Presentation
Young Medicine Archives of internal medicine 1972 Data presented from nine autopsied victims and one survivor suggest that death results from anoxia, with pulmonary edema and vascular congestion, in patients treated with respiratory support and nalorphine [semanticscholar.org]
This communication presents data on the value of osmotic diuresis, peritoneal, and hemodialysis for the therapy of propoxyphene poisoning. [jamanetwork.com]
Adverse drug reactions present a potentially serious problem for any patient for whom drugs are prescribed and particularly for those who must take multiple prescriptions. [books.google.com]
Patients with salicylate poisoning are often alkalemic on presentation with hyperventilation. [calpoison.org]
Entire Body System
- Gastric Lavage
Gastric lavage may be helpful. Activated charcoal can absorb a significant amount of ingested propoxyphene. [home.intekom.com]
lavage (in lethargic or comatose patients) • Activated charcoal (if bowel sounds are present) • Diuretics, dialysis and hemoperfusion are not indicated, because of large volume of distributions and reversibility with naloxone. [studyres.com]
Despite early hospitalization and treatment with gastric lavage, intubation and artificial ventilation in- ducing hypocapnia, we found a mortality rate of 8%. [docslide.us]
If the patient is seen within 4 hours of ingestion the stomach should be emptied by inducing vomiting or by gastric lavage as soon as possible. [ndrugs.com]
Cardiovascular
- Hypotension
Decreased sensitivity of the CO2 chemoreceptors • Noncardiogenic pulmonary edema • Hypothermia • Miosis (typically, tolerance to miosis is not developed, but miosis may not present in meperidine or lomotil overdose or in severe hypoxia) • Bradycardia • Hypotension [studyres.com]
Diagnosis Patients presenting with ventricular dysrhythmias, wide QRS complexes, or severe hypotension should be suspected of poisoning by a sodium channel antagonist. [calpoison.org]
[…] hypoglycemics, insulin Liquor (alcohols) Sedative-hypnotics Hyperthermia (NASA) Neuroleptic malignant syndrome, nicotine Antihistamines, alcohol withdrawal Salicylates, sympathomimetics, serotonin syndrome Anticholinergics, antidepressants, antipsychotics Hypotension [segwfg.nl]
Drugs & MedicationsPropoxyphene Capsule Conditions: suicidal thoughts alcoholism alcohol intoxication drug abuse depression cor pulmonale prolonged QT interval on EKG abnormal heart rhythm abnormal EKG with QT changes from birth orthostatic hypotension [webmd.com]
A case of ischemic colitis has been reported following an overdose of propoxyphene which was complicated by severe hypotension. [drugs.com]
Workup
Serum
- Hypercapnia
Canine experiments have indicated that reducing hypoxia and hypercapnia lowers serum catecholamine concentrations. [emj.bmj.com]
QRS Wave
- Wide QRS Complex
Diagnosis Patients presenting with ventricular dysrhythmias, wide QRS complexes, or severe hypotension should be suspected of poisoning by a sodium channel antagonist. [calpoison.org]
Treatment
Pharmacology and Therapeutics for Dentistry, 6th Edition describes how to evaluate a patient’s health and optimize dental treatment by factoring in the drugs they take. [books.google.com]
Young Medicine Drugs 2012 Dextropropoxyphene poisoning is now probably one of the most common causes of self-poisoning death because, although there is an effective antidote, subjects frequently succumb before treatment can be made available. [semanticscholar.org]
The patient's complete recovery was remarkable because of the large amounts of drugs ingested, the delayed treatment, and prior exposure to enzyme inducers (known to increase acetaminophen hepatotoxicity). [ucdavis.pure.elsevier.com]
Prognosis
Home | CCC | ECG in Toxicology by, last update March 26, 2019 OVERVIEW The ECG is important in the assessment and management of poisoned patients for: screening diagnosis prognosis monitoring progression to guide management and disposition USE AS A SCREENING [lifeinthefastlane.com]
I t is surprising that six patients admitted in asystole could be discharged without any sequelae, emphasis- ing a readily reversible depressed state and a positive prognosis if treated immediately. [docslide.us]
Etiology
Because chronic pain is a complex condition with intrinsic sensory, emotional, and behavioral components contributing to its etiology and severity, managing chronic pain disorders can be challenging. [hayes.web.fc2.com]
Common etiologies and new approaches to management of poisoning in pediatric practice. Curr Opin Pediatr. 1993 Oct; 5(5):524-30. View abstract Woolf AD, Lovejoy FH. Epidemiology of drug overdose in children. Drug Saf. 1993 Oct; 9(4):291-308. [childrenshospital.org]
Epidemiology
The epidemiology of dextropropoxyphene (Distalgesic) overdose fatalities in Birmingham and the West Midlands. J. Clin. Hosp. Pharm., 6,251-257. Google Scholar | Medline Young, D.J. (1972). Propoxyphene suicides. Arch. Intern. Med., 129, 62-66. [journals.sagepub.com]
Epidemiology of drug overdose in children. Drug Saf. 1993 Oct; 9(4):291-308. View abstract Ledley FD, Lovejoy FH. [childrenshospital.org]
This review considers the epidemiology, mechanisms, and management of opioid ... DA: 74 PA: 62 MOZ Rank: 5 9. Appendix B. [tiwebsite.com]
According to Gerald Dal Pan, M.D., M.H.S., director of the Office of Surveillance and Epidemiology, CDER, once patients stop taking propoxyphene, the risk of heart damage will go away. [lawyersandsettlements.com]
Epidemiology Drugs and toxins that act as sodium channel antagonists include agents listed in List 1. Together they comprise perhaps the largest group of cardiotoxic agents. [calpoison.org]
Pathophysiology
They also address the consequences of drug interactions and the basic pathophysiology of central nervous system toxicity. [books.google.com]
Pathophysiology The role of sodium bicarbonate as an antidote depends on the specific indication. Its mechanisms as an antidote for sodium channel blocking drugs are incompletely understood. [calpoison.org]
Prevention
Administration of N-acetylcysteine prevented inorganic sulfate depletion usually caused by acetaminophen and may have increased the formation of acetaminophen sulfate. Some patients eliminate large overdoses of acetaminophen very slowly. [ucdavis.pure.elsevier.com]
Centers for Disease Control and Prevention. Available at https://www.cdc.gov/drugoverdose/data/index.html. July 18, 2017; Accessed: October 1, 2018. Fentanyl. Centers for Disease Control and Prevention. [emedicine.medscape.com]
Estradiol is known to exert no protective effect against most toxicants amenable to prophylaxis by catatoxic steroids, yet it is highly efficacious in preventing propoxyphene poisoning; conversely, triamcinolone and thyroxine aggravate this intoxication [karger.com]