193 results match your criteria Whole-Bowel Irrigation


Sustained stimulation? Characteristics of modified release and immediate release stimulant exposures reported to the national poison data system.

Clin Toxicol (Phila) 2020 Jul 1:1-8. Epub 2020 Jul 1.

University of Kansas Medical Center, Kansas City, KS, USA.

We sought to examine ADHD modified release (MR) and immediate release (IR) stimulant ingestion exposures reported to the National Poison Data System (NPDS) to characterize the nature of the exposures and the outcomes associated with them. The NPDS was queried for all single-substance exposures to MR and IR ADHD preparations between January 1, 2007 and December 31, 2017. MR and IR preparations were identified by a generic code of "amphetamine and related compounds" or "methylphenidate" and specific product name containing XR, CD, ER, LA, and SR. Read More

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http://dx.doi.org/10.1080/15563650.2020.1787428DOI Listing

Whole bowel irrigation in dapsone intoxication with persistent methemoglobinemia: A case report.

Am J Emerg Med 2020 May 23. Epub 2020 May 23.

Intensive Care Unit, Sanatorio Franchin, Buenos Aires, Argentina.

Dapsone intoxication can be a life-threatening condition due its enterohepatic recirculation pharmacokinetics, and therefore, persistent methemoglobinemia development. We describe a case of a 17-year-old girl who was admitted 4 h after ingesting 5 g of dapsone. She presented methemoglobinemia (39%) and showed clinical signs of toxicity (cyanosis and altered mental status) despite mechanical ventilation. Read More

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http://dx.doi.org/10.1016/j.ajem.2020.05.056DOI Listing

Outcomes of acute exploratory pediatric lithium ingestions.

Clin Toxicol (Phila) 2020 Jan 8:1-5. Epub 2020 Jan 8.

Maryland Poison Center, University of Maryland School of Pharmacy, Baltimore, MD, USA.

To date, very little literature describes the outcomes of acute unintentional ingestions of lithium in young children. This study aimed to describe the clinical effects and outcomes reported in these patients reported to the National Poison Data System (NPDS). This is a retrospective observational study of acute unintentional lithium ingestions in children <6 years of age. Read More

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http://dx.doi.org/10.1080/15563650.2019.1704772DOI Listing
January 2020

Characteristics of emergency department presentations requiring consultation of the national Poisons Information Centre.

Swiss Med Wkly 2019 Dec 17;149:w20164. Epub 2019 Dec 17.

Department of Emergency Medicine, Inselspital, University Hospital Bern, University of Bern, Switzerland.

Aims Of The Study: To describe the characteristics of cases presenting at the emergency department due to (suspected) poisoning for which consultation on patient management with the national Poisons Information Centre was required.

Methods: Retrospective study at the emergency department of Bern University Hospital, Switzerland, from May 2012 to December 2017. Cases were identified in the electronic patient database using appropriate full-text search terms. Read More

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http://dx.doi.org/10.4414/smw.2019.20164DOI Listing
December 2019

Polyethylene glycol electrolyte lavage solution increases tablet dissolution of acetaminophen in an in vitro model mimicking acute poisoning.

Am J Emerg Med 2020 02 12;38(2):325-328. Epub 2019 Sep 12.

University of California, San Diego, Department of Emergency Medicine, San Diego, CA, United States of America; California Poison Control System - San Diego Division, San Diego, CA, United States of America.

Introduction: Polyethylene glycol electrolyte lavage solution (PEG-ELS) is similar to pharmaceutical solvent propylene glycol and used following acute poisonings for whole bowel irrigation (e.g., "body stuffing"). Read More

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http://dx.doi.org/10.1016/j.ajem.2019.158444DOI Listing
February 2020

Pennies for Your Thoughts: A Case Series of Pancytopenia Due to Zinc-induced Copper Deficiency in the Same Patient.

Clin Pract Cases Emerg Med 2019 Nov 14;3(4):341-344. Epub 2019 Oct 14.

Wayne State University, Department of Emergency Medicine, Detroit, Michigan.

