Pulmonary oedema

Tlie respiratory system is tlie main target organ for vapour, gas or mist. Readily-soluble cheirticals, e.g. chlorine or phosgene, attack the upper respiratory tract less soluble gases, e.g. oxides of nitrogen, penetrate more deeply into the conducting airways and, in some cases, may cause pulmonary oedema, often after a time delay. 

Tendency to pulmonary oedema and eventually respiratory paralysis... 

Prolonged exposure may cause pulmonary oedema Systemic symptoms may occur in 0.5 to 1 hr Rapid collapse, respiratory paralysis imminent Immediately fatal... 

PRACTICABLE Capable of being done in the light of current knowledge and invention. PULMONARY OEDEMA Production of watery fluid in the lungs. 

PULMONARY OEDEMA Production of Watery fluid in the lungs. 

Misra, N.P., Manoria, P.C., and Saxena, K. 1985. Fatal pulmonary oedema with phosgene poisining. 

Nocerini MR, Carlson JR, Yost GS. Electrophilic metabolites of 3-methylindole as toxic intermediates in pulmonary oedema. Xenobiotica 1984 14(7) 561—564. 

Laboratory evaluation [241] of acute and chronic toxicity of prenylamine indicates that, in high doses, convulsions accompanied by respiratory paralysis (often with pulmonary oedema) led to death. Doses inadequate to produce this result led only to phenomena characteristic of reserpine-like dmgs. Chronic administration failed to produce recognizable changes in any organs or tissues studied. No toxic effects, unattributable to amine depletion, have appeared during several years clinical use. 

Although the cellular basis for the action of ethacrynic acid may not yet be established its micro-anatomical effects on the nephron are well attested. The speed of onset and intensity of action make the drug (like frusemide) a valuable addition to existing compounds, especially where diuresis is urgently needed (for example, pulmonary oedema) or in patients resistant to milder drugs of the thiazide type. 

Lee CH, Guo YL, Tsai PJ, et al Fatal acute pulmonary oedema after inhalation of fumes from polytetrafluoroethylene (PTFE). Eur RespirJ 10(6) 1408-1411, 1997... 

Gastric lavage is contraindicated because of the serious danger of aspiration and the relatively benign gastrointestinal effects. Patients with respiratory difficulties require oxygen and sometimes mechanical ventilation. Pulmonary oedema, if it occurs, should be treated with diuretics (furosemide 25-100 mg intravenously) or by mechanical ventilation. Antibiotic treatment is unnecessary unless bacterial pneumonia, a rare sequel to kerosene pneumonitis, develops. Mortality is less than 1%. 

A higher proportion of salicylate is ionized in alkaline urine, and ionized salicylate is not reabsorbed. Urine can be made alkaline to pH 8-8.5 by giving sodium bicarbonate 100 mM in glucose 5% solution 1 litre at 100-200 ml/h. Overhydration can provoke pulmonary oedema, especially in seriously poisoned patients. 

The three main types of altitude illness, characterised initially by nausea, headache, sleep disturbance and stomach upset, are acute mountain sickness (AMS) high altitude pulmonary oedema (HAPE) and high altitude cerebral oedema (HACK). They occur after rapid ascent to altitudes greater than 2,500 m (about 8,000 feet) in unacclimatised people. In unacclimatised mountaineers, the prevalence of AMS at 4,559 metres (15,000 feet) is approximately 50% and HAPE 4%. Risk depends on individual susceptibility, rate of ascent and pre-exposure to high altitude. AMS is not a pre-requisite for HAPE. 

Ot and photo-oxidants Pulmonary oedema, emphysema, asthma, eye. nose, and throat irritation, reduced lung capacity. Vegetation damage, necrosis of leaves and pines, stunting of growth, photosynthesis inhibitor, probable cause of forest die-back, suspected cause of crop loss. Attack and destruction of natural rubber and polymers, textiles and materials. 

Despite being a wonder drug against malaria, quinine in therapeutic doses can cause various side-effects, e.g. nausea, vomiting and cinchonism, and in some patients pulmonary oedema. It may also cause paralysis if accidentally injected into a nerve. An overdose of quinine may have fatal consequences. Non-medicinal uses of quinine include its uses as a flavouring agent in tonic water and bitter lemon. 

Angina pectoris, hypertension, congestive heart failure, acute myocardial ischaemia, acute pulmonary oedema, unstable coronary syndromes especially when associated with elevated filling pressures. Nitrate therapy may exaggerate outflow obstruction in hypertrophic obstructive cardiomyopathy. 

These result from over-stimulation of the sympathetic nervous system anxiety, sweating, tachycardia, arrhythmia, hypertension, myocardial ischaemia, headache, cerebral haemorrhage, pulmonary oedema. Adrenaline may cause pupillary dilatation which must be distinguished from pupillary dilatation due to other causes, e.g. severe brain injury. 

If a (3-adrenoceptor antagonist is administered prior to sufficient ol-radrenoceptor blockade, a hypertensive episode may be precipitated with cardiac failure and pulmonary oedema. Most intravenous anaesthetic agents have been used safely, but ketamine is contraindicated. Sodium nitroprusside can be used to achieve arteriolar dilation. Esmolol, a pi-selective antagonist with very short duration of action, is administered intravenously to prevent cardiac arrhythmias intra-operatively. After tumour removal, volume administration should be aggressive to maintain haemodynamic stability, and a noradrenaline infusion may be required. 

Shankar PS. 1967. Pulmonary oedema in diazinon poisoning. Indian J Chest Dis 9(2) 106-110. 

Lung Dog Pulmonary oedema 100 mg/kg intravenous Single dose Graham (1965)... 

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