Methylene blue finds its major utilization in toxicology in the treatment of methemoglobinemia at a dose of 1 to 2 mg/kg intravenously. By interacting with methemoglobin and the erythrocyte's enzyme systems to reduce back to hemoglobin, methylene blue is a generally safe drug with dose-related hemolytic effects. People with G-6-PD deficiency, along with patients exposed to aniline dyes and dapsone, may present with special risks in the treatment of methemoglobinemia.
Among adults presenting with acute respiratory illness, a prediction rule based on clinical findings accurately discriminated patients with and without radiographic pneumonia, and was used in two other samples of patients without significant decrement in discriminatory ability. This rule can be used by physicians to develop more effective strategies for detecting pneumonia and for helping to determine the need for radiologic study among patients with acute respiratory disease.
Nerve agents are discussed. The article discusses their properties, routes of exposure, toxicodynamics, targets of toxicity, and treatment. It is concluded that a focused organized approach to the treatment of nerve agents is key to its successful management.
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