A 47-year-old schizophrenic male presented on three separate occasions with pancytopenia and sideroblastic anemia due to copper deficiency from massive zinc penny ingestion. The poisoning was treated differently on each visit: intravenous (IV) copper plus surgical decontamination and chelation with calcium disodium versenate (CaNa2EDTA); IV copper plus whole bowel irrigation; and IV copper with surgical decontamination only. Serum zinc half-lives were 80. Read More

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http://dx.doi.org/10.5811/cpcem.2019.7.43697DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6861045PMC
November 2019

Successful Medical Management of Methamphetamine Induced Ileus; A Rare Case Report and Literature Review.

Bull Emerg Trauma 2019 Jul;7(3):320-323

Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.

Ileus is a very rare complication of methamphetamine (MET) intoxication. We herein report a 15-year-old non-addict girl who ingested about 5 gr of MET. She suffered from bowel obstruction manifestations. Read More

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http://dx.doi.org/10.29252/beat-0703017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681882PMC
July 2019
5 Reads

An epidemiological snapshot of toxicological exposure in children 12 years of age and younger in Riyadh.

Ann Saudi Med 2019 Jul-Aug;39(4):229-235. Epub 2019 Aug 5.

From the Department of Pediatrics, King Saud Medical City, Riyadh, Saudi Arabia.

Background: Poisoning among the pediatric population is an important public health concern that is responsible for frequent pediatric emergency department visits and hospital admissions. Surveillance of poisoning cases is essential for designing and implementing effective preventive strategies.

Objective: Describe the characteristics of acute poison exposure and related therapeutic interventions in children aged 12 years and younger. Read More

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http://dx.doi.org/10.5144/0256-4947.2019.229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6838645PMC
January 2020
4 Reads

Successful use of the two-tube approach for the treatment of phenobarbital poisoning without hemodialysis.

Am J Emerg Med 2019 09 21;37(9):1809.e1-1809.e3. Epub 2019 Jun 21.

Department of Critical Care Medicine and Trauma, National Hospital Organization Disaster Medical Center, 3256 Midori-cho, Tachikawa City, Tokyo 190-0014, Japan.

Half-life of the antipsychotic vegetamin is very long, partially due to the presence of phenobarbital, and mortality due to phenobarbital poisoning is high. Here, we present the case of a 22-year-old female admitted to the emergency department with disturbed consciousness due to vegetamin overdose. Her blood phenobarbital level was elevated to 123 μg/ml. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.06.036DOI Listing
September 2019
9 Reads

[Treating poisoning; how do you choose the best type of gastrointestinal decontamination?]

Ned Tijdschr Geneeskd 2018;162:D1574

St Antonius Ziekenhuis, afd. Klinische Farmacie, Nieuwegein.

- A new guideline: 'Intoxication: initial approach in the hospital' will be published this year. This guideline sets out the latest insights on gastrointestinal decontamination in intoxication; the advice is summarized in a flowchart.- The advice is to generally administer activated charcoal, unless there are indications that the toxin will not bind to activated charcoal or that the amount of toxin that the patient has ingested is too great; in these cases gastric lavage can be considered. Read More

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December 2018
12 Reads

Pediatric Orbeez Ingestions Reported to Texas Poison Centers.

Pediatr Emerg Care 2019 Jun;35(6):426-427

From the Department of State Health Services, Austin, TX.

Objectives: There is concern that ingestion of superabsorbent polymer toys, which can absorb large amounts of fluid and increase greatly in volume, may pose a risk if swallowed by children.The intent of this study was to characterize pediatric Orbeez ingestions reported to a statewide poison center system.

Methods: Cases were Orbeez ingestions among patients 19 years or younger reported to Texas poison centers during January 2011 to June 2016. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001227DOI Listing
June 2019
45 Reads

Intentional ingestion of elemental mercury requiring multi-step decontamination and prophylactic appendectomy: a case report and treatment proposal.

