Presentation
The site of (CH(3))(3)Bi production could not be identified in the present study, but the intestinal microflora seems to be involved in this biotransformation if accompanying ex vivo studies are taken into consideration. [ncbi.nlm.nih.gov]
We present the first case report of AEN after using large doses of over-the-counter Pepto-Bismol (bismuth subsalicylate). [acgcasereports.gi.org]
He has been the principal investigator of many research projects funded by Swedish funding Agencies and is presently actively involved in such research. [books.google.com]
Calcium, magnesium, potassium, and sodium must be present for normal body functions. Cobalt, copper, iron, manganese, molybdenum, selenium, and zinc are needed. [books.google.de]
The site of (CH 3 ) 3 Bi production could not be identified in the present study, but the intestinal microflora seems to be involved in this biotransformation if accompanying ex vivo studies are taken into consideration. [dmd.aspetjournals.org]
Entire Body System
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Rigor
Written in an accessible style with just the right amount of technical rigor, the book covers: General fundamentals and specific hazards and effects of chemical substances The basics of exposures and responses to chemical substances in the work environment [books.google.de]
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Swelling
Neurological symptoms associated with lead overexposure include an impaired ability to coordinate voluntary movements (ataxia), brain damage (encephalopathy), seizures, convulsions, swelling of the optic nerve (papilledema), and/or impaired consciousness [rarediseases.org]
Gastrointestinal
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Constipation
Percy Medicine contains bismuth subsalicylate as the active ingredient and is used as a constipation reliever. [emedicine.medscape.com]
Additional symptoms may include fever, headaches, fatigue, sluggishness (letheragy), vomiting, loss of appetite (anorexia), abdominal pain, constipation, joint pain, loss of recently acquired skills, incoordination, listlessness, difficulty sleeping [rarediseases.org]
Anxiety any loss of hearing confusion constipation (severe) diarrhea (severe or continuing) difficulty in speaking or slurred speech dizziness or lightheadedness drowsiness (severe) fast or deep breathing headache (severe or continuing) increased sweating [drugs.com]
Clinical interpretation Carbamazepine poisoning may cause headache, dry mouth, abdominal discomfort, diarrhoea, constipation, ataxia, nystagmus, diplopia, hypotension, coma, convulsions and respiratory depression. [who.int]
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Black Stools
Check with your doctor immediately if any of the following side effects occur while taking bismuth subsalicylate: In some patients bismuth subsalicylate may cause dark tongue and/or grayish black stools. [drugs.com]
The common side effects of bismuth intake are abdominal pain, black stools, diarrhoea, dizziness, headache, metallic taste, nausea, vomiting, and black-colored tongue. [5] Other adverse effects include hepatitis, renal failure, and testicular macrophage [neurologyindia.com]
It can, however, cause a black tongue and black stools in some users of the drugs. [newworldencyclopedia.org]
Cardiovascular
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Vascular Disease
Mortality can reach as high as 32% (often in cases presenting with other comorbidities), but mortality specific to AEN is around 6%. 6 The exact etiology of AEN in this case is unclear in the absence of vascular disease. [acgcasereports.gi.org]
Jaw & Teeth
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Black Tongue
Black tongue secondary to bismuth subsalicylate: Case report and review of exogenous causes of macular lingual pigmentation. J Drugs Dermatol. 2009;8(12):1132–5. PubMed Sugawa C, Takekuma Y, Lucas CE, Amamoto H. [acgcasereports.gi.org]
The elderly may be particularly vulnerable to the development of salicylism. [ Ref ] Frequency not reported : Salicylism [ Ref ] Gastrointestinal Very common (10% or more): Black stool Common (1% to 10%): Black tongue Frequency not reported : Nausea, [drugs.com]
It can, however, cause a black tongue and black stools in some users of the drugs. [newworldencyclopedia.org]
Miller, “Black Tongue,” Archives of Dermatology, Vol. 137, No. 7, 2001, pp. 968-969. M. F. Gordon, R. I. Abrams, D. B. Rubin, W. B. Barr and D. D. [file.scirp.org]
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Black Tongue
Black tongue secondary to bismuth subsalicylate: Case report and review of exogenous causes of macular lingual pigmentation. J Drugs Dermatol. 2009;8(12):1132–5. PubMed Sugawa C, Takekuma Y, Lucas CE, Amamoto H. [acgcasereports.gi.org]
The elderly may be particularly vulnerable to the development of salicylism. [ Ref ] Frequency not reported : Salicylism [ Ref ] Gastrointestinal Very common (10% or more): Black stool Common (1% to 10%): Black tongue Frequency not reported : Nausea, [drugs.com]
It can, however, cause a black tongue and black stools in some users of the drugs. [newworldencyclopedia.org]
Miller, “Black Tongue,” Archives of Dermatology, Vol. 137, No. 7, 2001, pp. 968-969. M. F. Gordon, R. I. Abrams, D. B. Rubin, W. B. Barr and D. D. [file.scirp.org]
Skin
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Hyperpigmentation
