Henry Spiller

..We report a rare fatality in an infant after ingestion of amlodipine with benazepril, with postmortem blood concentrations...

..Modafanil, a non-amphetamine stimulant, is used for narcolepsy, sleep apnea, and shift work sleep disorder. There is little available information on the toxicity of modafinil overdose...

..The potential for severe toxicity in the setting of pediatric overdose should be recognized...

..We report a case of methemoglobinemia of 51% in a 3 year old girl after acute ingestion of malachite green from a commercially available aquarium product...

..We report a case of unintentional tetrahydrozoline ingestion with cardiovascular effects persisting for 36 hours...

..It may be warranted to include imidazoline derivatives in the testing for cases of DFSA...

....

..The toxicology of oral antidiabetic agents is reviewed...

..Tiagabine is an anticonvulsant that blocks reuptake of the inhibitory neurotransmitter GABA. There are no published studies or case series of tiagabine overdoses...

..Information calls to poison centers, particularly for pill identification (PID), have been increasing...

..The pills found in these patients may represent the residual matrix/shell with significant portions of the actual bupropion released and absorbed by the patients...

..No consistent trend was identified with population density and prescription opioid drug rates. Understanding trends may help guide distribution of scarce resources and prevention efforts to where they may have their greatest impact...

..We report the experience of the first 8 months of two regional poison centers after the emergence of a new group of substances of abuse...

..We investigated the incidence of hospital utilization for injuries and compared poisoning with other forms of injury. Previous studies have suggested poison control centers reduce health-care costs by decreasing hospital utilization...

..Adverse drug events in the ambulatory care setting are not uncommon and can cause significant morbidity. Little research has been published on the management of adverse drug events involving insulin in the outpatient setting...

..In 2001, a new antivenin was introduced to the United States and became widely available in the snakebite season of 2002. We investigated what impact this may have had on snakebite treatment and medical outcome...

..The purpose of this study was to examine trends in suspected suicide (SS) cases reported to the National Poison Data System (NPDS), over a 9-year period (2000-2008)...

..There is limited information on the effect of scheduling a drug as a controlled substance with comparable data from both a pre-scheduling and post-scheduling time period...

..No temporally related increase in abuse and misuse of prescription drugs was noted and conversely a trend toward decreased abuse and misuse of prescription drugs was suggested...

..Volatile substance abuse appears to increase as percentage of population with a bachelor's degree decreases...

..Atomoxetine uses a novel non-stimulant approach to the treatment of attention deficit hyperactivity disorder. There is limited information on overdose of atomoxetine in children or adults...

..This study summarizes the clinical course and outcomes of metformin ingestion in children reported to the American Association of Poison Control Centers-certified regional poison centers...

..Additionally, the blood was drawn from a femoral site, so that postmortem redistribution is not a likely factor. Blood concentration of > or = 0.8 mg/L cyclobenzaprine may be associated with a fatal outcome...

..The morbidity associated with snakebite envenomation has not been well documented...

..No data are available on the safety of senna use in children <6 years of age...

..This may represent enhanced information because of the larger sample group. Hydrocodone values associated with a fatality were similar to previously published values...

..The major risk associated with metformin is lactic acidosis. The incidence of lactic acidosis is not clear. Hypoglycemia is not expected to be a major concern after metformin exposure...

..The majority of UCA ingestions produced limited or no symptomatology. In this series, all children with ingestions of <5 mg/kg developed no or minor effects. Home monitoring might be appropriate in such cases...

..A small group of substances appears responsible for the majority of deaths. It is imperative that we continue to educate the public and healthcare professionals regarding the risks of VSA and hopefully impact the incidence of VSA...

....

..The seizures abated with the infusion of midazolam. This is a report of status epilepticus associated with wide complex tachycardia after carbamazepine overdose, which may be resistant to conventional therapy...

..AC use in the home has been limited by concerns that parents would not administer it properly and that children would refuse to take AC. Previous descriptions of home administration have reported mixed results...

..Valproic acid exposures reported to poison centers have increased more than 4-fold over the last 5 years. There are no large case series published on valproic acid ingestion...

..Tizanidine is a centrally acting muscle relaxant with a novel mechanism of action and structurally related to clonidine. There are no large case series of tizanidine exposure...

..2%. However, in many poison centers, > 80% of these patients are referred to the Emergency Department (ED) for evaluation...

..We underscore the view that a thoroughly documented medicolegal investigation and autopsy are indispensable to both inform matters of public health and thereby contribute to the formulation of sound public policy...

..5 u/ml) associated with coma, respiratory depression requiring mechanical ventilation, and hypotension...

..1 mg, (2) ingestion of >0.2 mg in children 5 to 8 years of age, and (3) ingestion of >or=0.4 mg in children older than 8 years of age. Observation for 4 hours may be sufficient to detect patients who will develop severe effects...

..Evaluation of 12 years of acute APAP overdoses suggests that the use of AC, in addition to NAC therapy, may provide improved patient outcomes...

..Based on its primary action of serotonin reuptake inhibition, venlafaxine overdose would be expected to result in serotonergic effects...

..The manner of death was suicide. This case report, which presents an overview of acute and chronic selenium poisoning, underscores the value of thorough toxicologic analyses of tissue and body fluids in humans...

....

..The addition of a public educator was associated with a positive impact on human exposures and penetrance reported to a regional poison center...

..In this limited first case series of iron carbonyl ingestion, serious toxicity did not occur...

..She recovered over the next day without sequelae. As with other potentially toxic products, we would recommend caution and direct supervision of use when this product is available to young children...

..Ingestions of calcium salts can result in necrosis of the stomach. Management includes aggressive treatment of hypercalcemia, supportive care and upper gastrointestinal endoscopy...

..This is an unusual case in that it occurred in a young child, was related to chlorpyrifos, and occurred despite continuous and adequate oxime therapy...

..A 3rd patient complained of lionfish envenomation with no tissue reaction and was refused analgesia. Inconsistent clinical presentations of envenomations may signal drug-seeking behaviors...

..Factors increasing the dermal absorption of the diphacinone were: prolonged skin contact in a confined area and exposure to a concentrated solution...

..No other drugs were detected. We report an unusual case of massive fluoxetine ingestion resulting in neurological and cardiovascular toxicity resulting in death...

....

..We characterized the clinical manifestations associated with ziprasidone overdoses, in particular the incidence and severity of QTc prolongation...

..Documented clinical experience involving exposure to these agents is limited. The lack of information makes decisions involving excessive or unintended CA-ChEI exposure difficult...