Clin Toxicol (Phila) 2018 Jan 26;56(1):69-73. Epub 2017 Jun 26.

c Department of Internal Medicine, Gastroenterology Unit , Ospedale dell'Angelo and Ospedale SS Giovanni e Paolo , Venice , Italy.

Background: Ingestion of elemental mercury (Hg0) is considered non-toxic. After massive ingestion, local intestinal complications may develop: retention within appendix is quite frequent but treatment is debated. We describe a case of intentional ingestion of Hg0 requiring multi-step decontamination and prophylactic appendectomy. Read More

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http://dx.doi.org/10.1080/15563650.2017.1338346DOI Listing
January 2018
66 Reads
3.122 Impact Factor

Chemical Hand Warmer Packet Ingestion: A Case of Elemental Iron Exposure.

Wilderness Environ Med 2017 Sep 17;28(3):246-248. Epub 2017 Jun 17.

Department of Emergency Medicine, Lehigh Valley Hospital/USF Morsani College of Medicine, Allentown, Pennsylvania. Electronic address:

For individuals who work outdoors in the winter or play winter sports, chemical hand warmers are becoming increasingly more commonplace because of their convenience and effectiveness. A 32-year-old woman with a history of chronic pain and bipolar disorder presented to the emergency department complaining of a "warm sensation" in her mouth and epigastrium after reportedly ingesting the partial contents of a chemical hand warmer packet containing between 5 and 8 g of elemental iron. She had been complaining of abdominal pain for approximately 1 month and was prescribed unknown antibiotics the previous day. Read More

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http://dx.doi.org/10.1016/j.wem.2017.04.006DOI Listing
September 2017
24 Reads

The Influence of Polyethylene Glycol Solution on the Dissolution Rate of Sustained Release Morphine.

J Med Toxicol 2016 12 13;12(4):391-395. Epub 2016 Jun 13.

Institute of Analytical Chemistry and Food Chemistry, Graz University of Technology, Graz, Austria.

Introduction: Whole bowel irrigation (WBI) is a management option for overdose of medications poorly adsorbed to activated charcoal, with modified release properties, or for body packers. Polyethylene glycol (PEG) is a mixture of ethylene oxide polymers of varying molecular weight. PEG with an average molecular weight of 3350 g/mol is used for WBI. Read More

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http://dx.doi.org/10.1007/s13181-016-0561-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5135674PMC
December 2016
43 Reads

Calcium channel antagonist and beta-blocker overdose: antidotes and adjunct therapies.

Br J Clin Pharmacol 2016 Mar 30;81(3):453-61. Epub 2015 Oct 30.

Monash Health Clinical Toxicology and Addiction Medicine Service, Monash Health, Dandenong Hospital, David Street, Dandenong, VIC, 3175, Australia.

Management of cardiovascular instability resulting from calcium channel antagonist (CCB) or beta-adrenergic receptor antagonist (BB) poisoning follows similar principles. Significant myocardial depression, bradycardia and hypotension result in both cases. CCBs can also produce vasodilatory shock. Read More

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http://dx.doi.org/10.1111/bcp.12763DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767195PMC
March 2016
37 Reads

Two Year Old With Water Bead Ingestion.

Pediatr Emerg Care 2015 Aug;31(8):605-7

From the Children's Mercy Hospital and Clinics, Kansas City, MO.

Foreign body ingestion is a common pediatric complaint. Two case reports describe intestinal obstruction in children from an ingestion of a single superabsorbent water ball, requiring surgical removal. We describe nonsurgical management of an asymptomatic child who ingested approximately 100 superabsorbent water beads. Read More

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http://pdfs.journals.lww.com/pec-online/2015/08000/Two_Year_
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http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:land
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http://dx.doi.org/10.1097/PEC.0000000000000520DOI Listing
August 2015
37 Reads

What is the main target: a clearer colon with a sennoside-based regime, or adequate bowel cleansing before colonoscopy with a PEG-EL-based regime?

