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Antiepileptic Drug Toxic Emergencies
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Overdosages with antiepileptic medications represent a significant proportion of hospital admissions for poisonings. For the year 1987, 26 of 824 (3.1%) adult admissions to a regional poisons center (Cardiff, Wales, U.K.) were for antiepileptic drug (AED) overdoses (1). In an earlier analysis of admissions to a children’s hospital for poisoning, 10 of 90 cases were barbiturate overdose, and another 10 of 90 were nonbarbiturate antiepileptic overdose, for a total of 22% of such cases in a 2-year period (2).
Intoxicants
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Barbiturates act by keeping the α-aminobutyric acid (GABA) channel in open state and include phenobarbital, sodium thiopental, and pentobarbital. Overdose presents with depression of respiratory and central nervous system (CNS) functions. There is no ceiling effect on the drug actions, making them lethal at high doses (Hadden et al.,1969). There is no antidote for barbiturate overdose, and treatment is supportive with the goals of blood pressure maintenance and adequate oxygenation.
The Nature of Disease
Published in Lawrie Reznek, The Nature of Disease, 1987
Similarly, some cases of poisoning are classified as diseases, whereas others are not. For example, chronic lead-poisoning is classified as a disease. But barbiturate overdose is not. Yet there does not seem to be any theoretical property that the one nature has and the other lacks that makes the one a disease and the other not. Both are due to the interference in the normal functioning of the body by a chemical agent.
Acute inhalation of ozone induces DNA methylation of apelin in lungs of Long-Evans rats
Published in Inhalation Toxicology, 2018
Colette N. Miller, Janice A. Dye, Mette C. Schladweiler, Judy H. Richards, Allen D. Ledbetter, Erica J. Stewart, Urmila P. Kodavanti
Approximately 1h post-exposure, rats were euthanized via barbiturate overdose (pentobarbital sodium, >200 mg/kg, i.p.). The left lung was ligated and bronchoalveolar lavage (BAL) was performed on the right lung using warmed Ca2+/Mg2+ free phosphate buffer saline (37 °C) equal to 28 mL/kg body weight (total lung capacity) × 0.6 (right lung representing 60% of total lung volume). Three washes using a syringe were performed using the same aliquot of buffer and the lavage was kept on ice until further processing. The number of cells present in the BAL fluid was determined using a Z1 Coulter Counter (Coulter, Inc.; Miami, FL). Cytospin preparations of BAL fluid were stained using Diff-quick (Fischer Scientific; Pittsburgh, PA) and cell differentials were determined. Remaining BAL fluid was centrifuged at 1500 rpm for 10 min at 4 °C to obtain cell-free supernatant for assessments including: albumin (antibody-based microalbumin assay; Sekisui Diagnostics; Canada), gamma-glutamyltranspeptidase activity (GGT) and lactate dehydrogenase activity (LDH) (Thermo Fisher Diagnostics; Middletown, VA), N-Acetyl-beta-glucosaminidase activity (NAG; Sigma-Aldrich Diagnostics; St. Louis, MO) and total protein (Coomassie Plus protein assay kit, Thermo Fisher Diagnostics; Middletown, VA) using kits modified for use on the Konelab Arena 30 system (Thermo LabSystems; Finland). The ligated left lung lobe was snap frozen in liquid nitrogen and stored at –80 °C for subsequent gene and protein analyses.
Microwave ablation of the liver in a live porcine model: the impact of power, time and total energy on ablation zone size and shape
Published in International Journal of Hyperthermia, 2020
Terrence Chi Hong Hui, Christopher Lee Brace, J. Louis Hinshaw, Lawrence Han Hwee Quek, Ivan Kuang Hsin Huang, Justin Kwan, Gavin Hock Tai Lim, Fred T. Lee, Uei Pua
The various protocols are summarized in Table 1. The power refers to the power setting at the generator; the actual power delivered is estimated to be 65% of the power setting at the generator. The first 4 protocols were designed to each deliver a fixed total energy of 650 W-min (39 kJ): (1) 65 W continuous for 10 min (65W 10MIN), (2) 25 W-65W ramped protocol (RAMPED), (3) high-power pulses with 31–32 s cooling pauses (95W PULSED), and (4) low-power 40 W continuous for 16 min 15 s (LOW POWER). Protocol 3 (95W PULSED) was designed to deliver total energy of 650 W-min (39 kJ) in 10 min, six 95 W/1-min pulses were performed with 31–32 s cooling pauses (570 W-min) followed by a shorter 51 s 95 W pulse (total 650 W-min). The rationale for including RAMPED and 95W PULSED protocols was to evaluate if techniques used in RFA to reduce charring are also advantageous in MWA. Protocols 5 and 6 were designed to explore power levels nearing the system limit (BOOKEND 95W), and prolonged high-power ablations (65 W 15 MIN), respectively. The BOOKEND 95W protocol consisted of a 95 W pulse for 1 min, followed by continuous 65 W for 8 min, then a second 1 min 95 W pulse with no interleaved cooling pauses (710 W-min, 42.6 kJ). The 65 W 15 MIN protocol was the longest and highest total energy protocol (975 W-min, 58.5 kJ) employed in this study. The different protocols were randomly distributed throughout the various lobes of the pig liver to minimize bias based on the assigned lobe. After ablations were completed, pigs were euthanized using an intravenous barbiturate overdose (300 mg/ml pentobarbitone sodium). Completing all ablations in 1 pig takes approximately 1 h–1 h 15 min. The liver was then harvested en-bloc and the ablations were sectioned in sequence.
The efficacy of pirfenidone in a sheep model of pulmonary fibrosis
Published in Experimental Lung Research, 2019
Sasika N. V. Dewage, Louise Organ, Emmanuel Koumoundouros, Habtamu B. Derseh, Kopiyawaththage U. E. Perera, Chrishan S. Samuel, Andrew W. Stent, Ken J. Snibson
At the end of the experiment, sheep were euthanised with intravenous barbiturate overdose (Pentobarbital sodium, Cenvet, Dandenong, Australia) at week 7 of the experiment as shown in Figure 1B. Left and right caudal lung segments were identified and carefully removed from surrounding tissue and processed as previously described.12,13 Briefly, 5 mm thick transverse sections were taken from corresponding lung segments and they were either fixed in 4% paraformaldehyde or embedded in optimal cutting compound (OCT) (Sakura FineTeK, USA) and frozen for cryosectioning and immunohistochemistry.