Dizziness

A small amount of acrolein may be fatal if swallowed. It produces bums of the mouth, throat, esophagus, and stomach. Signs and symptoms of poisoning may include severe pain in the mouth, throat, chest, and abdomen nausea vomiting, which may contain blood diarrhea weakness and dizziness and coUapse and coma (99). 

Full eye protection should be worn whenever handling acryhc monomers contact lenses must never be worn. Prolonged exposure to Hquid or vapor can result in permanent eye damage or blindness. Excessive exposure to vapors causes nose and throat irritation, headaches, nausea, vomiting, and dizziness or drowsiness (solvent narcosis). Overexposure may cause central nervous system depression. Both proper respiratory protection and good ventilation are necessary wherever the possibiHty of high vapor concentration arises. 

Swallowing acryhc monomers may produce severe irritation of the mouth, throat, esophagus, and stomach, and cause discomfort, vomiting, diarrhea, dizziness, and possible coUapse. 

Methanol is not classified as carcinogenic, but can be acutely toxic if ingested 100—250 mL may be fatal or result in blindness. The principal physiological effect is acidosis resulting from oxidation of methanol to formic acid. Methanol is a general irritant to the skin and mucous membranes. Prolonged skin contact with methanol vapor or Hquid can cause dermatitis. Methanol vapor can cause eye and respiratory tract irritation, nausea, headaches, and dizziness. 

Concentrations of nickel carbonyl as low as 30 ppm in air for 30 min may be lethal for humans. Individuals exposed to these high concentrations show immediate symptoms of dizziness, headache, shortness of breath, and vomiting. These early symptoms generally disappear in fresh air, but delayed symptoms may develop 12—36 h later. These latter symptoms include shortness of breath, cyanosis, chest pain, chills, and fever. In severe exposure cases. 

Phenol. Phenol monomer is highly toxic and absorption by the skin can cause severe blistering. Large quantities can cause paralysis of the central nervous system and death. Ingestion of minor amounts may damage kidneys, Hver, and pancreas. Inhalation can cause headaches, dizziness, vomiting, and heart failure. The threshold limit value (TLV) for phenol is 5 ppm. The health and environmental risks of phenol and alkylated phenols, such as cresols and butylphenols, have been reviewed (66). 

SSRIs are well tolerated. Adverse effects for compounds in this class include nervousness, tremor, dizziness, headache, insomnia, sexual dysfunction, nausea, and diarrhea. In addition, the tricycHc antidepressant clomipramine (33), which is a potent nonselective serotonin reuptake inhibitor, is approved for treatment of obsessive—compulsive disorder. 

Venlafaxine (48) is a stmcturaHy novel phenylethylamine derivative that strongly inhibits both noradrenaline and serotonin reuptake. It lacks anticholinergic, antihistaminergic, and antiadrenergic side effects. As compared to placebo, most common adverse events are nausea, somnolence, dizziness, dry mouth, and sweating. Venlafaxine-treated patients also experienced more headaches and nausea, but less dry mouth, dizziness, and tremor than patients treated with comparator antidepressants. 

SSRIs are widely used for treatment of depression, as well as, for example, panic disorders and obsessive—compulsive disorder. These dmgs are well recognized as clinically effective antidepressants having an improved side-effect profile as compared to the TCAs and irreversible MAO inhibitors. Indeed, these dmgs lack the anticholinergic, cardiovascular, and sedative effects characteristic of TCAs. Their main adverse effects include nervousness /anxiety, nausea, diarrhea or constipation, insomnia, tremor, dizziness, headache, and sexual dysfunction. The most commonly prescribed SSRIs for depression are fluoxetine (31), fluvoxamine (32), sertraline (52), citalopram (53), and paroxetine (54). SSRIs together represent about one-fifth of total worldwide antidepressant unit sales. 

Toxicology. Isoquinoline is a poison when ingested or injected intraperitoneally. Even in cases of skin contact it is moderately toxic. As in the case of quinoline, its vapors are irritating to the eyes, nose, and throat. Exposure causes headaches, dizziness, and nausea. Rapid absorption through the skin makes it a dangerous chemical. Its toxicity is oral LD q (i t)> mg/kg, and dermal LD q (rabbit), 590 mg/kg (65,66,182,183). 

The success of quinine inspired the search for other antimalarials. The greatest impetus for the development of synthetic dmgs came this century when the two World Wars intermpted the supply of cinchona bark to the combatants. A stmcturally related 4-quinolinemethanol is mefloquine (65, Lariam [51773-92-3]) which now serves as an effective alternative agent for chloroquine-resistant P. falciparum. This is a potent substance that requires less than one-tenth the dose of quinine to effect cures. There are some untoward side effects associated with this dmg such as gastrointestinal upset and dizziness, but they tend to be transient. Mefloquine is not recommended for use by those using beta-blockers, those whose job requires fine coordination and spatial discrimination, or those with a history of epilepsy or psychiatric disorders. A combination of mefloquine with Fansidar (a mixture of pyrimethamine and sulfadoxine) is known as Fansimef but its use is not recommended. Resistance to mefloquine has been reported even though the compound has not been in wide use. 

The Class I agents have many similar side effects and toxicities. The anticholinergic side effects include dry mouth, constipation, and urinary hesitancy and retention. Common gastrointestinal (GI) side effects include nausea, vomiting, diarrhea, and anorexia. Cardiovascular adverse effects are hypotension, tachycardia, arrhythmias, and myocardial depression, especially in patients with congestive heart failure. Common central nervous system (CNS) side effects are headache, dizziness, mental confusion, hallucinations, CNS stimulation, paraesthesias, and convulsions. 