Turk J Med Sci 2015 ;45(2):404-8

Background/aim: Even though polyethylene glycol-electrolyte lavage (PEG-EL)-based regimes have become the gold standard in recent years, to finish drinking 4 L of PEG-EL solution can be difficult. The quality of sennoside-based bowel-cleansing regimes used in Turkey has been known for some time. Therefore, we aimed to investigate the efficacy of both bowel-cleansing regimes. Read More

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http://journals.tubitak.gov.tr/medical/issues/sag-15-45-2/sa
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http://dx.doi.org/10.3906/sag-1402-86DOI Listing
July 2015
27 Reads
0.841 Impact Factor

[Iron intoxication--poisoning with easily accessible medicines].

Lakartidningen 2014 Sep 17-23;111(38):1576-7

A 20-year-old woman was found semiconscious on the floor in a pool of black diarrhea with an empty 100 jar of ferrous sulphate beside her (100 mg Fe2+/tablet), 160 mg/kg. She was brought to the hospital an estimated 4 hours after ingestion and presented with irritability and a fluctuating CNS depression. Her blood pressure was 190/85 mmHg and pulse 130 bpm. Read More

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February 2015
16 Reads

Symptomatic Exposures Among California Inmates 2011-2013.

J Med Toxicol 2015 Sep;11(3):309-16

Department of Internal Medicine, Tulane University Medical Center, New Orleans, LA, USA,

Prisoners have a high prevalence of substance misuse and abuse, but few studies have examined symptomatic exposures among incarcerated populations. We sought to further characterize the nature of these exposures among this population using the California Poison Control System data. Keyword searches identified inmate cases in 2011-2013 for patients 20+ years old exposed to a single substance and taken to hospital from jail, prison, or police custody. Read More

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http://link.springer.com/10.1007/s13181-014-0456-6
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http://dx.doi.org/10.1007/s13181-014-0456-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4547960PMC
September 2015
28 Reads

Position paper update: whole bowel irrigation for gastrointestinal decontamination of overdose patients.

Clin Toxicol (Phila) 2015 Jan 16;53(1):5-12. Epub 2014 Dec 16.

European Association of Poisons Centres and Clinical Toxicologists , Brussels , Belgium.

Context: A position paper on the use of whole bowel irrigation (WBI) was first published in 1997 by the American Academy of Clinical Toxicology (AACT) and the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) and updated in 2004. The aims of this paper are to briefly summarize the content of the 2004 Position Paper and to present any new data and recommendations.

Methods: A systematic review of the literature from January 2003 to February 28, 2013 was conducted using multiple online databases for articles concerning WBI for gastrointestinal decontamination. Read More

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http://dx.doi.org/10.3109/15563650.2014.989326DOI Listing
January 2015
39 Reads

Extended release potassium salts overdose and endoscopic removal of a pharmacobezoar: A case report.

Toxicol Rep 2014 22;1:209-213. Epub 2014 May 22.

Residente de Toxicología Hospital Angeles Lomas, Vialidad de la Barranca No. 14, Colonia Valle de las Palmas, Huixquilucan, Estado de México CP 52787, Mexico.

Background: Reported cases of potassium overdoses have shown that this condition could generate several morbidities, mainly related to cardiac dysrhythmias even with fatal outcomes in some cases. Potassium salts in extended release tablets could form pharmacobezoars if a large amount is ingested. In relation to the above, when the patient has a pharmacobezoar, clinical findings may be delayed and may persist. Read More

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http://dx.doi.org/10.1016/j.toxrep.2014.04.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598358PMC
May 2014
14 Reads

Endoscopic removal of pharmacobezoar in case of intentional potassium overdose.

J Emerg Med 2014 Mar 7;46(3):351-4. Epub 2013 Oct 7.

Department of Emergency Medicine, Carilion Roanoke Memorial Hospital, Roanoke, Virginia; Department of Pharmacy, Carilion Roanoke Memorial Hospital, Roanoke, Virginia.

Background: Hyperkalemia is a potentially life-threatening electrolyte abnormality commonly seen in the emergency department (ED). Intentional overdose of potassium supplements is an uncommon occurrence.

