Pulmonary congestion

Nausea, diarrhea, stomatitis, hypotension, anorexia, bone marrow depression, pulmonary congestion, dyspnea, oliguria Dysuria, urinary frequency, cystitis, hematuria, urinary incontinence... 

An estimated oral dose of 260 mg endosulfan/kg caused severe seizures in a 43-year-old man, and brain death from cerebral herniation and massive cerebral edema occurred within 4 days of exposure (Boereboom et al. 1998) there were no signs of myocardial infarction and only slight congestion of the heart, but pulmonary congestion and atelectasis were evident at autopsy. 

Human once Resp 260 M (pulmonary congestion, atelectasis) Boereboom et al. 1998 Technical... 

Patients can experience a variety of symptoms related to buildup of fluid in the lungs. Dyspnea, or shortness of breath, can result from pulmonary congestion or systemic hypoperfusion due to LVF. Exertional dyspnea occurs when patients describe breathlessness induced by physical activity or a lower level of activity than previously known to cause breathlessness. Patients often state that activities such as stair climbing, carrying groceries, or walking a particular distance cause shortness of breath. Severity of HF is inversely proportional to the amount of activity required to produce dyspnea. In severe HF, dyspnea will be present even at rest. 

STE and NSTE ACS, class I indication in patients with ongoing ischemic discomfort, control of hypertension or management of pulmonary congestion. 

Fluid overload can result in pulmonary congestion and peripheral edema. Nonspecific symptoms may include fatigue, nocturia, hemoptysis, abdominal pain, anorexia, nausea, bloating, ascites, poor appetite, ascites, mental status changes, and weight gain. 

Compensatory mechanisms in HF stimulate excessive sodium and water retention, often leading to systemic and pulmonary congestion. Consequently, diuretic therapy (in addition to sodium restriction) is recommended in all patients with clinical evidence of fluid retention. However, because they do not alter disease progression or prolong survival, they are not considered mandatory therapy for patients without fluid retention. 

Bolus diuretic administration decreases preload by functional venodilation within 5 to 15 minutes and later (>20 min) via sodium and water excretion, thereby improving pulmonary congestion. However, acute reductions in venous return may severely compromise effective preload in patients with significant diastolic dysfunction or intravascular depletion. 

The efficacy of diuretic treatment is evaluated by disappearance of the signs and symptoms of excess fluid retention. Physical examination should focus on body weight, extent of jugular venous distension, presence of hepatojugular reflux, and presence and severity of pulmonary congestion (rales, dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea) and peripheral edema. 

The AEGL values are supported by the study of Pryor et al. (1975) with the mouse in which a 24-h exposure at 30 ppm induced pulmonary congestion but was not lethal. The 30 ppm concentration divided by a total UF of 6 and scaled across time from 24 h to 30 min using C2 6xt=k results in a 30-min AEGL-2 of 22 ppm. The AEGL values are also supported by the study of Parmenter (1926) in which an individual potentially exposed at 25-75 ppm for part of a day had severe symptoms but recovered fully. Furthermore, Barcroft s subject withstood a 1.5-min exposure at 500-625 ppm (Barcroft 1931). Time scahng the AEGL-3 values to 1.5 min results in a concentration at 60 ppm, which is less than the actual exposure by a factor of approximately 10. 

No adverse health effects were observed in male rats exposed by inhalation to 3,3 -dichlorobenzidine free base (23,700 mg/m ) 2 hours per day for 7 days (Gerarde and Gerarde 1974). In another study, 10 rats were exposed to an unspecified concentration of 3,3 -dichlorobenzidine dihydrochloride dust particles for 1 hour and then observed for 14 days. Slight-to-moderate pulmonary congestion and one pulmonary abscess were observed upon necropsy (Gerarde and Gerarde 1974). The effects observed in the study using the ionized (hydroehloride) form of 3,3 -dichlorobenzidine may have been due to the irritative properties of hydrochlorie aeid released from the salt in combination with particulate toxicity. 

The LCso in mice for 60 minutes was 150 ppm effects were irritation of the eyes and nose and the delayed onset of labored breathing and lethargy autopsy findings included marked pulmonary congestion and hemorrhage. Mice exposed to sublethal concentrations had pulmonary irritation and delayed development of focal necrosis in the liver and kidneys. ... 

Cyanogen chloride is highly toxic by aU routes of exposure. It is a severe irritant to eyes, causing tears. Exposure to its vapors causes irritation of the respiratory tract and pulmonary congestion. 

Nitroglycerin by sublingual tablet (0.4 mg) every 5 minutes for a total of 3 doses will be used for ischemic discomfort relief. Intravenous injection will be considered when the ischemic discomfort, hypertension or pulmonary congestion cannot be controlled. Nitrates should not be used when the blood pressure is lower than 90 mmHg or 30 mmHg lower than a known base line value, bradycardia less than 50 bpm, tachycardia more than 100 bpm or suspected right ventricular (RV) infarction. 

The use of inotropic support will be acceptable only in low-cardiac-output status. Eor pulmonary congestion, ACE-inhibitor therapy and aldosterone blockade will be best recommended, especially for long term use. It will be good to start with a jS-blockers before discharge for secondary prevention. 

Contraindications Acute MI, pulmonary congestion, hypersensitivity to diltiazem or other antihypertensives, second- or third-degree AV block (except in the presence of a pacemaker), severe hypotension (less than 90 mm Hg, systolic), sick sinus syndrome... 

Cardiotoxicity may occur if ipecac syrup is not vomited (noted as hypotension, tachycardia, precordial chest pain, pulmonary congestion, dyspnea, ventricular tachycardia and fibrillation, cardiacarrest). 

Acidosis, electrolyte loss, marked diuresis, urinary retention, edema, dryness of mouth and thirst, dehydration, pulmonary congestion, hypotension, tachycardia, angina-like pains, blurred vision, convulsions, nausea, vomiting, diarrhea, rhinitis, chills, vertigo, backache, urticaria. 

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