Biomedical subjects

K S Merigian

Publications and source records attributed to K S Merigian.

21 records · Page 2Linked to original sources

PubMedDate not supplied

Adrenergic crisis from crack cocaine ingestion: report of five cases.

We report the historical, clinical, and laboratory findings in 5 patients after crack cocaine ingestion. All patients exhibited adrenergic crisis as a result of their ingestion. Analysis of their history revealed a latency period before signs and symptoms occurred as well as a wide variation in the number of crack cocaine nuggets ingested. Signs of intoxication were hypertension, tachycardia, hyperthermia, agitation, and generalized seizure activity. Treatment included therapeutic sedation with lorazepam and adrenolysis with esmolol infusion. The majority of patients showed electrocardiographic evidence of cardiac ischemia, but not elevations in serum creatinine phosphokinase enzymes--MB fraction. One patient died of complications associated with subclinical status epilepticus. The toxicities of crack cocaine ingestion are seldom appreciated. Prompt reversal of both cardiovascular and neurological signs and symptoms with appropriate pharmacologic agents is indicated.

Administration, Oral↗

PubMedDate not supplied

Foreign body ingestions in the Emergency Department: case reports and review of treatment.

We report a series of alleged ingestions of razor blades and other metal objects by prisoners presenting to an inner city Emergency Department. Fourteen claims of ingestions of razor blades or other metal objects involving eight prisoners occurred in a 5-week period. The motives behind the ingestions varied. Auditory hallucination was the most common reason given for the ingestions. Other motives included efforts to leave prison, depression, and accidental razor blade swallowing. Attempts were made in all patients to verify ingestions by radiograph. Some ingestions could not be confirmed by radiograph and were considered to be factitious. Only 1 of the 14 incidents resulted in hospital admission. All others were either treated in the Emergency Department or the patient was returned to jail with no treatment. No patient had a poor clinical outcome as a result of the ingestion, indicating that diagnostic radiographs and invasive procedures may not always be necessary. A review of treatment of foreign body ingestions is given as well as a summary of the treatment and outcome of these cases.

Adolescent↗

PubMedDate not supplied

Diagnosis and management of the drug overdose patient.

The manifestations of drug overdose can be complex and result in a variety of physiological effects. Drug overdose situations involving multiple agents further confuse the clinical picture. The clinician must be able to diagnose and treat the patient to prevent unnecessary morbidity or mortality. Often the risk of treating drug overdose with an additional pharmacological agent outweighs the potential benefit. In these cases, the best treatment may involve observation alone. This review describes the current diagnostic and management techniques for the drug overdose patient. Specific drug groups that are commonly used for overdose are discussed with emphasis on physiological manifestations of intoxication and poisoning and the potential for delayed effects. Treatment options for various groups are also discussed. It appears that invasive procedures such as gastric lavage and whole-bowel irrigation are not appropriate for the majority of overdose situations. The use of oral activated charcoal may also be of limited value. As specific antidotes for drug overdose are not widely available, supportive treatment must be based on the individual patient.

Drug Overdose↗