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Behavioural pharmacology
Published in Adam Doble, Ian L Martin, David Nutt, Calming the Brain: Benzodiazepines and related drugs from laboratory to clinic, 2020
Adam Doble, Ian L Martin, David Nutt
Central nervous system depression is an important behavioural consequence of the administration of benzodiazepines, although this effect is not nearly as pronounced as with other minor tranquillisers such as meprobamate, barbiturates or even alcohol. Extremely high doses (compared to anxiolytic and anticonvulsant doses) are needed to see benzodiazepine narcosis, and general anaesthesia is not observed, unlike barbiturates. There is a 100-fold difference between the dose of diazepam needed to block pentylenetetrazole-evoked seizures and the dose that will impair the righting reflex in mice.
Alcohol and Sedatives
Published in Frank Lynn Iber, Alcohol and Drug Abuse as Encountered in Office Practice, 2020
Central nervous system depression and respiratory suppression are marked. There may be Cheyne-Stokes respiration, areflexia, pupillary constriction, lowered body temperature, and even a flat EEG. Treatment is respiratory support and, if necessary, cardiovascular support. In known-agent suicide attempts, removal of unabsorbed material by gavage or retarding absorption with charcoal is performed, but the results are of limited benefit. Usually, awaiting the metabolic removal of the agent while supporting the respirations is adequate treatment. A chronic toxicity is observed in abusers in which the predominant manifestations are irritability, trouble sleeping, and confusion.
Medications That May Be Useful in the Management of Patients with Chronic Intractable Pain
Published in Michael S. Margoles, Richard Weiner, Chronic PAIN, 2019
Mechanism of action may be due to general central nervous system depression. The drug has no direct action on the contractile mechanism of striated muscle, motor endplate, or nerve fiber. It does not directly relax tense skeletal muscles.
Exposure to hand sanitisers and other cleaning products in Victoria, Australia during the COVID-19 pandemic
Published in Clinical Toxicology, 2022
Alice Norvill, Rohan A. Elliott, Anselm Wong
In the majority of cases, children in our study were able to be managed at home under the supervision of an adult. However, it is important to note that isolated cases of central nervous system depression following ingestion of an alcohol-based hand sanitiser have been described in other countries, including the US [8]. This highlights the importance of storing topical antiseptics, including hand sanitisers, out of reach of children. This is particularly important for younger children who are more likely to be unintentionally exposed than older children and are at greater risk of toxicity. Other measures to mitigate child exposure include keeping hand sanitisers in their original labelled containers to reduce the risk of accidental ingestion. Child-resistant containers and pump bottles that deliver a small amount of product limit access to large quantities. Washing hands with soap and water is also a low risk and effective alternative. Where hand sanitiser is used, young children should be closely supervised. Older children should be taught to use hand sanitiser safely and effectively. While this study was unable to differentiate between liquid and gel formulations, this is an area for further research.
Clinical effects and outcomes of perampanel overdoses reported to U.S. poison centers
Published in Clinical Toxicology, 2022
Faisal Syed Minhaj, James B. Leonard, Wendy Klein-Schwartz
Perampanel is a newer antiepileptic agent that was approved in the United States in 2012 for use in adults with partial onset seizures [1]. The mechanism of action for perampanel is unique among antiepileptic agents as it inhibits glutamate activity on AMPA (alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid) receptors. Glutamate is the primary excitatory neurotransmitter in the central nervous system acting on AMPA glutamate receptors. Perampanel is thought to antagonize this receptor and decrease the overstimulation that can occur with seizure activity, leading to decreased signal transmission. Currently, there are few published case reports describing acute overdose [2–5]. Reported symptoms include prolonged central nervous system depression, respiratory depression, and aggressive behavior requiring chemical and physical restraints. Recently, approval was expanded for more seizure disorders and for use in the pediatric population, potentially increasing availability.
Unwitting adult marijuana poisoning: a case series
Published in Clinical Toxicology, 2021
Kelly Fong, Andy Hsueh, Kayla Kendric, Karissa Kunihira, Nadia Siddiqi, Tammy H. Phan, Ellen Reibling, Brian J. Wolk
Despite edible cannabis products accounting for a small proportion of the total number of cannabis sold and used, they result in the majority of ED visits [8,25]. In one study during a workshop on using hemp for medical purposes, 12 patients ingested hemp cookies and developed vomiting, vertigo, slowed reaction times, and gait abnormalities. Two patients required intensive care unit (ICU) admission due to central nervous system depression though without respiratory compromise [17]. One prior report studied a series of 12 children and nine adults who became intoxicated at a children’s birthday party after eating THC-containing gummies. Many reported hallucinations, confusion, and dizziness. Pediatric patients also exhibited tachycardia, leukocytosis, and elevated lactic acid [14]. In our series, common features included sleepiness, confusion, speech difficulty, weakness, nausea, tremors, and distortions of reality (Table 1). All the interviewed subjects felt a degree of sleepiness after THC consumption (Table 1).