Use of Hemodialysis and Hemoperfusion in Poisoned Patients William J
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Management of Acute Clonidine Poisoning in Adults: the Role of Resin Hemoperfusion
Management of Acute Clonidine Poisoning in Adults: The Role of Resin Hemoperfusion Shanshan Fang Department of Nephrology, 307 Hospital Bo Han Department of Nephrology, 307 Hospital Xiaoling Liu Department of Nephrology, 307 Hospital Dan Mao Department of Nephrology, 307 Hospital Chengwen Sun Laboratory of Poisonous Substance Detection, 307 Hospital Zhi Chen Department of Nephrology, 307 Hospital Ruimiao Wang Department of Nephrology, 307 Hospital Xishan Xiong ( [email protected] ) Aliated Hengsheng Hospital of the Southern Medical University https://orcid.org/0000-0002-8557- 8025 Methodology Keywords: clonidine poisoning, adrenergic alpha-agonists, bradycardia, hemoperfusion, hypotension Posted Date: September 21st, 2020 DOI: https://doi.org/10.21203/rs.3.rs-76660/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/14 Abstract Clonidine poisoning in adults is rare. An observational retrospective study including 102 adults with clonidine poisoning was conducted. 57 patients with relatively mild conditions were placed in the local emergency departments (EDs) for clinical observation, while the remaining 45 were transferred to the tertiary hospital for intensive treatment, of whom 9 were given supportive care only and 36 were given hemoperfusion (HP), as well as similar supportive treatment. The main symptoms of these cases were: sleepiness, dizziness, fatigue, headache, inarticulacy, tinnitus and dry mouth. Physical examination showed hypotension, bradycardia and shallow and slow breathing. Serum and urine clonidine concentrations were signicantly elevated24.4 ng/ml, 313.2 ng/ml, respectively. All cases slowly returned to their baseline state over 48 to 96 hours, which is co-related with the drawn of serum clonidine level. -
Effect of Hemoperfusion Using Polymyxin B-Immobilized Fiber on IL-6, HMGB-1, and IFN Gamma in a Neonatal Sepsis Model
0031-3998/05/5802-0309 PEDIATRIC RESEARCH Vol. 58, No. 2, 2005 Copyright © 2005 International Pediatric Research Foundation, Inc. Printed in U.S.A. Effect of Hemoperfusion Using Polymyxin B-Immobilized Fiber on IL-6, HMGB-1, and IFN Gamma in a Neonatal Sepsis Model MOHAMED HAMED HUSSEIN, TAKENORI KATO, TAKAHIRO SUGIURA, GHADA A. DAOUD, SATOSHI SUZUKI, SUMIO FUKUDA, HISANORI SOBAJIMA, INEKO KATO, AND HAJIME TOGARI Department of Pediatrics, Neonatology and Congenital Disorders [M.H.H., T.K., T.S., G.A.D., S.F., H.S., I.K., H.T.], Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan, Department of Pediatrics [S.S.], Nagoya City Johoku Hospital, Nagoya, Japan, Neonatal Intensive Care Unit [M.H.H.], Pediatric Hospital, Cairo University, Cairo, Egypt, Maternal and Child Health Department [M.H.H., G.A.D.], VACSERA, Giza, Egypt ABSTRACT To evaluate effects of polymyxin B direct hemoperfusion at 6 h. IFN-␥ was only detected in the control group at 9 h. (PMX-DHP) on a neonatal sepsis cecal ligation and perforation Survival times in the PMX-DHP group were longer than in the (CLP) model, in 24 anesthetized and mechanically ventilated control. Thus, PMX-DHP improved septic shock in a neonatal 3-d-old piglets, 16 were assigned to CLP and an arteriovenous septic model. (Pediatr Res 58: 309–314, 2005) extracorporeal circuit from 3 h until 6 h post-CLP, with a PMX-column in PMX-DHP–treated group (8 piglets) and 8 as sham. Plasma lipopolysaccharide (LPS) was measured at before Abbreviations CLP and at 3 and 9 h. -
Uremic Toxins and Blood Purification: a Review of Current Evidence and Future Perspectives
toxins Review Uremic Toxins and Blood Purification: A Review of Current Evidence and Future Perspectives Stefania Magnani * and Mauro Atti Aferetica S.r.l, Via Spartaco 10, 40138 Bologna (BO), Italy; [email protected] * Correspondence: [email protected]; Tel.: +39-0535-640261 Abstract: Accumulation of uremic toxins represents one of the major contributors to the rapid progression of chronic kidney disease (CKD), especially in patients with end-stage renal disease that are undergoing dialysis treatment. In particular, protein-bound uremic toxins (PBUTs) seem to have an important key pathophysiologic role in CKD, inducing various cardiovascular complications. The removal of