Health Hazard Evaluation Report 77-73-610
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Focus on Over-The-Counter Drugs' Misuse: a Systematic Review On
SYSTEMATIC REVIEW published: 07 May 2021 doi: 10.3389/fpsyt.2021.657397 Focus on Over-the-Counter Drugs’ Misuse: A Systematic Review on Antihistamines, Cough Medicines, and Decongestants Fabrizio Schifano 1, Stefania Chiappini 1,2*, Andrea Miuli 2, Alessio Mosca 2, Maria Chiara Santovito 2, John M. Corkery 1, Amira Guirguis 3, Mauro Pettorruso 2, Massimo Di Giannantonio 2 and Giovanni Martinotti 2 1 Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom, 2 Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, Chieti, Italy, 3 Swansea University Medical School, Institute of Life Sciences 2, Swansea Edited by: University, Swansea, United Kingdom Nicolas Simon, Aix Marseille Université, France Background: Over the past 20 years or so, the drug misuse scenario has seen the Reviewed by: Nicolas Franchitto, emergence of both prescription-only and over-the-counter (OTC) medications being Université Toulouse III Paul reported as ingested for recreational purposes. OTC drugs such as antihistamines, Sabatier, France Oussama Kebir, cough/cold medications, and decongestants are reportedly the most popular in being Institut National de la Santé et de la diverted and misused. Recherche Médicale (INSERM), France Objective: While the current related knowledge is limited, the aim here was to *Correspondence: examine the published clinical data on OTC misuse, focusing on antihistamines Stefania Chiappini (e.g., diphenhydramine, promethazine, chlorpheniramine, and dimenhydrinate), [email protected] dextromethorphan (DXM)- and codeine-based cough medicines, and the nasal Specialty section: decongestant pseudoephedrine. This article was submitted to Methods: A systematic literature review was carried out with the help of Scopus, Addictive Disorders, a section of the journal Web of Science databases, and the related gray literature. -
درمان و تشخیص نامه شیوه کلرین گاز با مسمومیت Medical Guideline For
شیوه نامه تشخیص و درمان مسمومیت با گاز کلرین Medical Guideline for Chlorine Gas Poisoning اداره کل پدافند غیرعامل وزارت بهداشت، درمان و آموزش پزشکی مرداد 6931 فهرست مطالب عنوان صفحه 1- مشخصات کلی ....................................................................................................................................... 1 1 ....................................................................................................................... Threshold Limit Values; 2- ویژگیها ............................................................................................................................................... 2 2-1: مکانیسم اثر ...................................................................................................................................... 2 3- نحوه مواجهه و تماس ............................................................................................................................... 3 3-1- مواجهه حاد تنفسی ............................................................................................................................ 4 3-2- مواجهه حاد پوستی ـ مخاطی ................................................................................................................ 4 3-3- مواجهه حاد گوارشی .......................................................................................................................... 5 4- عﻻیم و نشانه های مسمومیت ...................................................................................................................... 5 4-1- عﻻیم مواجهه حاد تنفسی -
Toxicological Profile for Chlorine
