ACMT Position Statement: Toxicology Issues in Determining Brain Death

4 out of 5 stars ACMT Position Statement: Determining Brain Death in Adults After Drug Overdose. Neavyn MJ et al. J Med Toxicol 2017;13:271-273. Full Text The American Academy of Neurology guidelines on determining brain death in adults states that the clinician can not make such a determination unless he or she can  “[e]xclude the presence of a CNS-depressant drug effect by history, drug screen, calculation of clearance using 5 times the drug’s half-life (assuming normal hepatic and renal function), or, if available, drug plasma levels below the therapeutic range.” Excluding drug effect in these cases is not at all straightforward, and this position statement — developed by the American College of Medical Toxicology and endorsed by both the American Academy of Clinical Toxicology and the Society of Critical Care Medicine — discusses the crucial nuances that must be considered. The authors note that a drug screen can neither exclude intoxication nor establish a clinical significant depressant effect. They also point out that while a period of 5 half-lives in generally considered time enough for a drug to be essentially eliminated from the system, in overdose situations all bets are off. In overdose, standard assumptions about rates of drug absorption and elimination go out the window. In addition, with massive overdose, the amount of drug remaining in the CNS can still be clinically significant. For example, although baclofen has a...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical american college of medical toxicology baclofen brain death position statement Source Type: news

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This article is republished from The Conversation under a Creative Commons license. Read the original article. The post Why More Must be Done to Fight Bogus COVID-19 Cure Claims appeared first on Inter Press Service.
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Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
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Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
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Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
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Source: Molecules - Category: Chemistry Authors: Tags: Review Source Type: research
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Source: Molecules - Category: Chemistry Authors: Tags: Review Source Type: research
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