Cardiovascular collapse

The active drug and metabolites can be detected from the urine by thin-layer chromatography, gas-liquid chromatography, or gas chromatography-mass spectrometry. However, assays are available only at specialized centers. Treatment of acute intoxication with mescaline is virtually identical to the treatment outlined for LSD intoxication. DOM-induced vasospasm responds well to intra-arterial tolazohne or sodium nitroprusside. Major life-threatening complications of hallucinogenic amphetamine derivatives include hyperthermia, hypertension, convulsions, cardiovascular collapse, and self-inflicted trauma. 

Fisher MMD Clinical observations on the pathophysiology and treatment of anaphylactic cardiovascular collapse. Anesth Intensive Care 1986 17 17-21. Galli S (ed) Anaphylaxis. Novartis Foundation Symposium 157. Chichester, Wiley, 2004. Gronemeyer W Noradrenalin statt Adrenalin beim anaphylaktischen Schock. Dtsch Med Wochenschr 1980 102 101. 

Anaphylaxis is the most dramatic and potentially catastrophic manifestation of allergic disorders. It can affect virtually any organ including the cardiovascular system. Cardiovascular collapse and hypotensive shock in anaphylaxis have been attributed to peripheral vasodilation, enhanced vascular permeability and plasma leakage, rather than any direct effect on the myocardium. However, there is increasing experimental and clinical evidence that the human heart is a site and target of anaphylaxis. 

Initial features are mostly pulselessness, difficulty in ventilation, desaturation, and a decreased end-tidal CO2. Cutaneous symptoms are observed in 66-70% of patients in case of IgE-mediated reactions but in more than 90% in non-IgE-mediated reactions. On the contrary, cardiovascular collapse and bronchospasm are more frequent in IgE-dependent reactions (table 2). Severe anaphylaxis may be a primary cardiac arrest [9]. 

Propofol infusion syndrome has been described and may result in severe metabolic acidosis, cardiac dysrhythmias, cardiovascular collapse, rhabdomyolysis, and death. The risk may be increased with concomitant catecholamine infusions or when the dose exceeds... 

Most healthy adults with diarrhea do not develop dehydration or other complications and can be treated symptomatically by self medication. When diarrhea is severe and oral intake is limited, dehydration can occur, particularly in the elderly and infants. Other complications of diarrhea resulting from fluid loss include electrolyte disturbances, metabolic acidosis, and cardiovascular collapse. 

Many of these reactions are related to the quantity of excipient found in a dosage form. Benzyl alcohol benzalkonium chloride, propylene glycol, lactose, and polysorbates are all associated with dose-related toxic reactions [52-54], Large-volume parenterals containing 1.5% benzyl alcohol as a preservative have caused metabolic acidosis, cardiovascular collapse, and death in low birth weight premature neonates and infants. The cumulative dose of benzyl alcohol ranged from 99 to 234 mg/kg per day in these patients [55,56], Dose-related adverse effects to excipients are of particular concern in the preterm, low birth weight infant because... 

The precise mechanism of dimethylhydrazine toxicity is uncertain. In addition to the contact irritant effects, the acute effects of dimethylhydrazine exposure may involve the central nervous system as exemplified by tremors and convulsions (Shaffer and Wands 1973) and behavioral changes at sublethal doses (Streman et al. 1969). Back and Thomas (1963) noted that the deaths probably involve respiratory arrest and cardiovascular collapse. The central nervous system as a target is consistent with the delayed latency in response reported for dimethylhydrazine (Back and Thomas 1963). There is some evidence that 1,1-dimethylhydrazine may act as an inhibitor of glutamic acid decarboxylase, thereby adversely affecting the aminobutyric acid shunt, and could explain the latency of central-nervous-system effects (Back and Thomas 1963). Furthermore, vitamin B6 analogues that act as coenzymes in the aminobutyric acid shunt have been shown to be effective antagonists to 1,1-dimethylhydrazine toxicity (reviewed in Back and Thomas 1963). 

A casualty with cardiovascular collapse or severe hyperthermia. Immediate attention to ventilation, hemodynamic status, and temperature control could be life-saving. 

