Biomedical subjects

Jolanta Wilimowska

Publications and source records attributed to Jolanta Wilimowska.

9 recordsLinked to original sources

PubMed2006

Monitoring of verapamil enantiomers concentration in overdose.

A 52-year-old woman with a history of depression and personality disorders, hypertension, coronary disease and asthma was admitted to the Department of Clinical Toxicology after taking 60 tablets of Staveran (immediate release verapamil), and 4 tablets of acetaminophen. One and a half hours after ingestion her condition was critical. She required endotracheal intubation and artificial respiration. Her heart rate was 75 beats per minute, (bpm) and her blood pressure dropped from 70/50 to 50/00 mmHg. Additionally, drowsiness and headache were observed. On admission, R-(+)- and S-(-)-verapamil serum concentrations were 2252 ng/ml and 810 ng/ ml, respectively. Monitoring of the verapamil serum concentration was carried out over 74 h. Terminal elimination half-lives were 18.7 (21.3) and 17.0 (18.5) hours, respectively, for R-(+)- and S-(-)-verapamil. Monitoring of verapamil enantiomers concentrations in serum indicated a higher concentration of the less active form and slightly faster elimination of the more active enantiomer. The data-support a stereoselective difference between first pass clearance and later systemic clearance of verapamil, when taken in overdose.

Blood Pressure↗

PubMed2006

Disposition of valproic acid in self-poisoned adults.

Acute intoxication with valproic acid is increasingly being observed in clinical practice. In Poland, such intoxication frequently occurs as a result of mixing different drugs or alcohol. We studied the pharmacokinetics of valproic acid in five intoxicated patients. Apart from valproic acid, barbiturates, chlorprotixene, tricyclic antidepressants, tetrahydrocannabinols and alcohol were detected and measured. The absorption of the drug was rapid and the maximum concentration was observed after the period of 3.5-5.6 hr. The lowering of the valproic acid level in plasma was biphasic, with terminal half-life ranging between 8.8-30.9 hr. The calculated apparent volume of distribution was 0.17-0.72 l/kg and could be affected by varied levels of doses as well as time of drug intake (data from interviews of patients) used for calculation and reduction in plasma protein binding at higher concentration of valproic acid. Frequent multiple drug poisonings oblige toxicological laboratories not only to monitor valproic acid concentration in serum, but also to perform the toxicological screenings.

Adolescent↗

PubMed2005

B-type natriuretic peptide plasma concentration in acutely poisoned patients.

B-type natriuretic peptide (BNP) is synthesized in the cardiac ventricles upon ventricular myocyte stretch. BNP plasma concentration is useful in cardiology especially for identifying patients with congestive heart failure (CHF), as a prognostic marker of acute coronary syndromes and independent predictor of sudden cardiac death. Its value in clinical toxicology is unclear. As toxins frequently produce deleterious effects on the cardiovascular system we have decided to carry out the pilot study on BNP plasma levels in acutely poisoned patients. The 117 patients (65 males and 52 females) treated at the Department of Clinical Toxicology Jagiellonian University Medical College in Kraków in 2004 were included. 42 of them were intoxicated with ethanol, 35 with pharmaceuticals (mostly tricyclic antidepressants), 13 with CO. The mean age of examined group was 34.07 +/- 12.08 year. The control group consisted of 54 healthy volunteers and employees of the Department (mean age; 32.7 +/- 11.74). A significantly higher BNP concentration was found in poisoned patients than in the control group. The highest BNP plasma concentration was noted in pharmaceutical poisoned patients. Mean BNP concentration in poisonings of minor severity (grade 1) was significantly lower then in moderate (grade 2) or severe (grade 3) poisonings. BNP plasma measurement as an additional marker of cardiac disturbances in clinical toxicology practice may be suggested.

Acute Disease↗

PubMed2005

Comparison of fluorescence polarization immunoassay and high performance liquid chromatography for determination of carbamazepine concentration in blood of poisoned patients.

Carbamazepine is an antiepileptic drug widely used by neurological and psychiatric patients. Because of it's low therapeutic index and increasing number of acute carbamazepine intoxications there is a need of routine serum carbamazepine assay in toxicological laboratories. Determinations of serum carbamazepine concentrations are 5.3% of all toxicological analysis carried on in Department of Analytical Toxicology and Therapeutic Drug Monitoring, Collegium Medicum, Jagiellonian University in Kraków. The goal of the study was comparison of two analysis methods: FPIA and HPLC-DAD for the diagnostics of patients intoxicated with carbamazepine. Material for analysis were 21 samples of blood collected from poisoned patients treated in Department of Clinical Toxicology in Kraków. Measurements of serum carbamazepine concentration by FPIA method and carbamazepine and it's main active metabolite carbamazepine-10,11-epoxide concentrations by HPLC-DAD method were made. Statistical analysis showed that serum carbamazepine concentrations measured by FPIA method were higher than serum carbamazepine concentrations measured by HPLC-DAD method (t21 = 2.21, p = 0.0384). The mean difference of serum carbamazepine concentrations measured by the two methods was 2.67 mg/l (SD = 5.69 mg/l) and didn't depend on the carbamazepine concentration measured by FPIA method (r = -0.137, p = 0.5431). There was no statistical difference between serum carbamazepine concentration measured by FPIA method and the sum of serum carbamazepine and carbamazepine-10,11-epoxide concentrations measured by HPLC-DAD method (t21 = 1.42, p = 0.1690).

