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Overdoses with Aripiprazole: Signs, Symptoms and Outcome in 239 Exposures Reported to the Danish Poison Information Centre

In conclusion, we found that aripiprazole overdoses had few and mild symptoms predominantly related to the sedative properties. We detected a benign cardiovascular safety profile and no new safety concerns. Our findings may support an increased threshold of 300 mg for hospital admission after a single‐drug exposure with aripiprazole and symptoms not worse than light sedation.
Source: Basic and Clinical Pharmacology and Toxicology - Category: Drugs & Pharmacology Authors: Tags: Original Article Source Type: research

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Alexander Gettler Once again, last year’s outstanding examples of long-form journalism dealing with topics related to medical toxicology were dominated by coverage of the opioid crisis, its origins and the resulting carnage. The must-read article of the year was “The Family That Built a Empire of Pain,” Patrick Radden Keefe’s massive history of the Sacklers, one of America’s richest clans, much of whose wealth comes from their ownership of Purdue Pharma and the marketing and distribution of Oxycontin. The article, which appeared in the New Yorker, notes that the clan’s patriarch, Ar...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical 2017 Alexander awards opioids Purdue Pharma Sackler Source Type: news
We report a case in which activated-charcoal column hemoperfusion was dramatically effective for life-threatening disopyramide poisoning. Patient concerns: A teenage girl who had overdosed on disopyramide (total dose, 4950 mg) was brought to our hospital. She was resuscitated from short period cardiopulmonary arrest and subsequently showed severe cardiogenic shock and ventricular arrhythmia. Diagnoses: Disopyramide poisoning (self-evident). Interventions: As hemodynamics remained unstable after providing percutaneous cardiopulmonary support and intra-aortic balloon pumping, we attempted direct hemoperfusion using a ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Conclusion and Recommendations More intervention-based clinical trials are needed to provide a strong alternative candidate therapy for management of opiate use disorder. Buprenorphine, although a promising candidate, should be researched more regarding treatment retention and patient satisfaction before any conclusions can be made regarding its standard use for opiate substitution maintenance treatment of pregnant patients with opiate use disorder. Heroin-assisted treatment still cannot be considered in opiate addicts refractory to MMT; more data should be collected regarding efficacy in larger participant populations un...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Current Issue General Review buphernorphin heroin methadone opiate opiate addiction treatment withdrawal Source Type: research
In conclusion, we found that aripiprazole overdoses had few and mild symptoms predominantly related to the sedative properties. We detected a benign cardiovascular safety profile and no new safety concerns. Our findings may support an increased threshold of 300 mg for hospital admission following a single‐drug exposure with aripiprazole and symptoms not worse than light sedation. This article is protected by copyright. All rights reserved.
Source: Basic and Clinical Pharmacology and Toxicology - Category: Drugs & Pharmacology Authors: Tags: Original Article Source Type: research
Authors: Pillans PI, Page CB, Ilango S, Kashchuk A, Isbister GK Abstract OBJECTIVE: To examine the epidemiology and severity of self-poisoning by older people in Australia; to compare these data with those for overdoses in younger adults. DESIGN, SETTING, PARTICIPANTS: A cohort study of people presenting to a tertiary toxicology centre after self-poisoning over 26 years (1987-2012). MAIN OUTCOME MEASURES: Hospital length of stay (LOS); types of drug ingested; intensive care unit (ICU) admissions; in-hospital deaths. RESULTS: Of 17 276 admissions, 626 patients (3.6%) were at least 65 years old. There was...
Source: Medical Journal of Australia - Category: Journals (General) Tags: Med J Aust Source Type: research
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Source: The Poison Review - Category: Toxicology Authors: Tags: Medical AMB-FUBINACA Brooklyn synthetic cannabinoid zombie Source Type: news
We report two cases of severe bupropion toxicity resulting in refractory cardiogenic shock, cardiac arrest, and repeated seizures treated successfully. Patients with cardiovascular failure related to poisoning may particularly benefit from extracorporeal membrane oxygenation (ECMO). These are the first cases of bupropion toxicity treated with veno-arterial EMCO (VA-ECMO) in which bupropion toxicity is supported by confirmatory testing. Both cases demonstrate the effectiveness of VA-ECMO in poisoned patients with severe cardiogenic shock or cardiopulmonary failure. PMID: 26856351 [PubMed - as supplied by publisher]
Source: Journal of Medical Toxicology - Category: Toxicology Authors: Tags: J Med Toxicol Source Type: research
Antihistamines are commonly used to treat allergy, dizziness and nausea. The sedating antihistamines are non-specific in their actions and often have marked anticholinergic effects. Features of toxicity are likely to develop within 6 hours of overdose and include tachycardia, blood pressure disturbances, dry mouth, ataxia, agitation, psychosis and, uncommonly, convulsions or arrhythmias. Sedation is exacerbated by co-ingestion of other central nervous system depressants including alcohol. Non-sedating antihistamines are less toxic in overdose but may cause tachycardia, drowsiness, gastrointestinal disturbances and headache.
Source: Medicine - Category: Internal Medicine Authors: Tags: Specific substances Source Type: research
Publication date: Available online 28 November 2015 Source:Journal of Cardiology Cases Author(s): Mari Amino, Koichiro Yoshioka, Yuji Ikari, Sadaki Inokuchi Tizanidine hydrochloride, α2-receptor stimulant, is a central muscle relaxant. Etizolam is a benzodiazepine-based anti-anxiety agent. Both drugs are widely used for the treatment of a variety of muscle pain and frequently used together in Japan. We experienced a case of complicating prolonged myocardial dysfunction in a 56-year-old woman. Six hours after overdose of 48mg tizanidine and 24mg etizolam, she showed sinus bradycardia and peripheral vascular resi...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research
4 out of 5 stars Flumazenil, naloxone and the ‘coma cocktail’ Sivilotti MLA Br J Clin Pharmacol 2015 Aug 7 [Epub ahead of print] Abstract This very smart paper reviews factors affecting the clinical use of two antidotes that reliably reverse  coma caused by two major classes of poisons: flumazenil for benzodiazepines, and naloxone for opiates. Both these antidotes are specific, rapid-acting, short-lived, and titratable. However, significant adverse effects have been associated with each of them. Unwise or overly aggressive administration of flumazenil can cause acute benzodiazepine withdrawal, agitati...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical antidote benzodiazepine coma cocktail flumazenil naloxone opiate Source Type: news
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