Convulsive syncope

Human Papillomavirus (Types 6, 11, 16, 18) Recombinant Vaccine (Gardasil) [Vaccine] Uses Prevent cervical CA, precancer-ous genital lesions, and genital warts d/t HPV types 6, 11, 16, 18 in females 9-26 y Action Recombinant vaccine, passive humoral immunity Dose 0.5 mL EM initial, then 2 and 6 mo observe for 15 min after, keep seated or lying down Caution [B, /-] Disp Inj SE Site Rxn (pain, erythema, swelling, pruritus), fever, fainting w/ administration Interactions W/ immunosuppressants, may get decreased response EMS Convulsive syncope (fainting associated w/ Sz -like activity) OD Unlikely... 

Abdominal discomfort and convulsive syncope occurred after the ingestion of raw horseradish that had not been properly aired before use (1). 

Sodium picosulfate Electrolyte disturbance, convulsions, syncope, metabolic alkalosis (40)... 

CA/S-Agitation, akathesia, akinesia, anxiety, asthenia, confusion, convulsions, dizziness, drowsiness, dystonia, extrapyramidal symptoms, gait abnormal, headache, hypokinesia, insomnia, libido decreased, light-headedness, restlessness, somnolence, syncope, tardive dystonia, tremor, vertigo. 

Disuifiram-aicohoi reaction Disulfiram plus alcohol, even small amounts, produces flushing, throbbing in head and neck, throbbing headaches, respiratory difficulty, nausea, copious vomiting, sweating, thirst, chest pain, palpitations, dyspnea, hyperventilation, tachycardia, hypotension, syncope, marked uneasiness, weakness, vertigo, blurred vision, and confusion. In severe reactions there may be respiratory depression, cardiovascular collapse, arrhythmias. Ml, acute CHF, unconsciousness, convulsions, and death. The intensity of the reaction is proportional to the amounts of disulfiram and alcohol ingested. The duration of the reaction varies from 30 to 60 minutes to several hours. 

Meperidine (Demerol) [C-ll] [Narcotic Analgesic] Uses Moderate/ severe pain Action Narcotic analgesic Dose Adults. 25-50 mg IV, 50-100 mg IM Peds. 1 mg/kg IV/IM (onset w/in 5 min IV and 10 min IM duration about 2 h) Caution [C, ] Contra Convulsive disorders and acute abdomen Disp Prefilled 1 mL syringes 25, 50, 75, 100 mg/mL various amps and vials oral syrup and tabs SE N/V (may be severe), dizziness, weakness, sedation, miosis, resp d ession, xerostomia (dry mouth) Interactions t CNS depression W/ opiates, sedatives/ hypnotics TCNS stimulation W/amphetamines t risk of tox W7 phenytoin EMS Pt should be receiving O2 prior to administration have resuscitation equipment and naloxone available naloxone can be used as an antidote to reverse resp depression aspirate prior to IM administration inadv tent IV admin of IM doses may cause tach and syncope mix w/ NS to make a 10 mg/mL soln and inj very slowly N/V may be sev e may premedicate w/ an antiemetic... 

Adverse effects inevitably include cholinergic symptoms with nausea, diarrhoea and abdominal cramps appearing commonly. There may also be bradycardia, sinoatrial or atrioventricular block. Urinary incontinence, syncope, convulsions, and psychiatric disturbances also occur. Rapid dose increase appears to make symptoms more pronounced. Hepatotoxicity is a rare association with donepezil. 

The other group of cocaine poisonings is characterized by delirium, increased reflexes, more or less violent convulsions, the pulse usually being rapid and fairly strong but later may become weak, and syncope and cyanosis may intervene. The delirium is frequently associated with hallucinations and at times the patient may develop a violent mania of even homicidal character, as in a case reported by Mattison. In fatal cases death is usually due to respiratory failure although the circulation is also depressed. 

Effects Carbon monoxide causes tissue hypoxia. Headache is one of the first symptoms, followed by confusion, decreased visual acuity, tachycardia, syncope, coma, convulsions, and death. Collapse and syncope occur when approximately 40% of hemoglobin has been converted to carboxyhemoglobin. These adverse effects may be aggravated by high ambient temperature and high altitude. 

A. The majority of patients complain of headache, dizziness, and nausea. Patients with coronary disease may experience angina or myocardial infarction. With more severe exposures, impaired thinking, syncope, coma, convulsions, cardiac arrhythmias, hypotension, and death may occur. Although blood carboxyhemoglobin levels may not correlate reliably with the severity of intoxication, levels greater than 25% are considered significant and levels greater than 40-50% are usually associated with obvious intoxication. 

Cimetidine 1.2 g daily for 5 days had no effect on the pharmacokinetics of a single 120-mg dose of terfenadine in 12 healthy subjects. Another study in two groups of 6 healthy subjects confirmed that cimetidine 600 mg every 12 hours or ranitidine 150 mg every 12 hours had no effect on the pharmacokinetics of terfenadine 60 mg every 12 hours. No adverse ECG changes were seen. However, an isolated case report describes a 63-year-old woman who had 8 episodes of syncope (later identiiied as being due to torsade de pointes) and a convulsion 2 days after starting terfenadine 60 mg twice daily and cimetidine 400 mg twice daily. She was also taking chiorphenamine and co-proxamol (paracetamol (acetaminophen) and dextropropoxyphene (propoxyphene)). ... 

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