Update in clinical toxicology.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE(2002)
摘要
Each year, new agents are added to the pharmacopoeia, ex- panding the list of possible toxicologic reactions. In response, new antidotes are introduced, uses of more established anti- dotes evolve, and new therapeutic approaches to well-estab- lished toxicologic syndromes are developed. This brief update on critical care toxicology focuses on a few of the most impor- tant new developments. The recognition and management of the serotonin syndrome are discussed as an example of a toxi- cologic syndrome that is occurring more frequently as a conse- quence of the introduction of new pharmacotherapies. New de- velopments in the therapy of well-known toxicologic reactions are next considered in relation to acetaminophen overinges- tion. Examples of evolving uses of older antidotes include oct- reotide to treat sulfonylurea overdose and glucose and insulin to treat calcium channel blocker overdose. Finally, we examine new antidotes including fomepizole to inhibit alcohol dehydro- genase, and snake antivenom antibodies to treat envenoma- tions. Critical care specialists must keep abreast of these trends to most effectively care for patients with toxicologic exposures.
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