uremic toxins from the blood with dialytic techniques represents a proved approach to limit the CKD-related complications. However, conventional dialysis mainly focuses on the removal of water-soluble compounds of low and middle molecular weight, whereas PBTUs are strongly protein-bound, thus not efficiently eliminated. Therefore, over the years, dialysis techniques have been adapted by improving membranes structures or using combined strategies to maximize PBTUs removal and eventually prevent CKD-related complications. Recent findings showed that adsorption-based extracorporeal techniques, in addition to conventional dialysis treatment, may effectively adsorb a significant amount of PBTUs during the course of the sessions. This review is focused on the analysis of the current state of the art for blood purification strategies in order to highlight their potentialities and limits and identify the most feasible solution to improve toxins removal effectiveness, exploring possible future strategies and applications, such as the study of a synergic approach by reducing PBTUs production and increasing their blood clearance. -
TERTIARY ACETYLENIC ALCOHOLS Compound, Ethchlorvynol (S 94) Is
36 H. ISBELL & T. L. CHRUSCIEL TERTIARY ACETYLENIC ALCOHOLS Only two compounds are listed (Table IV). Of 152. Csarza-Perez, J., Lal, S. & Lopez, E. (1967) Med. these, methylpentynol (S 95) is a weak, short-acting Serv. J. Can., 23, No. 5, 775-778 (Addiction to hypnotic. Sales have been low and few instances chlorvynol) of abuse have been reported.155' 157 The other 153. Essig, C. F. (1964) Clin. Pharmacol., 5, 334 (Addic- compound, ethchlorvynol (S 94) is more potent and tion to sedatives and tranquilizers) instances of abuse are more frequent. There is 154. Government of the United States of America, stiong clinical documentation for abrupt withdrawal US Food and Drug Administration (1965) Back- of ethchlorvynol being followed by convulsions and ground material supplied to Advisory Committee delirium.151-154, 156 Accordingly, ethchlorvynol must on Abuse of Stimulant and Depressant Drugs, be judged to have moderate abuse potential and 27 December 1965, Washington, D.C. 155. Hitsche, B. & Herbst, A. (1967) Psychiat. et methylpentynol must, by analogy, be regarded as Neurol. (Basel), 153, 308-318 (Beobachtungen having dependence potential equivalent to that of bei Missbrauch von Methylpentinol) ethchlorvynol. 156. Hudson, H. S. & Walker, H. I. (1961) Amer. J. Psychiat., 118, 361 (Withdrawal symptoms REFERENCES following ethchlorvynol (Placidyl) dependence) 157. Marley, E. & Bartholomew, A. A. (1958) J. Neurol. 151. Cohn, C. H. (1959) Canad. med. Ass. J., 81, 733 Neurosurg. Psychiat., 21, 129-140 (Clinical (Intoxication by ethchlorvynol-Placidyl) aspects of susceptibility of methylpentol) CYCLIC ETHERS The only compound in this group is paraldehyde dogs physically dependent on barbital. -
Process Design and Simulation of Propylene and Methanol Production Through Direct and Indirect Biomass Gasification by Bernardo
Process Design and Simulation of Propylene and Methanol Production through Direct and Indirect Biomass Gasification by Bernardo Rangel Lousada A dissertation submitted to the graduate faculty of Auburn University in partial fulfillment of the requirements for the degree of Master in Chemical Engineering Auburn, Alabama August 6, 2016 Keywords: Process Design, Gasification, Biomass, Propylene, Methanol, Aspen Plus, Simulation, Economic, Synthesis Copyright 2016 by Bernardo Lousada Approved by Mario R. Eden, Chair and McMillan Professor of Chemical Engineering Allan E. David, John W. Brown Assistant Professor Professor of Chemical Engineering Selen Cremaschi, B. Redd Associate Professor Professor of Chemical Engineering Abstract As a result of increasing environmental concerns and the depletion of petroleum resources, the search for renewable alternatives is an important global topic. Methanol produced from biomass could be an important intermediate for liquid transportation fuels and value-added chemicals. In this work, the production of methanol and propylene is investigated via process simulation in Aspen Plus. Two gasification routes, namely, direct gasification and indirect gasification, are used for syngas production. The tar produced in the process is converted via catalytic steam reforming. After cleanup and treatment, the syngas is converted to methanol which will be further converted to high value olefins such as ethylene, propylene and butene via the methanol to propylene (MTP) processes. For a given feedstock type and supply/availability, we compare the economics of different conversion routes. A discounted cash flow with 10% of internet rate of return along 20 years of operation is done to calculate the minimum selling price of propylene required which is used as the main indicator of which route is more economic attractive. -
