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Biomedical subjects

D Joksović

Publications and source records attributed to D Joksović.

16 recordsLinked to original sources
PubMed1991

HI-6 in man: efficacy of the oxime in poisoning by organophosphorus insecticides.

The efficacy of the oxime HI-6 was studied as a treatment for organophosphorus poisoning. HI-6 was given four times daily as a single intramuscular injection of 500 mg accompanied by atropine and diazepam therapy. Oxime treatment was started on admission and continued for a minimum of 48 h and a maximum of 7 d. HI-6 rapidly reactivated human blood acetylcholinesterase inhibited by dimethoxy organophosphorus compounds, while the dimethoxy-inhibited enzyme was mainly resistant to the treatment by HI-6. Although both HI-6 and pralidoxime chloride reactivated the red blood cell cholinesterase in quinalphos-poisoned subjects, the return of enzyme activities was more rapid following the use of HI-6. The general improvement of poisoned patients, which was sometimes more rapid than the rise of acetylcholinesterase activity, pointed to direct pharmacological effects of HI-6. No undesirable side-effects were noted in patients when HI-6 plasma concentrations were maintained at levels far above the 'therapeutic' concentration for up to 7 d.

Adult↗
PubMed1990

A case of unusual suicidal poisoning by the organophosphorus insecticide dimethoate.

A 20-year-old male who attempted suicide by injecting subcutaneously 10 ml of Sistemin 40 (40% dimethoate) was admitted 16 h later. General weakness, muscular fibrillations and a marked inhibition of red blood cell and serum cholinesterases were the prominent signs of intoxication. The antidotal treatment of intermittent boluses of atropine, oxime HI-6 and diazepam was combined with symptomatic therapy. Cholinesterase activity decreased within the next 3 d. In contrast to the marked general improvement of the patient, the return of cholinesterase activities was very slow. The patient was discharged 24 d after the poisoning with no notable consequences which could be ascribed to the intoxication.

Adult↗
PubMed1989

[Familial poisoning by carbon monoxide with different ECG changes].

The paper presents the poisoning of a family of three by carbon monoxide, caused by incomplete combustion of butane gas in a central heating system, with various disturbances in conduction and ishaemic changes in the ECG. The father, mother and son were poisoned. The father had increased amylase activity in urine (507 i.u./L) and, a COHb concentration of 4.8%. An ECG registered a temporary block of the left branch of the His bundle and a negative T wave in the III lead, which continued for about two weeks. The mother had a COHb concentration of 6% and an extended PQ interval, whereas the son had 8.5% of COHb in the blood and a transient incomplete block of the right branch of the His bundle. After treatment with pressurised pure oxygen, the symptoms of poisoning disappeared, COHb concentration fell to below 1% and the ECG registered an improvement. During treatment the patients also received an infusion of piracetam.

Adult↗
PubMedDate not supplied

Factors influencing the degree and outcome of acute beta-blockers poisoning.

Since severe and fatal poisoning with beta-blockers due only to beta-receptor blockade is unlikely, a prospective and partly retrospective analysis of 67 patients with beta-blockers poisoning was done in five-year period in order to determine the factors influencing the degree and outcome of acute poisoning. According to pharmacological properties of drugs, the patients were divided in groups: group I--50 patients with propranolol, group II-A--10 patients with atenolol and group II-B--7 patients with metoprolol poisoning. Electrocardiogram (ECG), 24-h ECG monitoring, toxicological screening (determination of beta-blockers in blood, urine and lavage by high performance liquid chromatography) and biochemical analysis were performed in all patients. Significantly smaller number of patients with serious poisoning was observed in group II-B. Patient's age did not correlate with the degree of poisoning, but significant correlation was found between preexisting disease, ingested dose and the time elapsed before the treatment started. Analysis of pharmacological properties showed that membrane stabilizing activity and lipophilicity of the drug might be the important determinants of the toxicity, while the role of cardioselectivity was lost in an overdose.

Acute Disease↗
PubMedDate not supplied

[Carbamazepine cardiotoxicity in acute poisoning].

Manifestations of cardiotoxicity in 9 patients with acute carabamazepine poisoning treated at the Clinic of Toxicology and Clinical Pharmacology of the M.M.A. in 1989 are reported. In all patients together with symptoms and signs characteristic for acute carbamezapine poisoning, there have been also present disorders of the cardiovascular system. The most common clinical signs of cardiotoxicity have been tachycardia and hypotension, and electrocardiographic, ventricular extrasystoles and repolarization disorders. Cardiotoxic manifestations in two cases have been the vital threat for the patients. After application of nonspecific and symptomatic therapy, clinical and electrocardiographic signs of cardiotoxicity were withdrawn, that is, heart sequeles were not recorded.

Acute Disease↗
PubMedDate not supplied

[Pharmacokinetics of the oxime, HI-6, in patients with acute organophosphorus insecticide poisoning].

The results of the study of the pharmacokinetics of a new cholinesterase reactivator--the HI-6 oxime in patients with acute organophosphorus insecticide poisoning and results of effects of its way of application on the rapidity and efficacy of treatment are reported. The results have shown that pharmacokinetic behaviour of HI-6 oxime has been changed during poisoning but these changes have not caused additional risks or changes in the accepted regime of drug dosage. Also, there have been no significant differences in efficacy and speed of reactivation of acetylcholinesterase inhibited by organophosphates when HI-6 is applied in the form of permanent intravenous infusion or repeated intramuscular injections.

Acute Disease↗
PubMedDate not supplied

[Aspiration bronchopneumonia as a complication of acute poisoning with psychotropic drugs].

In the five year period, retrospectively and prospectively, the frequency, clinical, radiographic and bacteriological characteristics of the aspiration bronchopneumonia (ABPN) were followed in the acute poisoning by psychotropic drugs (PD). In 1769 patients with acute poisoning by PD, ABPN was determined in 44 (2.49%) patients, and most frequently in groups with polymedicamentous (5.99%) and neuroleptic (5.17%) poisoning, and rarely in the group poisoned by anxiolytics (0.77%). Severest poisonings by PD were complicated by ABPN in 16.84% of cases. High conformity of clinical and radiographic finding of bronchopneumonia was achieved. The diagnosis of bronchopneumonia was established on the day of admission at the Clinic in 81.9% of cases on the other day in 13.6% and on the third day in 4.5% of patients. Bacteriological examination of sputum revealed the pathogens in 63.6% of patients, but in no patients the anaerobic bacteria were isolated. The treatment was very complex, and beside the detoxification measures, it was necessary to remove the aspirated contents from the respiratory tract (usually during endotracheal intubation or therapeutic bronchoscopy) and immediately apply antibiotics. The examinees were hospitalized twice longer than the patients whose course of poisoning by PD was not complicated by ABPN. The poisoning ended lethally in two (4.5%) patients. In no cases the ABPN was the immediate cause of death, but it significantly contributed to the lethal outcome.

Adolescent↗