Objective: This case illustrates a novel approach to treatment of pharmacobezoar with esophagogastroduodenoscopy (EGD) and demonstrates its effectiveness in the setting of extended-release potassium chloride overdose. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07364679130094
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http://dx.doi.org/10.1016/j.jemermed.2013.08.031DOI Listing
March 2014
13 Reads

Factors associated with severe effects following acute glufosinate poisoning.

Clin Toxicol (Phila) 2013 Nov 18;51(9):846-9. Epub 2013 Sep 18.

Department of Emergency Medicine, Iwate Medical University, School of Medicine , Morioka, Iwate , Japan.

Context: In acute glufosinate poisoning, sudden respiratory arrest and convulsion can occur after a latent period of 4-60 h. There is still no factor that accurately predicts the occurrence of these symptoms.

Objective: To elucidate the predictors of severe effects following acute glufosinate poisoning. Read More

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http://dx.doi.org/10.3109/15563650.2013.841180DOI Listing
November 2013
9 Reads

Mechanical bowel preparation and prophylactic antibiotic administration in colorectal surgery: a survey of the current status in Korea.

Ann Coloproctol 2013 Aug 29;29(4):160-6. Epub 2013 Aug 29.

Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.

Purpose: The usefulness of mechanical bowel preparation (MBP) in colon surgery was recently challenged by many multicenter clinical trials and meta-analyses. The objectives of this study were to investigate current national opinions about MBP and prophylactic antibiotics (PA) and to provide preliminary data for developing future Korean guidelines for MBP and PA administration in colorectal surgery.

Methods: A questionnaire was mailed to 129 colorectal specialists. Read More

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http://dx.doi.org/10.3393/ac.2013.29.4.160DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767866PMC
August 2013
41 Reads

Lithium poisoning: the value of early digestive tract decontamination.

Clin Toxicol (Phila) 2013 May 9;51(4):243-8. Epub 2013 Apr 9.

CHU Angers, Pôle Médecines Intensives et spécialisées, Centre antipoison et Toxicovigilance, Angers, France.

Objective: The objective of this study was to evaluate the effects of early digestive tract decontamination on the severity of acute-on-chronic lithium poisoning (acute poisoning in patients under long-term therapy).

Materials And Methods: This was an observational and retrospective study of acute-on-chronic lithium overdoses recorded by the Angers Poisons and Toxicovigilance Centre between February 2006 and September 2010. The cases of overdose were divided into two groups: those undergoing early decontamination (by sodium polystyrene sulphonate and/or whole bowel irrigation) and those in whom decontamination was delayed (> 12 h) or not performed. Read More

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http://dx.doi.org/10.3109/15563650.2013.782409DOI Listing
May 2013
17 Reads

Position paper update: ipecac syrup for gastrointestinal decontamination.

Clin Toxicol (Phila) 2013 Mar 13;51(3):134-9. Epub 2013 Feb 13.

European Association of Poison Centres and Clinical Toxicologists.

Context: An update of the first position paper on ipecac syrup from 1997 was published by the American Academy of Clinical Toxicology and the European Association of Poison Centres and Clinical Toxicologists in 2004. The aims of this paper are to briefly summarize the content of the 2004 Position Paper and to present any new data.

Methods: A systematic review of the literature from the year 2003 forward. Read More

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http://dx.doi.org/10.3109/15563650.2013.770153DOI Listing
March 2013
15 Reads

A retrospective review of whole bowel irrigation in pediatric patients.

Clin Toxicol (Phila) 2012 Jun;50(5):414-7

University of California-San Diego, Toxicology, San Diego, CA 92103, USA.

Background: Traditionally whole bowel irrigation (WBI) has been advocated for ingestions involving substances not bound with activated charcoal as well as extended release and enteric coated medications. Other than isolated case reports, little exists in the literature regarding the use of WBI in poisoned pediatric patients. The purpose of this study is to better understand the use of WBI in pediatric patients. Read More

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http://dx.doi.org/10.3109/15563650.2012.679277DOI Listing
June 2012
10 Reads

Lipid therapy for the treatment of a refractory amitriptyline overdose.