Methanol:Acetone Fixation and PGL-1 Staining Protocol
MeOH/Acetone fixation and staining of C. elegans for anti-PGL-1 whole-mount staining adapted by Erik Andersen from Mello Lab protocol by Daryl Conte, February, 2006 Things you will need: Micro Slides, precleaned, frosted, 25 x 75 mm (VWR cat no. 48312-002) Micro cover glasses, 25 mm square (VWR cat no. 48366-067) Micro cover glasses, 18 mm square (VWR cat no. 48366-045) PAP pen Polylysine (Sigma) Coplin jars Block/wedge of dry ice in Styrofoam box with lid – dry ice must be flat as slides will be placed on top 100% Methanol (-20°C in Coplin jar) 100% Acetone (-20°C in Coplin jar) Humid chamber – a plastic lidded box with moistened paper towels or whatmann paper in the bottom and a support to hold slides above paper Gravid adult worms or Larvae grown at 23ºC for at least two generations Mounting medium with antifade DAPI or other counterstain Glass Depression slide Water in which to wash larvae 20 μL pipet and mouth-pipette tubing Coating slides with polylysine – do this the day before. Many slides can be coated and stored for future use. 1. Prepare 0.01% polylysine solution. 2. Pipette polylysine solution (about 10 μL) onto surface of slide. 3. Dry slides thoroughly at 65°C. I dry them overnight. 4. It seems best to label your slides with a diamond pen, because later alcohol-fixation steps dissolve most inks. Fixing larvae to slides 1. Transfer >100 larvae of the same stage to 100 μL of water in a glass depression slide. It is very important to pick animals of the same stage, as larger worms, detritus or embryos will not allow for good crushing and subsequent fixation. -
Hand Sanitizers and Updates on Methanol Testing
Hand Sanitizers and Updates on Methanol Testing Francis Godwin Director, Office of Manufacturing Quality, Office of Compliance Center for Drug Evaluation and Research, FDA USP Global Seminar Series: Ensuring Quality Hand Sanitizer Production During Covid-19 for Manufacturers February 23, 2021 • DISCLAIMER: The views and opinions expressed in this presentation are those of the authors and do not necessarily represent official policy or positions of the Food & Drug Administration www.fda.gov 2 Outline ● What OMQ Does ● General Background on Hand Sanitizer ● Recent Safety Concerns and FDA Actions ● Substitution ● Methanol Testing Requirements for Drug Product Manufacturers www.fda.gov 3 Office of Manufacturing Quality What We Do 4 CDER/OC Mission To shield patients from poor- quality, unsafe, and ineffective drugs through proactive compliance strategies and risk-based enforcement action. www.fda.gov 5 What OMQ Does • We evaluate compliance with Current Good Manufacturing Practice (CGMP) for drugs based on inspection reports and evidence gathered by FDA investigators. • We develop and implement compliance policy and take regulatory actions to protect the public from adulterated drugs in the U.S. market. Source: FDA www.fda.gov 6 Drug Adulteration Provisions U.S. Federal Food, Drug, & Cosmetic Act • 501(a)(2)(A): Insanitary conditions • 501(a)(2)(B): Failure to conform with CGMP • 501(b): Strength, quality, or purity differing from official compendium • 501(c): Misrepresentation of strength, etc., where drug is unrecognized in compendium • 501(d): Mixture with or substitution of another substance • 501(j): Deemed adulterated if owner/operator delays, denies, refuses, or limits inspection www.fda.gov 7 CGMP Legal Authority Section 501(a)(2)(B) requires conformity with CGMP A drug is adulterated if the methods, facilities, or controls used in its manufacture, processing, packing, or holding do not conform to CGMP to assure that such drug meets purported characteristics for safety, identity, strength, quality, and purity. -
Fluvoxamine Maleate Tablets Safely and Effectively
