Is activated charcoal useful for acetaminophen overdose beyond two hours after ingestion?
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Biomedical subjects
Publications and source records attributed to H C Mofenson.
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This is a case of magnesium intoxication in a neonate produced by an oral magnesium cathartic. A review of the literature revealed there are very few cases that have been reported of magnesium toxicity due to cathartics. There is no recommended dose for magnesium cathartics in neonates or data on their safety. A review of the management of magnesium intoxication is presented.
This is the fourth reported case of acute pancreatitis associated with acetaminophen overdose. The patient had ingested the smallest amount of acetaminophen (9.75-13 g) that has been reported to produce acute pancreatitis. This patient also suffered liver and renal impairment and developed an ileus and ascites. Despite late therapy and laboratory tests that indicated a poor prognosis the patient made a complete recovery without sequelae.
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This article discusses the management of antidysrhythmic drug overdoses in children and adolescents.
The status of syrup of ipecac as a nonprescription drug has helped reduce the death rate in children, ages 1 to 5 years. The drug has proven safe and effective in children in the recommended doses. To deprive parents of ready access to ipecac syrup would result in increased disability and death from poisoning and more emergency department visits.
The problem of toy-related injuries is a complicated one. The authors detail specific hazards related to toys, playgrounds, skateboards, and baby walkers. Guidelines are provided for toy suitability for children of all ages.
There is controversy regarding the best maneuver to expel a completely obstructing foreign body from the upper airway of a patient. Further study and research are needed. However, we recommend that no change in the present recommendations be made until these studies are accomplished. We have attempted to outline the major aspects of the controversy and give the rationale for the present recommendations.
This article reports five patients who had taken a substantial medication overdose and presented in coma. Two had taken a salicylate overdose and three a phenobarbital overdose (one of these ingested a combination of phenobarbital and phenytoin). The cases were treated by our standard protocol of supportive therapy and alkaline diuresis plus repetitive oral doses of activated charcoal (gastrointestinal dialysis). All patients were alert and oriented within 24 hours. Toxicokinetic analysis of the blood levels is discussed. Gastrointestinal dialysis represents a relatively noninvasive method that may benefit certain intoxicated patients even after systemic absorption has occurred. The technique and recommendations for its use are discussed and described in detail.