salicylates and Vomiting

Topics: Acetaminophen; Acid-Base Equilibrium; Acidosis; Acute Kidney Injury; Alkalosis, Respiratory; Aspirin; Calcium; Coma; Dehydration; Fever; Gastric Lavage; Hemorrhage; Humans; Hydrogen-Ion Concentration; Infusions, Parenteral; Poisoning; Salicylamides; Salicylates; Seizures; Tetany; Vomiting

Topics: Antidotes; Apomorphine; Barbiturates; Blood Proteins; Cell Membrane Permeability; Charcoal; Cyanides; Dialysis; Diuresis; Emetics; Gastric Lavage; Glycine; Intestinal Absorption; Ipecac; Poisoning; Salicylates; Skin Absorption; Time Factors; Vomiting

Pulmonary embolism (PE) is a serious complication following hip surgery. Trials of antiplatelet thromboprophylaxis indicated a substantial reduction in PE rate, and we prospectively studied the effect of a combination of low-dose heparin and two different antiplatelets. Furthermore, our experience in previous studies suggested that platelet count (PC) levels could be useful to reliably suspect PE at a very early stage, and we prospectively tried to confirm our previous findings. Ours is a prospective study in 459 consecutive patients operated on because of hip fracture (265) or elective hip replacement (194), aimed to determine: 1) whether the benefits of antiplatelets plus heparin on PE outweigh the risks; 2) to assess the clinical usefulness of PC monitoring in these patients, so as to confirm whether PE could be recognized early. It was a prospective, randomized, double-blind study. All patients received unfractioned heparin (7500 IU sc twice daily, starting 2 h before operation). In addition, they received aspirin (200 mg thrice daily, with meals), Triflusal (300 mg thrice daily, with meals), or placebo. Real time B-mode ultrasonography (US) was performed on all patients on the 8-9th day after surgery. Venography was performed in patients with normal US, if clinical symptoms suggested venous thrombosis. Twelve out of the 459 patients (2.6%) had to discontinue prophylaxis, because of major bleeding (6 patients), or gastric intolerance (6 patients). There were no significant differences between groups in either deep vein thrombosis (26 patients (18%) with aspirin, 18 (12%) with Triflusal, 26 (17%) with placebo), or PE development (7 patients (5%) with aspirin, 3 (2%) with Triflusal, 8 (5%) taking placebo).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aged; Aged, 80 and over; Aspirin; Double-Blind Method; Drug Therapy, Combination; Female; Hemorrhage; Heparin; Hip Fractures; Hip Prosthesis; Humans; Male; Middle Aged; Platelet Aggregation Inhibitors; Platelet Count; Postoperative Complications; Prospective Studies; Pulmonary Embolism; Radionuclide Imaging; Salicylates; Thrombophlebitis; Treatment Outcome; Ultrasonography; Vomiting

A double-blind study of 43 patients undergoing excision of haemorrhoids under spinal anaesthesia was carried out to compare the analgesic effects of diflunisal (DFL, 21 patients) and dextropropoxyphene napsylate (DPN, 22 patients) on post-operative pain. Eleven patients (25%) reported no significant pain during the study indicating that they had needed no analgesic medication (4 in the DFL group and 7 in the DPN group). Thus 17 patients in the DFL group and 15 patients in the DPN group contributed to the analysis data. Seven patients in the DFL group and 9 patients in the DPN group needed additional analgesic therapy on the day of surgery. After the day of surgery the analgesic effect of both of the test medications was sufficient but DFL proved to provide slightly better pain relief than DPN. Two patients in each study group had mild adverse reactions including vomiting and epigastric pain, which were probably drug related. It is concluded that both DFL and DPN are safe and sufficiently effective treatments for pain after haemorrhoidectomy but not until one day after surgery.

Topics: Administration, Oral; Adult; Aged; Benzilates; Benzophenones; Dextropropoxyphene; Diflunisal; Dipyrone; Double-Blind Method; Drug Combinations; Female; Hemorrhoids; Humans; Male; Middle Aged; Nausea; Pain; Postoperative Period; Random Allocation; Salicylates; Vomiting

The influence of a typical 60-mL dose of subsalicylate bismuth (Pepto-Bismol) on the absorption of 200 mg of orally administered doxycycline hyclate was studied. Bioavailability of doxycycline was significantly reduced by 37% and 51%, respectively, when subsalicylate bismuth was given simultaneously and as a multiple-dose regimen before doxycycline. Peak serum concentrations of doxycycline were significantly decreased when subsalicylate bismuth was given two hours before doxycycline but not when given two hours after doxycycline. Subsalicylate bismuth should not be taken when doxycycline is used for therapeutic purposes, and we suggest travelers should not take the agents together in an effort to prevent diarrhea.