CJEM 2012 May;14(3):193-7

Departmens of Medicine, Dalhousie University, Halifax, NS.

Tricyclic antidepressant (TCA) overdose is a leading cause of death among intentional overdoses. Intravenous lipid emulsion therapy is an emerging antidote for local anesthetic toxicity, and there is animal evidence that lipid therapy may be efficacious in TCA overdose. Furthermore, case reports in humans have described the use of lipid therapy to reverse the toxicity of other lipophilic drugs. Read More

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http://dx.doi.org/10.2310/8000.2011.110486DOI Listing
May 2012
17 Reads

Fecal transplantation, through colonoscopy, is effective therapy for recurrent Clostridium difficile infection.

Gastroenterology 2012 Mar 7;142(3):490-6. Epub 2011 Dec 7.

Department of Infectious Diseases, Helsinki University Central Hospital, Helsinki, Finland.

Background & Aims: Treatment of recurrent Clostridium difficile infection (CDI) with antibiotics leads to recurrences in up to 50% of patients. We investigated the efficacy of fecal transplantation in treatment of recurrent CDI.

Methods: We reviewed records from 70 patients with recurrent CDI who had undergone fecal transplantation. Read More

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http://dx.doi.org/10.1053/j.gastro.2011.11.037DOI Listing
March 2012
12 Reads

Decontamination and enhanced elimination in sustained-release potassium chloride poisoning.

Authors:
Naren Gunja

Emerg Med Australas 2011 Dec;23(6):769-72

New South Wales Poisons, The Children's Hospital at Westmead, New South Wales, Australia.

Potassium chloride poisoning can be potentially life-threatening, particularly in massive ingestions of sustained-release preparations. Profound hyperkalaemia, developing over several hours, can lead to cardiac arrhythmias and death. This case series reports three episodes of sustained-release potassium chloride poisoning in two individuals requiring whole bowel irrigation or haemodialysis. Read More

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http://dx.doi.org/10.1111/j.1742-6723.2011.01469.xDOI Listing
December 2011
12 Reads

Gastrointestinal decontamination in the acutely poisoned patient.

Int J Emerg Med 2011 Oct 12;4:65. Epub 2011 Oct 12.

Department of Internal Medicine, School of Medicine, University of California, Davis, Sacramento, California, USA.

Objective: To define the role of gastrointestinal (GI) decontamination of the poisoned patient.

Data Sources: A computer-based PubMed/MEDLINE search of the literature on GI decontamination in the poisoned patient with cross referencing of sources.

Study Selection And Data Extraction: Clinical, animal and in vitro studies were reviewed for clinical relevance to GI decontamination of the poisoned patient. Read More

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http://dx.doi.org/10.1186/1865-1380-4-65DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3207879PMC
October 2011
14 Reads

Management of an oral ingestion of transdermal fentanyl patches: a case report and literature review.

Case Rep Med 2011 12;2011:495938. Epub 2011 May 12.

Department of Pharmacy Services, University Health System, 4502 Medical Drive, San Antonio, TX 78229, USA.

Purpose. Fentanyl is available as a transdermal system for the treatment of chronic pain in opioid-tolerant patients; however, it carries a black box warning due to both the potency of the product and the potential for abuse. In this report, we describe a case of transbuccal and gastrointestinal ingestion of fentanyl patches and the management of such ingestion. Read More

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http://dx.doi.org/10.1155/2011/495938DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099212PMC
July 2011
21 Reads

The effect of decontamination procedures on the pharmacodynamics of venlafaxine in overdose.

Br J Clin Pharmacol 2011 Jul;72(1):125-32

School of Pharmacy, University of Otago, Dunedin, New Zealand.

Aims: To investigate the relationship between decontamination procedures and seizure events caused by venlafaxine overdose and to estimate the time at which 90% of patients would have had their first seizure in the presence and absence of decontamination.

