Management of Specific Poisonings

  • C. Bismuth
  • F.-J. Baud


Although they have no place in therapy except as anticonvulsants, barbiturates are still extensively prescribed and constitute a major cause of acute drug overdose. Traditionally, the barbiturate drugs are divided into four classes, and their main properties and hazards are shown in Table 63.1 [32].


Peritoneal Dialysis Metabolic Acidosis Neuroleptic Malignant Syndrome Methanol Poisoning Gastric Aspiration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Amin DN, Henry JA (1985) Propranolol administration in theophylline overdose. Lancet i: 520–521Google Scholar
  2. 2.
    Baud F-J, Bismuth C (1988) Intoxication aiguë par la chloroquine. In: Actualités en réanimation préhospitalière. Masson, Paris, 42–56Google Scholar
  3. 3.
    Baud F-J, Bismuth C, Pontal PG et al. (1982–83) Time course of antidigoxin Fab fragment and plasma digitoxin concentrations in an acute digitalise intoxication. J Toxicol Clin Toxicol 19: 857–860Google Scholar
  4. 4.
    Baud F-J, Bismuth C, Gamier R et al. (1986–87) 4- Methylpyrazole may be an alternative to ethanol therapy for ethylene glycol intoxication in man. J Toxicol Clin Toxicol 24: 463–483Google Scholar
  5. 5.
    Berg MJ, Berlinger WG, Goldberg MJ, Spector R, Johnson G (1982) Acceleration of the body clearance of phénobarbital by oral activated charcoal. N Engl J Med 307: 642–644PubMedCrossRefGoogle Scholar
  6. 6.
    Bismuth C, Sebag C (1981) Choc cardiogénique lors d’une intoxication aiguë par la Colchicine. Nouv Presse Méd 10 (13): 1073PubMedGoogle Scholar
  7. 7.
    Bismuth C, Elkharrat D (1982) Theoretical indication of dantrolene in neuroleptic malignant syndrome. Efficacy in three cases. Vet Hum Toxicol 3: 52–55Google Scholar
  8. 8.
    Bismuth C, Baud F-J, Fournier PE, Mellerio F (1985) Résumé de l’étude: antagoniste RO 15–1788 dans l’intoxication volontaire par benzodiazépines. Valeur diagnostique et thérapeutique. Etude sur 40 cas. Ann Med Int 137: 363Google Scholar
  9. 9.
    Bismuth C, Baud F-J, Galliot M (1987) Toxicocinétique plasmatique et globulaire du lithium après ingestion unique. J Toxicol Clin Exp 7: 171–176PubMedGoogle Scholar
  10. 10.
    Bismuth C, Baud F-J, Conso F, Frejaville JP, Garnier R (1987) Toxicologie clinique, 4th edn, vol 1. Flammarion, ParisGoogle Scholar
  11. 11.
    Bismuth C, Scherrmann JM, Garnier R, Baud FJ, Pontal PG (1987) Elimination of paraquat. Hum Toxicol 6: 63–67PubMedCrossRefGoogle Scholar
  12. 12.
    Bismuth C, Garnier R, Baud F-J, Muszynski J, Keyes C (1990) Paraquat poisoning. Am overview of the current status. Drug Safety 5: 243–251Google Scholar
  13. 13.
    Bocland ME, Brennand Roper SM, Henry JA (1985) Complications of quinine poisoning. Lancet i: 384–385Google Scholar
  14. 14.
    Brown SS (1977) Clinical chemistry and chemical toxicology of metals. Elsevier/North Holland, AmsterdamGoogle Scholar
  15. 15.
    Browne GF, Coppec DL (1984) Management of quinine overdose. Bilateral stellate ganglion blockade. Hum Toxicol 3: 399–402Google Scholar
  16. 16.
    Connel JMC, Cook GM, Mclnnes GT (1982) Metabolic consequences of salbutamol poisoning reversed by propranolol. Br Med J 285: 779CrossRefGoogle Scholar
  17. 17.
