Bromide Intoxication

Barbour, R. F.; Pilkington, F.; Sargant, W.

doi:10.1136/bmj.2.3958.957

Cited by 26 publications

(14 citation statements)

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“…There were no marked signs clinically of bromide intoxication in any of these patients, who were all on similar diets and in whom the chloride intake could be assuLmed to be fairly general. This would appear to differ from the usual findings of most writers (Barbour, Pilkington, and Sargant, 1936) that older patients and those with arteriosclerosis, renal insufficiency, etc., tend to show early signs of intoxication. Barbour (1936) states that the greater part of tihe bromide is excreted by the kidneys, and that the blood bromide level varies with the urinary outpuLt, which in turn depends on the fluid intake and renal efficiency.…”

contrasting

confidence: 53%

“…This would appear to differ from the usual findings of most writers (Barbour, Pilkington, and Sargant, 1936) that older patients and those with arteriosclerosis, renal insufficiency, etc., tend to show early signs of intoxication. Barbour (1936) states that the greater part of tihe bromide is excreted by the kidneys, and that the blood bromide level varies with the urinary outpuLt, which in turn depends on the fluid intake and renal efficiency. In those patients with arteriosclerosis there was evidence of impaired renal efficiency also, and the bromide was excreted more slowty than in patients who were physically well.…”

contrasting

confidence: 53%

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Blood Bromide in Psychotic Epileptics

Minski¹,

Gillen²

1937

BMJ

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contrasting

confidence: 53%

contrasting

confidence: 53%

Blood Bromide in Psychotic Epileptics

Minski¹,

Gillen²

1937

BMJ

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“…The results obtained by using a large number of subjects and a machine which more nearly approximates actual working conditions is in harmony with the findings of Roughton and his co-workers°a nd of Reynolds and Shaffer. 10 Any impairment of visual efficiency, as might be expected from the findings of Reynolds and his co-workers,11 was not reflected in change great enough to affect the hand-eye coordina¬ tion or the reaction time as determined by our tests.…”

mentioning

confidence: 61%

Bromide Intoxication From Prolonged Self Medication With B. C. Headache Powder

Kracke¹,

Platt²

1944

JAMA

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“…Suspicion can be confirmed by a simple urine-screening test (Reye and Joffe, 1959) and followed if necessary by estimation of the serum bromide level (Barbour et al, 1936). Levels over 150 mg./100 ml.…”

Section: Commentmentioning

confidence: 99%

“…The "bromide hazard" was well recognized in the 1930s (Diethelm, 1930 ;Wagner and Bunbury, 1930;Barbour et al, 1936), when vast quantities of bromides were prescribed. Today, however, when their use has been largely replaced by barbiturates, phenothiazines, and other tranquillizers, it seems likely that bromide intoxication is not considered promptly enough in the differential diagnosis of obscure neuropsychiatric problems.…”

mentioning

confidence: 99%

Four cases of bromism.

Nuki¹,

Richardson²,

Goggin³

et al. 1966

BMJ

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Intravenous Diets-Peaston MEDIBALIJOURNAL balance for water. The results in six patients were compared with those obtained during intragastric feeding of the same patients. The intragastric diet of milk powder and glucose maintained metabolic balance except for a negative chloride balance. The urinary total nitrogen, ammonia, and aminoacids were similar on the two diets, but urea excretion was reduced on the intravenous diet, suggesting a decrease in protein catabolism.The investigation was suggested by Professor A. Wilson Although bromide poisoning was described by Huette (1850), it was Wuth (1927) who drew attention to its high incidence in psychiatric hospital wards. The "bromide hazard" was well recognized in the 1930s (Diethelm, 1930 ;Wagner and Bunbury, 1930;Barbour et al., 1936), when vast quantities of bromides were prescribed. Today, however, when their use has been largely replaced by barbiturates, phenothiazines, and other tranquillizers, it seems likely that bromide intoxication is not considered promptly enough in the differential diagnosis of obscure neuropsychiatric problems. Case 1A 59-year-old woman had been in poor health for many years. Her main complaints were of constipation and fatigue, which were so extreme that she seldom went out and spent much of her day resting on a sofa. At times she was confused, her speech slurred, and her memory poor. In June 1965 she slipped and fractured the neck of her femur. Her post-operative condition gave cause for alarm. She was drowsy, disorientated, and incontinent. She was emaciated ; her tongue was dry and furred. She had bilateral ptosis, constricted pupils, extreme muscular weakness, and depressed tendon reflexes. There were no localizing signs in the central nervous system, and biochemical tests showed no evidence of renal, hepatic, or other metabolic disorder. It was then learned that she had for many years been taking an " innocuous sleeping mixture " prescribed originally for her husband in 1939. Each night she took at least three tablespoonfuls, containing in all 30 minims (1.5 ml.) of tincture of morphine and 60 gr. (3.9 g.) of ammonium bromide. The serum bromide level was found to be 380 mg./ 100 ml. Her mental and physical condition improved gradually but strikingly on withdrawal of the bromide mixture and the administration of ammonium chloride and mersalyl. Case 3A 59-year-old man was admitted to hospital in May 1965 with a six-months history of progressive mental deterioration and a twomonths history of dragging his right foot. A week before admission he became paranoid and violent before lapsing into a semicoma. He was found at home, in bed, dehydrated, too weak to move, and surrounded by broken furniture. He was dysarthric and his pupils were constricted. Tendon reflexes were diminished in both legs but increased in the right arm, with an equivocal right plantar response.On admission to a general hospital medical ward, examination revealed sordes in the mouth and an acneiform rash on the chest.There was nominal dysphasia as well as dys...

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Bromide Intoxication

Cited by 26 publications

References 0 publications

Blood Bromide in Psychotic Epileptics

Blood Bromide in Psychotic Epileptics

Bromide Intoxication From Prolonged Self Medication With B. C. Headache Powder

Four cases of bromism.

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