Topics: Adult; Biological Availability; Bismuth; Clinical Trials as Topic; Double-Blind Method; Doxycycline; Drug Interactions; Humans; Male; Organometallic Compounds; Random Allocation; Salicylates; Vomiting

Topics: Gastric Lavage; Humans; Infant; Ipecac; Methods; Poisoning; Salicylates; Vomiting

Renal pigmentation due to the administration of exogenous compounds is an uncommon finding in most species. This report describes renal pigmentation and intranuclear inclusions of the proximal convoluted tubules due to chronic bismuth administration in a rhesus macaque. An 11-year-old Indian-origin rhesus macaque with a medical history of chronic intermittent vomiting had been treated with bismuth subsalicylate, famotidine, and omeprazole singly or in combination over the course of 8 years. At necropsy, the renal cortices were diffusely dark green to black. Light and electron microscopy revealed intranuclear inclusions within the majority of renal proximal tubular epithelial cells. These inclusions appeared magenta to brown when stained with hematoxylin and eosin and were negative by the Ziehl-Neelsen acid-fast stain. Elemental analysis performed on frozen kidney measured bismuth levels to be markedly elevated at 110.6 ppm, approximately 500 to 1000 times acceptable limits. To our knowledge, this is the first report of renal bismuth deposition in a rhesus macaque resulting in renal pigmentation and intranuclear inclusions.

Topics: Animals; Antiemetics; Bismuth; Kidney; Kidney Diseases; Macaca mulatta; Male; Monkey Diseases; Organometallic Compounds; Pigmentation; Pigmentation Disorders; Salicylates; Vomiting

A 16-month-old child developed a brief generalised tonic-clonic fitting episode and vomiting at home, after accidental ingestion of traditional massage oil. As the patient presented with clinical features of salicylate toxicity, appropriate management was instituted. He was admitted to the intensive care unit for multiorgan support. The child was discharged well 1 week after the incident. Methyl-salicylate is a common component of massage oils which are used for topical treatment of joint and muscular pains. However, these massage oils may be toxic when taken orally. Early recognition of the salicylate toxicity is very important in producing a good patient outcome.

Topics: Antidotes; Bicarbonates; Charcoal; Diuretics; Fluid Therapy; Furosemide; Humans; Infant; Intubation, Intratracheal; Male; Massage; Oils; Renal Dialysis; Salicylates; Seizures; Vomiting

Topics: Animals; Bismuth; Chelating Agents; Dog Diseases; Dogs; Female; Foreign Bodies; Organometallic Compounds; Radiography, Abdominal; Salicylates; Tablets; Treatment Outcome; Vomiting

Methyl salicylate (oil of wintergreen) in the form of candy flavoring was ingested by a 21-month-old male infant who subsequently developed vomiting, lethargy, and hyperpnea. A "swallow" of the solution resulted in a serum salicylate concentration of 81 mg/dL six hours after ingestion. The infant was treated with parenteral fluids and sodium bicarbonate and he recovered rapidly. Hazards associated with salicylate use in this form include lack of parental awareness of the substance's toxic potential, the attractiveness of the candy-like odor, and the availability of the liquid in non-child-resistant packaging containing potentially lethal quantities.

Topics: Candy; Flavoring Agents; Humans; Infant; Male; Respiration Disorders; Salicylates; Sleep Stages; Vomiting

Serum salicylate concentration was measured at admission in 130 children with liver-biopsy-confirmed Reye's disease. Mean serum salicylate was 12.3 mg/dl and mean salicylate concentrations by neurological grade (Lovejoy) were: stage I, 12, stage II, 13, stage III, 11, stage IV, 13, and stage V, 13 mg/dl. However, mean serum salicylate (15 mg/dl) at admission in 21 patients who died or had serious neurological deficits was significantly higher than that in 103 patients who survived without neurological sequelae (10 mg/dl). Serum salicylate in a group of 27 age-matched, community-matched control children collected consecutively over the period 1978-80 was less than 2 mg/dl, and children with varicella or influenza had salicylate concentrations indistinguishable from apparently well classmates or siblings. It is impossible to determine from this data whether salicylates are involved in the aetiology of or in determining the outcome of Reye's disease. Increased concentrations of salicylates at admission could be the result of excessive dosage because of a greater severity of the prodromal illness, or to diminished excretion because of impaired hepatic metabolism. It seems likely that serum salicylate concentrations entered the toxic range in many patients with Reye's disease before they presented for treatment. Most had been vomiting and had diminished oral intake for 33-55 h before hospital admission. Since the average number of hours from the beginning of vomiting to admission was no different in non-comatose and comatose cases, the time at which salicylate concentration was measured in relation to the last dose was probably similar in the two groups and therefore does not account for the higher levels in children with poor outcome. Salicylates are mitochondrial toxins and mitochondria are known to be significantly injured in Reye's disease; therefore, it seems wise to avoid the use of aspirin in children during outbreaks of Reye's disease.

