Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A prospective review of 51 cases of tobacco ingestion and 5 cases of nicotine resin chewing gum exposure was conducted to evaluate the incidence and degree of toxicity caused by these products in children. A dose-response relationship was observed for cigarette exposures. Nine of 10 children ingesting more than one cigarette or three cigarette butts developed signs or symptoms, while 12 of 24 ingesting lesser amounts became symptomatic (P less than 0.01). Severe symptoms (e.g. limb jerking and unresponsiveness) were only seen with the larger amounts. Nicotine resin gum produced toxicity in 4 of 5 children who chewed 1/2 to 4 pieces. Agitation, lethargy, tachycardia, hypotension, abdominal pain, and vomiting were seen within 30 min of exposure to the gum.
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PMID:Cigarette and nicotine chewing gum toxicity in children. 334 35

An 8-month-old female infant was brought in after ingesting cigarette butts. Upon presentation to the ED approximately 2.5 hr post-ingestion, the child was very lethargic and respirations were depressed. She was intubated and a NG tube was placed. Gastric lavage was performed, after which activated charcoal and sorbitol were given. Atropine was administered to treat excessive secretions. The patient became progressively more obtunded throughout the emergency department stay. Upon admission to the PICU she was minimally responsive. The urine tox screen was positive only for nicotine. The patient gradually improved with supportive care and was sent home on the third hospital day. Although the effects of Nicotine are well documented, few cases have been reported of severe toxicity in pediatric patients. We believe this to be the only reported case of severe CNS depression secondary to the ingestion of cigarette butts in a pediatric patient.
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PMID:CNS depression in an infant after the ingestion of tobacco: a case report. 335 77