CHLORINE 25 3. HEALTH EFFECTS 3.1 INTRODUCTION The primary purpose of this chapter is to provide public health officials, physicians, toxicologists, and other interested individuals and groups with an overall perspective on the toxicology of chlorine. It contains descriptions and evaluations of toxicological studies and epidemiological investigations and provides conclusions, where possible, on the relevance of toxicity and toxicokinetic data to public health. A glossary and list of acronyms, abbreviations, and symbols can be found at the end of this profile. 3.2 DISCUSSION OF HEALTH EFFECTS BY ROUTE OF EXPOSURE To help public health professionals and others address the needs of persons living or working near hazardous waste sites, the information in this section is organized first by route of exposure (inhalation, oral, and dermal) and then by health effect (death, systemic, immunological, neurological, reproductive, developmental, genotoxic, and carcinogenic effects). These data are discussed in terms of three exposure periods: acute (14 days or less), intermediate (15–364 days), and chronic (365 days or more). Levels of significant exposure for each route and duration are presented in tables and illustrated in figures. The points in the figures showing no-observed-adverse-effect levels (NOAELs) or lowest observed-adverse-effect levels (LOAELs) reflect the actual doses (levels of exposure) used in the studies. LOAELs have been classified into "less serious" or "serious" effects. "Serious" effects are those that evoke failure in a biological system and can lead to morbidity or mortality (e.g., acute respiratory distress or death). "Less serious" effects are those that are not expected to cause significant dysfunction or death, or those whose significance to the organism is not entirely clear. -
Neurotoxicity: Identifying and Controlling Poisons of the Nervous System
Index -i abused drugs activities of, 33, 81, 88, 322 addiction, 6, 52,74, 75 aldicarb, 47, 173,251 designer drugs, 51 aldrin, 250,252,292 effects on nervous system, 6,9, 51–53, 71 allyl chloride, 303 health costs of, 20,53,232 aluminum, 48 psychoactive drugs, 6, 10,27,44,50 and Alzheimer’s disease, 54-55 withdrawal from, 74 oxide, 14, 136 see also specific drugs Alzheimer’s disease academic research effects on hippocampus, 71 cooperative agreements with government, 94 environmental cause, 3, 6, 54-55, 70, 72 factors influencing directions of, 92-94 research on, 259 acetaldehyde, 297 American Academy of Pediatrics, 189 acetone, 14, 136,296, 297,303 American Conference of Governmental Industrial Hygienists, acetylcholine, 26, 66, 109, 124,294, 336 28, 151, 185, 186,203,302-303 acetylcholinesterase, 11,50,74,84,187,203, 289,290-292,336 American National Standards Institute, 185 acetylethyl tetramethyl tetralin (AETT) ammonia, 14, 136 exposure route, 108 amphetamines, 74 incidents of poisoning, 47, 54 amyotrophic lateral sclerosis neurological effects of, 54 characteristics of, 54 acrylamide, 73, 120 environmental cause, 3, 6, 54-55, 70, 72 neurotoxicity testing, 166, 175 incidence of, 54, 55 regulation for neurotoxicity, 178 research on, 259 risk assessment approaches, 150, 151,216 anencephaly, 70 research on neurotoxicity, 258 anilines and substituted anilines, 179 acrylates, 175 animal tests, 13 acrylonitrile, 203 accuracy and reliability, 106, 115 neurotoxicity testing, 166, 173 advantages and limitations of, 105, 106, 111, 112, 114, -
Chlorine and Hydrogen Chloride
This report contains the collective views of an nternational group of experts and does not xcessarily represent the decisions or the stated 1 icy of the United Nations Environment Pro- '€mme, the International Labour Organisation, or the World Health Organization. Environmental Health Criteria 21 CHLORINE AND HYDROGEN CHLORIDE 'ublished under the joint sponsorship of Ic United Nations Environment Programme. the International Labour Organisation, and the World Health Organization / \r4 ( o 4 UI o 1 o 'T F- World Health Organization kz Geneva, 1982 The International Programme on Chemical Safety (IPCS) is a joint ven- ture of the United Nations Environment Programme. the International Labour Organisation, and the World Health Organization. The main objective of the IPCS is to carry out and disseminate evaluations of the environment. Supporting activities include the development of epidemiological, experi- mental laboratory, and risk assessment methods that could produce interna- tionally comparable results, and the development of manpower in the field of toxicology. Other relevant activities carried out by the IPCS include the development of know-how for coping with chemical accidents, coordination of laboratory testing and epidemiological studies, and promotion of research on the mechanisms of the biological action of chemicals. ISBN 92 4 154081 8 World Health Organization 1982 Publications of the World Health Organization enjoy copyright protec- tion in accordance with the provisions of Protocol 2 of the Universal Copy- right Convention. For rights of reproduction or translation of WHO publica- tions, in part or in loto, application should be made to the Office of Publica- tions, World Health Organization, Geneva. Switzerland. The World Health Organization welcomes such applications. -