Acute Disease↗

PubMed2004

[Psychoactive substances in biological samples--toxicological laboratory data].

The subject of the research was the analysis of frequency and type of psychoactive substances used, basing on the determinations the blood and/or urine samples, performed in the toxicological laboratory of the Department of Clinical and Industrial Toxicology Jagiellonian University in Kraków in the period from December 2001 to November 2003. From 17,649 performed determinations--45.5% were positive. 50% of the positive determinations were psychoactive substances. The most often psychoactive substance determined was ethyl alcohol (52.86%), next benzodiazepines (17.41%), amphetamines (10.54%), opiates (8.05%), THC (6.87%), barbiturates (3.74%), and occasionally atropine and cocaine. There was observed a variety of mixed, simultaneously taking psychoactive substances, especially ethyl alcohol, opiates, amphetamine derivatives and cannabinoids. The analysis of the occurrence of psychoactive substances in biological samples from patients treated in different hospital departments, others hospitals and ordered by private persons also was performed. In the last two years 369 private patients ordered psychoactive substances determinations and 78 of them were positive.

Amphetamines↗

PubMed2004

[Proper use of own data bases warranted by call recording system].

A newly created computer system for call (toxicological information) recording and a Base of Toxic Substances created in native Polish language are presented in the paper. An extended structure of this data base enable to catalogue different groups of toxic substances (e.g. medication drugs, psychoactive substances, pesticides), and toxins (animals' poisons, toxic plants and mushrooms) concerning their specificity. Construction of the Base also enable to reach necessary information quickly. What more, identification of toxic substances could be easier due to possibility enclosing photos.

Databases as Topic↗

PubMed2004

[The effect of smoking on serum nitric oxide (NO) in acutely carbon monoxide poisoned patients].

An important role of Nitric Oxide (NO) in relaxing vascular smooth muscle is commonly known. In this pilot study we aimed to asses an impact of cigarette smoking on NO serum concentration in acutely CO poisoned patients. The measured marker of cigarette smoking was urea cotinine. A highest NO concentration and lowest diastolic blood pressure were noted in the subgroup of acutely CO poisoned smokers. Diastolic blood pressure in the subgroup of not CO poisoned non-smokers and was higher compared to acutely CO poisoned (both smokers and nonsmokers) and also to subgroup of those person who were exposed only to CO in cigarette smoke.

Acute Disease↗

PubMed2004

[The level of cotinine in urine and placenta of women smoking or exposure to tobacco smoke during pregnancy].

The aim of the studies was evaluation smoking habit by delivering woman using objective method--determination of cotinine in urine and placenta. In the study participated 93 woman delivering in Gynaecological-Obstetric Clinical Hospital of Medical University at Warsaw. Evaluation of tobacco smoking and exposure to ETS performed on the base of questionnaire and level of cotinine in urine. In the group of non smoking woman cotinine was not detected any in urine any in placenta. In the second group (19 patients), woman exposure to ETS concentration of cotinine in urine was 28.9 +/- 14.9 ng/mg of creatinine and only in two placentas was detected a low level of cotinine. In smoking delivering woman the urine concentration was 837.0 +/- 1324.5 ng/mg of creatinine and 21.3 +/- 7.5 ng/g placenta calculated from all results and 67.0 +/- 3.5 ng/g calculated only from positive results. A weak relation between concentration of cotinine in placenta and urine of smoking woman was shown.

Adult↗

PubMed2003

[Cardiotoxic agents in the practice of the toxicological laboratory].

Basing on toxicological examination performed between December 1, 2001 and November 6, 2002 the analysis of cardiotoxic agents was carried out. As much as 69.7% of 2523 positive results was related to cardiotoxic agents. Ethanol (57.4%) followed by anticholinergic drugs (15.7%), amphetamine (11.6%) and carbon monoxide (8.9%) were most frequently determined cardiotoxic agents. Relatively small number of cardiovascular medication drugs (0.3%) was stated in biological samples. The cardiotoxic agents were detected mostly in men (68.8%), even after ethanol was excluded from the analysis (54.8%).

Antidepressive Agents↗