Methods: Data were collected from 319 patients who took an overdose of venlafaxine on 436 occasions. Seizures occurred on 24 of 436 occasions (5%). Read More

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http://dx.doi.org/10.1111/j.1365-2125.2011.03934.xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3141194PMC
July 2011
24 Reads

Drugs and pharmaceuticals: management of intoxication and antidotes.

Authors:
Silas W Smith

EXS 2010 ;100:397-460

New York City Poison Control Center, New York University School of Medicine, New York, USA.

The treatment of patients poisoned with drugs and pharmaceuticals can be quite challenging. Diverse exposure circumstances, varied clinical presentations, unique patient-specific factors, and inconsistent diagnostic and therapeutic infrastructure support, coupled with relatively few definitive antidotes, may complicate evaluation and management. The historical approach to poisoned patients (patient arousal, toxin elimination, and toxin identification) has given way to rigorous attention to the fundamental aspects of basic life support--airway management, oxygenation and ventilation, circulatory competence, thermoregulation, and substrate availability. Read More

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http://dx.doi.org/10.1007/978-3-7643-8338-1_12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7123602PMC
April 2010
13 Reads

Clinical management of cocaine body packers: the Hillingdon experience.

Can J Surg 2009 Oct;52(5):417-21

Department of Surgery, Charing Cross Hospital, Fulham Palace Road, London, UK.

Background: International smuggling of cocaine by internal concealment is a serious and growing problem. People who engage in this practice are commonly referred to as body packers or mules. The most serious risks associated with body packing include intestinal obstruction and death from cocaine intoxication. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769129PMC
October 2009
35 Reads

The effect of decontamination procedures on the pharmacokinetics of venlafaxine in overdose.

Clin Pharmacol Ther 2009 Oct 15;86(4):403-10. Epub 2009 Jul 15.

School of Pharmacy, University of Otago, Dunedin, New Zealand.

The aim of this work was to investigate the pharmacokinetics (PK) of venlafaxine in overdose and the effects of single-dose activated charcoal (SDAC) and whole-bowel irrigation (WBI), alone or in combination, as methods of decontamination. The data included 339 concentration-time points from 76 venlafaxine overdose events (median dose 2,625 (150-13,500 mg)); 69 were slow-release doses. SDAC, WBI, a combination of both, or no decontamination were administered to patients as decided by the treating clinician. Read More

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http://dx.doi.org/10.1038/clpt.2009.114DOI Listing
October 2009
10 Reads

[Decontamination and antidotes in acute cases of poisoning].

Ther Umsch 2009 May;66(5):331-4

Schweizerisches Toxikologisches Informationszentrum, Zürich.

In acute poisoning the maintenance or reconstitution of vital functions is the first and most critical action. All subsequent therapies and the prognosis depend on the identification of the causative agent and on information about substance-specific toxicity. Despite incomplete evidence the concept of harm reduction by decreased absorption of the toxicants and by shortening the course of illness is consistent with toxicokinetic-dynamic principles and is therefore still used by clinical toxicologists. Read More

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https://econtent.hogrefe.com/doi/10.1024/0040-5930.66.5.331
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http://dx.doi.org/10.1024/0040-5930.66.5.331DOI Listing
May 2009
49 Reads

Severe iron intoxication treated with exchange transfusion.

BMJ Case Rep 2009 8;2009. Epub 2009 May 8.

Pediatric Intensive Care Unit, Odense University Hospital, Odense, Denmark.

An 18-month-old previous healthy girl who had ingested 442 mg elemental iron/kg was admitted to a paediatric intensive care unit. The child was treated with gastric lavage, whole bowel irrigation and intravenous deferoxamine. After 2 h of standard therapy serum iron had risen threefold to 1362 µg/dl (244 µmol/l). Read More

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http://dx.doi.org/10.1136/bcr.01.2009.1445DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3029243PMC
November 2011
11 Reads

Successful whole bowel irrigation in self-poisoning with potassium capsules.

Clin Toxicol (Phila) 2008 Dec;46(10):1102-3

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http://dx.doi.org/10.1080/15563650802415165DOI Listing
December 2008
9 Reads

Lithium overdose with electrocardiogram changes suggesting ischemia.

