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Full-Text Articles in Medicine and Health Sciences
Risk Of Road Traffic Accidents In Patients Discharged Following Treatment For Psychotropic Drug Overdose: A Self-Controlled Case Series Study In Australia, Tharaka L. Dassanayake, Alison L. Jones, Patricia Michie, Gregory Carter, Patrick Mcelduff, Barrie J. Stokes, Ian Whyte
Risk Of Road Traffic Accidents In Patients Discharged Following Treatment For Psychotropic Drug Overdose: A Self-Controlled Case Series Study In Australia, Tharaka L. Dassanayake, Alison L. Jones, Patricia Michie, Gregory Carter, Patrick Mcelduff, Barrie J. Stokes, Ian Whyte
Alison L Jones
Background: Use of psychotropic drugs is known to impair driving and increase the risk of road traffic accidents. They are also the most common drugs taken in overdose in hospital-treated episodes of self-poisoning. Most patients who take psychotropic drug overdoses are discharged within 48 hours, while they still have possible subclinical drug effects. Objective: Using a self-controlled case series design, we aimed to determine whether patients with psychotropic drug overdose are at a higher risk of a traffic accident in the period following discharge compared with a control period not associated with hospital-treated drug overdose. Methodology: Using the New South …
Neuroleptic Malignant Syndrome Or A Statin Drug Reaction? A Case Report, Joyce Cooper, Alison Jones
Neuroleptic Malignant Syndrome Or A Statin Drug Reaction? A Case Report, Joyce Cooper, Alison Jones
Alison L Jones
A 60-year-old woman with a long psychiatric history presented with delirium and mutism. She was febrile, with marked limb rigidity and elevated creatinine kinase (CK) level. Current medications included pericyazine. Current or recent use of dopamine-blocking agents, such as pericyazine, together with a disturbance in conscious state, autonomic dysfunction, and an elevated CK level may be suggestive of neuroleptic malignant syndrome (NMS). The diagnosis was confirmed as NMS, and she was successfully treated with bromocriptine. Eight years later, she represents with symptoms suggesting recurrence of NMS including elevated CK level and myalgia, however, without limb rigidity. Current medications include quetiapine, …
A Case Of Hypomagnesaemia Due To Malabsorption, Unresponsive To Oral Administration Of Magnesium Glycerophosphate, But Responsive To Oral Magnesium Oxide Supplementation, J Ross, Paul Dargan, Alison Jones, A Kostrzewski
A Case Of Hypomagnesaemia Due To Malabsorption, Unresponsive To Oral Administration Of Magnesium Glycerophosphate, But Responsive To Oral Magnesium Oxide Supplementation, J Ross, Paul Dargan, Alison Jones, A Kostrzewski
Alison L Jones
Introduction—Oral and intravenous replacement of minerals such as magnesium and calcium are usually straightforward in clinical practice, the choice generally being governed by the preparation most readily available. There are very few data comparing efficacy and absorption profiles of different magnesium salts. This case report highlights the importance of considering alternative preparations of oral magnesium salts in patients who appear unresponsive to one preparation, rather than moving on to chronic intravenous therapy via a Hickman line. In the case of patients with small bowel shortening, the use of magnesium oxide should be considered.
Propafenone Poisoning: A Case Report With Plasma Propafenone Concentrations, Hanna Ovaska, Andrew Ludman, Edgar Spencer, David Wood, Alison Jones, Paul Dargan
Propafenone Poisoning: A Case Report With Plasma Propafenone Concentrations, Hanna Ovaska, Andrew Ludman, Edgar Spencer, David Wood, Alison Jones, Paul Dargan
Alison L Jones
Propafenone is an anti-arrhythmic drug used in the management of supraventricular and ventricular arrhythmias. It is metabolised through cytochrome P450 2D6 pathways; the major metabolites possess antiarrhythmic activity. The cytochrome P450 CYP2D6 is coded by more than 70 alleles resulting in great genetic polymorphism of CYP2D6 isoenzymes, and up to 7% of Caucasian population are poor metabolisers. This case report describes a patient with severe overdose of propafenone who presented with coma, seizures and cardiotoxicity. The patient was managed with intravenous glucagon, hypertonic sodium bicarbonate, hypertonic saline and inotropic support. The propafenone and its 5-hydroxypropafenone (5-OHP) metabolite were measured by …
A Case Of Lead Poisoning Due To Snooker Chalk, Paul Dargan, P Evans, Ivan House, Alison Jones
A Case Of Lead Poisoning Due To Snooker Chalk, Paul Dargan, P Evans, Ivan House, Alison Jones
Alison L Jones
A 3 year, 9 month old child with pica presented with a blood lead concentration of 1.74 μmol/l (360 μg/l). The source of poisoning was snooker chalk (lead content 7200 μg/g). She was treated with intravenous calcium disodium edetate chelation. Thirty months later her blood lead was 0.39 μmol/l (80 μg/l). This case illustrates the need to be vigilant for more unusual causes of lead poisoning in the home.
