BackgroundIntoxications are a cause of potentially serious hospitalisations whose treatment is commonly based on the use of specific antidotes.PurposeThe objetive of the present study was to analyse the use of specific antidotes for the treatment of rare poisonings.Material and methodsRetrospective longitudinal study. The analysed period was between June 2013 and June 2015. The variables studied were: type of antidote, number of patients, sex, age, clinical outcome indication of intoxication and time from admission to drug administration.Results33 patients (57.7% male) were analysed, 10 of whom were dismissed due to lack of data, with a mean age of 48 years. Antidotes used were: silymarin (43.48%) for the treatment of mushroom poisoning, rabies immunoglobulin (17.39%) for prophylaxis after animal bites, botulinum antitoxin (13.04%) for the treatment of botulism food, absolute alcohol (8.7%) for the treatment of methanol and ethylene glycol poisoning, methylene blue (8.7%) for methaemoglobinaemia after poisoning spinach and ifosfamide encephalopathy, dantrolene (4.35%) for the treatment of neuroleptic malignant syndrome, pralidoxime (4.35%) after organophosphate poisoning (insecticide) and digoxin antibody (4.35%) after intoxication by this drug. In 13% of cases the poisoning was intentional and 87% were casual. For 95.65% of the cases evaluated the antidote was administered within the first 24 h after admission and diagnosis. In all cases, the antidote was effective for the specific treatment for which they were meant to be used. The average length of hospital stay after the start of treatment was 5.9 days.ConclusionAdministration of antidotes is largely in line with the indications described in the bibliography. The use of these drugs at the right time is critical to reverse the effect of intoxications for which they are indicated.No conflict of interest.
BackgroundFungal infection is a significant source of morbidity and mortality in lung-transplant recipients (LTR). To avoid systemic toxicity, various nebulised antifungal agents are used after transplant to prevent or treat invasive fungal infections (IFI). Nebulised liposomal amphotericin B (n-LAB) has been widely used. However, some fungal agents, such as Scedosporium spp. with reduced amphotericin susceptibility, are emerging. Thus, new antifungal drugs are required.PurposeTo evaluate prescription profile, efficacy and tolerability of nebulised voriconazole (n-V) administered at a dose of 40 mg twice-daily in LTR in a tertiary hospital.Material and methodsObservational, retrospective study of patients who underwent lung transplant (LT) between January 2008 and September 2017 who received n-V. Data collected from electronic health records were age at LT, cause of transplantation, post-transplant fungal isolations in bronchoalveolar lavage, bronchial suction or sputum, n-LAB use, n-V treatment duration, and adverse effects and efficacy in terms of fungal infection resolution or culture negativity.ResultsEleven LTR received n-V , average age 40 (20–66). Causes of transplantation were: six diffuse parenchymal lung disease (DPLD), four cystic fibrosis (CF) and one chronic obstructive pulmonary disease (COPD). Ten patients (91%) previously received n-LAB as antifungal prophylaxis in the post-transplant period. Fungal isolations observed in LTR who received n-V were: Aspergillus Terreus (two), Aspergillus Fumigatus (two), Paecilomyces Lilacinus (three), Scedosporium Apisopermum (three), Scedosporium Prolificans (one) and Scedosporium Aurantiacum (one). There were five cases (46%) of fungal pulmonary infection, three (27%) of airway colonisation, two (18%) IFI and one (9%) S. Apiospermum mycetoma. Average treatment duration was 9.5 months (SD: 6) and no adverse effects were reported. Culture negativity took place in 82% of cases and there was one exitus related to S. Apiospermum and S. Prolificans IFI with n-V therapy duration of 9 months.ConclusionNebulised voriconazole seems to be an effective alternative to prevent and treat fungal infections when n-LAB antifungal spectrum is not adequate to airway isolations. That occurs in most Scedosporium spp., Paecilomyces spp. and some Aspergillus spp. Its tolerability is good, although n-V is not commercially available and it is prepared from intravenous vials. Further studies will be required to accurately assess the use of n-V in clinical practice.No conflict of interest
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.