Objectives: Drug sequestration to an expanded plasma lipid phase has been proposed as a potential mechanism of action for lipid emulsions in lipophilic cardiotoxin overdose. The authors set out to document plasma and peritoneal diasylate clomipramine concentration after resuscitation with lipid emulsion in a rabbit model of clomipramine-induced hypotension.Methods: Twenty sedated mechanically ventilated New Zealand White rabbits were allocated to receive either 12 mL ⁄ kg 20% Intralipid or 12 mL ⁄ kg saline solution, following clomipramine infusion to 50% baseline mean arterial pressure (MAP). Hemodynamic parameters and serum clomipramine concentration were determined to 59 minutes. Peritoneal dialysis with 20% Intralipid or saline solution was evaluated for clomipramine concentration.
Ecstasy or 3,4-methylenedioxymethamphetamine is a commonly used illicit recreational drug, enjoying popularity for its stimulant effects. Although acute coronary syndrome is recognized after cocaine and methamphetamine use, association with Ecstasy use has rarely been reported. We report three cases of significantly delayed acute coronary syndrome and ST elevation myocardial infarction related to ingestion of Ecstasy.
Calcium channel blockers (CCB) overdose can result in cardiogenic shock and that high dose insulin euglycaemic therapy (HIet) is increasingly used to treat CCB poisoning. this case illustrates the risk of severe hypokalaemia resulting from HIet for calcium channel blocker poisoning.
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