Case Report: Severe Mercuric Sulphate Poisoning Treated With 2,3-Dimercatopropane-1-Sulphonate And Haemodiafiltration, Paul Dargan, Lucy Giles, Craig Wallace, Ivan House, Alison Thomson, Richard Beale, Alison Jones
Case Report: Severe Mercuric Sulphate Poisoning Treated With 2,3-Dimercatopropane-1-Sulphonate And Haemodiafiltration, Paul Dargan, Lucy Giles, Craig Wallace, Ivan House, Alison Thomson, Richard Beale, Alison Jones
Alison L Jones
No abstract provided.
Should A Lower Treatment Line Be Used When Treating Paracetamol Poisoning In Patients With Chronic Alcoholism? A Case Against, Paul Dargan, Alison Jones
Should A Lower Treatment Line Be Used When Treating Paracetamol Poisoning In Patients With Chronic Alcoholism? A Case Against, Paul Dargan, Alison Jones
Alison L Jones
The widespread practice of using a lower plasma paracetamol (acetaminophen) concentration threshold for the treatment of paracetamol poisoning in patients with chronic alcoholism has been introduced on the basis of anecdotal case reports. In animals, acute alcohol loading inhibits toxic metabolic activation of paracetamol whilst chronic alcohol administration results in cytochrome P450 (CYP) 2E1 induction with increased toxic metabolic activation of paracetamol by CYP2E1 and increased hepatotoxicity. However, due to species differences in CYP expression, activity and induction, it is not possible extrapolate the results of these animal studies to clinical situations in humans. Isoenzymes are also responsible for the …
A Case Of Severe Mercuric Sulphate Ingestion Treated With 2,3-Kimercaptopropane 1 Sulphonate (Dmpd) And Hi-Flow Hemodiafiltration, Paul Dargan, Lucy Giles, Ivan House, N Murphy, Craig Wallace, Alison Jones, Richard Beale
A Case Of Severe Mercuric Sulphate Ingestion Treated With 2,3-Kimercaptopropane 1 Sulphonate (Dmpd) And Hi-Flow Hemodiafiltration, Paul Dargan, Lucy Giles, Ivan House, N Murphy, Craig Wallace, Alison Jones, Richard Beale
Alison L Jones
Objective: Our training program uses senior emergency medicine residents (SEMRs) as toxicology consultants, with the back-up of the physician toxicologist on-call. We assessed health care practitioner (HCP) satisfaction with this toxicology consulting service. Methods: For 5 months, HCPs who spoke to a toxicology consultant (SEMR or attending on-call toxicologist) were contacted by telephone and a 12 question survey was implemented. Results: 48 toxicology consultant cases were identified. 9 HCPs did not respond to initial or 3 follow-up calls. 3 surveys were eliminated because they were incomplete. Of the 36 completed surveys, 21 used the SEMR as consultant, and 15 used …
Status Epilepticus Following Intentional Overdose Of Fluvoxamine: A Case Report With Serum Fluvoxamine Concentration, David Wood, Yadhunanthanan Rajalingam, S Greene, Phillip E. Morgan, David Gerrie, Alison Jones, Paul Dargan
Status Epilepticus Following Intentional Overdose Of Fluvoxamine: A Case Report With Serum Fluvoxamine Concentration, David Wood, Yadhunanthanan Rajalingam, S Greene, Phillip E. Morgan, David Gerrie, Alison Jones, Paul Dargan
Alison L Jones
Fluvoxamine is a selective serotonin reuptake inhibitor (SSRI) that is used in the management of depression and obsessive compulsive disorders. We report a patient with status epilepticus requiring quadruple anti-convulsant treatment following a fluvoxamine overdose. Case Report. A 25-year-old female presented with drowsiness at 12 hours following deliberate ingestion of 9.6 grams of fluvoxamine. Sixteen hours after ingestion, she developed status epilepticus that required treatment with benzodiazepines (lorazepam and midazolam), thiopentone, phenytoin and phenobarbitone. Her serum fluvoxamine concentration on presentation was 1970 μg/L (therapeutic 160–220 μg/L) and routine toxicological screening was negative for other drugs. She was discharged home after …
A Case Of Severe Iatrogenic Bismuth Poisoning, Paul Dargan, C Bailey, S Greene, Shona Murray, Alison Jones
A Case Of Severe Iatrogenic Bismuth Poisoning, Paul Dargan, C Bailey, S Greene, Shona Murray, Alison Jones
Alison L Jones
Background: In 1999, a new synthetic tryptamine, 5-MeO-DIPT, became known as a street drug, with the street name of ‘‘Foxy’’ or ‘‘Foxy Methoxy.’’ By February 2003, DEA reported law enforcement seizures and=or reports of abuse in 12 states. We report the first published case of toxicity. Methods: After an index case, AAPCC TESS data were examined to determine trends and extent of abuse of this agent. Case Report: A 19 year-old, multiple-pierced, male was brought to the emergency department following ingestion of ‘‘Foxy.’’ Upon arrival, he displayed hallucinations, hypertension, tachycardia, mydriasis, and catalepsy, inability to answer questions, and staring into …