy. From observational studies, 37 patients out of 1,367 patients from five studies presented muscle weakness related to the use of CQ/HCQ, and 252 patients presented elevated levels of muscle enzymes (aldolase, creatine phosphokinase, and lactate dehydrogenase). Four studies presented data on 34 patients with confirmatory biopsy for drug-induced myopathy. No study presented randomized samples. The chronic use of CQ/HCQ may be a risk for drug-induced myopathy. There is substantiated need for proper randomized trials and controlled prospective studies needed to assess the clinical and subclinical stages of CQ/HCQ -induced muscle myopathy.

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Peaked “T” Waves with Tranylcypromine (Parnate) Overdose

The International Journal of Psychiatry in Medicine ◽

10.2190/qa6e-7q65-5kwb-8pr2 ◽

1982 ◽

Vol 11 (2) ◽

pp. 155-160 ◽

Cited By ~ 5

Author(s):

Timothy E. Quill

Keyword(s):

Monoamine Oxidase ◽

Intracranial Hemorrhage ◽

Case Reports ◽

Monoamine Oxidase Inhibitors ◽

Toxic Effects ◽

Recent Case ◽

Clinical Use ◽

Ecg Changes ◽

T Waves

A case of tranylcypromine (Parnate) overdose is presented in which the main toxic effects were headache, obtundation, hypertension, and diffusely peaked T-waves on ECG. The latter effect, which occurred in the absence of hyperkalemia, has not been previously associated with monoamine oxidase inhibitors (MAOI). Recent case reports of tranylcypromine toxicity are briefly reviewed, confirming the potential for hypertension, hypotension, shock, hyperpyrexia, intracranial hemorrhage, agitation, hyperkinesis, coma and death in association with overdosage, or concommitant ingestion of sympathomimetic substances or other drugs. These ECG changes add to the worrisome list of potential toxicities in an era in which MAOI are finding increased clinical use.

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Intravenous Lipids: Antidotal Therapy for Drug Overdose and Toxic Effects of Local Anesthetics

Critical Care Nurse ◽

10.4037/ccn2014755 ◽

2014 ◽

Vol 34 (5) ◽

pp. 62-66 ◽

Cited By ~ 2

Author(s):

Dana Bartlett

Keyword(s):

Cardiac Arrest ◽

Critical Care ◽

Local Anesthetics ◽

Lipid Emulsion ◽

Case Reports ◽

Psychotropic Medications ◽

Critical Care Nurses ◽

Toxic Effects ◽

Intravenous Lipids ◽

Antidotal Therapy

Intravenous lipid emulsion is an accepted therapy for the treatment of severe cardiac toxic effects caused by local anesthetics. Lipid emulsion therapy has also been used successfully to treat cardiac arrest and intractable arrhythmias caused by overdoses of antiepileptic drugs, cardiovascular drugs, and psychotropic medications, but experience with intravenous lipids as antidotal therapy in these clinical situations is limited. However, intravenous lipids are relatively safe, widely available, and easy to administer, and many published case reports document their dramatic effectiveness. Patients who have not responded to standard therapies have been quickly revived by administration of intravenous lipids. Use of lipids most likely will increase, and critical care nurses should be familiar with lipid therapy.

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Safety profile of lamotrigine in overdose

Therapeutic Advances in Psychopharmacology ◽

10.1177/2045125316656707 ◽

2016 ◽

Vol 6 (6) ◽

pp. 369-381 ◽

Cited By ~ 9

Author(s):

Akintunde Alabi ◽

Adam Todd ◽

Andrew Husband ◽

Joe Reilly

Keyword(s):

Mental Disorders ◽

Drug Overdose ◽

Safety Profile ◽

Case Reports ◽

Mood Stabilizer ◽

Evidence Base ◽

Toxic Effects ◽

Qtc Interval ◽

Narrative Synthesis ◽

Increased Risk

Background: Lamotrigine is an anticonvulsant as well as a mood stabilizer. Apart from its established use in the treatment of epilepsy, there has been an expansion of its use in the treatment of mental disorders. Patients with epilepsy as well as those with mental disorders are at increased risk of deliberate drug overdoses. An evidence base for the safety profile of lamotrigine in overdose is an essential tool for prescribers. The objective of this study was to carry out a narrative synthesis of the existing evidence for the safety profile of lamotrigine in overdose. Methods: A systematic search was conducted of EMBASE (1974 to December 2015), MEDLINE (1946 to December 2015), PsycINFO (1806 to December 2015) and CINAHL (1981 to December 2015) databases. Studies were included in which there was a deliberate or accidental single drug overdose of lamotrigine, with its toxic effects described. Studies that did not involve an overdose were excluded. A narrative synthesis of the described toxic effects was carried out. Results: Out of 562 articles identified, 26 studies were included, mainly in the form of case reports and series. The most commonly described toxic effects of lamotrigine were on the central nervous system, specifically seizures, movement disorders and reduced consciousness. Other toxic effects included QTc interval and QRS complex prolongations, hypersensitivity reactions, serotonin syndrome as well as rhabdomyolysis possibly due to seizures and/or agitation. Deaths were recorded in two studies, with cardiovascular and neurological toxic effects described. Conclusions: Even though lamotrigine has been reported to be well tolerated, there is a risk of toxic effects which can be life threatening in overdose. This needs to be borne in mind when prescribing to patients at an increased risk of deliberate drug overdose.

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Ultrastructure of the effect of T-514 obtained from Karwinskia humboldtiana on assembly and integrity of yeast's peroxisomes

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100084983 ◽

1991 ◽

Vol 49 ◽

pp. 136-137

Author(s):

J. Sepulveda-Saavedra ◽

I. Vander-Klei ◽

M. Venhuis ◽

Y. Piñeyro-Lopez

Keyword(s):

Culture Conditions ◽

Toxic Effects ◽

Candida Boidinii ◽

Central Mexico ◽

Poisonous Plant ◽

Biological Behaviour ◽

Enzyme Content ◽

Fat Deposits ◽

Yeast Model

Karwinskia humboldtiana is a poisonous plant that grows in semi desertic areas in north and central México. It produces several substances with different toxic effects. One of them designated T-514 damages severely the lung, kidney and liver, producing in the hepatoeyte large intracellular fat deposits and necrosis. Preliminary observations demonstrated that three is a decrease in the amount of peroxisomes in the hepatocytes of experimentally intoxicated rats and monkeys. To study the effect exerted by the T-514 on peroxisomes, a yeast model was selected, thus, three species: Saccha romices cerevisiae, Ilansenula polymorpha and Candida boidinii were used, because there is information concerning their peroxisome's morphology, enzyme content, biological behaviour under different culture conditions and biogenesis.

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Some Conditions Necessary for Pinocytosis

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100100457 ◽

1968 ◽

Vol 26 ◽

pp. 142-143

Author(s):

M. W. Brightman

Keyword(s):

Smooth Muscle ◽

Cell Membrane ◽

Toxic Effects ◽

Cytological Evidence ◽

Cell Processes

The cytological evidence for pinocytosis is the focal infolding of the cell membrane to form surface pits that eventually pinch off and move into the cytoplasm. This activity, which can be inhibited by oxidative and glycolytic poisons, is performed only by cell processes that are at least 300A wide. However, the interpretation of such toxic effects becomes equivocal if the membrane invaginations do not normally lead to the formation of migratory vesicles, as in some endothelia and in smooth muscle. The present study is an attempt to set forth some conditions under which pinocytosis, as distinct from the mere inclusion of material in surface invaginations, can take place.

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