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Biomedical subjects

M A Montoya-Cabrera

Publications and source records attributed to M A Montoya-Cabrera.

At least 19 recordsLinked to original sources
PubMed1996

Carbamazepine poisoning in adolescent suicide attempters. Effectiveness of multiple-dose activated charcoal in enhancing carbamazepine elimination.

The aim of the study was to evaluate continuous administration of multiple-dose activated charcoal (MDAC) in enhancing elimination of carbamazepine (CBZ) in eight consecutive adolescent suicide attempters. Diluted charcoal was administered through a nasogastric tube at a dose of 1 g/kg every 4 h, and a saline cathartic at the same dosage was administered every 12 h. Plasma CBZ concentrations were measured at 0.0, 12, 24 and 36 h by means of a modified EMIT technique. As a measure of CBZ disappearance, half life of elimination (t1/2 beta) and exogenous total body clearance (CLB) were calculated. Clinical improvement occurred after 12 to 24 h, except in one patient who was the most severely intoxicated and who required advanced life-support therapy. Pharmacokinetic data reported a mean t1/2 beta of 9.5 h, shorter than the reference value of 18-54 h (p < 0.05), and a mean CLB of 103.13 ml/ min/kg, higher than the reference of 75.01 ml/min/ kg (p < 0.05). Initial mean CBZ levels of 27.9 decreased to 0.82 microgram/ml (97% of elimination, p < 0.05). MDAC was free from adverse side effects. In conclusion, MDAC is an effective procedure in enhancing CBZ elimination in overdosed patients as well as being relatively free from serious side effects, widely available, inexpensive and non-invasive.

Adolescent↗
PubMed1980

Treatment of acute carbamazepine intoxication according to its pharmacological properties. Preliminary report.

Acute carbamazepine intoxication represents a pediatric emergency case with symptoms of CNS depression, seizures and water retention. A symptomatic, maintenance treatment is recommended. Taking into account some of the pharmacodynamic properties of this drug (low volume distribution, and antidiuretic activity) we propose a treatment protocol by means of forced diuresis and peritoneal dialysis. This is a preliminary report of the first four cases treated in this way. Objective assessment of intoxication and response to treatment were made based upon urine and blood determinations of the drug. In three cases cure was obtained with a single dose of furosemide; the fourth patient who was critically ill, was dialyzed and improvement was observed 12 hours after. In spite of the reduced number of patients studied, results obtained allow us to conclude that this procedure is advisable in the treatment of carbamazepine intoxication cases.

Acute Disease↗
PubMed1977

[The appearance of stippling of the retina].

In sixty workers exposed to the absorption of large amounts of lead, stippling of the retina was searched by direct retinoscopy and eye-fundi photography. Fifty patients had clinical manifestations of lead poisoning and the other ten did not, but showed evidences of lead accumulation. Non of the patients had stippling of the retina; however, functional alterations were detected in the muscles of the eye in seven lead poisoned patients. In 25 patients there were also other kinds of retinal alteration, unrelated to lead poisoning.

Adult↗
PubMedDate not supplied

[Acute methyl parathion poisoning with extrapyramidal manifestations not previously reported].

A 14-year-old female attempted suicide by ingesting the organophosphate methyl parathion. A severe acute poisoning developed with the characteristic symptomatology: muscarinic, nicotinic and neurologic, as well serum cholinesterase activity decreased 88%. An extrapyramidal syndrome appeared suddenly nine days after the onset with ocular and buccal crisis, neck and trunk dystonic movements, and hypertonia and tremors. The patient improved with the administration of i.v. diphenhydramine. Other causes of toxic extrapyramidalism and organophosphate intermediate syndrome were discarded. Although an absolute causal relationship of the transient extrapyramidal symptomatology to the organophosphate exposure cannot be clearly established in this case, we speculate a possible delayed inhibition of the dopaminergic receptors in the substantia nigra and the basal ganglia.

Acute Disease↗
PubMedDate not supplied

[Evaluation of the efficacy of N-acetylcysteine administered alone or in combination with activated charcoal in the treatment of acetaminophen overdoses].

STUDY OBJECTIVE: To evaluate the efficacy of N-acetylcysteine (N-AC) alone or combined with multiple-dose activated charcoal (AC) in the treatment of acetaminophen (ACT) overdose. DESIGN: Prospective observational case series of 14 consecutive pediatric patients. Group A (n = 7) were treated only with N-AC and group B (n = 7) with N-AC combined with AC. Plasma ACT concentrations were measured at 0.0, 24 and 48 h. As a measure of ACT disappearance, half-life of elimination (t1/2 beta) and exogenous body clearance (ClB) were calculated. RESULTS: Group A, Initial and final mean ACT plasmatic levels were 27 micrograms/mL and 4 micrograms/mL; t1/2 beta of 17 h and ClB 0.640 mL.kg.min. Group B, 27 micrograms/mL and 0.66 microgram/mL; t1/2 beta of 10 h and ClB 1.092 mL.kg.min. For both t1/2 beta and ClB differences, p < 0.05 (SS). CONCLUSION: N-AC significantly decreased the plasma ACT levels in both treatments; however, there were several advantages with the combined therapy: AC enhanced the efficacy of N-AC according with the higher eliminatión of the overdosed drug (97.6% vs. 85.2%), the t1/2 beta decreased 42%, and the ClB increased 70% in relation to the group A. Data of this study suggested that N-AC plus AC is more effective than N-AC alone in enhancing ACT elimination in overdosed patients and that it provided additional hepatoprotective benefit.

Acetaminophen↗