Common ocular effects reported to a poison control center after systemic absorption of drugs in therapeutic and toxic doses

Slattery, Ann P.; Liebelt, Erica L.; Gaines, LaDonna

doi:10.1097/icu.0000000000000103

Cited by 11 publications

(8 citation statements)

References 10 publications

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“…86-88 Voriconazole can cause blurred vision, changes in visual acuity and color perception, photophobia and visual hallucinations. 89 Other medications such as antihistamines 90 (e.g., diphenhydramine, loratadine) and anticholinergics 91 (e.g., sedatives, sleep aids, cold preparations, antidiarrheal and nasal decongestants) can inhibit lacrimal glandular secretions and cause dry eyes. Scopolamine patches used as antiemetic after high-dose chemotherapy can lead to anisocoria or mydriasis if the eye is contaminated with scopolamine.…”

Section: Medications With Ocular Toxicitiesmentioning

confidence: 99%

Non-GVHD ocular complications after hematopoietic cell transplantation: expert review from the Late Effects and Quality of Life Working Committee of the CIBMTR and Transplant Complications Working Party of the EBMT

Inamoto¹,

Petriček

Burns

et al. 2019

Bone Marrow Transplant

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Non-graft-versus-host disease (non-GVHD) ocular complications are generally uncommon after hematopoietic cell transplantation (HCT), but can cause prolonged morbidity affecting activities of daily living and quality of life. Here we provide an expert review of non-GVHD ocular complications in a collaboration between transplant physicians and ophthalmologists through the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research and the Transplant Complications Working Party of the European Society of Blood and Marrow Transplantation. Complications discussed in this review include cataracts, glaucoma, ocular infections, ocular involvement with malignancy, ischemic microvascular retinopathy, central retinal vein occlusion, retinal hemorrhage, retinal detachment and ocular toxicities associated with medications. We have summarized incidence, risk factors, screening, prevention and treatment of individual complications and generated evidence-based recommendations. Baseline ocular evaluation before HCT should be considered in all patients who undergo HCT. Follow-up evaluations should be considered according to clinical symptoms, signs and risk factors. Better preventive strategies and treatments remain to be investigated for individual ocular complications after HCT. Both transplant physicians and ophthalmologists should be knowledgeable of non-GVHD ocular complications and provide comprehensive collaborative team care.

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Section: Medications With Ocular Toxicitiesmentioning

confidence: 99%

Non-GVHD ocular complications after hematopoietic cell transplantation: expert review from the Late Effects and Quality of Life Working Committee of the CIBMTR and Transplant Complications Working Party of the EBMT

Inamoto¹,

Petriček

Burns

et al. 2019

Bone Marrow Transplant

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“…Among other factors, the consumption of caffeine or alcoholic beverages was associated with significant increases in pupil size [17,18]. Finally, pupil dilation can be caused by amphetamines and diphenhydramine, and pupil constriction by clonidine and opioids [19].…”

Section: Pupillary Responsesmentioning

confidence: 99%

Pupillary Responses for Cognitive Load Measurement to Classify Difficulty Levels in an Educational Video Game: Empirical Study

Mitre‐Hernandez¹,

Carrillo²,

Lara–Alvarez³

2021

JMIR Serious Games

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Background A learning task recurrently perceived as easy (or hard) may cause poor learning results. Gamer data such as errors, attempts, or time to finish a challenge are widely used to estimate the perceived difficulty level. In other contexts, pupillometry is widely used to measure cognitive load (mental effort); hence, this may describe the perceived task difficulty. Objective This study aims to assess the use of task-evoked pupillary responses to measure the cognitive load measure for describing the difficulty levels in a video game. In addition, it proposes an image filter to better estimate baseline pupil size and to reduce the screen luminescence effect. Methods We conducted an experiment that compares the baseline estimated from our filter against that estimated from common approaches. Then, a classifier with different pupil features was used to classify the difficulty of a data set containing information from students playing a video game for practicing math fractions. Results We observed that the proposed filter better estimates a baseline. Mauchly’s test of sphericity indicated that the assumption of sphericity had been violated (χ 2 14 =0.05; P =.001); therefore, a Greenhouse-Geisser correction was used (ε=0.47). There was a significant difference in mean pupil diameter change (MPDC) estimated from different baseline images with the scramble filter ( F 5,78 =30.965; P <.001). Moreover, according to the Wilcoxon signed rank test, pupillary response features that better describe the difficulty level were MPDC ( z =−2.15; P =.03) and peak dilation ( z =−3.58; P <.001). A random forest classifier for easy and hard levels of difficulty showed an accuracy of 75% when the gamer data were used, but the accuracy increased to 87.5% when pupillary measurements were included. Conclusions The screen luminescence effect on pupil size is reduced with a scrambled filter on the background video game image. Finally, pupillary response data can improve classifier accuracy for the perceived difficulty of levels in educational video games.

