The anticancer efficacy of doxorubicin (DOX) is dose-limited because of cardiomyopathy, the most significant adverse effect. Initially, cardiotoxicity develops clinically silently, but it eventually appears as dilated cardiomyopathy with a very poor prognosis. Dexrazoxane (DEX) is the only FDA-approved drug to prevent the development of anthracycline cardiomyopathy, but its efficacy is insufficient. Carvedilol (CVD) is another product being tested in clinical trials for the same indication. This study’s objective was to evaluate anthracycline cardiotoxicity in rats treated with CVD in combination with DEX. The studies were conducted using male Wistar rats receiving DOX (1.6 mg/kg b.w. i.p., cumulative dose: 16 mg/kg b.w.), DOX and DEX (25 mg/kg b.w. i.p.), DOX and CVD (1 mg/kg b.w. i.p.), or a combination (DOX + DEX + CVD) for 10 weeks. Afterward, in the 11th and 21st weeks of the study, echocardiography (ECHO) was performed, and the tissues were collected. The addition of CVD to DEX as a cardioprotective factor against DOX had no favorable advantages in terms of functional (ECHO), morphological (microscopic evaluation), and biochemical alterations (cardiac troponin I and brain natriuretic peptide levels), as well as systemic toxicity (mortality and presence of ascites). Moreover, alterations caused by DOX were abolished at the tissue level by DEX; however, when CVD was added, the persistence of DOX-induced unfavorable alterations was observed. The addition of CVD normalized the aberrant expression of the vast majority of indicated genes in the DOX + DEX group. Overall, the results indicate that there is no justification to use a simultaneous treatment of DEX and CVD in DOX-induced cardiotoxicity.

Introduction.Verapamil is a widely used cardiac drug. It belongs to the non-dihydropiridine subgroup of calcium channel blockers (CCBs), and is used mainly for the treatment of atrial dysrhythmias, hypertension or angina. In this article, we describe a case of poisoning with verapamil mixed with ethanol and review current treatment options. A 54-year-old female was admitted to the Toxicology Clinic by emergency medical services after ingesting sustained-release CCBs and ethanol in a suicidal attempt. The patient was successfully treated by administration of catecholamines and calcium, and the introduction of a high-dose insulin infusion (HDI). Conclusions. This case report emphasizes that even in severe poisoning, early and proper intervention may prevent circulatory breakdown. It also summarizes treatment options in patients after verapamil overdose. Along with decontamination, administration of catecholamines and correcting electrolyte abnormalities, the main options are HDI and lipid emulsion therapy (LET).

No abstract

Introduction. There are approximately 300 species of poisonous plants in Poland. About 50 of them contain toxic substances which pose threat to health when consumed. Accidental poisonings remain the most common cause, but there were also cases correlated to suicidal or criminal purposes. There are only few toxicological departments in Poland keeping the records of plant poisonings, what makes presented data inaccurate. Aim. The authors decided to evaluate knowledge of Polish medical students regarding toxic plants and symptoms of its intoxication. Material and methods. The number of 734 online responses from students enrolled in medical studies at 16 different Polish universities were collected and analyzed to draw a conclusion. Results. As many as 87.6% of all respondents were in favor of introducing obligatory classes covering the issue of toxic plants. They were also asked to identify plants presented in the pictures. When it comes to 53.1% of students, they were familiar with Datura stramonium L. Over half of the participants were able to recognize the mild symptoms of intoxication, when 25.9% linked the poisoning to narcotic sleep. Taxus baccata L. was identified by 86.6% of the respondents and the majority of them possessed knowledge about the related symptoms. Heracleum sosnowskyi Manden. and Caltha palustris L. were recognized by respectively 94% and 64% of the students. As many as 84.1% of participants knew the effects of Heracleum sosnowskyi Manden intoxication. All correct answers related to this poisoning were chosen by 48.3% respondents. The results revealed that the symptoms of Caltha palustris L. are unknown to the majority. Atropa belladonna L. was successfully identified by 93.6%, Galanthus nivalis L. by 55.4% of the students, with a lower percentage of correct responses related to its intoxication. Conclusions. Such differentiated knowledge can be the result of both educational variances and personal experience. Polish medical universities should consider introducing extra classes that would cover the issue of toxic plant intoxications.