    Conso F, Souquière JP, Bismuth C, Efthymiou ML, Fournier E, Valence B (1982) Hépatonéphrites et hépatites toxiques par inhalation de trichloréthylène frauduleux. Gastroenterol Clin Biol 6: 539–541PubMedGoogle Scholar
  18. 18.
    Cregler LL, Marks H (1986) Special report. Medical complications of cocaine abuse. N Engl J Med 315: 1495–1500Google Scholar
  19. 19.
    Dally S, Alperovitch A, Lagier G et al. (1981) Facteurs pronostiques de l’intoxication digitalique aiguë. Nouv Presse Méd 10: 2257–2260PubMedGoogle Scholar
  20. 20.
    Elkharrat D, Bismuth C (1982) Acute intoxication by beta-blocking agents: no mortality in 40 cases. Int J Clin Pharmacol Res II (3): 207–210Google Scholar
  21. 21.
    Ellenhorn MJ, Barceloux DG (1987) Medical toxicology. Diagnosis and treatment of human poisoning, vol 1. Elsevier, AmsterdamGoogle Scholar
  22. 22.
    Flanagan RJ, Mant TGK (1986) Coma and metabolic acidosis early in severe acute paracetamol poisoning. Hum Toxicol 5: 179–182PubMedGoogle Scholar
  23. 23.
    Gaudreault P, Guay J (1986) Theophylline poisoning. Pharmacological considerations and clinical manag- ment. Med Toxicol 1: 169–191Google Scholar
  24. 24.
    Gaudreault P, Wason S, Lovejoy FH (1983) Acute pediatric theophylline overdose: a summary of 28 cases. J Pediatr 102: 474–476PubMedCrossRefGoogle Scholar
  25. 25.
    Goldfrank LR, et al. Toxicologic emergencies, (1986) 3rd edn, vol 1. Appleton-Century-Croft, New YorkGoogle Scholar
  26. 26.
    Hamburger J, Crosnier J, Grunfeld JP (1979) Nephrology. Wiley, New York [édition française ( 1979 ) Néphrologie. Flammarion, Paris]Google Scholar
  27. 27.
    Jacobsen D, McMartin KE (1986) Methanol and ethylene glycol poisonings: mechanism of toxicity, clinical course,« diagnosis and treatment. Med Toxicol 1: 309–334PubMedGoogle Scholar
  28. 28.
    Jaeger A, Sauder Ph, Kopferschmitt J et al. (1982) Acute disopyramide poisoning: a multicenter study of 106 cases. Vet Hum Toxicol 24: 285 (abstract)Google Scholar
  29. 29.
    Jaeger A, Sauder Ph, Kopferschmitt J, Jaegle ML (1985–86) Toxicokinetics of lithium intoxication treated by hemodialysis. J Toxicol Clin Toxicol 23: 501–517Google Scholar
  30. 30.
    Lofaso F, Baud F-J, Halna du Fretay X, Bismuth C, Staikowsky F, Sidhom N (1987) Hypokaliémie au cours d’intoxications massives par la chloroquine. Presse Méd 16: 22–24PubMedGoogle Scholar
  31. 31.
    Mant TGK, Tempowski JH, Volans GN, Talbot JCC (1984) Adverse reactions to acetylcysteine and effects of overdose. Br Med J 289: 217–219CrossRefGoogle Scholar
  32. 32.
    Matthew H, Lawson AAM (1978) Treatment of common acute poisonings, 4th edn. Churchill Livingstone, EdinburghGoogle Scholar
  33. 33.
    McMartin KE, Hedstrom KLG, Tolf BR, Ostling-Wintzell H, Blomstrand R (1980) Studies on the metabolic interactions between 4-methylpyrazole and methanol using the monkey as an animal model. Arch Biochem Biophys 199: 606–614PubMedCrossRefGoogle Scholar
  34. 34.
    Neuvonen PJ (1982) Clinical pharmacokinetics of oral activated charcoal in acute intoxications. Clin Phar- macokinet 7: 465–489CrossRefGoogle Scholar
  35. 35.
    Pentel P (1984) Toxicity of over-the-counter stimulants. JAMA 252: 1898–1903PubMedCrossRefGoogle Scholar
  36. 36.
