Extracorporeal treatment in the management of acute poisoning: What an intensivist should know?

Jha, Vijoy Kumar; Padmaprakash, K V

doi:10.4103/ijccm.ijccm_425_18

Cited by 13 publications

(5 citation statements)

References 50 publications

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“…CRRT is an effective treatment for MALA if intermittent hemodialysis cannot be performed due to hemodynamic instability. Also, one of many advantages of the CRRT is the removal of substances that can produce severe metabolic acidosis, such as alcohol, whose abuse was noted in medical history of our patient, proven by Jha et al [9]. In our case, applying of CVVHDF in the setting of hemodynamic instability, led to rapid correction of metabolic disorders and hemodynamic stabilization, and, in final, to good recovery.…”

Section: Disscusionsupporting

confidence: 56%

Early initiation of continuous renal replacement therapy for metformin-associated lactic acidosis

et al. 2023

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Introduction. Rapid diagnosis of metformin-associated lactic acidosis (MALA) and initiation of continuous renal replacement therapy (CRRT) in diabetic patient successfully corrects a severe metabolic disorder of a patient with acute renal failure. Case outline. A 58-year-old male patient with a medical history of type 2 diabetes and alcohol abuse was admitted to Emergency department because of the vomiting, diarrhea and altered mental status. Initial arterial blood gas (ABG) analysis revealed severe metabolic acidosis (pH: 6.8, PaCO2: 12 mmHg, HCO3: 3.2 mmol/l), but the lactate level was too high to measure. MALA was suspected based on progressive lactic acidosis and past intake of metformin. The renal replacement therapy (RRT) was initiated- continuous veno-venous hemodiafiltration (CVVHDF), and as a result a significant improvement of the clinical status, with both blood pH and lactate level showing normalization was achieved after finishing CRRT. Conclusion. Acute metformin-associated lactic acidosis carries an ominous prognosis. This case suggests the application of early initiation of CRRT in hemodynamically unstable diabetic patients with MALA.

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Section: Disscusionsupporting

confidence: 56%

Early initiation of continuous renal replacement therapy for metformin-associated lactic acidosis

et al. 2023

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“…Generally, if a drug is amenable to dialysis, and the decision to dialyze is made, intermittent hemodialysis is the preferred mode of clearance as it results in the fastest toxin elimination. 13 Listing the individual considerations for when to dialyze each specific toxin and which modality to use is beyond the scope of this review. The EXtracorporeal TReatment in Poisoning (EXTRIP) workgroup is a multidisciplinary group that creates guidelines on extracorporeal elimination of poisons and drugs in overdose.…”

Section: Enhanced Eliminationmentioning

confidence: 99%

Part I: Case series: Acute management of prescription and nonprescription drug overdoses

Feldman,

Leonard

2024

J Am Coll Clin Pharm

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Reviewed by Julianne Yeary, Pharm.D., BCCCP; and Monica Owen, Pharm.D., BCPS, BCCCP LEARNING OBJECTIVES 1. Classify prescription drug overdose by patient presentations.2. Evaluate the causative agents of a drug overdose based on history and clinical findings of presentation.3. Develop a treatment paradigm that may be applied in all prescription drug overdoses.4. Assess the relevance of each therapeutic target in drug overdose in a specific drug overdose scenario.5. Devise a plan for treatment of anticholinergic, sodium channel blocker, tricyclic antidepressant, bupropion, digoxin, sulfonylurea, alpha-2 agonist, iron, valproic acid, clonidine, and salicylate overdose.6. Justify the use of specific antidotes in overdose.Target audience for this application-based activity: Pharmacotherapy specialists and advanced level clinical pharmacists whose practice involves the direct care and management of critically ill patients in the ICU and emergency department.

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“…Activated charcoal gastric lavage may be helpful. Techniques like hemodialysis or Kakkar et al 10.3389/fpls.2023.1139215 Frontiers in Plant Science frontiersin.org extracorporeal filtration are less effective for treating cardiotoxic plant poisoning (Magnani and Woolf, 2017;Jha and Padmaprakash, 2018). Antiemetic medications make it simple to treat nausea and vomiting.…”

Section: • Customers Got Sick At the Toronto-based Delightmentioning

confidence: 99%

The known, unknown, and the intriguing about members of a critically endangered traditional medicinal plant genus Aconitum

Kakkar,

Haneen,

Parida

et al. 2023

Front. Plant Sci.

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Humanity will always be indebted to plants. In the ongoing scientific era, the ‘Herbal Revolution’ has helped discover several valuable medicinal plants and associated novel secondary metabolites from the diverse unexplored ecosystems, treating several diseases via phytotherapy. The Aconitum genus comprises several economically-important poisonous mountainous medicinal plant species whose unique biodiversity is on the verge of extinction due to illegal human intervention triggered habitat loss, over-harvesting, and unrestricted trading. Owing to its vast diversity of diterpene alkaloids, most species are extensively used to treat several ailments in rural parts of the world. Irrespective of this, many unexplored and intriguing prospects exist to understand and utilize this critical plant for human benefit. This systematic review tries to fill this gap by compiling information from the sporadically available literature known for ~300 Aconitum spp. regarding its nomenclature and classification, endangerment, plant morphology, ploidy, secondary metabolites, drug pharmacokinetics, conservation, and omics-based computational studies. We also depicted the disparity in the studied model organisms for this diverse genus. The absence of genomic/metagenomic data is becoming a limiting factor in understanding its plant physiology, metabolic pathways, and plant-microbes interactions, and therefore must be promoted. Additionally, government support and public participation are crucial in establishing conservation protocols to save this plant from endangerment.

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Extracorporeal treatment in the management of acute poisoning: What an intensivist should know?

Cited by 13 publications

References 50 publications

Early initiation of continuous renal replacement therapy for metformin-associated lactic acidosis

Early initiation of continuous renal replacement therapy for metformin-associated lactic acidosis

Part I: Case series: Acute management of prescription and nonprescription drug overdoses

The known, unknown, and the intriguing about members of a critically endangered traditional medicinal plant genus Aconitum

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