naloxone and Foreign-Bodies

New data are reviewed in two areas in the management of the acute overdose: gastrointestinal decontamination and systemic antidotes. The mechanism and effectiveness of Ipecac syrup, gastric aspiration and lavage, activated charcoal, gastrointestinal dialysis, and saline cathartics are discussed. Special problems posed by disc batteries and packet ingestion of cocaine (in transporting contraband) are highlighted. The pharmacology and uses of pyridoxine and naloxone as antidotes are detailed.

Topics: Antidotes; Cathartics; Charcoal; Child; Cocaine; Deglutition; Foreign Bodies; Gastric Lavage; Humans; Ipecac; Isoniazid; Naloxone; Narcotics; Poisoning; Pyridoxine; Substance-Related Disorders; Suction; Time Factors; Toxicology; Vomiting

Topics: Administration, Intravenous; Adult; Digestive System; Drug Overdose; Foreign Bodies; Heroin; Humans; Iran; Male; Naloxone; Narcotic Antagonists; Radiography, Abdominal; Therapeutic Irrigation

Topics: Adult; Drug Overdose; Emergency Medicine; Foreign Bodies; Gastrointestinal Tract; Heroin; Humans; Illicit Drugs; Male; Naloxone; Radiography; Treatment Outcome; United States

Recent events in the United States have led to increased security at national borders, resulting in an unexpected increase in drug seizures. In response, drug smugglers may begin using children as couriers, including using them as "body packers.". To look at the occurrence of body packing, the concealing of contraband within the human body, which is well documented in adults, in the pediatric literature.. Two cases of pediatric body packing, in boys aged 16 years and 12 years. Patient 1, a 16-year-old boy, presented with findings consistent with opioid intoxication after arriving in the United States on a transcontinental flight. His mental status improved after he received naloxone hydrochloride, and he subsequently confessed to body packing heroin. He was treated with a naloxone infusion and aggressive gastrointestinal decontamination. He ultimately passed 53 packets of heroin, one of which had ruptured. He recovered uneventfully. Patient 2, a 12-year-old boy, presented to the emergency department with rectal bleeding. He had recently arrived in the United States from Europe, and he confessed to body packing heroin. He was treated with whole-bowel irrigation and activated charcoal, and he subsequently passed 84 packets. He also recovered uneventfully.. We report the first 2 cases of body packing in the pediatric literature and review the diagnosis and management of this clinical entity. Pediatricians should be aware that body packing, regrettably, is not confined to the adult population.

Topics: Adolescent; Charcoal; Child; Crime; Digestive System; Drug Overdose; Foreign Bodies; Heroin; Humans; Male; Naloxone; Narcotic Antagonists; Narcotics; Radiography, Abdominal; Therapeutic Irrigation; Tomography, X-Ray Computed

Mytilus edulis has been the subject of recent studies to determine whether the relationship between the immune and nervous systems seen in vertebrates also exists in invertebrates. In the present study the effects of experimentally induced "stressful" stimuli on immunoactive hemocytes were studied in this mollusc. This subpopulation of invertebrate blood cells, resembling vertebrate granulocytes, has been previously shown to produce and react to opioid peptides. Their activation, like that of vertebrate immunocytes, expresses itself in distinctive conformational changes preceding cellular mobilization. The cellular response to "stress" observed is the same as that to the administration of exogenous mammalian opioid peptides. This strongly suggests that under the conditions of stressful stimuli, the immune/defense system can be altered by endogenous neuropeptides. The involvement of opioids in neuroimmunoregulatory phenomena appears to have a long evolutionary history.

Topics: Animals; Bivalvia; Electroshock; Foreign Bodies; Ganglia; Hemocytes; Naloxone; Neuroimmunomodulation; Stress, Physiological