ABSTRACT
Plant poisonings are rare in Denmark, but can have fatal consequences. We present a case in which a woman went into cardiac arrest after having ingested leaves from the foxglove plant. Sinus rhythm was not restored until Digibind was administered. Literature in this field is sparse, but we conclude that the following advice can be given: 1) assessment of the degree of poisoning should be based on clinical features and changes of the electrocardiogram; 2) activated charcoal should be given; 3) in case of malignant arrhythmia or cardiac arrest, the use of Digibind should be considered.
Subject(s)
Digitalis/poisoning , Heart Arrest , Immunoglobulin Fab Fragments/therapeutic use , Immunologic Factors/therapeutic use , Plant Poisoning/drug therapy , Electrocardiography , Female , Heart Arrest/chemically induced , Heart Arrest/drug therapy , Humans , Middle Aged , Plant Poisoning/complications , Suicide, Attempted , Treatment OutcomeABSTRACT
Since postoperative pain often is undermanaged, and opioids, although being efficient analgesics, have undesirable side effects, attention has turned towards adjuvant therapies, among them nicotine. We present seven studies of which six show an effect of nicotine on postoperative pain when given in a low dose, with short time of exposure and to non-smokers. Other possible confounders are gender and type of anaesthesia. Nicotine seems to increase the occurrence of nausea and vomiting. More research is needed, and nicotine cannot currently be recommended as part of a multimodal pain management regime.