Recreational Use of Popular Otc Drugs – Pharmacological Review
FARMACIA, 2018, Vol. 66, 2 REVIEW RECREATIONAL USE OF POPULAR OTC DRUGS – PHARMACOLOGICAL REVIEW PIOTR JAKUBOWSKI *, PUCHAŁA ŁUKASZ, GRZEGORZEWSKI WALDEMAR Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Aleja Warszawska 30, 11-041 Olsztyn, Poland *corresponding author: [email protected] Manuscript received: June 2017 Abstract Over-the-counter medicines use disorder is a serious and growing health problem affecting mainly adolescents. Drugs from many therapeutic classes, including antitussive agents such as dextromethorphan and codeine, antihistamine drugs diphenhydramine and dimenhydrinate, nasal decongestant pseudoephedrine and anti-inflammatory drug benzydamine are used for this purpose. Habitual users of most of these drugs can develop symptoms of substance dependence. When used in large quantities, these drugs can cause numerous toxic effects, including death. Recently many countries introduced legal restrictions in codeine, dextromethorphan and pseudoephedrine sales. Rezumat Abuzul de medicamente eliberate fără rețetă reprezintă o problemă gravă a sănătății care afectează în principal adolescenții. În acest scop, sunt utilizate medicamente din mai multe clase terapeutice, incluzând agenți antitusivi precum dextrometorfan și codeină, medicamente antihistaminice difenhidramină și dimenhidrinat, pseudoefedrină decongestionant nazal și benzidamină medicament antiinflamator. Utilizatorii obișnuiți ai majorității acestor medicamente pot dezvolta simptome de -
Question of the Day Archives: Monday, December 5, 2016 Question: Calcium Oxalate Is a Widespread Toxin Found in Many Species of Plants
Question Of the Day Archives: Monday, December 5, 2016 Question: Calcium oxalate is a widespread toxin found in many species of plants. What is the needle shaped crystal containing calcium oxalate called and what is the compilation of these structures known as? Answer: The needle shaped plant-based crystals containing calcium oxalate are known as raphides. A compilation of raphides forms the structure known as an idioblast. (Lim CS et al. Atlas of select poisonous plants and mushrooms. 2016 Disease-a-Month 62(3):37-66) Friday, December 2, 2016 Question: Which oral chelating agent has been reported to cause transient increases in plasma ALT activity in some patients as well as rare instances of mucocutaneous skin reactions? Answer: Orally administered dimercaptosuccinic acid (DMSA) has been reported to cause transient increases in ALT activity as well as rare instances of mucocutaneous skin reactions. (Bradberry S et al. Use of oral dimercaptosuccinic acid (succimer) in adult patients with inorganic lead poisoning. 2009 Q J Med 102:721-732) Thursday, December 1, 2016 Question: What is Clioquinol and why was it withdrawn from the market during the 1970s? Answer: According to the cited reference, “Between the 1950s and 1970s Clioquinol was used to treat and prevent intestinal parasitic disease [intestinal amebiasis].” “In the early 1970s Clioquinol was withdrawn from the market as an oral agent due to an association with sub-acute myelo-optic neuropathy (SMON) in Japanese patients. SMON is a syndrome that involves sensory and motor disturbances in the lower limbs as well as visual changes that are due to symmetrical demyelination of the lateral and posterior funiculi of the spinal cord, optic nerve, and peripheral nerves. -
Application of Neutron Activation Analysis Method on Biomonitors for Assessing Environment Quality
