4-Aminopyridine Toxicity: a Case Report and Review of the Literature

King, Andrew; Menke, Nathan B.; Katz, Kenneth D.; Pizon, Anthony F.

doi:10.1007/s13181-012-0248-9

Cited by 46 publications

(31 citation statements)

References 56 publications

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“…In contrast, the duration of toxic encephalopathy may be several days or even weeks. The neurologic recovery is not complete in all of the patients reported in the literature, as well as in our case [3]. Some patients suffered from a greater and chronic neurologic disability after the overdose episode; short or long-term memory loss is also a possible delayed complication [9].…”

Section: Discussionmentioning

confidence: 73%

Prolonged Toxic Encephalopathy following Accidental 4-Aminopyridine Overdose

Méndez

Pesch

Capron

et al. 2014

Case Reports in Neurological Medicine

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Background. 4-Aminopyridine (4-AP) is a drug that is used to improve motor fatigue in patients suffering from multiple sclerosis (MS). Medication error can occur, as commercial preparation may not be available in some countries. Case Presentation. A 58-year-old woman with progressive MS presented with status epilepticus. She was receiving 4-AP for more than 3 years. The symptoms started soon after the ingestion of a single pill that was supposed to contain 10 mg 4-AP, but further investigations revealed that each pill had been inadvertently prepared with an 100 mg 4-AP concentration. The patient was admitted to the intensive care unit (ICU) for appropriate management (orotracheal intubation, sedation, and antiepileptic drugs). The first electroencephalogram (EEG) showed abundant irregular spike-waves on the left central regions. Neurological condition gradually improved from day 7, while the EEG did not reveal any more electrical seizures but was still consistent with toxic encephalopathy. The patient stayed in the ICU until day 13. At discharge from the rehabilitation ward (2.5 months later), the patient had not yet recovered her previous cognitive and functional condition. Conclusion. A single 100 mg 4-AP accidental overdose may cause serious immediate complications, with a slow and incomplete neurological recovery.

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Section: Discussionmentioning

confidence: 73%

Prolonged Toxic Encephalopathy following Accidental 4-Aminopyridine Overdose

Méndez

Pesch

Capron

et al. 2014

Case Reports in Neurological Medicine

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“…The net effect of this action is enhancement of cholinergic activity. In mammals, the clinical signs of hyperexcitability, salivation, tremors, muscular incoordination, cardiac or respiratory arrest, and death can be seen after an acute oral toxic exposure [6]. In humans, three adult males experienced immediate burning of the throat and abdominal discomfort within 15 min after ingesting a pinch of 99 % pure 4-AP by mistake in a manufacturing plant followed by development of nausea, vomiting, weakness, dizziness, diaphoresis, and convulsive-like movements [7].…”

Section: Discussionmentioning

confidence: 99%

A Review of 29 Incidents Involving 4-Aminopyridine in Non-target Species Reported to the ASPCA Animal Poison Control Center

McLean

Khan

2013

J. Med. Toxicol.

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4-Aminopyridine (4-AP) is an avicide used in products that are approved by the Environmental Protection Agency (EPA) to control populations of various birds. Pharmaceutical 4-AP is also used in humans to treat neural and muscular dysfunctions associated with multiple sclerosis. Although strict restrictions for its use are in place, exposures to 4-AP bait by non-target species still occur. Twenty-nine exposures of 4-AP bait involving non-target species were identified and retrieved from the ASPCA Animal Poison Control Center medical record database. Canines were the most commonly exposed (86 %) species followed by felines (10 %). The highest frequency of exposures was reported from Colorado (22 %). Most commonly reported clinical signs in canines were tremors, hypersalivation, seizures, tachycardia, and ataxia.

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“…In addition to the reactivity challenge associated with the unprecedented use of ynamides in inverse‐electron‐demand Diels–Alder cycloadditions, the final cycloadducts obtained are also valuable aminopyridines. These privileged scaffolds have found numerous applications in pharmaceutical science and agrochemistry …”

Section: Inverse‐electron‐demand [4+2] Cycloadditions Between Ynammentioning

confidence: 99%

Diels–Alder and Formal Diels–Alder Cycloaddition Reactions of Ynamines and Ynamides

et al. 2017

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Nitrogen‐substituted alkynes such as ynamines and ynamides are competent partners in [4+2] cycloaddition reactions. This microreview aims to discuss in a historical context the main achievements in the work on this class of reactions that leads to valuable nitrogen‐containing heterocycles in a single‐step fashion. In the last section, our own work in the field of inverse‐electron‐demand Diels–Alder reactions between ynamides and pyrimidines is discussed.

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4-Aminopyridine Toxicity: a Case Report and Review of the Literature

Cited by 46 publications

References 56 publications

Prolonged Toxic Encephalopathy following Accidental 4-Aminopyridine Overdose

Prolonged Toxic Encephalopathy following Accidental 4-Aminopyridine Overdose

A Review of 29 Incidents Involving 4-Aminopyridine in Non-target Species Reported to the ASPCA Animal Poison Control Center

Diels–Alder and Formal Diels–Alder Cycloaddition Reactions of Ynamines and Ynamides

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