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“…Antidepresivos tricíclicos, anestésicos locales, tetrodotoxina saxitoxina, ranas de dardo (género phylobates y dendrobates con batracotoxina), acotinina, ciguatoxinas, toxinas de anémonas y escorpiones el caso de la escopolamina. Otros ejemplos de pupilas intermedias incluyen la intoxicación por metanol, la hipotermia y la hipoxia 22 . Las sustancias asociadas con la producción de nistagmus (componente lento inicial y de corrección rápida final en la dirección opuesta), comúnmente incluyen el alcohol, bloqueadores de canales de sodio y solventes.…”

Section: Coma De Origen Tóxicounclassified

“…Las sustancias asociadas con la producción de nistagmus (componente lento inicial y de corrección rápida final en la dirección opuesta), comúnmente incluyen el alcohol, bloqueadores de canales de sodio y solventes. La importancia de evaluar y describir los movimientos oculares es que se asocian con otras alteraciones, por ejemplo, el nistagmus vertical se asocia con lesión de tallo o cerebelo, el bobbing se asocia con lesión pontina bilateral o hemorragia cerebral y el dipping con encefalopatía hipóxica [22][23][24] .…”

Section: Coma De Origen Tóxicounclassified

“…La caracterís-tica diferencial de un coma tóxico es la disociación de los hallazgos físicos esperados, por ejemplo, un reflejo pupilar a la luz intacto en ausencia de respuesta oculovestibular y motora 19,20 . Este fenómeno de disociación es explicado porque varias funciones del tallo cerebral tienden a ser más vulnerables a la agresión tóxica y metabólica que los reflejos pupilares a la luz 21,22 . Dentro de las excepciones para considerar están la intoxicación por opioides, barbitúricos y amitraz que producen miosis puntiforme no reactiva, mientras que algunos agentes anticolinérgicos causan midriasis no reactiva como en Tabla 2.…”

Section: Manejo En El Servicio De Urgenciasunclassified

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Alteración del estado de conciencia en el paciente intoxicado

Mejía

Ramos

Calzada

2017

MedUPB

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Alteración del estado de conciencia en el paciente intoxicadoAlterations in the state of consciousness in intoxicated patients / Alteração do estado de consciência no paciente intoxicado Marie Claire Berrouet Mejía 1 Natalia Eugenia Pino Ramos 2 Marcela Castro Botero 3 Ubier Eduardo Gómez Calzada 4 RESUMEN La disminución del estado de conciencia, específicamente el coma, es un motivo de consulta frecuente en el servicio de urgencias y constituye un reto para el personal de salud por el número de condiciones amenazantes de la vida que se acompañan de este signo clínico. La toxicidad en el sistema nervioso central es una de las manifestaciones más comunes en el paciente intoxicado por cuanto se han encontrado signos y síntomas hasta en un 30%. Este porcentaje es considerable en personas en edad laboral pues la morbilidad derivada de un retraso en la atención y las lesiones secundarias, implican repercusiones sociales. Según su acción en el sistema nervioso central los xenobióticos se dividen en dos grupos: estimulantes que causan agitación, delirium o convulsiones y depresores que provocan grados variables de alteración en el estado de conciencia, desde la somnolencia hasta el coma. El propósito de este artículo es revisar las sustancias depresoras, con enfoque en el coma de origen tóxico. Además de la fisiopatología y los principales tóxicos implicados, se plantea, con base en la evidencia, la mejor aproximación a esta clase de pacientes con el objeto de favorecer el uso razonable de los recursos disponibles y evitar complicaciones y disminuir costos al sistema de salud. Palabras clave: conciencia; sistema nervioso central; coma; toxicidad; envenenamiento agudo; estado mental alterado. ABSTRACTDepression of consciousness -coma, specifically -is a frequent complaint in the emergency room consultation and is a challenge for health personnel, considering the number of life-threatening conditions that may be associated with this clinical sign. Toxicity in the central nervous system is one of the most common manifestations in the poisoned patient, where signs and symptoms have been found in up to 30%. This percentage is significant in working-age individuals as morbidity resulting from a delay in care and secondary lesions involves a social impact. According to their effect on the central nervous system, xenobiotics can be divided into two groups: stimulants that cause states of agitation, delirium or convulsions, and depressants that cause varying degrees of alteration in the state of consciousness, anywhere from drowsiness to coma. The purpose of this article was to review depressants, focusing on coma induced by intoxication. In addition to reviewing the pathophysiology and the main toxic substances involved, we consider the best approach to this class of patients based on the evidence, in order to favor the reasonable use of resources available, while avoiding complications and reducing health system costs.

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Common ocular effects reported to a poison control center after systemic absorption of drugs in therapeutic and toxic doses

Abstract: Ocular findings are a pertinent component of any patient assessment involving therapeutic and/or toxic exposure to medications and other substances.

Cited by 11 publications

References 10 publications

Non-GVHD ocular complications after hematopoietic cell transplantation: expert review from the Late Effects and Quality of Life Working Committee of the CIBMTR and Transplant Complications Working Party of the EBMT

Non-GVHD ocular complications after hematopoietic cell transplantation: expert review from the Late Effects and Quality of Life Working Committee of the CIBMTR and Transplant Complications Working Party of the EBMT

Pupillary Responses for Cognitive Load Measurement to Classify Difficulty Levels in an Educational Video Game: Empirical Study

Alteración del estado de conciencia en el paciente intoxicado

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