Highlights Of Prescribing Information hypotension or seizures (5.7). Methadone: Coadministration may produce These highlights do not include all the information needed to use opioid intoxication. Discontinuation of fluvoxamine may produce opioid Fluvoxamine Maleate Tablets safely and effectively. See full prescribing withdrawal (5.7). Mexiletine: Monitor serum mexiletine levels (5.7). information for Fluvoxamine Maleate Tablets. Ramelteon: Should not be used in combination with fluvoxamine (5.7). Theophylline: Clearance decreased; reduce theophylline dose by one-third Fluvoxamine Maleate Tablets for oral administration (5.7). Warfarin: Plasma concentrations increased and prothrombin times Initial U.S. Approval: 1994 prolonged; monitor prothrombin time and adjust warfarin dose accordingly Warning: Suicidality and Antidepressants (5.7). Other Drugs Affecting Hemostasis: Increased risk of bleeding with See full prescribing information for complete boxed warning. concomitant use of NSAIDs, aspirin, or other drugs affecting coagulation (5.7, Increased risk of suicidal thinking and behavior in children, adolescents, and 5.9). See Contraindications (4). Discontinuation: Symptoms associated with young adults taking antidepressants for major depressive disorder and other discontinuation have been reported (5.8). Abrupt discontinuation not psychiatric disorders. Fluvoxamine Maleate Tablets are not approved for use in recommended. See Dosage And Administration (2.8). pediatric patients except those with obsessive compulsive disorder (5.1). Activation -
In Vitro Nitric Oxide Scavenging Activity of Methanol Extracts of Three Bangladeshi Medicinal Plants
ISSN: 2277- 7695 CODEN Code: PIHNBQ ZDB-Number: 2663038-2 IC Journal No: 7725 Vol. 1 No. 12 2013 Online Available at www.thepharmajournal.com THE PHARMA INNOVATION - JOURNAL In Vitro Nitric Oxide Scavenging Activity Of Methanol Extracts Of Three Bangladeshi Medicinal Plants Rozina Parul1*, Sukalayan Kumar Kundu 2 and Pijush Saha2 1. Department of Pharmacy, Gono Bishwabidyalay, Savar, Dhaka – 1344, Bangladesh. E-mail: [email protected] 2. Department of Pharmacy, Jahangirnagar University, Savar, Dhaka – 1342, Bangladesh. The methanol extracts of three medicinal plants named Phyllunthus freternus, Triumfetta rhomboidae and Casuarina littorea were examined for their possible regulatory effect on nitric oxide (NO) levels using sodium nitroprusside as a NO donor in vitro. Most of the extracts tested demonstrated direct scavenging of NO and exihibited significant activity and the potency of scavenging activity was in the following order: Phyllunthus freternus > Leaves of Triumfetta rhomboidae > Casuarina littorea > barks of Triumfetta rhomboidae > roots of Triumfetta rhomboidae. All the evaluated extracts exhibited a dose dependent NO scavenging activity. The methanolic extracts of Phyllunthus freternus showed the greatest NO scavenging effect of 60.80% at 200 µg/ml with IC50 values 48.27 µg/ml as compared to the positive control ascorbic acid where 96.27% scavenging was observed at similar concentration with IC50 value of 5.47 µg/ml. The maximum NO scavenging of Leaves of Triumfetta rhomboidae, barks of Triumfetta rhomboidae, roots of Triumfetta rhomboidae and Casuarina littorea were 53.94%, 50.43%, 33.23% and 54.02% with IC50 values 97.81 µg/ml, 196.89 µg/ml, > 200 µg/ml and 168.17 µg/ml respectively. -
And Isopropyl Alcohol for Methanol, Including During the Public Health Emergency (COVID-19)
Contains Nonbinding Recommendations Policy for Testing of Alcohol (Ethanol) and Isopropyl Alcohol for Methanol, Including During the Public Health Emergency (COVID-19) Guidance for Industry January 2021 U.S. Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation and Research (CDER) Center for Biologics Evaluation and Research (CBER) Center for Veterinary Medicine (CVM) Current Good Manufacturing Practice (CGMP) Contains Nonbinding Recommendations Preface Public Comment This guidance is being issued to address the Coronavirus Disease 2019 (COVID-19) public health emergency. This guidance is being implemented without prior public comment because the Food and Drug Administration (FDA or the Agency) has determined that prior public participation for this guidance is not feasible or appropriate (see section 701(h)(1)(C) of the Federal Food, Drug, and Cosmetic Act (FD&C Act) and 21 CFR 10.115(g)(2)). This guidance document is being implemented immediately, but it remains subject to comment in accordance with the Agency’s good guidance practices. Comments may be submitted at any time for Agency consideration. Submit written comments to the Dockets Management Staff (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852. Submit electronic comments to https://www.regulations.gov. All comments should be identified with the docket number FDA-2020-D-2016 and complete title of the guidance in the request. Additional Copies Additional copies are available from the FDA webpage -