NUCLEAR – 2016 ███████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████ █████████████████████████████████████████████████ APPLICATION OF NEUTRON ACTIVATION ANALYSIS METHOD ON BIOMONITORS FOR ASSESSING ENVIRONMENT QUALITY E.A. NITESCU, S. VALECA, A.F. BUCSA* University of Pitesti, Pitesti, Romania, [email protected] *RATEN-ICN Pitesti, Mioveni, Romania, [email protected] ABSTRACT The purpose of this paper is to determine the chemical elements concentrations which affect both the population health and environment, such as toxic agents which are contained in air and are retained by precipitation inside the biomonitors vegetal tissues. The Neutron Activation Analysis is an analytic technique based on measuring the numbers and the energy of gamma radiation emitted by the radioactive isotopes produced in the sample matrix by irradiation with thermal neutrons in a nuclear reactor [1]. Usually, the samples are irradiated together with specific neutron flux monitors, duplicates and interest elements standards for a prior selected period of time inside the core of nuclear reactor. After the irradiation experiment and the specific radioactive decaying, can proceed measuring the gamma energies spectrum by using a high resolution detection system (HPGe – High Purity Germanium crystal) for gamma spectrometry and then assess the impact of the traced elements on population and environment. Key words: Neutron Activation Analysis, -
Drome De ROSENTHAL (II) 14944 Rc)SSLE's Syndrome
ROSSLE'S 14944-14967 Saccharomyces halluzinatorisches Angst-Syndrom) / syn 14954 rules, pregnancy control / Schwanger drome de ROSENTHAL (II) schaftskontrollregeln f (1. moglichst nicht 14944 Rc)SSLE'S syndrome / ROSSLE' Syndrom (Se invasiv [Ultraschall], 2. nur mit kurzlebigen xogener Kleinwuchs) / nanisme sexoge Radionukliden, vor allem zur Diagnose der nique Nieren- und Plazentafunktion, erst ab 3. 14945 rotation, chromosomal / Rotation, chromo Trimenon [JANISCH]) / regles de controle de somale f (in Bivalenten mit Chiasma zwi grossesse f schen Diplotan und Diakinese eintretende 14955 rules, sense for / Gefuhl fur Regeln n Formverandrung) / rotation chromosomi (psych.) / regles, sens pour m quef 14956 ruling forecast; science forecasting / Richtli 14946 round pronator syndrome / Pronator-teres nienprognose; Wissenschaftsprognose f / Syndrom (Schwache in den langen Finger prevision directrice; prevision scientifique f beugem) / syndrome de pronateur rond 14957 rumors / Geriichte n (konnen aus Traumen 14947 ROVIRALTA'S syndrome / ROVIRALTA' Syn entstehen) / rumeurs f drom (Pylorusstenose und Hiatushemie 14958 running, dancing / Laufen, tanzerisches n mit Magenektopie beim Saugling) / syn (tagliches ohne Leistungsdruck bis zur Er drome phrenopylorique (ROVIRALTA) miidung, besser als Radfahren, Schwim 14948 ROWLEY'S syndrome / ROWLEY' Syndrom men, Reiten, halt aerobe Kapazitat kon (SchwerhOrigkeit mit Halsfisteln) / syn stant, eroffnet Kollateralen und vermehrt drome de ROWLEY Zahl und GroBe der Mitochondrien) / cou 14949 ROWLEy-ROSENBERG syndrome / ROWLEY rir dansant m ROSENBERG' Syndrom (Gestorte Riickab 14959 rupture of the bladder / Blaseruptur f(klin. sorption fast aller Aminosauren) / syn Leitsymptom: blutige Dysurie; sichre Dia drome de ROWLEy-ROSENBERG gnose: Zystographie mit Kontrastmittel, 14950 rubb~~g, emotional/ Reibung, emotionale f wenn nicht moglich, Probelaparotomie und (bei UbervOlkrung groBres Problem als bei jeder gesicherten Ruptur sofortige Op. -
Date: 1/9/2017 Question: Botulism Is an Uncommon Disorder Caused By
6728 Old McLean Village Drive, McLean, VA 22101 Tel: 571.488.6000 Fax: 703.556.8729 www.clintox.org Date: 1/9/2017 Question: Botulism is an uncommon disorder caused by toxins produced by Clostridium botulinum. Seven subtypes of botulinum toxin exist (subtypes A, B, C, D, E, F and G). Which subtypes have been noted to cause human disease and which ones have been reported to cause infant botulism specifically in the United States? Answer: According to the cited reference “Only subtypes A, B, E and F cause disease in humans, and almost all cases of infant botulism in the United States are caused by subtypes A and B. Botulinum-like toxins E and F are produced by Clostridium baratii and Clostridium butyricum and are only rarely implicated in infant botulism” (Rosow RK and Strober JB. Infant botulism: Review and clinical update. 