Potassium acute poisoning

Goldman M, Karotkin RH. 1935. Acute potassium bichromate poisoning. Am J Med Sci 189 400-403. 

Kaufman DB, DiNicola W, McIntosh R. 1970. Acute potassium dichromate poisoning Treated by peritoneal dialysis. Am J Dis Child 119 374-376. 

Partington CN. 1950. Acute poisoning with potassium bichromate. Br Med J ii 1097-1098. 

Sharma BK, Singhal PC, Chugh KS. 1978. Intravascular haemolysis and acute renal failure following potassium dichromate poisoning. Postgrad Med J 54 414-415. 

Stift, A., Friedl, X, Langle, R, Berlakovich, G., Steininger, R., Muhlbacher, F. Successful treatment of a patient suffering from severe acute potassium dichromate poisoning with liver transplantation. Transplantation 2000 69 2454-2455... 

Addition of sodium sulfate as a lavage solution may precipitate the very insoluble barium sulfate. As potassium deficiency occurs in acute poisoning, serum potassium and cardiac rhythm must be monitored closely. Administration of intravenous potassium appears beneficial. As renal failure is also a concern, urinary output also must be monitored closely. 

One in vitro study on rat renal tissue homogenate showed barium weakly inhibited the sodium-potassium-adenosine triphosphatase enzyme system (Kramer et al. 1986). A second study on mouse kidney tubules showed barium chloride could depolarize the membrane and inhibit potassium transport (Volkl et al. 1987). A similar defect in cell membrane transport in humans could be responsible for the renal involvement observed in some cases of acute barium poisoning. 

Hypokalemia is commonly seen in cases of acute barium toxicity and may be responsible for some of the symptoms of barium poisoning (Proctor et al. 1988). Plasma potassium should be monitored and hypokalemia may be relieved by intravenous infusion of potassium (Dreisbach and Robertson 1987 Haddad and Winchester 1990 Proctor et al. 1988). 

Acute digoxin poisoning causes initial nausea and vomiting and hyperkalaemia because inhibition of the Na, K" -ATPase pump prevents intracellular accumulation of potassium. The ECG changes (see Table 24.1) of prolonged use of digoxin may be absent. There may be exaggerated sinus arrhythmia, bradycardia and ectopic rhythms with or without heart block. 

For acute toxicity, emesis is recommended. Treatment is symptomatic. A combination of BAL (British AntiLewisite 2,3-dimercaptopropanol) and calcium-ethylene diamine tetraacetic acid has been used successfully in a poisoned infant. Penicillamine has also been used. Recently, oral administration of 2,3-dime-rcaptol-propane sulfonate was found to be effective in experimental rodents. Electrolyte balance must be maintained when gastric lavage is indicated. Potassium ferrocyanide should be added to precipitate the copper. 

II. Toxic dose. The acute ingestion of 200-500 mg/kg of potassium bromate is likely to cause serious poisoning. Ingestion of 2-4 oz of 2% potassium bromate solution caused serious toxicity in children. The sodium salt is believed to be less toxic. 

IV. Diagnosis is based on a history of recent overdose or characteristic arrhythmias (eg, bidirectional tachycardia and accelerated junctional rhythm) in a patient receiving chronic therapy. Hyperkalemia suggests acute ingestion but may also be seen with very severe chronic poisoning. Senim potassium levels higher than 5.5 mEq/L are associated with severe poisoning. 

This is used to make manganese alloy steels, dry batteries and potassium permanganate which is an oxidising agent and disinfectant. Poisoning is rare but may cause acute irritation of the lungs. It may also cause muscular pain and an unstable gait with inability to maintain control of the limbs rather like... 

Insulin is a powerful positive inotropic drug. It increases the cardiac output and HR due to increased catecholamine discharge and calcium uptake by heart cells. Insulin reduces plasma potassium levels, thereby increasing cellular transmission and automaticity [32]. The first reported case of a pahent with acute propafenone poisoning and treatment with high-dose insulin and glucose ... 

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