Clinical Toxicology
Gholamreza Faridaalaee; Seyed Hesam Rahmani; Amin Mahboubi
Volume 2, Issue 2 , July 2016, , Pages 58-61
Abstract
Cisplatin was the first of the platinum drugs. Second-generation platinum derivative was carboplatin that its efficacy in the treatment of many malignancies is equal to cisplatin, and its toxicity profile is more favorable. Here we report on a 50-year-old woman with a history of cervix cancer who developed ...
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Cisplatin was the first of the platinum drugs. Second-generation platinum derivative was carboplatin that its efficacy in the treatment of many malignancies is equal to cisplatin, and its toxicity profile is more favorable. Here we report on a 50-year-old woman with a history of cervix cancer who developed a severe hypersensitivity reaction (HSR) to carboplatin. She was admitted to the emergency department (ED) with shortness of breath, tachypnea, restless, agitation, and lethargy. On arrival, the patient was hemodynamically unstable; we initiated treatment immediately with hydration, oxygen therapy with mask, hydrocortisone, midazolam, and adrenalin. After 1 hour, BP and O2 sat improved to 100/70 mm Hg and 92% respectively, but there was not any significant improvement in tachycardia as well as tachypnea and she was still lethargic and agitated. Her symptoms improved gradually after 18 hours of admission. She was discharged after 36 hours. HSRs to cisplatin and carboplatin can be potentially life-threatening. The symptoms can range from a mild rash to severe anaphylaxis. Doctors should be aware of these reactions, determine appropriate treatment, and know the cross-reactivity among these drugs.
Clinical Toxicology
Gholamreza Faridaalaee; Seyed Hesam Rahmani; Sajjad Ahmadi; Amin Mahboubi
Volume 2, Issue 1 , January 2016, , Pages 29-30
Abstract
Ingestion and inhalation of phosphine are 2 forms of toxicity and their clinical manifestation is extremely wide. A 22-year-old girl was admitted with complaints of nausea, vomiting and epigastric pain after eating lunch. She had a history of celiac disease. On arrival, she was alert and hemodynamically ...
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Ingestion and inhalation of phosphine are 2 forms of toxicity and their clinical manifestation is extremely wide. A 22-year-old girl was admitted with complaints of nausea, vomiting and epigastric pain after eating lunch. She had a history of celiac disease. On arrival, she was alert and hemodynamically stable. There was not any abdominal tenderness or guarding. Food poisoning treatment initiated but after 1 hour her condition deteriorated with hypotension, tachycardia, and epigastric pain. Venous blood gas (VBG) showed severe metabolic acidosis. She denied any drug ingestion again. New Electrocardiogram (ECG) showed extensive inferolateral ST elevation myocardial infarction (STEMI). Bicarbonate plus dopamine was initiated. After 8 hours of admission, rhythm became ventricular fibrillation (VF) and cardiopulmonary resuscitation (CPR) began. Peritoneal dialysis was performed. Next morning frequent VF occurred again but CPR was unsuccessful. Family found aluminum phosphide (AIP) tablets in her purse. Early diagnosis and supportive treatment may be effective but the most important factor is the dose of ingestion.