Study Protocol for a Randomized
The Efficacy of Initial Hemopurification Strategy for Acute Paraquat Poisoning in Adults: Study Protocol for a Randomized Controlled Trial (HeSAPP) 2018-4-6 NCT03314909 PROTOCOL Study setting Patient recruitment would be completed in The First Affiliated Hospital of Zhengzhou University, a comprehensive tertiary medical center in Henan Province, China with 50 beds in emergency intensive care units (EICU). The estimated number of admitted acute paraquat poisoned patients ranges from 50-200 persons per year. To assist participant enrolment, after acceptance of this protocol, a notice of this trial would be sent to the Emergency Room (ER) of all secondary hospitals in Henan Province to improve transference to the First Affiliated Hospital of Zhengzhou University. Considering the fact that intervention would be administered in ER setting, and the relatively short duration of assigned hemopurification, adherence of patients is promising. Patients’ families would receive full explanation of treatment plan and continuous follow-up in order to promote adherence. Study population Upon admission to ER, patients suspected with PQ intoxication would receive a urine dithionite test, and only those with a positive result would be invited to participate in this trial. The urine dithionite test would be measured by Spectrophotometer Type 721, and the minimal measurable concentration of paraquat is 0.2 μg/ml. Detailed inclusion and exclusion criteria are listed as follows. Inclusion criteria Patients meeting with all of the following criteria would be included in this trial: (1) Suspected paraquat ingestion history (intended or accidental), which is confirmed by positive urine dithionite result (light blue, navy blue and dark blue). (2) Arriving at the ER within 24 hours after PQ digestion. -
Bhopal Disaster
Bhopal disaster From Wikipedia, the free encyclopedia Jump to: navigation, search Bhopal memorial for those killed and disabled by the 1984 toxic gas release. The Bhopal disaster also known as Bhopal Gas Tragedy was a gas leak accident in India, considered one of the world's worst industrial catastrophes.[1] It occurred on the night of December 2–3, 1984 at the Union Carbide India Limited (UCIL) pesticide plant in Bhopal, Madhya Pradesh, India. A leak of methyl isocyanate gas and other chemicals from the plant resulted in the exposure of hundreds of thousands of people. Estimates vary on the death toll. The official immediate death toll was 2,259 and the government of Madhya Pradesh has confirmed a total of 3,787 deaths related to the gas release.[2] Others estimate 3,000 died within weeks and another 8,000 have since died from gas-related diseases.[3][4] A government affidavit in 2006 stated the leak caused 558,125 injuries including 38,478 temporary partial and approximately 3,900 severely and permanently disabling injuries.[5] UCIL was the Indian subsidiary of Union Carbide Corporation (UCC). Indian Government controlled banks and the Indian public held 49.1 percent ownership share. In 1994, the Supreme Court of India allowed UCC to sell its 50.9 percent share. Union Carbide sold UCIL, the Bhopal plant operator, to Eveready Industries India Limited in 1994. The Bhopal plant was later sold to McLeod Russel (India) Ltd. Dow Chemical Company purchased UCC in 2001. Civil and criminal cases are pending in the United States District Court, Manhattan and the District Court of Bhopal, India, involving UCC, UCIL employees, and Warren Anderson, UCC CEO at the time of the disaster.[6][7] In June 2010, seven ex-employees, including the former UCIL chairman, were convicted in Bhopal of causing death by negligence and sentenced to two years imprisonment and a fine of about $2,000 each, the maximum punishment allowed by law.