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Cristina Iolanda Vivisenco

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

Severe acute propafenone poisoning – diagnosis and therapeutic approaches

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 3, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Severe acute propafenone poisoning – diagnosis and therapeutic approaches

and

ABSTRACT

Propafenone is an antiarrhythmic drug which blocks myocardial sodium channels as the main mechanism of action. Ingestion of a toxic dose of propafenone induces through the membrane stabilizing effect a clinical presentation with cardiovascular, neurological and metabolic expression, sometimes life-threatening. The authors present the case of a 13 year old female patient admitted for cardiac conduction abnormalities, seizures and coma after intentional ingestion of a toxic dose of propafenone. The patient was successfully treated with intravenous sodium bicarbonate therapy and supportive measures. The authors mention also the latest information from the literature regarding the management of propafenone poisoning.

Key words: propafenone, poisoning, child, membrane stabilizing effect

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INTOXICATIA ACUTA GRAVA CU PROPAFENONA – ABORDARE DIAGNOSTICA SI TERAPEUTICA

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 3, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
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DOAJ
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ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

INTOXICATIA ACUTA GRAVA CU PROPAFENONA – ABORDARE DIAGNOSTICA SI TERAPEUTICA

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REZUMAT

Propafenona este un medicament antiaritmic ce are ca mecanism principal de acţiune blocarea canalelor de sodiu din miocard. Ingestia unei doze toxice de propafenonă determină prin intermediul efectului stabilizator de membrană un tablou clinic deosebit de grav cu răsunet cardiovascular, neurologic şi metabolic, uneori cu potenţial letal. Autorii prezintă cazul unei paciente în vârstă de 13 ani internată pentru tulburare de conducere cardiacă, convulsii şi comă, după ce a ingerat voluntar o doză toxică de propafenonă. Pacienta a fost tratată cu succes cu bicarbonat de sodiu administrat intravenos şi măsuri suportive. Autorii menţionează şi cele mai noi informaţii din literatură privind abordarea terapeutică a intoxicaţiei cu propafenonă.

Cuvinte cheie: propafenonă, intoxicaţie, copil, efect stabilizator de membrană

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HIPERTENSIUNEA ARTERIALA SECUNDARA IN INTOXICATIILE ACUTE LA COPIL SI ADOLESCENT

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 2, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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HIPERTENSIUNEA ARTERIALA SECUNDARA IN INTOXICATIILE ACUTE LA COPIL SI ADOLESCENT

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REZUMAT

Introducere. Expunerea la diverse medicamente cardiovasculare şi non-cardiovasculare, substanţe de abuz, substanţe chimice sau porţiuni de plante poate genera hipertensiune arterială secundară. Autorii raportează experienţa personală legată de hipertensiunea arterială secundară intoxicaţiilor acute la copil şi adolescent.

Material şi metodă. Am condus un studiu prospectiv pe o perioadă de 24 de luni în care am inclus 151 de copii şi adolescenţi cu afectare toxică cardiovasculară. Pentru depistarea cazurilor de hipertensiune arterială secundară, semnele vitale au fost analizate la internare şi în dinamică ţinând cont de valorile normale pentru vârstă.

Rezultate. 11,1% din totalul cazurilor de intoxicaţie acută internate şi tratate în departamentul nostru au asociat afectare toxică cardiovasculară. Dintre acestea, 18,5% au fost cazuri de hipertensiune arterială secundară. Principala cauză a hipertensiunii arteriale în lotul studiat a fost expunerea la insecticide organofosforice, urmată de expunerea la medicamente simpatomimetice. În cazul insecticidelor organofosforice am constatat un comportament dual. Pacienţii au prezentat la debutul intoxicaţiei o scurtă perioadă de tahicardie şi hipertensiune arterială, ulterior instalându-se tabloul colinergic clasic din intoxicaţia acută cu insecticide organofosforice, cu bradicardie şi/sau hipotensiune arterială. Toate cazurile de hipertensiune arterială identificate au fost creşteri tranzitorii, autolimitate ale valorilor tensiunii arteriale, ce nu au necesitat asocierea agenţilor hipotensori în abordarea terapeutică.

Concluzii. Intoxicaţiile acute ale copilului şi adolescentului se pot complica cu hipertensiune arterială, cel mai adesea uşoară şi tranzitorie. Monitorizarea semnelor vitale este esenţială pentru abordarea acestor cazuri. Personalul medical trebuie să cunoască temeinic particularităţile legate de vârstă, inclusiv intervalele de referinţă pentru valorile tensiunii arteriale la copil şi adolescent.

Cuvinte cheie: hipertensiune arterială secundară, intoxicaţie acută, insecticide organofosforice, copil, adolescent

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SECONDARY HYPERTENSION IN ACUTE POISONING IN CHILDREN AND ADOLESCENTS

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 2, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

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Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

SECONDARY HYPERTENSION IN ACUTE POISONING IN CHILDREN AND ADOLESCENTS

and

ABSTRACT

Introduction. Exposure to various cardiovascular and non-cardiovascular drugs, drugs of abuse, chemicals and plants may cause secondary hypertension. The authors report their personal experience related to secondary hypertension due to acute poisoning in children and adolescents.

Materials and methods. We conducted a 24 month prospective study that included 151 children and adolescents with acute poisoning who developed cardiovascular abnormalities. In order to detect cases of secondary hypertension, vital signs were assessed on admission and in evolution, considering the normal values by age.

Results. 11.1% of all cases with acute poisoning admitted and treated in our department have associated cardiovascular impairment. Of these, 18.5% were cases of secondary hypertension. The main cause of hypertension in the study group was exposure to organophosphate insecticides, followed by exposure to sympathomimetic drugs. We noticed a dual effect exerted by organophosphate insecticides. At the beginning patients experienced a short period of tachycardia and hypertension, followed by the installation of the classic cholinergic feature of acute poisoning with organophosphate insecticides, with bradycardia and / or hypotension. All cases of hypertension were transient, self-limiting elevations of blood pressure, which did not require association of antihypertensive agents in the therapeutical approach.

Conclusion. In children and adolescents, acute poisoning may be complicated by hypertension, which is mostly mild and transient. Vital signs monitoring is essential to address these cases. Medical staff must know thoroughly age peculiarities, including reference ranges for blood pressure in children and adolescents.
Keywords: secondary arterial hypertension, acute poisoning, organophosphate insecticides, child, adolescent

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