The reactivity of bismuth with sulfur molecules ingested from food can lead to linguinal hyperpigmentation (black tongue), which is often benign and reversible with medication discontinuation. 8 The high doses of an alkalizing medication such as bismuth [acgcasereports.gi.org]
Skin and nail symptoms include hardened patches of skin (hyperkeratosis) with unusually deep creases on the palms of the hands and the soles of the feet, unusual darkening of certain areas of the skin (hyperpigmentation), transverse white bands on the [rarediseases.org]
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Alopecia
Overexposure to selenium may cause irritation of the respiratory system, gastrointestinal tract, and eyes; inflammation of the liver; loss of hair (alopecia); loss of skin color (depigmentation); and peripheral nerve damage. [rarediseases.org]
Urogenital
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Anuria
We report a 17-year-old girl who was admitted to the emergency room with complaints of nausea, vomiting, and anuria. She had taken 25 tablets containing 300 mg bismuth subcitrate (total 7.5 g). [ncbi.nlm.nih.gov]
Workup
(See Presentation and Workup .) Phase 1 of the toxicity is characterized by hyperventilation resulting from direct respiratory center stimulation, leading to respiratory alkalosis and compensatory alkaluria. [emedicine.medscape.com]
Her autoimmune workup, CSF NMO antibodies, and viral markers were negative. MRI of the brain showed further decrease in basal ganglia signal changes with cerebral and cerebellar atrophy. [neurologyindia.com]
Treatment
Our study found that treatment with bismuth significantly improved the clinical course of disease even when the currently recommended oral treatment regimen was followed. [nejm.org]
Treatment A high index of suspicion of salicylate toxicity is necessary, with prompt recognition of clinical signs and symptoms of salicylate poisoning, such as tinnitus, hyperventilation, tachycardia, and metabolic acidosis. [3] Early treatment can prevent [emedicine.medscape.com]
Meredith T, Vale JA (1995) Treatment of paraquat poisoning: gastrointestinal decontamination. In: Bismuth C, Hall AH, editors. Paraquat poisoning: mechanisms, prevention, treatment. New York: Marcel Dekker. pp. 297–314. 12. [journals.plos.org]
However it has been used for some time as a medicine (tripotassium dicitratobismuthate) for treatment of stomach upsets. In combination with antibiotics it is now used for treatment of some stomach ulcers. [webelements.com]
[O-]C( O)CC([O-])(CC([O-]) O)C([O-]) O Indication For the treatment of peptic ulcer and gastro-oesophageal reflux disease (GORD). [drugbank.ca]
Prognosis
Bismuth C, Garnier R, Dally S, Fournier PE, Scherrman JM (1982) Prognosis and treatment of paraquat poisoning: a review of 28 cases. J Toxicol Clin Toxicol 19: 461–474. View Article Google Scholar 22. [journals.plos.org]
Etiology
Mortality can reach as high as 32% (often in cases presenting with other comorbidities), but mortality specific to AEN is around 6%. 6 The exact etiology of AEN in this case is unclear in the absence of vascular disease. [acgcasereports.gi.org]
An etiologic agent was identified in 166 of the 249 patients (67 percent) evaluated. Duration of Diarrhea Figure 1. Figure 1. Percentage of Patients Who Continued to Have Diarrhea over a Given Period (Eight Hours), According to Study Group. [nejm.org]
Epidemiology
His Scientific Publications are mainly on Toxicology and Epidemiology of environmental agents, particularly metals. [books.google.com]
Epidemiologic survey (in French). Therapie 1976;31:683–702. [karger.com]
Onyon LJ, Volans GN (1987) The epidemiology and prevention of paraquat poisoning. Hum Toxicol 6: 19–29. View Article Google Scholar 21. [journals.plos.org]
Epidemiology Heavy metal poisoning is rare in the UK, even in industries where there is an increased risk. [ 1 ] The most common cause of heavy metal poisoning is lead. [patient.info]
Very common 1/10 Common 1/100 and 1/10 Uncommon 1/1,000 and Rare 1/10,000 and Very rare Not known (cannot be estimated from the available data) ADRs are presented by frequency category based on 1) incidence in adequately designed clinical trials or epidemiology [medicines.org.uk]
Pathophysiology
[…] diarrhoea, dizziness, headache, metallic taste, nausea, vomiting, and black-colored tongue. [5] Other adverse effects include hepatitis, renal failure, and testicular macrophage destruction leading to infertility and encephalopathy. [6], [7], [8] The pathophysiology [neurologyindia.com]
Prevention
Skin: Wear appropriate protective gloves to prevent skin exposure. Clothing: Wear appropriate protective clothing to prevent skin exposure. [chemicalbook.com]
Low-dose aspirin helps to prevent thrombosis. Acetylsalicylic acid is colorless or white in crystalline, powder, or granular form. The chemical is odorless and is soluble in water. [emedicine.medscape.com]
Controlled studies indicate that this treatment is effective and prevents traveler's diarrhea 2. [nejm.org]
Paraquat poisoning: mechanisms, prevention, treatment. New York: Marcel Dekker. pp. 297–314. 12. [journals.plos.org]
DuPont HL "Bismuth subsalicylate in the treatment and prevention of diarrheal disease." Drug Intell Clin Pharm 21 (1987): 687-93 7. Gorbach SL "Bismuth therapy in gastrointestinal diseases." Gastroenterology 99 (1990): 863-75 8. [drugs.com]