Benzodiazepine poisoning: experience of 702 admissions to an intensive care unit during a 14-year period

A retrospective study covering a 14-year period was carried out to estimate the incidence and assess the clinical features of benzodiazepine (BZD) poisoning. The annual contribution of BZDs to the total number of drug overdose cases admitted to an intensive care unit displayed an increasing trend over the period, and during the last years BZDs were involved in nearly one-third of all cases. Among the 702 cases of BZD overdosage, 144 had ingested BZD alone, 200 had poisoned themselves with BZD combined with alcohol and 358 had taken BZD with other miscellaneous drugs. In 56% of all the cases the patients had severe central nervous system depression on admission. In 47% orotracheal intubation was performed and in 18% artificial ventilation was administered. Complications were recorded in 69 of the 702 cases (9.8%) and five cases were fatal. These clinical features were essentially the same in the group that had overdosed with just BZD. In conclusion, patients with drug overdosage involving BZD have a low hospital mortality, but the acute somatic risk is not negligible. Moreover, they consume a substantial proportion of the resources in the emergency room and the intensive care unit.     

Cyanide loss from tissue baths in the presence and absence of tissue

Loss of cyanide from Krebs-Henseleit solution (KHS) was studied in aerated tissue baths at 38°C in the presence and in the absence of tissue. The rate of cyanide loss was greater from 300-μM than from 30-μM solutions and still greater from 300-μM solutions in the presence of vascular tissue. Initial cyanide loss was much greater from the tissue-containing bath, and the half-time was shorter in the presence of tissue (54 min) than in its absence (98 min) in baths containing the same initial cyanide concentration (300 μM).     

Asymptomatic sequelae to acute sarin poisoning in the central and autonomic nervous system 6 months after the Tokyo subway attack

Six to eight months after the Tokyo subway attack in March 1995, the neurophysiological effects of acute sarin poisoning were investigated in 18 passengers exposed to sarin (sarin cases) in the subways to ascertain the focal or functional brain deficits induced by sarin. The event-related and visual evoked potentials (P300 and VEP), brainstem auditory evoked potential, and electrocardiographic R-R interval variability (CV_RR), together with the score on the posttraumatic stress disorder (PTSD) checklist, were measured in the sarin cases and the same number of control subjects matched for sex and age. None of the sarin cases had any obvious clinical abnormalities at the time of testing. The P300 and VEP (P100) latencies in the sarin cases were significantly prolonged compared with the matched controls. In the sarin cases, the CV_RR was significantly related to serum cholinesterase (ChE) levels determined immediately after exposure; the PTSD score was not significantly associated with any neurophysiological data despite the high PTSD score in the sarin cases. These findings suggest that asymptomatic sequelae to sarin exposure, rather than PTSD, persist in the higher and visual nervous systems beyond the turnover period of ChE; sarin may have neurotoxic actions in addition to the inhibitory action on brain ChE. Received: 2 April 1997 Received in revised from: 15 July 1997 Accepted: 1 August 1997     

Sodium Polystyrene Sulfonate Treatment for Lithium Toxicity: Effects on Serum Potassium Concentrations

Objective: To examine the effects of sodium polystyrene sulfonate (SPS) on serum potassium (K) concentrations in mice pretreated with parenteral lithium (Li).
Methods: A placebo–controlled murine model trial of SPS therapy following IV Li was performed. Sixty male CD–I mice weighing 18–22 g were administered either IV LiCl (125 mg/kg) or a control solution (normal saline). Half of the mice in each of these groups were then given orogastric water 20, 40, 90, 150, and 210 minutes after LiCl or normal saline; the other half received SPS (5 g/kg/dose) at equivalent times. Subgroups of each of these four groups were sacrificed at one, two, and six hours after pretreatment and the serum was analyzed for K concentration. Serum K concentrations for the various groups were compared with analysis of variance and Newman–Keuls tests for the comparison of multiple means.
Results: A statistically significant reduction of serum K concentrations occurred in the animals that received SPS treatment following either IV saline or LiCl solutions. The degree of K reduction that resulted from the combination of LiCl and SPS treatment (35% reduction at six hours, compared with the placebo–treated controls) was larger than that which resulted from eimer IV Li with oral water (15% reduction) or IV saline with oral SPS (20% reduction).
Conclusions: These findings suggest that development of hypokalemia may represent a potential limitation in the use of SPS in the treatment for Li toxicity.     

吡乙酰胺对三氯化铝中毒大白鼠回避反应受损的对抗作用

本文报道了吡乙酰胺对三氯化铝中毒大白鼠回避反应受损的治疗作用。也观察了该药对正常大白鼠回避反应的影响。结果表明吡乙酰胺加强正常大白鼠回避反应的获得(acquisition);三氯化铝抑制大白鼠回避反应的获得和保留(retention),吡乙酰胺有对抗作用。     

Carbon Monoxide Poisoning from Spray Paint Inhalation

This case report emphasizes the varied manifestation of CO poisoning and its genesis from methylene chloride. Because DCM is now an ingredient in many popular spray paints, the ingredients should be checked routinely in toxic exposures. Manufacturer's suggestions concerning the use these products in ventilated areas to avoid harmful effects do not always protect the consumer, and the public should be well informed regarding this issue.     

锰对大鼠脂质过氧化及抗氧化能力影响的研究

锰对大鼠脂质过氧化及抗氧化能力影响的研究王薛君，崔金山，马明月，李宏革，张玉敏（沈阳医学院毒理学教研室，沈阳１１００３１）本研究选用体重１８０～２２０ｇ健康Ｗｉｓｔａｒ大鼠４８只，雌雄各半，随机区组分为对照组，８ｍｇ／ｋｇ，１６ｍｇ／ｋｇ，２４ｍｇ／...     

Three cases of severe verapamil poisoning

Three cases of verapamil intoxication are described. The first two patients took 6.4 g verapamil each and the third one took 0.8 g of verapamil and alcohol. All three developed a third-degree atrioventricular dissociation, the first patient developed a slow idioventricular rhythm without atrial activity, the second a temporary asystole. All were hypotensive, had anuria and shock, the first two were unconscious for several hours. The first one was treated with artificial cardiac pacing, orciprenaline and calcium gluconate, the second with cardiac pacing and orciprenaline. The third patient received fluids and a dopamine infusion. In the first case sinus rhythm returned 31 h after the swallowing of tablets, in the second after 32 h and in the third after 10 h. Pacing with intensive monitoring and care seemed to be the most beneficial treatments in these cases.     

古尼拟青霉对小白鼠的致畸试验

为确定古尼拟青霉有无胚胎毒和致畸作用,于母鼠妊娠的第6～14天每天灌胃给予0.6,2.0,6.0g/kg 古尼拟青霉。母鼠体重增长和胚胎外形、内脏及骨髓异常与阴性对照组(给予自来水)无明显差异。提示上述剂量范围内古尼拟青霉没有胚胎毒和致畸作用。给予五氯酚钠的阳性对照组则出现明显的胚胎毒和致畸作用。