An Observational Study of the Factor Xa Inhibitors Rivaroxaban and Apixaban as Reported to Eight Poison Centers.

Study Objective: Rivaroxaban and apixaban are part of a new group of oral anticoagulants targeting factor Xa and approved by the Food and Drug Administration in 2011 and 2012. These oral anticoagulants are administered at fixed daily doses, without the need for laboratory-guided adjustments. There are limited data available on supratherapeutic doses or overdose of the oral Xa inhibitors.

Benzonatate Ingestion Reported to the National Poison Center Database System (NPDS).

Little has been published on benzonatate ingestion, with the few case reports suggesting significant risk of seizures after poisoning. A 7-year retrospective review of all single substance ingestion of benzonatate reported to the National Poison Center Database System (NPDS) from 2000 to 2006. In this review, there were 2,172 patients, of which 1,280 (58%) were female.

Increasing burden of pill identification requests to US Poison Centers.

Introduction: Information calls to poison centers, particularly for pill identification (PID), have been increasing.

Methods: Retrospective review of information calls reported to U.S.

Toxicity from modafinil ingestion.

Introduction: Modafanil, a non-amphetamine stimulant, is used for narcolepsy, sleep apnea, and shift work sleep disorder. There is little available information on the toxicity of modafinil overdose.

Method: We performed a retrospective multi-poison center chart review of patients from 11 states who had a single substance ingestion of modafanil with follow up to a known outcome for the years 2000-2007.

Prolonged cardiovascular effects after unintentional ingestion of tetrahydrozoline.

Tetrahydrozoline is an imidazoline derivative with alpha receptor agonist activity widely available in over-the-counter topical ocular and nasal formulations. More than 1,600 cases of oral exposures are reported to United States poison centers annually (1,2). Reports of significant toxicity from tetrahydrozoline ingestion are unusual but have occured primarily in small children after unintentional ingestion (3-63, 6).

Consequences of use of anabolic androgenic steroids.

Whether providing anticipatory guidance to the young adolescent patient, conducting a preparticipation examination on a young athlete, or treating a sick user of anabolic androgenic steroids (AASs), the primary care physician must be familiar with the adverse consequences of the use of these compounds. This article reviews the endocrine, cardiovascular, neuropsychiatric, musculoskeletal, hematologic, hepatic, and miscellaneous effects of AASs, highlighting effects reported in children and adolescents, and relying on consequences in adults when pediatric data is unavailable.

Herbal weight-loss supplement misadventures per a regional poison center.

Background: Many herbal supplements used for weight loss contain stimulants. The poison control center has noted an increase in reports of adverse events with intentional and unintentional ingestion of herbal weight-loss supplements.

Objective: To identify characteristics of the callers (eg, demographic properties, underlying type of ingestion) and, from this information, determine populations at increased risk for adverse events secondary to intentional and unintentional herbal weight-loss supplement ingestion.

Intoxication with sodium monofluoroacetate (compound 1080).

The highly toxic sodium monofluoroacetate (SMFA) was banned as a rodenticide in the U.S. in 1972.