Antidotal use of lipid emulsion - the pendulum swings.

Intravenous lipid emulsion (ILE) is a widely accepted treatment for local anesthetic systemic toxicity (LAST), particularly resulting from bupivacaine. The past decade has seen interest in antidotal use of ILE for other poisonings wax and wane. Numerous anecdotes have raised enthusiasm while more rigorous reviews have cast skepticism.

Naloxone reversal of clonidine toxicity: dose, dose, dose.

Context: Following clonidine ingestion, naloxone is seldom administered as it is considered ineffective in reversing somnolence, bradycardia, or hypotension. However, this conclusion has been based on administration of small doses (2 mg or less) of naloxone. The somnolence is frequently treated with endotracheal intubation (ETI), a procedure with significant morbidity.

Adverse events are rare after single-dose montelukast exposures in children.

Study Objective: Montelukast sodium is a leukotriene-receptor antagonist approved as a controller medication for chronic asthma and allergic rhinitis in children and adults. We sought to characterize adverse events associated with single montelukast exposures in children ages 5-17 years and to determine whether adverse events were dose related for all-dose and for ultra-high-dose (≥50 mg) exposures.

Methods: This is a retrospective analysis of data from the National Poison Data System for exposures that included montelukast in individuals aged 5-17 years for calendar years 2000-2016.

Notes from the Field: Intoxication and Deaths Associated with Ingestion of a Racing Fuel and Carbonated Soft Drink Mixture - Tennessee, January 2016.

In January 2016, the Tennessee Poison Center and Tennessee Department of Health learned of the deaths of two adolescents, and the nonfatal intoxication of two other adolescents, after ingestion of a mixture of racing fuel (approximately 100% methanol) and a carbonated soft drink. The Tennessee Department of Health reviewed medical records and police reports to learn more about the racing fuel source, assess ongoing risk, and guide prevention efforts. These are the first reported deaths in the United States associated with ingestion of this racing fuel mixture.

Hydrocarbon toxicity: an analysis of AAPCC TESS data.

Introduction: Human hydrocarbon exposures have the potential to cause significant morbidity and mortality. To determine which hydrocarbons were associated with the most severe adverse outcomes, human exposure data reported to American poison information centers were analyzed.

Methods: Outcome data for single-substance, hydrocarbon exposures reported to the American Association of Poison Control Centers Toxic Exposure Surveillance System from 1994 through 2003 were analyzed.

A critical reconsideration of the clinical effects and treatment recommendations for sodium channel blocking drug cardiotoxicity.

The cardiac sodium channel is comprised of proteins that span the cardiac cell membrane and form the channel pore. Depolarisation causes the proteins to move and open the sodium channel. Once the channel is open (active conformation), sodium ions move into the cell.

Flumazenil--treatment or toxin.

Flumazenil is frequently administered to the poisoned patient. Seizures may be precipitated and resedation may occur in patients who awakened following flumazenil administration. Seizures may increase morbidity and mortality of the overdose.

Clonidine toxicity revisited.

The incidence of clonidine overdose is increasing, yet there is a paucity of new information regarding treatment options for clonidine toxicity. Reported treatment approaches vary widely, demonstrating the lack of science on which current treatment is based. Available research needs to be reassessed.