Isoproterenol is given sublingually or by iv. It is metabolized by monoamine oxidase and catechol-0-methyltransferase in brain, Hver, and other adrenergically innervated organs. The pharmacological effects of isoproterenol are transient because of rapid inactivation and elimination. About 60% is excreted unchanged. Adverse effects using isoproterenol therapy include nervousness, hypotension, weakness, dizziness, headache, and tachycardia (86). 

Adverse reactions to digoxin include anorexia, vomiting, diarrhea, dizziness, headaches, visual disturbances, and cardiac arrhythmias. Allergic reaction such as urticaria, skin emptions, fever, and edema have been reported (87). 

Adenosine in large doses produces vasodilation resulting in facial flushing, Hghtheadedness, dizziness, and hypotension. Shortness of breath and... 

Better antihypertensive effect of P-adrenoceptor blockers is found in patients having high PRA and most are not efficacious in patients having low PRA or in elderly patients. P-Adrenoceptor blockers usually lower arterial blood pressure about 10 mm Hg (1.3 kPa). Side effects include lethargy, dyspnea, nausea, dizziness, headache, impotency, cold hands and feet, vivid dreams and nightmares, bronchospasm, bradycardia, and sleep disturbances. 

Verapamil (Table 1), the first slow channel calcium blocker synthesized to selectively inhibit the transmembrane influx of calcium ions into cells, lowers blood pressure in hypertensive patients having good organ perfusion particularly with increased renal blood flow. Sustained-release verapamil for once a day dosing is available for the treatment of hypertension. Constipation is a prominent side effect. Headache, dizziness, and edema are frequent and verapamil can sometimes cause AV conduction disturbances and AV block. Verapamil should not be used in combination with -adrenoceptor blockers because of the synergistic negative effects on heart rate and contractile force. 

Nifedipine (Table 3) is a potent vasodilator that selectively dilates resistance vessels and has fewer effects on venous vessels. It does not cause reflex tachycardia during chronic therapy. Nifedipine is one of the first-line choices for black or elderly patients and patients having concomitant angina pectoris, diabetes, or peripheral vascular diseases. Nifedipine, sublingually, is also suitable for the treatment of hypertensive emergencies. Nifedipine does not impair sexual function or worsen blood Hpid profile. The side effects are flushing, headache, and dizziness. 

Diltiazem inhibits calcium influx via voltage-operated channels and therefore decreases intracellular calcium ion. This decreases smooth muscle tone. Diltiazem dilates both large and small arteries and also inhibits a-adrenoceptor activated calcium influx. It differs from verapamil and nifedipine by its use dependence. In order for the blockade to occur, the channels must be in the activated state. Diltiazem has no significant affinity for calmodulin. The side effects are headache, edema, and dizziness. 

Dichloroethylene is toxic by inhalation and ingestion and can be absorbed by the skin. It has a TLV of 200 ppm (10). The odor does not provide adequate warning of dangerously high vapor concentrations. Thorough ventilation is essential whenever the solvent is used for both worker exposure and flammabihty concerns. Symptoms of exposure include narcosis, dizziness, and drowsiness. Currently no data are available on the chronic effects of exposure to low vapor concentrations over extended periods of time. 

Overexposure to tetrachloroethylene by inhalation affects the central nervous system and the Hver. Dizziness, headache, confusion, nausea, and eye and mucous tissue irritation occur during prolonged exposure to vapor concentrations of 200 ppm (15). These effects are intensified and include incoordination and dmnkenness at concentrations in excess of 600 ppm. At concentrations in excess of 1000 ppm the anesthetic and respiratory depression effects can cause unconsciousness and death. A single, brief exposure to concentrations above 6000 ppm can be immediately dangerous to life. Reversible changes to the Hver have been reported foUowing prolonged exposures to concentrations in excess of 200 ppm (16—22). Alcohol consumed before or after exposure may increase adverse effects. 

Two men were inspecting a large tank in which other equipment was installed. The tank had two large manways attached to it, one near the bottom and one near the top. Ventilation was provided by air entering the bottom manway and leaving the top manway. A sheet of plastic had temporarily been placed over the top manway, which decreased the amount of air circiilation. One of the inspectors chmbed a ladder in the tank, became dizzy, and fell to the tank floor below. He died from the injuries received in the fall. It was found that... 

Loss of balance, dizziness. Respiration deeper, increased pulse rate, impaired coordination, perception, and judgment. 

CNS DEPRESSANT Substanccs, e.g. anaesthetics and narcotics, which depress the activity of the central nervous system. Symptoms following exposure include headache, dizziness, loss of consciousness, respiratory or cardiac depression, death. 

Vomiting, dizziness, disorientation, breathing difficulties after 30 min Headache, vomiting, dizziness, disorientation, breathing difficulties after short exposure... 

Solvents acetone, methyl ethyl ketone (MEK), toluene, xylene, glycol, ethers, alcohol defats and dries skin some may be absorbed may carry other components through skin high volatility, exposure possible irritation central nervous system depression (e.g. dizziness, loss of coordination) low to high toxicity, longterm effects... 

Move casualties becoming dizzy or losing consciousness into fresh air and provide artificial respiration if breathing stops. Obtain medical attention (Chapter 13). 

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