levoleucovorin and Substance-Related-Disorders

Significant toxicity can result from intentional methanol inhalation. We report seven cases, involving four patients, of intentional inhalation of CARB-MEDIC carburetor cleaner containing toluene (43.8%), methanol (23.2%), methylene chloride (20.5%), and propane (12.5%). Patients arrived at the emergency department with central nervous system depression, nausea, vomiting, shortness of breath, photophobia, and/or decreased visual acuity. Treatment included correction of acidosis, leucovorin and/or folic acid, ethanol infusions, and supportive care. Hemodialysis was necessary in three cases. Measured blood methanol levels ranged from 50.4 to 128.6 mg/dL. Blood formic acid levels were 120, 193, and 480 micrograms/mL, respectively, in three patients. Ophthalmic examinations revealed hyperemic discs and decreased visual acuity in one patient. One individual was found pulseless with several CARB-MEDIC cans nearby. Attempts at revival were unsuccessful. Clinicians should be aware that significant blood methanol and formic acid levels may occur after inhalation of methanol.

Topics: Administration, Inhalation; Adult; Ethanol; Folic Acid; Humans; Leucovorin; Male; Methanol; Poisoning; Substance-Related Disorders

A man with previous addiction to parenteral drugs presented infection by human immunodeficiency virus (HIV) with persistent generalised lymph node enlargement. Sixteen months after diagnosis, he developed intermediate-grade lymphoma of the stomach. Partial response was achieved by chemotherapy, and the patient presented pulmonary and meningeal tuberculosis which led him to exitus.

Topics: Adult; AIDS-Related Complex; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Cyclophosphamide; Dexamethasone; Doxorubicin; Humans; Leucovorin; Lymphoma, Non-Hodgkin; Male; Methotrexate; Opportunistic Infections; Stomach Neoplasms; Substance-Related Disorders; Tuberculosis, Miliary; Vincristine

A 20-year-old Caucasian male with acute leukemia developed acute organic brain failure after treatment with intensive cytostatic chemotherapy. His delirious state was successfully controlled by neuroleptic therapy with intravenous haloperidol and lorazepam. We propose that this regimen may be useful in treating organic brain failure following intensive chemotherapy for malignant disease.

Topics: Acute Disease; Adult; Antineoplastic Combined Chemotherapy Protocols; Antipsychotic Agents; Asparaginase; Cytarabine; Humans; Leucovorin; Leukemia, Lymphoid; Male; Methotrexate; Substance-Related Disorders