RESUMO
The efficacy of lithium in the prevention of bipolar disorders is now well established. However, acute lithium intoxications still occur, often after suicide attempts. Symptoms are often different from one patient to the other, and long lasting neurologic sequelae may happen. Active treatments are available, notably haemodialysis, which increase lithium clearance dramatically. We report cases quoted in the department of intensive care of Tours University Hospital over the last three years and compared them with the literature. Lithium level and treatment of these intoxications were analysed. Although new medicines are available for the treatment of bipolar disorders, lithium is still an important drug in this disease, therefore, the prescribers have to be aware of the consequences of acute lithium intoxications.
Assuntos
Compostos de Lítio/intoxicação , Doença Aguda , Adulto , Idoso , Feminino , Humanos , Compostos de Lítio/farmacocinética , Masculino , Pessoa de Meia-Idade , Intoxicação/terapiaRESUMO
The aim of this review is to describe the present knowledge about chemical submission. The number of scientific publications on this phenomenon has increased over the last 10 years. Perpetrators choose drugs which act rapidly, produce desinhibition, sedation, and anterograde amnesia during the abuse. Ethanol and benzodiazepines are the most frequently used. A few drugs, including flunitrazepam and gamma-hydroxybutyric acid (GHB), have received widespread media coverage. Toxicological investigations on blood, urine or hair samples allow to detect the substance used. Every effort should be made to collect appropriate specimens as quickly as possible. Gas chromatography-mass spectrometry is at present the most appropriate analytical method to detect these drugs in a biological specimen.
Assuntos
Dominação-Subordinação , Comportamento Social , Transtornos Relacionados ao Uso de Substâncias/psicologia , Flunitrazepam/efeitos adversos , Humanos , Estupro , Oxibato de Sódio/efeitos adversosAssuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Citocromo P-450 CYP2D6/metabolismo , Metilfenidato/farmacocinética , Transtorno do Deficit de Atenção com Hiperatividade/genética , Transtorno do Deficit de Atenção com Hiperatividade/metabolismo , Estimulantes do Sistema Nervoso Central/metabolismo , Estimulantes do Sistema Nervoso Central/farmacocinética , Estimulantes do Sistema Nervoso Central/uso terapêutico , Criança , Pré-Escolar , Citocromo P-450 CYP2D6/genética , Genótipo , Humanos , Masculino , Taxa de Depuração Metabólica , Metilfenidato/metabolismo , Metilfenidato/uso terapêutico , Fatores de TempoRESUMO
The aim of this study was to assess a residual gravimetric method based on weighing dry filters to measure the aerosol output of nebulizers. This residual gravimetric method was compared to assay methods based on spectrophotometric measurement of terbutaline (Bricanyl, Astra Zeneca, France), high-performance liquid chromatography (HPLC) measurement of tobramycin (Tobi, Chiron, U.S.A.), and electrochemical measurements of NaF (as defined by the European standard). Two breath-enhanced jet nebulizers, one standard jet nebulizer, and one ultrasonic nebulizer were tested. Output produced by the residual gravimetric method was calculated by weighing the filters both before and after aerosol collection and by filter drying corrected by the proportion of drug contained in total solute mass. Output produced by the electrochemical, spectrophotometric, and HPLC methods was determined after assaying the drug extraction filter. The results demonstrated a strong correlation between the residual gravimetric method (x axis) and assay methods (y axis) in terms of drug mass output (y = 1.00 x -0.02, r(2) = 0.99, n = 27). We conclude that a residual gravimetric method based on dry filters, when validated for a particular agent, is an accurate way of measuring aerosol output.