These materials are hazardous through inhalation, penetration through broken skin, and ingestion. Symptoms include tingling, burning, numbness, drowsiness, incoherent speech, respiratory paralysis, and possibly cardiovascular collapse. 

VF is electrical anarchy of the ventricle resulting in no cardiac output and cardiovascular collapse. Sudden cardiac death occurs most commonly in patients with ischemic heart disease and primary myocardial disease associated with LV dysfunction. VF associated with acute MI may be classified as either (1) primary (an uncomplicated MI not associated with heart failure [HF]) or (2) secondary or complicated (an MI complicated by HF). 

VF is electrical anarchy of the ventricle resulting in no cardiac output and cardiovascular collapse. 

Symptoms of PE include dyspnea, tachypnea, pleuritic chest pain, tachycardia, palpitations, cough, diaphoresis, and hemoptysis. Cardiovascular collapse, characterized by cyanosis, shock, and oliguria, is an ominous sign. 

Signs and symptoms of BZ withdrawal are similar to those of alcohol withdrawal, including muscle pain, anxiety, restlessness, confusion, irritability, hallucinations, delirium, seizures, and cardiovascular collapse. Withdrawal from short-acting BZs (e.g., oxazepam, lorazepani, alprazolam) has an onset within 12 to 24 hours of the last dose. Diazepam, chlordiazep-oxide, and clorazepate have elimination half-lives (or active metabolites with elimination half-lives) of 24 to greater than 100 hours. So, withdrawal may be delayed for several days after their discontinuation. 

The first group persons in grave condition threatening their life (acute respiratory failure and cardiovascular collapse, coma, convulsions, paralytic manifestations). Upon first aid provided, these persons are to be evacuated to specialized medical institutions as soon as possible, preferably by ambulance cars, equipped with reanimation facilities. 

Signs and Symptoms Weakness, fever, cough, and hypothermia about thirty-six hours after aerosol exposure, followed in the next twelve hours by hypotension and cardiovascular collapse. 

Neuroleptic malignant syndrome is an acute iatrogenic condition caused by neuroleptics, characterized by tremor, catatonia, fluctuating consciousness, hyperthermia, and cardiovascular instability. It is relatively uncommon, occuring in 1-1.5% of patients but is fatal in 11-38%, most often due to cardiovascular collapse (Jahan et al. 1992). The pathogenesis of neuroleptic malignant syndrome is poorly understood, but it is believed to result from altered dopamine and serotonin transmission in the hypothalamus, spinal cord, and striatum. Treatment includes discontinuation of neuroleptics and administration of drugs that increase dopamine transmission bromocriptine or L-dopa (Jahan etal. 1992 Baldessarini 1996). 

Therapeutic doses of scopolamine produce CNS depression, characterized by drowsiness, amnesia, and dreamless sleep (Brown and Taylor 1996). It reduces arousal and increases the effort required to awaken (Parrott 1987). Higher therapeutic doses of atropine cause central excitation, characterized by restlessness, irritability, confusion, disorientation, hallucinations, and delirium. Larger doses produce central depression, paralysis, coma, and death by respiratory failure and cardiovascular collapse. 

Toxicology. Borates are irritants of the eyes, nose, and throat at high concentrations ingestion of the compounds can result in gastrointestinal irritation, kidney injury, and even death from central nervous system depression or cardiovascular collapse. 

Excessive absorption of boron oxide may lead to cardiovascular collapse, alterations in temperature regulation, and coma. ... 

The lowest LDso reported for q clohex-imide is 2mg/kg after oral administration in the rat. In animal experiments, cycloheximide is irritating to the skin and eyes. Animals given toxic doses exhibit salivation, bloody diarrhea, tremors, and excitement leading to death from cardiovascular collapse. ... 

Renal disease or renal dysfunction (eg, as suggested by serum creatinine levels greater than or equal to 1.5 mg/dL [males], greater than or equal to 1.4 mg/dL [females], or abnormal Ccr) that may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction (Ml), and septicemia CHF requiring pharmacologic treatment hypersensitivity to metformin acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma. Treat diabetic ketoacidosis with insulin. 

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