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Acute myocardial infarction in a patient using bupropion to aid smoking cessation
Abstracts / Toxicology Letters 164S (2006) S1–S324
S89
P2-43 Epidemiology of acute pesticide poisoning admitted in ICU II Toxicology—Emergency Clinical Hospital Bucharest between 1997 and 2005
show a higher proportion of severe and fatal cases. To decrease the morbidity and mortality through pesticide poisoning, it is needed a more severe control of the sale and use of these products.
Radu Alexandru Macovei, Ilenuta Danescu, Mihail S. Tudosie, Victor A. Voicu
doi:10.1016/j.toxlet.2006.06.184
ICU II Toxicology, Emergency Clinical Hospital Bucharest, Romania
P2-44 Acute myocardial infarction in a patient using bupropion to aid smoking cessation
Objective: Acute pesticide poisoning, a medical emergency requiring prompt treatment, is a common problem in our country due to widespread use of these compounds. We present an epidemiological profile of acute pesticide poisoning admitted in our department between 1997 and 2005. Methods: We retrospectively analyzed the records of pesticide poisoning admitted in ICU Toxicology. Results: During 9 years, 818 cases of acute pesticide poisoning were recorded. The frequency in total poisoning was: 1997—3.13% (106 cases), 1998—4.05% (126), 1999—3.31% (89), 2000—4.80% (118), 2001—5.03% (107), 2002—3.98% (84), 2003—4.93% (74), 2004—4.38% (58), 2005—4.98% (56). The most common occupations were associated with agriculture. The seasonal distribution peaked in spring and autumn months. In most cases oral ingestions was reported. The majority (86%) was suicide attempts and the remaining (14%) was accidental exposures. The most frequent implicated was 21–30 year group for both males and females. Of the patients studied, 49.27% was females and 50.73% males. The products involved were: organophosphates 42%, carbamates 30%, other insecticides and herbicides 18%, rodenticides 8%. In 76% of admitted patients were severe symptoms (coma 46%, respiratory failure 42%, cardiac troubles 18%). 46% underwent mechanical ventilation. 62% received atropine, 40% received fresh frozen plasma, 8% received cholinesterase reactivators. Blood pseudocholinesterase measurements were regularly performed. The mortality was 4% in the total of poisonings, through cardiac arrhythmias and respiratory disturbances, higher in males group and in the patients with associate morbidities. All patients with suicide attempts were referred to a psychiatry specialist. Conclusions: The acute pesticide poisoning counts for 4.12% in the total number of poisoning admitted in our department. The number of patients decreased in the last years because the legal measures of availability of these products and the use of more non-toxic substances. Most of the cases admitted were suicidal with oral route of exposure and in severe condition. Organophosphates
Yuksel Gokel, Akkan Avci, Mehmet Kanadası Cukurova University School of Medicine, Balcali, Dana, Turkey Bupropion is a new monocyclic antidepressant that has seen increased usage in smoking cessation. Bupropion has cardiovascular, neurologic, and gastrointestinal toxicity. The case is reported of a patient who had been using bupropion to aid smoking cessation. The patient suffered from chest pain, pruritus, and rashes. Electrocardiographic examination revealed ST segment elevation in DI, V5, and V6 leads. Cardiac enzymes, CK-MB and Troponin T levels are elevated. The patient was considered as acute myocardial infacrtion. This case is the second case of acute myocardial infarction in a patient using bupropion to aid smoking cessation. doi:10.1016/j.toxlet.2006.06.185 P2-45 Therapeutic effect of bis-pyridinium oximes against tabun poisoning Bozica Radic 1 , Ana Fuchs 1 , Kamil Kuˇca 2
Lucic
Vrdoljak 1 , Radovan
1 Institute
for Medical Research and Occupational Health, Zagreb, Croatia; 2 Faculty of Military Health Sciences, Zagreb, Croatia Organophosphorus compounds are widely used as pesticides and unfortunately as nerve agents in chemical warfare. They are known inhibitors of acetylcholinesterase (AChE, EC 3.1.1.7) an enzyme that hydrolysis the neurotransmitter acetylcholine in the nervous system. The clinical signs of AChE inhibition manifest as hypersalivation, lacrimation, diarrhoea, tremor, respiratory distress, convulsion and seizures. Signs are dosedependent, leading to severe incapacitation and rapid death. Together with atropine, pyridinium oximes are known to be successfully used to treat poisoning with many organophosphorus compounds. In this paper three new bis-pyridinium compounds: K033 [1,4-bis (2-hydroxyiminomethylpyri-
S89
P2-43 Epidemiology of acute pesticide poisoning admitted in ICU II Toxicology—Emergency Clinical Hospital Bucharest between 1997 and 2005
show a higher proportion of severe and fatal cases. To decrease the morbidity and mortality through pesticide poisoning, it is needed a more severe control of the sale and use of these products.
