Case presentation A 17-year old Sri Lankan male (body weight – 42 kg), presented to a local hospital 1 hour after self-ingestion of nearly 500 ml (4.3 g/kg) of liquid Propanil (concentration – 360 g/l). [bmcresnotes.biomedcentral.com]

Above 70% of this depletion, the reactive N-acetylimidoquinone metabolite will begin to react with nucleophilic thiol (-SH) groups that are present on hepatic and renal proteins. [pharmaxchange.info]

See Clues on the Skin: Acute Poisonings, a Critical Images slideshow, to help diagnose patients based on their dermatologic presentations. [emedicine.medscape.com]

First Aid EYES: First check the victim for contact lenses and remove if present. Flush victim's eyes with water or normal saline solution for 20 to 30 minutes while simultaneously calling a hospital or poison control center. [cameochemicals.noaa.gov]

If oil particles (e.g. lubricants, cutting fluids, glycerine, etc.) are present, use a NIOSH type R or P filter. For emergencies or instances where the exposure levels are not known, use a full-face positive-pressure, air-supplied respirator. [nilechemicals.com]

• Neurologic Manifestation

  The presence of neurologic manifestations, hypotension, lower GCS score, and larger ingested volumes was associated with more serious effects and mortalities. [koreamed.org]

(See Workup.) The most important aspects of the management of methemoglobinemia are recognition of the condition and prompt initiation of treatment, when indicated. [emedicine.medscape.com]

• Hepatocellular Carcinoma

  Acetaminophen hepatotoxicity and targeted rescue: a model for specific chemotherapy of hepatocellular carcinoma G. Y. Wu, C. H. Wu, M. I. Rubin, Hepatology 1985, 5, 709. [tcichemicals.com]

The most important aspects of the management of methemoglobinemia are recognition of the condition and prompt initiation of treatment, when indicated. For mild asymptomatic cases, treatment is purely for cosmetic or psychological reasons. [emedicine.medscape.com]

Drug treatments / 002B02V Drug intoxications. [pascal-francis.inist.fr]

Treatment by administration of tolonium chloride (toluidine blue) resulted in complete recovery of the patient. [ncbi.nlm.nih.gov]

Winchester JF et al:Extracorporeal treatment of salcylate or acetaminophen poisoing: Is there a role? Arch Intern Med 141:370,1985. Doul J, Klaassen CD, Amdur MO: Casarett and Doull's Toxicology. 2nd ed.,Acetaminophen. [med.teikyo-u.ac.jp]

N-acetylcysteine serves three purposes towards the antidote treatment in case of paracetamol poisoning and overdose: (i) serves as a substitute for depleted glutathione (ii) N-acetylcysteine being the precursor of glutathione, can help in replenishing [pharmaxchange.info]

Prognosis The prognosis of mild cases of methemoglobinemia is very favorable. In severe cases, the prognosis is determined by the degree of anoxic end-organ damage. [emedicine.medscape.com]

The presence of anemia and cyanosis despite oxygen treatment results from both of these effects. [4, 5] (See Pathophysiology and Etiology.) Methemoglobinemia occurs when red blood cells (RBCs) contain methemoglobin at levels higher than 1%. [emedicine.medscape.com]

PubMed View Article Google Scholar Wright RO, Lewander WJ, Woolf AD: Methemoglobinemia: etiology, pharmacology, and clinical management. Ann Emerg Med. 1999, 34 (5): 646-656. 10.1016/S0196-0644(99)70167-8. [bmcresnotes.biomedcentral.com]

Epidemiology of nonsteroidal anti-inflammatory drug-associated gastrointestinal injury. Am J Med 1998;104:23s-29s. Google Scholar Dajani EZ, Agrawal NM. Prevention and treatment of ulcers induced by nonsteroidal anti-inflammatory drugs: An update. [link.springer.com]

Indigo carmine Resorcinol Metoclopramide [50] Antibiotics – Sulfonamides, nitrofurans, and para-aminosalicylic acid Industrial/household agents – Aniline dyes, nitrobenzene, naphthalene (moth balls), aminophenol, and nitroethane (nail polish remover) Epidemiology [emedicine.medscape.com]

Pathophysiology RBCs contain hemoglobin, which has a quaternary structure. Each hemoglobin molecule is composed of 4 polypeptide chains. [emedicine.medscape.com]

Skin Protection: Wear impervious protective clothing, including boots, gloves, lab coat, apron or coveralls, as appropriate, to prevent skin contact. [nilechemicals.com]

Prevention and treatment of ulcers induced by nonsteroidal anti-inflammatory drugs: An update. J Physiol Pharmacol 1995;46:3-16. Google Scholar Taha AS, Hudson N, Hawkey CJ et al. [link.springer.com]

You can help prevent errors by Knowing your medicines. When you get a prescription, ask the name of the medicine and check to make sure that the pharmacy gave you the right medicine. [icdlist.com]

Reduction of the amount of prostoglandin, therefore, helps prevent headaches and other pain. How it's made Paracetamol is one of the most common drugs used in the world, and is manufactured in huge quantities. [ch.ic.ac.uk]

Cover with plastic sheet to prevent spreading. Absorb or cover with dry earth, sand or other non-combustible material and transfer to containers. DO NOT GET WATER INSIDE CONTAINERS. [chemicalbook.com]