Acute respiratory distress syndrome following intralipid emulsion therapy
2.5 out of 5 stars
Acute respiratory distress syndrome following verapamil overdose treated with intravenous lipid emulsion; A rare life-threatening complication. Martin C et al. Ann Fr Anesth Reanim 2014 [Epub ahead of print]
Reference
This interesting French case report is a textbook example of how not to use intralipid emulsion therapy (ILE) in calcium-channel-block (CCB) overdose.
It describes a 51-year-old woman who present to the emergency room 8 hours after ingesting forty 240 mg verapamil, a total of 9.6 grams. She was hypotensive and bradycardic, although alert and oriented. Initial echocardiography showed goo...
Source: The Poison Review - July 12, 2014 Category: Toxicology Authors: Leon Tags: Medical adverse drug reaction calcium channel blocker overdose intralipid emulsion therapy verapamil Source Type: news
trandolapril/verapamil extended-release - oral, Tarka
Title: trandolapril/verapamil extended-release - oral, TarkaCategory: MedicationsCreated: 3/2/2005 12:00:00 AMLast Editorial Review: 4/16/2014 12:00:00 AM (Source: MedicineNet High Blood Pressure General)
Source: MedicineNet High Blood Pressure General - April 16, 2014 Category: Cardiology Source Type: news
Do two dissimilar cases represent a case series?
2 out of 5 stars
High-dose Insulin and Intravenous Lipid Emulsion Therapy for Cardiogenic Shock Induced by Intentional Calcium-Channel Blocker and Beta-Blocker Overdose: A Case Series. Doepker B et al. J Emerg Med 2014 Apr;46:486-490.
Abstract
The problems with this confused and confusing paper start with the title, which suggests that it will describe a series patients who presented with overdose of a calcium-channel blocker (CCB) and beta-blocker (BB), who were treated with high-dose insulin (HDI) and intravenous lipid emulsion (ILE).
Well, this may be a case series, but the series includes only 2 patients, and ...
Source: The Poison Review - April 3, 2014 Category: Toxicology Authors: Leon Tags: Medical beta blocker overdose calcium channel blocker overdose high-dose insulin intralipid intravenous fat emulsion Source Type: news
The Top 7 Tox Articles of 2013
As we celebrate the year just ending, and welcome in 2014, let’s pause and remember some of the articles in the field of medical toxicology that most impressed TPR during 2013. The following 7 papers are listed in chronological order (links connect to TPR‘s discussion of each article):
Pediatric Marijuana Exposures in a Medical Marijuana State. Wang GS et al. JAMA Pediatr 2013 July;167:630-3 With several states legalizing recreational marijuana — and many more allowing medical marijuana — cases of inadvertent pediatric exposure to cannabis will undoubtedly increase, and it is important for emergency practi...
Source: The Poison Review - December 31, 2013 Category: Toxicology Authors: Leon Tags: Medical 2013 medical toxicology top articles Source Type: news
Calan SR (Verapamil Hydrochloride Sustained-Release Oral Caplets) - updated on RxList
(Source: RxList - New and Updated Drug Monographs)
Source: RxList - New and Updated Drug Monographs - December 3, 2013 Category: Drugs & Pharmacology Source Type: news
Lipid rescue therapy can cause lab errors
3 out of 5 stars
Caution with interpreting laboratory results after lipid rescue therapy. Punja M et al. Am J Emerg Med 2013 Aug 8 [Epub ahead of print]
No abstract available
This short case report from Emory University and the Georgia Poison Center makes the point that administering lipid rescue therapy (LRT) may affect laboratory results in ways that may be unanticipated. In the case, a 54-year-old man who ingested a mixed overdose of diphenhydramine, amitriptyline and acetaminophen. His initial aspartate aminotransferase level (measured on a Siemens Vista 1500 analyzer) was 138 U/L. After 20% IV lipids were given, a re...