    Pentel P, Benowitz N (1984) Efficacy and mechanism of action of sodium bicarbonate in the treatment of desipramine toxicity in rats. J Pharmacol Exp Ther 230: 12–19PubMedGoogle Scholar
  37. 37.
    Peterson DC, Collins AJ, Himes JM et al. (1981) Ethylene glycol poisoning: pharmacokinetics during therapy with ethanol and hemodialysis. N Engl J Med 304: 21–23PubMedCrossRefGoogle Scholar
  38. 38.
    Pond SM (1986) Role of repeated oral doses of activated charcoal in clinical toxicology. Med Toxicol 1: 3–11PubMedGoogle Scholar
  39. 39.
    Prescott LF (1983) Paracetamol overdosage. Pharmacological considerations and clinical management. Drugs 25: 290–314PubMedCrossRefGoogle Scholar
  40. 40.
    Prescott LF, Paris J, Ballantyne A, Adriacussens P, Proudfoot AT (1977) Treatment of paracetamol (acetaminophen) poisoning with N-acetylcysteine. Lancet ii: 432–434Google Scholar
  41. 41.
    Prescott LF, Balali-Mood M, Critchley JAJH (1982) Diuresis or urinary alkalinisation for salicylate poisoning. Br Med J 285: 1383–1386CrossRefGoogle Scholar
  42. 42.
    Prior JG, Cochrane G, Raper SM (1981) Self-poisoning with oral salbutamol. Br Med J 282: 1932CrossRefGoogle Scholar
  43. 43.
    Riou B, Barriot P, Rimailho A, Baud FJ (1988) Treatment of severe chloroquine poisoning. N Engl J Med 318: 1–6PubMedCrossRefGoogle Scholar
  44. 44.
    Rumack BH, Peterson RC, Koch GG, Amara IA (1981) Acetaminophen overdose, 662 cases with evaluation of oral acetylcysteine treatment. Arch Intern Med 141: 382–390Google Scholar
  45. 45.
    Ruprah M, Mant TGK, Flanagan RJ (1985) Acute carbon tetrachloride poisoning in 19 patients. Implications for diagnosis and treatment. Lancet i: 1027–1029Google Scholar
  46. 46.
    Sangster B, Landberg P (1980) The usefulness of physo- stigmine in clinical toxicology. Paper presented at a joint meeting of WHO, and the Association of Poison Control Centres, CopenhagenGoogle Scholar
  47. 47.
    Sasyniuk BI, Jhamandas V (1984) Mechanism of reversal of toxic effects of amitriptyline on cardiac purkinje fibers by sodium bicarbonate. J Pharmacol Exp Ther 231: 387–394PubMedGoogle Scholar
  48. 48.
    Smith TW, Butler VP Jr, Haber E et al. (1982) Treatment of life-threatening digitalis intoxication with digoxin- specific Fab antibody fragments: experience in 26 cases. N Engl J Med 307: 1357–1362PubMedCrossRefGoogle Scholar
  49. 49.
    Smolarz A, Rolesch E, Lenz E et al. (1985) Digoxin specific antibody (Fab) fragments in 34 cases of severe digitalis intoxication. Clin Toxicol 23: 327–340CrossRefGoogle Scholar
  50. 50.
    Van Asbeck BS, Hillen BC, Boonen HCM et al. (1986) Death following paraquat intake in the rat is completely prevented by desferrioxamine. In: Proceedings of the III world congress of the World Federation of Associations of Clinical Toxicology and Poison Control Centres, BrusselsGoogle Scholar
  51. 51.
    Ward DE, Jones B (1976) Glucagon and beta-blocker toxicity. Br Med J ii: 151Google Scholar
  52. 52.
    Wason S, Lacouture PG, Loveloy FH Jr (1981) Single high dose pyridoxine treatment for isoniazid overdose. JAMA 246: 1102–1104PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 1992

Authors and Affiliations

  • C. Bismuth
  • F.-J. Baud

There are no affiliations available

Personalised recommendations