Extreme Intoxication Reactions

In some disruptive children, drug-induced compliant behavior may be accompanied by isolated, withdrawn, and overfocused behavior. Some medicated children may seem zombie-like and high doses which make ADHD children more somber, quiet, and still may produce social isolation by increasing time spent alone and decreasing time spent in positive interaction on the playground. 

These findings are very similar to even more extreme reactions with larger, chronic doses. Schiorring (as cited by Spotts et al., 1980) studied amphetamine intoxication in monkeys and in humans. In monkeys, mothers on amphetamine lost contact with their infants and became obsessed in a stereotypical fashion  

In mother-infant dyadic relationships, amphetamine eliminated the eye contact, the specific gaze that is an important cue for contact in these animals. In addition, the parental care behavior pattern was disrupted. 

The mother lost her interest in the infant. She did not react to the calling signals of the infant, spent most of the time away from the infant and was preoccupied with stereotyped self-grooming behavior. 

In amphetamine addicts, similar behaviors were observed, including stereotypical, bizarre movements, repetition of single words or phrases, stereotyped writing or drawing, talking without listening, and social withdrawal and isolation (see also Schiorring, 1981). 

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Parenteral.Hyperkalemia Adverse reactions involve the possibility of potassium intoxication. Signs and symptoms include paresthesias of extremities flaccid paralysis muscle or respiratory paralysis areflexia weakness listlessness mental confusion weakness and heaviness of legs hypotension cardiac arrhythmias heart block ECG abnormalities such as disappearance of P waves, spreading and slurring of the QRS complex with development of a biphasic curve and cardiac arrest. 

Salicylism and death have occurred following topical application. In an adult, 1 g of a topically applied 6% salicylic acid preparation will raise the serum salicylate level not more than 0.5 mg/dL of plasma the threshold for toxicity is 30-50 mg/dL. Higher serum levels are possible in children, who are therefore at a greater risk for salicylism. In cases of severe intoxication, hemodialysis is the treatment of choice (see Chapter 58). It is advisable to limit both the total amount of salicylic acid applied and the frequency of application. Urticarial, anaphylactic, and erythema multiforme reactions may occur in patients who are allergic to salicylates. Topical use may be associated with local irritation, acute inflammation, and even ulceration with the use of high concentrations of salicylic acid. Particular care must be exercised when using the drug on the extremities of patients with diabetes or peripheral vascular disease. 

Reaction time increased, muscle coordination impaired. Sensory feelings of numbness in cheeks, lips, and extremities. Further impairment in judgment. Legal level of intoxication is. 08% in all 50 of the United States, Puerto Rico, and the District of Columbia. 

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