Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The adverse effects of theophylline were recognized soon after its introduction into clinical medicine. Reports of major toxic reactions to theophylline, particularly in children, discouraged its use and led to homeopathic dosing recommendations that had little therapeutic effect. Concomitant with the renaissance in theophylline use during the past decade, reports of theophylline toxicity have increased. The epidemiology of theophylline intoxication has changed in recent years, and today most instances of serious toxicity are due to intentional overdosage, as in a suicide attempt. The adverse effects of theophylline involve the gastrointestinal, nervous, cardiovascular, and urinary systems. In addition, significant metabolic derangements are noted in patients with severe intoxication. Treatment of theophylline intoxication involves attention to fluid and electrolyte balance and initiation of measures to remove theophylline from the body (gastric lavage or emesis, repeated charcoal administration by mouth, and charcoal hemoperfusion in serious cases).
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PMID:Theophylline toxicity. 401 58

Acetaminophen is a remarkably safe agent when used in therapeutic doses. Most reported overdoses of acetaminophen are the result of suicide attempts. The clinical course of patients with toxic blood levels follows four distinct stages. Symptoms of nausea, vomiting, diaphoresis, and anorexia usually begin within seven to 14 hours after ingestion. After 24 to 48 hours, these symptoms may diminish, but SGOT, SGPT, bilirubin, and prothrombin time begin to rise. Peak hepatotoxicity occurs at 72 to 96 hours, and SGOT levels of 20,000 I.U. are not unusual. Oral N-acetylcysteine is the drug of choice for acetaminophen overdose. Intravenous use of N-acetylcysteine is advocated in England, Europe, and elsewhere, but it is not available in the United States. Clinical studies of oral and intravenous N-acetylcysteine clearly demonstrate that the drug has a profound effect on reducing morbidity and mortality if it is administered during the first 16 hours after the overdose. In addition, data from these studies have shown that alcohol taken simultaneously with an overdose of acetaminophen is actually hepatoprotective. Therefore, patients who have consumed alcohol at the time of overdose, or those who are chronic alcoholics, should be managed in the same way as patients with no exposure to alcohol. However, study results also reveal that overdose in children under 10 to 12 years of age follows a distinctly different pattern. These children demonstrate a lesser degree of hepatotoxicity and have only minor increases in transaminase levels.
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PMID:Acetaminophen overdose. 635 59

One hundred eleven cases of poisoning (over a 4 1/2-year period) were retrospectively reviewed at a military medical center. Results of the review included the following: (1) two peak age ranges for poisoning were identified: the 1 1/2- to 4-year-old child who accidently ingests both drugs and non-drugs, and the female adolescent who ingests drugs as a suicide attempt or gesture; (2) hydrocarbons and aspirin were the most common agents ingested; however, if grouped, drugs with anticholinergic effects would replace aspirin as the second most common poison; (3) emergency treatment included emesis or lavage in four fifths of poisonings except in ingestions of hydrocarbons or caustics where its use is controversial; (4) incidence of recurrence of poison ingestion was three percent, and morbidity and mortality combined were less than one percent; and (5) two thirds of patients were asymptomatic on admission and hospitalized primarily for observation.
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PMID:Poisoning in childhood and adolescence: a study of 111 cases admitted to a military hospital. 741 Oct 39

Carbamate insecticides (mainly aldicarb) are illegally commercialized as rat poisons and commonly used by the population of Rio de Janeiro for this purpose. A retrospective study concerning 189 cases (80 men, 109 women) of carbamate poisoning referred to the Poison Control Center of Rio de Janeiro throughout 1993 is described. The causes of carbamate poisoning were suicide attempts (65%) and accidental ingestions (35%). The main signs and symptoms found (86%) were those related to the SLUDGE syndrome (increased salivation, lacrimation, urinary incontinence, diarrhea, gastrointestinal cramping and emesis) which were more commonly seen in adults than in children. Despite treatment with atropine, the case-fatality was 4%. It is concluded that there is a widespread risk of carbamate poisoning in Rio de Janeiro due to its clandestine use as a rodenticide. Effective measures by the government authorities should be implemented to stamp out the illicit commercialization of these compounds.
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PMID:Poisoning due to illegal use of carbamates as a rodenticide in Rio de Janeiro. 852 93

A 65-year old woman with known history of reactive depression and failed suicide attempts ingested 7 mg digitoxin at 09.00 h. After vomiting 4 hours later, she reported the drug intake to her husband who thereupon summoned a physician. Arriving at 16.00 h, the physician was informed about the suicide attempt, but failed to initiate any specific measures. After a second doctor's visit at 22.00 h, the patient was rushed to hospital in a moribund state. In spite of a gastric lavage, treatment with activated charcoal and insertion of a transvenous pacemaker, the patient died at 23.45 h with signs of total atrioventricular block. Digitalis fab fragments could not be administered in time. A calculation based on the plasma digitoxin concentration of 212 ng.ml-1 measured at 23.00 h indicated that nearly the entire ingested dose had been absorbed. Thus, neither the vomiting nor the gastric lavage eliminated significant amounts of the drug which had left the stomach without delay. Under these circumstances, the failure to initiate timely therapy with specific digitalis fab fragments ultimately contributed to the lethal outcome.
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PMID:Digitoxin intoxication with lethal outcome. 943 60

We report on a 13 years 7 months old boy who ingested 650 mg azathioprine in a suicide attempt. His baseline medication was azathioprine and methotrexate for control of juvenile chronic polyarthritis. After the induction of vomiting by ipecacuanha sirup and administration of charcoal (1 g/kg), he was closely followed for haematological, hepatic, and renal side effects. During the following days, no serious adverse events were noted except that the thrombocyte (from 403,000 down to 199,000/microliter) and total leukocyte count decreased moderately (from 12,000 down to 7100/microliter). On the basis of this case report and the available literature, the potential acute toxicity of azathioprine and possible treatment modalities are discussed.
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PMID:[Azathioprine ingestion with suicidal intent by an adolescent with chronic juvenile polyarthritis]. 962 49

