Adenosine antagonists were found to be effective in improving hypotension, QRS prolongation and survival time in our rat model of amitriptyline toxicity. Additionally, amitriptyline-induced cardiotoxicity was abolished by pretreatment with adenosine receptor antagonists. These results suggest that adenosine receptors may have a role in the pathophysiology of amitriptyline-induced cardiovascular toxicity. Adenosine A1 and A2a receptor antagonists may be promising agents for reversing amitriptyline-induced cardiovascular toxicity.
The aim of the present study is to evaluate the relationship between the Poisoning Severity Score (PSS) and carboxyhaemoglobin (COHb) levels in patients with carbon monoxide poisoning (COP) using outcome as the measure. The study was designed as a retrospective chart review of patients with final diagnosis of COP. Correlation of PSS and COHb levels at presentation was evaluated with collected data. Majority of the cases were grade 1 (minor) PSS (134 cases, 73.6%) and 93.4% of these patients made a complete recovery. There were six deaths (mortality 3.3%) and six in-hospital major complications (IHMCs) (3.3%) (please specify whether the complications were in the patients who died). There is moderate correlation between PSS and outcome (p < 0.001, r = 0.493). Grade 3 (severe) PSS was significantly different from other grades for outcome (six mortalities and three IHMCs). Patients classified as grade 3 and patients who died had a significantly higher mean age (p < 0.05, 41.8 +/- 23.6 and p < 0.01, 60.1 +/- 20.3, respectively). Mean COHb level of grade 3 (33.2 +/- 13.9%) was significantly higher than that of other grades (p < 0.05). COHb levels according to outcome were not different (? within the patients in grade 3). Decreased level of consciousness, acidosis, tachycardia, high glucose and leucocyte levels showed significant relation with higher PSS, COHb level and adverse outcome. We conclude that the PSS is a reliable guide in COP. Value of the PSS in COP may be enhanced if additional factors and investigations are included.
Men seem to have a higher activity relative to women for the drug efflux transporter P-gp. Our results suggest that carvedilol will cause drug interaction with digoxin following the inhibition of P-gp-mediated transcellular transport of digoxin in males.
The aim of this study was to investigate the effect of glucagon on cardiovascular parameters in anesthetized rat model of tricyclic antidepressant overdose. Toxicity was induced by infusion of amitriptyline 0.94 mg/kg/min until a 40–45% of reduction in mean arterial pressure was observed. Amitriptyline infusion rats were then randomized into three groups. Control group of rats (group 1) received a bolus of 5% dextrose followed by the continuous infusion of dextrose, whereas treatment groups received 1 mg/kg (group 2) or 2 mg/kg (group 3) bolus doses of glucagon followed by continuous infusion (0.1 mg/kg/min) of glucagons for 60 min. Mean arterial pressure, heart rate, and electrocardiogram were recorded. Amitriptyline caused a significant decrease in mean arterial pressure and a prolongation in QRS, yet it did not change the heart rate. High-bolus dose of glucagon (2 mg/kg) followed by glucagon infusion significantly increased mean arterial pressure at 40, 50, and 60 min ( P < 0.05) and shortened the prolonged QRS at 50 and 60 min ( P < 0.05) when compared with control group. There was also a significant increase in heart rate. In conclusion, bolus doses followed by a continuous infusion of glucagon were found to be effective in reversing the hypotension and QRS prolongation in the rat model of amitriptyline toxicity. Further studies are needed to reveal the exact mechanism of the proposed effect.
While 10(-4) M DPCPX shortened QRS prolongation, 10(-5) M CSC prolonged QRS duration in the isolated rat hearts with prolonged QRS duration induced by 5.5 x 10(-5)M amitriptyline. An adenosine A(1) receptor antagonist, DPCPX, might shorten amitriptyline-induced QRS prolongation by activating beta adrenergic receptors.
A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : We investigated the etiological and demographical characteristics of exposures to drugs and poisons reported to the Dokuz Eylul University Drug and Poison Information Center (DPIC), in 2007. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The data regarding demographic details of the cases and involving substance(s), route and reason for the exposure, date, time, site and circumstances of poisonings are reviewed retrospectively. Beside these, clinical effects of the incidents, the recommendations by DPIC and outcomes of the patients were also evaluated from the standard data forms. Descriptive statistics, contingency tables and Pearson Chi-square test was performed to analyze the data. R Re es su ul lt ts s: : DPIC received 2576 calls in 2007 and most of them were related to poisoning incidents. A vast majority (97%) of these calls was made from the health care facilities and 73.3 % of them were from Izmir. Most of the incidents were intentional attempts (65.5%) in nature and there was a female predominance (χ 2 =385.03, P<0.001). Rate of unintentional exposures was significantly higher in 0-12 year-old children than in the 13-18 year-old teenagers (χ 2 =374.59, P<0.001). Ingestion was the most common route of exposure (92.7%). Medications were the predominant substances in the exposures (72.5%) followed by chemicals, metals, cosmetics (4.7%) and alcohol (4.7%). Analgesics (15.5%) and antidepressants (13.5%) were leading drugs involved in these events, particularly paracetamol and amitriptyline (11.8 and 3.9%)respectively. Recommended treatments by DPIC included activated charcoal (24.5%), supportive care (23.1%), gastric lavage (15.0%), antidotes (2.2%) and skin decontamination. There were two mortalities (0.08%) associated with a scorpion sting and carbon monoxide inhalation. C Co on nc cl lu us si io on n: : Analgesics and antidepressants were found to be the main causes of poisoning exposures in the review of DPIC reports. Research studies can be accomplished in this field with the assistance of national poisoning database system which compiles the information gained from all poison information centers in Turkey.K Ke ey y W Wo or rd ds s: : Poison control centers; poisoning Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmada, Dokuz Eylül Üniversitesi İlaç ve Zehir Bilgi Merkezi'ne (İZBM) 2007 yılı içinde bildirilen ilaç ve diğer zehirlenme olgularının etyolojik ve demografik özellikleri incelenmiştir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Olguların ve kullanılan maddelerin demografik özelliklerine, alım yolu ve nedenine ilişkin veriler, zehirlenmelerin tarih, zaman, yer ve koşulları geriye dönük olarak gözden geçirildi. Bunların dışında, olayların klinik etkileri, İZBM'in önerileri ve hasta sonuçları da standart veri formları aracılığı ile değerlendirildi. Verilerin değerlendirilmesinde tanımlayıcı istatistikler, olumsallık tabloları ve Pearson Kikare testi kullanıldı. B Bu ul lg gu ul la ar r: : 2007 yılında İZBM'e toplam 2576 çağrı ...
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.