Síndrome de dress asociado a fenobarbital en paciente pediátrico. Reporte de caso / Dress Syndrome in a pediatric patient asocciated to Phenobarbital. Case Report

Introducción: El síndrome de DRESS por sus siglas en inglés (Drug Rash with Eosinophilia and Sistemic Symptoms), re-presenta una enfermedad grave (1) potencialmente letal que incluye reacción cutánea, iebre, anomalías hematológicas e involucro de diversos órganos. Caso Clínico: Masculino de 2 años con antecedente de uso de Fenobarbital, quien ingresó con historia de iebre, adenopatías y rash cutáneo generalizado. En los exámenes de laboratorio se evidencio leucopenia con eosinoilia con elevación de las enzimas hepáticas; se realizaron pruebas de imagen que reportaron hepatomegalia, y nefromegalia bilateral, mostrando evolución satisfactoria inmediata después del retiro de fenobarbital y una terapia esteroidea sistémica. Discusión: Al ser una reacción adversa de baja frecuencia que presenta una mortalidad de hasta un 30% se considera de importancia conocer su comportamiento clínico, así como el diagnóstico y manejo...(AU)

Effect of phenobarbitone administration to pregnant rats on anxiety in offsprings.

Adults Charles-Foster rats were prenatally treated to phenobarbitone (10 mg/kg, i.p.) from day 13 to 21 of gestation, this being the critical period of neural development. Pregnant control rats were similarly treated with equal volume of vehicle. Adult rat offsprings at 8-9 weeks of age were subjected to open-field exploratory behaviour, elevated plus-maze and elevated zero-maze tests. The rat offsprings displayed significantly increased ambulation and rearings in an open-field arena when compared to control offsprings whereas self-grooming and faecal droppings remain unchanged. On elevated plus-maze test these prenatally treated rat offsprings spent significantly less time on open arms and more time and more number of entries in enclosed arms as compared to controls. Prenatally exposed rats also showed significant less time on open arms, less number of head dips and stretched attend postures on elevated zero-maze test indicating increased anxiogenic behavioural pattern in these animals. The results suggest that prenatal exposure to phenobarbitone leaves a lasting effect on the anxiety state of the offsprings.

Intoxicación barbitúrica grave / Dangerous barbituric intoxication

Se realizó un estudio retrospectivo con los objetivos de establecer la prevalencia de la intoxicación barbitúrica grave en un servicio de Terapia Intensiva, conocer la incidencia de complicaciones y la mortalidad, y evaluar el tratamiento utilizado. Se analizaron 15 pacientes, la mayoría jóvenes y de sexo femenino. Se registraron 19 episodios de complicaciones. El 86 por ciento de los pacientes se hallaba en coma al ingreso (escala de Glasgow < 8). El deterioro hemodinámico se observó en el 46,7 por ciento de los casos, y el 60 por ciento requirió ventilación mecánica. El protocolo de tratamiento incluyó: 1) Diálisis intestinal (utilización de carbón activado y de purgantes salinos con el objetivo de lograr catarsis en las primeras 48 hs del tratamiento); 2) Diuresis alcalina; 3) Sostén de funciones vitales. La mortalidad fue del 13 por ciento. Conclusión: Evitar el lavado gástrico, iniciar precozmente el protocolo de diálisis intestinal y realizar hemodiálisis sólo si aquélla fracasa, durante las primeras 24 hs

study of free radical injury to vital organs

The study of toxicities which are caused by free radical inducing chemicals [e.g., carbon tetrachloride], helps to determine the mode of action of those important drugs which act by inhibiting free radicals. Evaluation of toxicities induced by carbon tetrachlonde and phenobarbitone administration was carried out in seventy healthy male rabbits. Each animal received CCL4 0.25-0.5 mL/kg body weight, intraperitoneally, twice weekly for eleven doses. During this period, the only water which was provided for drinking to these animals contained 0.25 g/L pentobarbitone. Examination of these animals revealed that carbon tetrachloride produced severe liver and kidney injuries which could be assessed by physical parameters, liver and kidney function tests, and microscopic examinations of the vital organs of these animals

Hepatic mixed function oxidase system and effect of phenobarbital, 3-methylcholanthrene and 1, 1, 1-trichloro-2, 2-bis(p-chlorophenyl)ethane in developing chickens.

Contents of hepatic microsomal protein, aminopyrine N-demethylase, acetanilide hydroxylase, aniline hydroxylase, hydrogen peroxide formation, cytochrome-c-reductase, cytochrome b5 and cytochrome P-450 were examined in control, phenobarbital (PB), 3-methylcholanthrene (3-MC) and 1, 1, 1-trichloro-2, 2-bis(p-chlorophenyl)ethane (DDT) treated group of 1-28 days old chickens. Increase in aminopyrine N-demethylase, acetanilide hydroxylase, aniline hydroxylase, cytochrome-c-reductase, cytochrome b5 and cytochrome P-450 was noticed at all stages of development during administration of PB and 3-MC. But these enzyme activities were not always paralleled by increase in age. Aminopyrine N-demethylase was increased in early stages only during DDT administration, which indicates that the form of cytochrome P-450, responsible for aminopyrine N-demethylation is present in early stages only. However, acetanilide hydroxylase was decreased in all stages of development, in postnatal development the basal activities of the enzymes for various substrates do not exhibit identical pattern, the degree of inducibility by inducers varied in relation to age of animal. Hydrogen peroxide formation increased in all stages of developing chickens due to the administration of PB and DDT. It however decreased due to 3-MC administration which may be due to induction of high spin cytochrome P-450.

Hemoperfusion como tratamiento depurador en intoxicaciones exógenas e insuficiencia hepática aguda / Hemoperfusion: a purifir therapy in exogenous intoxications and acute liver failure

Se describen los resultados obtenidos en 12 pacientes ingresados en el Hospital Clínico Quirúrgico de Santa Clara desde julio de 1987 hasta diciembre de 1988, los cuales recibieron tratamiento con hemoperfusión. De ellos 10 correspondían a intoxicaciones exógenas agudas y 2 a comas hepáticos. Se analizan las causas que motivaron la hemoperfusiónm, fármacos más utilizados, criterios para su aplicación, complicaciones y resultados. Las complicaciones fueron pocas y de fácil correlación. Se concluye que la hemoabsorción es una técnica posible de aplicación a nuestro centro

Comparison of five methods for the determination of lethal dose in acute toxicity studies

The aim of the prsent study was to compare the realibility of LD50 determination using the traditional Litchfield and Wilcoxon method with that obtained by forur alternative tests requiring smaller numbers of animals, for the purpose of classifyng chemicals according to their acute toxicity. Acute lethal dose determinations were carried out in mice for oral and intraperitoneal administration of hexachlorophene, lidocaine, methanol, phenobarbital and physostigmine. The Molinengo method proved not to be as reliable as suggested by its author. Determination of LD50 using the Thompson and Weil method or, alternatively, the maximal non-lethal dose and the approximate lethal dose permitted the classification of the chemicals in essentially the same order. The approximate lethal dose method, in particular, seems to be a very suitable alternative method to the classical LD50 test since it requires only about 6 animals, provides enough information to order chemicals according to their toxicities, and provides useful information for planning subsequent repeated-dose studies