J Med Toxicol 2008 Sep;4(3):170-2

Department of Emergency Medicine, Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA.

Background: Lithium toxicity is associated with electrocardiogram (ECG) changes, but changes suggestive of an ST segment elevation myocardial infarction have not been reported.

Case Report: A 46-year-old incarcerated man suffering from diabetes, hypertension, and schizoaffective/bipolar disorder was treated with lithium 1,200 mg twice daily. Two days prior to presentation the patient became confused, ataxic, and anorexic in jail. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3550041PMC
http://dx.doi.org/10.1007/BF03161196DOI Listing
September 2008
13 Reads

Whole bowel irrigation and the hemodynamically unstable calcium channel blocker overdose: primum non nocere.

J Emerg Med 2010 Feb 9;38(2):171-4. Epub 2008 Jul 9.

The Toxikon Consortium at Cook County Hospital, Chicago, Illinois 60612, USA.

Sustained-release calcium channel blocker (CCB SR) overdoses are potentially life-threatening ingestions. These patients may not become hemodynamically unstable until many hours after ingestion. On theoretical grounds, some have suggested that whole bowel irrigation (WBI) with polyethylene glycol electrolyte lavage solution may be of value in the management of these cases. Read More

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http://dx.doi.org/10.1016/j.jemermed.2007.11.100DOI Listing
February 2010
13 Reads

Severe iron intoxication treated with exchange transfusion.

Arch Dis Child 2008 Apr;93(4):321-2

Pediatric Intensive Care Unit, Afdeling V, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C., Denmark.

An 18-month-old previous healthy girl who had ingested 442 mg elemental iron/kg was admitted to a paediatric intensive care unit. The child was treated with gastric lavage, whole bowel irrigation and intravenous deferoxamine. After 2 h of standard therapy serum iron had risen threefold to 1362 microg/dl (244 micromol/l). Read More

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http://dx.doi.org/10.1136/adc.2007.123240DOI Listing
April 2008
9 Reads

Gastrointestinal decontamination of the poisoned patient.

Pediatr Emerg Care 2008 Mar;24(3):176-86; quiz 187-9

Department of Emergency Medicine, Wright State University Boonshoft School of Medicine, Dayton, OH 45429, USA.

Gastrointestinal decontamination has been a historically accepted modality in the emergency management of oral intoxicants. Theoretically, gastric and whole-bowel emptying procedures hinder absorption, remove toxic substances, prevent clinical deterioration, and hasten recovery. This article presents a current overview of gastrointestinal decontamination. Read More

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http://dx.doi.org/10.1097/PEC.0b013e318166a092DOI Listing
March 2008
20 Reads

A case of fatal felodipine overdose.

Acute Med 2008 ;7(1):39-42

Imperial College Healthcare NHS Trust Department of Medicine Praed Street London W2 1NY Tel: 07941346678.

A 54 year gentleman was admitted to hospital within four hours of taking an overdose of modified release felodipine tablets, with a total dose of approximately 250 mg. The initial management comprised fluid resuscitation, calcium chloride and glucagon. He remained hypotensive and was commenced on hyperinsulinaemia-euglycaemic therapy. Read More

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October 2012
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Use of neostigmine for the management of drug induced ileus in severe poisonings.

J Med Toxicol 2005 Dec;1(1):18-22

Departments of Clinical Toxicology, Prince of Wales Hospital and Westmead Hospital, Sydney, Australia.

Introduction: Effective whole bowel irrigation may be difficult in the presence of drug-induced ileus. Neostigmine, which inhibits the enzymatic degradation of acetylcholine, has been suggested to improve drug-induced ileus. We present two poisoning cases in which neostigmine was used to facilitate gut decontamination complicated by ileus. Read More

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December 2005
13 Reads

[Whole bowel irrigation].

Authors:
Yoichi Shirakawa

Chudoku Kenkyu 2007 Oct;20(4):358-60

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October 2007
8 Reads