Journal de toxicologie clinique et experimentale最新文献

A fatality involving amitriptyline is described. The drug and its metabolite nortriptyline were separately quantified in various post-mortem samples, including hair. Results are discussed in the light of the existing literature.

This experiment was performed in Wistar rats of both sexes exposed subchronically to 1:100, 1:500, 1:1000 and 1:1500 LD50. The evaluation was based on endpoints measured on the 30th and 90th after starting exposure and after a recovery period of 30 days: these included clinical signs, functional changes, hematological parameters, urine analysis, biochemical, histochemical, immunomorphological endpoints, electron microscopy of internal organs, chromosome examination of bone marrow. A high lethality was shown to occur with a characteristic clinical picture: interruption of weight gain, behavioural changes, leucopenia mainly involving neutrophil leucocytes, biochemical changes characteristic of liver, cardio-vascular system (myocardium and aorta) together with pathologic, biochemical, histochemical and ultrastructural changes in liver, brain, thyroid gland, myocardium, spleen and bone marrow. Endpoints were shown to be clearly dose-dependently related with small variations with the low dose, i.e. 1:1500 LD50 (5 mg/kg-1 bw).

A case of acute meprobamate poisoning in a 43 year-old-woman is reported. Twenty five hours after admission in the intensive care unit, deep coma and cerebral electrical silence were observed whereas the meprobamate plasmatic concentration was 250 mg/l. The patient recovery was uneventful. Meprobamate analysis must be performed for unexplained coma with isoelectric EEG.

After a brief recall of toxicological data about germanium compounds, the authors relate subacute and subchronic oral toxicities of beta bis carboxyethyl-germanium sesquioxide in rats. During 28 days and six months, male and female animals have received 1 mg/kg/day. No particular toxic symptoms, no behaviour trouble except a small decrease of body weight, in male rats, at the end of the 6-month experimentation, were observed. A light decrease of erythropoiesis and a general stimulation of cellular metabolism has been noticed after 28 days. The only marked effect was a moderate renal deficiency characterized by a tubular disease with presence of cylinders, swelling of tubulus cells and floculus amounts after 6 months. Germanium urinary excretion was constant and linked to the received dose. Six months later, no preferential accumulation in organs was observed.

In children, 23 caustic injuries of oesophagus with deep lesions (second or third degree of burn) were treated in pediatric ENT department (Pr ANDRIEU--Rouen) during a 19 years long period. Endoscopy in emergency, nasogastric tube for stent and repeated dilatations were the bases of the treatment. 14 second degree burns and 7 third degree burns were complicated of 9 stenosis and one death. The mean duration of total treatment was 43 months. The mean number of dilatations was 38 months. 4 stenosis were definitely cured. 8 children had normal feeding. Mean following was 8 years with good long term results.

A 48-year-old man chronically treated with digitoxin and verapamil for prevention of atrial fibrillation voluntarily ingested 2.2 mg of digitoxin. Serum digitoxin concentrations and the urinary elimination of the drug were followed over a 12-day period. Urinary data indicate that a large percentage (50%) of the drug was eliminated renally despite administration of multiple doses of activated charcoal, cholestyramine and hyperosmotic laxatives. The possible interaction with two other drugs, heparin and verapamil, is also discussed.

Antitoxinum viperinum was tested for its ability to prevent alteration of the myocardium induced by Vipera ammodytes ammodytes venom. Antivenom was injected intraperitoneally either immediately, 30 min or 2 hr after the intraperitoneal injection of venom. The light microscopic examination showed that the antiserum neutralized the effects of venom and antivenom might be useful in treating V.a. ammodytes venom poisoning.

Changes in the liver of male rats were studied on the 1, 3, 5, 7, 10 and 14 days after a single oral application of 1/5 DL 50 of the chloracetanilic herbicide Acetochlor (DL50 = 1063 mg/kg-1). Two main periods in the action of acetochlor can be identified: between 1-2 days when the influence of the compound itself is predominant and between 5-7 days, when the toxic action of the slowly eliminated metabolites is most pronounced. These two periods provoke a biphasic activation/inhibition response of the liver. Remarkable is the compensatory effect of the cytochrome P-450 system responsible for the metabolism of acetochlor. The phase-specific changes were are followed by pathomorphological observations of liver tissue as well as by the time-course of the biochemical parameters studied in different liver fractions.

Self poisoning with beta-blocking drugs might increase with the extension of their therapeutic fields. Usually the management of this intoxication is mainly directed toward antagonizing the beta-adrenoreceptor blocking effects. Thus attention is specially directed to the cardiovascular condition and to the bronchoconstrictor effect. Nonetheless, in spite of this treatment, fatal cases have been reported, suggesting that other complications are responsible of the clinical course of this acute poisoning. In fact, in some cases, a respiratory arrest appeared as the major determinant of death, although the cardiovascular effects were correctly antagonized. Furthermore, the few studies in animals and in healthy volunteers indicated that beta-adrenergic mechanisms in the brain stem stimulate the ventilatory control system. Beta 1 lipophilic antagonists induce a central ventilatory depression and consecutively a respiratory arrest, which is not antagonized by beta mimetic drugs. Awareness of this complication may lead to a greater care in managing the poisoned patients and in starting early mechanical ventilation, which influence the outcome favourably.

A 42-year-old woman had an accidental overdose of chloral hydrate due to repeated absorption of a therapeutic dose of chloral syrup for insomnia. The total ingestion was estimated at 8 g. Overnight slight loss of consciousness associated with severe cardiac arrhythmia (bigeminia ventricular extra-systole) needed admission to the intensive care unit and intravenous lignocaine for two days. The evolution was satisfactory.