Radu Alexandru Macovei, Ilenuta Danescu, Mihail S. Tudosie, Victor A. Voicu
doi:10.1016/j.toxlet.2006.06.184
ICU II Toxicology, Emergency Clinical Hospital Bucharest, Romania
P2-44 Acute myocardial infarction in a patient using bupropion to aid smoking cessation
Objective: Acute pesticide poisoning, a medical emergency requiring prompt treatment, is a common problem in our country due to widespread use of these compounds. We present an epidemiological profile of acute pesticide poisoning admitted in our department between 1997 and 2005. Methods: We retrospectively analyzed the records of pesticide poisoning admitted in ICU Toxicology. Results: During 9 years, 818 cases of acute pesticide poisoning were recorded. The frequency in total poisoning was: 1997—3.13% (106 cases), 1998—4.05% (126), 1999—3.31% (89), 2000—4.80% (118), 2001—5.03% (107), 2002—3.98% (84), 2003—4.93% (74), 2004—4.38% (58), 2005—4.98% (56). The most common occupations were associated with agriculture. The seasonal distribution peaked in spring and autumn months. In most cases oral ingestions was reported. The majority (86%) was suicide attempts and the remaining (14%) was accidental exposures. The most frequent implicated was 21–30 year group for both males and females. Of the patients studied, 49.27% was females and 50.73% males. The products involved were: organophosphates 42%, carbamates 30%, other insecticides and herbicides 18%, rodenticides 8%. In 76% of admitted patients were severe symptoms (coma 46%, respiratory failure 42%, cardiac troubles 18%). 46% underwent mechanical ventilation. 62% received atropine, 40% received fresh frozen plasma, 8% received cholinesterase reactivators. Blood pseudocholinesterase measurements were regularly performed. The mortality was 4% in the total of poisonings, through cardiac arrhythmias and respiratory disturbances, higher in males group and in the patients with associate morbidities. All patients with suicide attempts were referred to a psychiatry specialist. Conclusions: The acute pesticide poisoning counts for 4.12% in the total number of poisoning admitted in our department. The number of patients decreased in the last years because the legal measures of availability of these products and the use of more non-toxic substances. Most of the cases admitted were suicidal with oral route of exposure and in severe condition. Organophosphates
Yuksel Gokel, Akkan Avci, Mehmet Kanadası Cukurova University School of Medicine, Balcali, Dana, Turkey Bupropion is a new monocyclic antidepressant that has seen increased usage in smoking cessation. Bupropion has cardiovascular, neurologic, and gastrointestinal toxicity. The case is reported of a patient who had been using bupropion to aid smoking cessation. The patient suffered from chest pain, pruritus, and rashes. Electrocardiographic examination revealed ST segment elevation in DI, V5, and V6 leads. Cardiac enzymes, CK-MB and Troponin T levels are elevated. The patient was considered as acute myocardial infacrtion. This case is the second case of acute myocardial infarction in a patient using bupropion to aid smoking cessation. doi:10.1016/j.toxlet.2006.06.185 P2-45 Therapeutic effect of bis-pyridinium oximes against tabun poisoning Bozica Radic 1 , Ana Fuchs 1 , Kamil Kuˇca 2
Lucic
Vrdoljak 1 , Radovan
1 Institute
for Medical Research and Occupational Health, Zagreb, Croatia; 2 Faculty of Military Health Sciences, Zagreb, Croatia Organophosphorus compounds are widely used as pesticides and unfortunately as nerve agents in chemical warfare. They are known inhibitors of acetylcholinesterase (AChE, EC 3.1.1.7) an enzyme that hydrolysis the neurotransmitter acetylcholine in the nervous system. The clinical signs of AChE inhibition manifest as hypersalivation, lacrimation, diarrhoea, tremor, respiratory distress, convulsion and seizures. Signs are dosedependent, leading to severe incapacitation and rapid death. Together with atropine, pyridinium oximes are known to be successfully used to treat poisoning with many organophosphorus compounds. In this paper three new bis-pyridinium compounds: K033 [1,4-bis (2-hydroxyiminomethylpyri-