2015 Pediatr Neurol 52: 487-492) Date: 1/10/2017 Question: A variety of clinical forms of botulism have been recognized. These include wound botulism, food borne botulism, and infant botulism. What is the most common form of botulism reported in the United States? Answer: According to the cited reference, “In the United States, infant botulism is by far the most common form [of botulism], constituting approximately 65% of reported botulism cases per year. Outside the United States, infant botulism is less common.” (Rosow RK and Strober JB. Infant botulism: Review and clinical update. 2015 Pediatr Neurol 52: 487-492) Date: 1/11/2017 Question: Which foodborne pathogen accounts for approximately 20 percent of bacterial meningitis in individuals older than 60 years of age and has been associated with unpasteurized milk and soft cheese ingestion? Answer: According to the cited reference, “Listeria monocytogenes, a gram-positive rod, is a foodborne pathogen with a tropism for the central nervous system. -
Support Document for Revised
Support Document for the Revised National Priorities List Final Rule - July 2000 State, Tribal, and Site Identification Center Office of Solid Waste and Emergency Response U.S. Environmental Protection Agency Washington, DC 20460 ABSTRACT Pursuant to Section 105(a)(8)(B) of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) as amended by the Superfund Amendments and Reauthorization Act of 1986 (SARA), the U.S. Environmental Protection Agency (EPA) periodically adds hazardous waste sites to the National Priorities List (NPL). Prior to actually listing a site, EPA proposes the site in the Federal Register and solicits public comments. This document provides responses to public comments received on one site proposed on January 19, 1999 (64 FR 2950), one site proposed on April 23, 1999 (64 FR 19968), one site proposed on July 22, 1999 (64 FR 39886), and two sites proposed on February 4, 2000 (65 FR 5468). All of the sites are added to the NPL based on an evaluation under the HRS. These sites are being added to the NPL in a final rule published in the Federal Register in July 2000. ii CONTENTS Executive Summary ............................................................ v Introduction ................................................................... vii Background of the NPL ....................................................... vii Development of the NPL ......................................................viii Hazard Ranking System........................................................ix Other -
Serum Anion Gap: Its Uses and Limitations in Clinical Medicine
In-Depth Review Serum Anion Gap: Its Uses and Limitations in Clinical Medicine Jeffrey A. Kraut* and Nicolaos E. Madias† *Medical and Research Services VHAGLA Healthcare System, UCLA Membrane Biology Laboratory, and Division of Nephrology VHAGLA Healthcare System and David Geffen School of Medicine, Los Angeles, California; and †Department of Medicine, Division of Nephrology, Caritas St. Elizabeth’s Medical Center, and Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts The serum anion gap, calculated from the electrolytes measured in the chemical laboratory, is defined as the sum of serum chloride and bicarbonate concentrations subtracted from the serum sodium concentration. This entity is used in the detection and analysis of acid-base disorders, assessment of quality control in the chemical laboratory, and detection of such disorders as multiple myeloma, bromide intoxication, and lithium intoxication. The normal value can vary widely, reflecting both differences in the methods that are used to measure its constituents and substantial interindividual variability. Low values most commonly indicate laboratory error or hypoalbuminemia but can denote the presence of a paraproteinemia or intoxi- cation with lithium, bromide, or iodide. Elevated values most commonly indicate metabolic acidosis but can reflect laboratory error, metabolic alkalosis, hyperphosphatemia, or paraproteinemia. Metabolic acidosis can be divided into high anion and normal anion gap varieties, which can be present alone or concurrently. A presumed 1:1 stoichiometry between change in the ؊ ⌬ ⌬ serum anion gap ( AG) and change in the serum bicarbonate concentration ( HCO3 ) has been used to uncover the concurrence of mixed metabolic acid-base disorders in patients with high anion gap acidosis.