Source: The Poison Review - August 22, 2013 Category: Toxicology Authors: Leon Tags: Medical aspartate aminogransferase AST erroneous lab values laboratory error lipid rescue therapy Source Type: news
Why Shouldn't I Drink Grapefruit Juice With My...
Any number of medications can apply to this question: Prozac, BuSpar, Tegretol, Verapamil, Prednisone and a host of others - even Viagra! There are a large number of other medications affected by grapefruit juice as well, including all the cholesterol-lowering statins and even some antibiotics and birth control pills. (Source: About.com Bipolar Disorder)
Source: About.com Bipolar Disorder - July 21, 2013 Category: Psychiatry Authors: bipolar.guide at about.com Tags: health Source Type: news
What are the Recommendations for Neuromaging Because of Headaches?
Discussion
Headaches are not only painful but can significantly affect the lives of patients and families. Education and support for patients is key to managing headaches. Detailed diaries not only help with initial diagnosis but also chronic management.
Common headache types include:
Tension headache
Location – bilateral
Intensity – mild or moderate
Description – non-pulsating tightening or pressure
Activities – not aggravated by usual activities
Duration – 30 minutes – continuous
Frequency – < 15 days/month for episodic tension headache, > 15 days per month for more than 3 mon...
Source: PediatricEducation.org - July 15, 2013 Category: Pediatrics Authors: Donna M. D'Alessandro, M.D. Tags: Uncategorized Source Type: news
Pressors or high-dose insulin for calcium channel blocker overdose?
4 out of 5 stars
What Is the Best Treatment for Acute Calcium Channel Blocker Overdose? Olson KR. Ann Emerg Med 2013 Apr 5 [Epub ahead of print]
Abstract
This excellent editorial is a comment on the paper by Levine et al, “Critical Care Management of Verapamil and Diltiazem Overdose with a Focus on Vasopressors: A 25-year Experience at a Single Center”. In that paper, which TPR reviewed last month, the authors advocated that fluids and vasopressors should be first-line treatment for hypotension and shock caused by overdose or verapamil or diltiazem, with high-dose insulin/euglycemia 9HIE) therapy used sparin...
Source: The Poison Review - June 21, 2013 Category: Toxicology Authors: Leon Tags: Medical calcium channel blocker overdose diltiazem high-dose insulin norepinephrine shock vasopressors verapamil Source Type: news
Are vasopressors effective therapy in calcium channel blocker overdose?
4 out of 5 stars
Critical Care Management of Verapamil and Diltiazem Overdose with a Focus on Vasopressors: A 25-Year Experience at a Single Center. Levine M et al. Ann Emerg Med 2013 May 1 {Epub ahead of print]
Abstract
This uncommonly interesting and thought-provoking study comes from the Department of Medical Toxicology at Banner Good Samaritan Medical Center in Phoenix. The authors note that in recent years, many toxicologists have suggested that hyperinsulinemic euglycemic therapy (HIT) is superior to vasopressors in the treatment of calcium channel blocker (CCB) toxicity. However, there have been no studies compari...
Source: The Poison Review - May 18, 2013 Category: Toxicology Authors: Leon Tags: Best of TPR Medical calcium channel blocker toxicity diltiazem hyperinsulinemic euglycemic therapy verapamil Source Type: news
The many potential problems with using dabigatran
3.5 out of 5 stars
Dabigatran: Uncharted Waters and Potential Harms. Radecki RP. Ann Intern Med 2012;157:66-68.
No abstract available
The Institute for Safe Medication Practices has reported that soon after its approval in October 2010, the oral direct thrombin inhibitor dabigatran etexilate (Pradaxa) was associated with a higher incidence of adverse events than almost any other drug.
In this opinion piece, Ryan Radecki — curator and author of the essential blog Emergency Medicine Literature of Note — reviews some of the factors contributing to this alarming alarming association:
Dabigatran etexilate is avail...
Source: The Poison Review - January 23, 2013 Category: Toxicology Authors: Leon Tags: Medical adverse effects complications dabigatran pradaxa Source Type: news