A 36-year-old man with a history of depression presented to the emergency department after ingesting approximately 3,000 mL of ethylene glycol antifreeze in a suicide attempt. The patient's ethylene glycol concentration, 1,889 mg/dL, was higher than any level previously documented in the medical literature. Although his course was complicated by nausea, emesis, lethargy, metabolic acidosis, and kidney failure, the patient survived without persistent kidney failure or other chronic problems. Sustained hemodialysis and ethanol infusion were instituted in the ED, on the basis of the patient's history, before laboratory confirmation of the ingestion was obtained.
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PMID:Emergency department hemodialysis in a case of severe ethylene glycol poisoning. 986 97

Feminists, among others, should not be too quick to hail assisted suicide and euthanasia as extensions of human freedom. Indeed, there are good reasons why women should be especially suspicious of such "reforms." First, it is not clear that a person has a moral right to end his or her existence. Feminists understand that suicide and murder are irretrievably linked, and that a person is not a monad. We often hear of suicide attempts in which the person's body--by vomiting up poison, for instance--overrules his or her mind. If there can be such miscommunication between a mind and a body, how are we to trust the communication between a person and the physician ready to assist his or her suicide? Ambivalent motivation and ambiguous meanings have always characterized human relations. In the past, however, an absolute taboo against suicide or euthanasia cemented a patient's right to expect the care of his or her physician, family, and community. If we were to discard that taboo, we would subtly alter these relationships and make each other more vulnerable. History suggests that women, minorities, the ill, the old, and the handicapped would be most at risk. Finally, the assisted-suicide debate has even larger social implications. Unconditional respect for the gift of life is eroding in the United States. The suicide rate is already climbing at all levels of society, especially among teenagers. Wouldn't the acceptance of suicide and euthanasia make it even more acceptable for people to check out of all kinds of uncomfortable situations--marriages or life?
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PMID:A feminist case against euthanasia. Women should be especially wary of arguments for "the freedom to die". 1016 32

Cases involving ingestion of a dextromethorphan-containing product recorded at a poison control center were studied. A retrospective review of all consultations involving the ingestion of Coricidin HBP Cough & Cold tablets recorded by the California Poison Control System was conducted for the period from January 1 to October 1, 2000. Computerized charts on the consultations were reviewed to obtain data on patient age and sex, number of tablets taken, reason for tablet ingestion, symptoms, treatment, disposition, and outcome. A total of 92 charts (for 92 patients) documenting Coricidin HBP Cough & Cold tablet ingestion were reviewed. The reason for tablet ingestion was classified as abuse in 65 patients (71%), a suicide attempt in 8 (9%), misuse in 1 (1%), malicious administration in 1 (1%), and normal use (but with an adverse drug reaction) in 1 (1%); 16 patients (17%) consumed the tablets for an unknown reason. The 92 patients comprised 42 males and 50 females. Among all patients, 78 (85%) were 13-17 years old, and among those classified as having abusive intent, 58 (89%) were in the same age range. The most commonly reported signs and symptoms associated with ingestion were tachycardia (50 patients), hypertension (29), lethargy (40), mydriasis (20), agitation (15), ataxia or dizziness (20), and vomiting (9). Sixty-one patients (66%) had some alteration in mental status. Fifty-six (61%) were treated in the emergency department; 11 (12%) were admitted. All patients recovered completely. Information on the ingestion of Coricidin HBP Cough & Cold tablets recorded at a poison control center indicated a high rate of abuse of the product among teenagers.
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PMID:Abuse of Coricidin HBP cough & cold tablets: episodes recorded by a poison center. 1159 95

In this study, sociodemographic, laboratory, and clinical features of cases of organic phosphorus (OP) intoxication in the Southeast Anatolian region of Turkey were investigated. Patients with OP intoxication admitted to the Emergency Service of Dicle University Hospital in Diyarbakyir City between May and August 1998 were evaluated. This prospective cohort study included five male (M) and 19 female (F) consecutive patients. Five cases were accidental intoxication; however, 19 cases were suicide attempts. Mean age of cases was 24+/-11 years; 54.2% of them were under the age of 20 years and 83.3% of them were under the age of 30 years. The M/F ratio was 1.0/3.8. The cases of suicidal purposeful intoxications were mostly determined in singles (58.3%, P<0.05). Most of the cases had a primary education level (16, 66.7%) and a lower socioeconomic status (14, 58.3%); 79.2% of cases admitted to our emergency service received atropine in primary health care centers. In emergency service, pralidoxime (PAM) was administered to only 29.2% of cases. According to ECG examination, tachycardia (14, 58.3%), ST changes (13, 54.2%), and T changes (3, 12.5%) were mostly seen; bradycardia and serious ventricular arrhythmias were not seen in any case. Patients who received atropine plus PAM had higher rates of arrhythmias, but this was not statistically significant (P>0.05). The most observed biochemical features of cases were leukocytosis (21 cases), hypokalemia (18 cases), and hyponatremia (4 cases). Other biochemical features were not evidently altered. In present cases, the most frequently seen symptoms and findings were vomiting (18, 75%), feeling faint (17, 70.8%), and tachycardia and dozing off (14, 58.3%). Serious ventricular arrhythmias were not observed, and in our region, OP intoxication especially affected young unmarried females, and most of them resulted from a suicidal purpose.
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PMID:Sociodemographic, clinical, and laboratory features of cases of organic phosphorus intoxication who attended the Emergency Department in the Southeast Anatolian Region of Turkey. 1190 32


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