ABSTRACT
BACKGROUND: The management and toxicokinetics of hydroxychloroquine overdose are poorly described. CASE REPORT: We report a case of an 18-year-old girl who ingested 20 g of hydroxychloroquine. She developed marked hypokalemia, hypotension, and ventricular tachyarrhythmias but survived with treatment including intubation, adrenaline infusion, high-dose diazepam, and aggressive potassium replacement. Plasma hydroxychloroquine level was 29.40 mumol/L (9.87 mg/L) 2 hours after ingestion and the elimination half-life of hydroxychloroquine was 22 hours. CONCLUSIONS: The clinical manifestations of this hydroxychloroquine overdose were similar to those reported for chloroquine overdose and the management principles recommended for chloroquine overdose appeared to be efficacious in this case.
Subject(s)
Antimalarials/poisoning , Hydroxychloroquine/poisoning , Adolescent , Antimalarials/pharmacokinetics , Area Under Curve , Chromatography, High Pressure Liquid , Drug Overdose , Electrocardiography , Female , Half-Life , Humans , Hydroxychloroquine/pharmacokinetics , Lupus Erythematosus, Systemic/complications , Suicide, Attempted , Ventricular Premature Complexes/chemically induced , Ventricular Premature Complexes/pathologyABSTRACT
Lepidopterism is a general term for the ill-effects to humans from contact with moths and butterflies. We describe two cases of systemic reactions after contact with the cocoon of the Australian species Chelepteryx collesi, or white-stemmed gum moth--irritant and toxic effects in one and a systemic allergic reaction in the other. Early removal of urticating hairs from the skin in such cases may be advisable.
Subject(s)
Anaphylaxis/etiology , Dermatitis, Allergic Contact/etiology , Moths , Adult , Animals , Australia , Humans , Larva , MaleABSTRACT
OBJECTIVE: To determine the incidence, morbidity, and mortality associated with fractures of the sternum. DESIGN: A retrospective review of the medical records of all patients treated in an emergency department with the radiologic diagnosis of sternal fracture during a 6 1/2 year period between January 1, 1985 and June 30, 1991. SETTING: A level II trauma center in the eastern suburbs of Melbourne, Australia. PATIENTS: 272 patients were eligible for analysis. Only 6 patients of 251 involved in motor vehicle collisions were documented as not wearing seatbelts. RESULTS: The incidence of sternal fracture as a result of motor vehicle collisions was 3%. Sternal fracture is more common in female victims and the elderly and is associated with a very low incidence of cardiac arrhythmias requiring treatment. It has a mortality of 0.7%. CONCLUSIONS: Sternal fracture is a common injury in a population where restraints are frequently used. PATIENTS with an isolated sternal fracture do not require cardiac monitoring and those under 40 years of age may be cared for in a short stay ward.