Topics: Biopsy; Child; Humans; Kinetics; Liver; Mitochondria, Liver; Oxidative Phosphorylation; Reye Syndrome; Salicylates; Vomiting

To evaluate the relative severity of acute vs chronic salicylate poisoning in children, 112 cases (65 acute and 47 chronic) of salicylate poisoning (salicylate concentration greater than or equal to 20 mg/100 ml) admitted to The Children's Hospital Medical Center in Boston and Primary Children's Medical Center in Salt Lake City between the years 1967 and 1978 were analyzed. Hyperventilation (P less than .01), dehydration (P less than .001), and severe central nervous system manifestations (P less than .001) occurred more frequently in the chronic group and remained more frequent (P less than .01) when patients having disease states capable of producing these signs and symptoms were removed from statistical analysis. At three separate salicylate concentration ranges (20 to 39, 40 to 59, and greater than or equal to 60 mg/100 ml) hyperventilation, dehydration, and severe CNS manifestations tended to occur with greater frequency in the chronic group. When severity of salicylate poisoning was categorized based on a combination of signs and symptoms, mild cases occurred more frequently in the chronic group. Finally, systemic acidosis (pH less than 7.32) was found more frequently in the chronic group (P less than .01), more frequently in patients with severe manifestations than in those with mild manifestations, and in patients with dehydration (P less than .01) and severe CNS manifestations (P less than .05). Based on the variables evaluated, chronic salicylism produces a greater morbidity than does acute salicylate poisoning in the pediatric patient.

Topics: Acidosis; Acute Disease; Adolescent; Central Nervous System Diseases; Child; Child, Preschool; Chronic Disease; Dehydration; Female; Humans; Hyperventilation; Infant; Male; Nausea; Salicylates; Vomiting

52 outpatients with rheumatoid arthritis or osteoarthritis were given benorylate (as the 40% suspension) in doses of up to 8 g daily. Peroids of medication were varied but some patients were given the drug for nearly 2 years. Assessments of clinical progress were made at regular intervals by recording both subjective and objective measurements including duration of morning stiffness, grip strength, joint size. Laboratory investigations include renal function tests, liver function tests, blood picture and occult blood. No serious side effect, attributable to benorylate was reported and it was concluded that the drug is satisfactory for the long term treatment of rheumatic diseases.

Topics: Arthritis, Rheumatoid; Blood Sedimentation; Drug Evaluation; Dyspepsia; Humans; Nausea; Osteoarthritis; Rheumatic Diseases; Salicylates; Urea; Vomiting

Aspirin dosages calculated from published pharmacokinetic data were tested in 3 male and 3 female Basset Hounds. Emesis occurred frequently after dosing at the rate of 50 mg/kg of body weight, a dosage that would be required for a convenient 12-hour dosing interval. A dosage of 25 mg/kg every 12 hours avoided emesis but did not maintain serum salicylate concentrations within the desired range of 10 to 30 mg/100 ml. A dosage of 25 mg/kg every 8 hours resulted in serum salicylate concentrations varying from 12.5 to 17.8 mg/100 ml. It was concluded that a maintenance dosage of 25 to 35 mg/kg every 8 hours in optimal for the dog, based on extrapolation of data obtained in man.

Topics: Administration, Oral; Animals; Aspirin; Dog Diseases; Dogs; Female; Male; Salicylates; Time Factors; Vomiting

Topics: Alanine Transaminase; Aspartate Aminotransferases; Chemical and Drug Induced Liver Injury; Eosinophilia; Feeding and Eating Disorders; Humans; Nausea; Salicylates; Vomiting

Topics: Acute Disease; Adult; Barbiturates; Charcoal; Coma; Emergency Service, Hospital; First Aid; Humans; Intensive Care Units; Poisoning; Psychology; Respiratory Function Tests; Salicylates; Shock; Vomiting

Topics: Adrenal Gland Diseases; Alkalosis; Amino Acids; Burns; Diabetes Insipidus; Diarrhea; Diet, Sodium-Restricted; Dietary Fats; Dietary Proteins; Diuretics; Endocrine System Diseases; Gastrointestinal Diseases; Glucose; Humans; Infusions, Parenteral; Kidney Diseases; Parenteral Nutrition; Salicylates; Sodium Chloride; Vomiting; Water-Electrolyte Balance

Topics: Acute Disease; Antidotes; Charcoal; Child, Preschool; Copper; Dimercaprol; Edetic Acid; Humans; Mycotoxins; Nicotine; Petroleum; Poison Control Centers; Poisoning; Salicylates; Vomiting

Topics: Adult; Emetics; Gastric Lavage; Humans; Poisoning; Salicylates; Vomiting

Topics: Acute Disease; Amphetamine; Aspirin; Barbiturates; Dialysis; Diuresis; Gastric Lavage; Half-Life; Humans; Hydrogen-Ion Concentration; Intestinal Absorption; Poisoning; Salicylates; Vomiting

Topics: Acid-Base Equilibrium; Child; Gastric Lavage; Gastrointestinal Hemorrhage; Humans; Hypotonic Solutions; Poisoning; Salicylates; Vomiting

Topics: Animals; Apomorphine; Cerebral Ventricles; Cevanes; Copper; Dogs; Female; Gelatin; Male; Ouabain; Parasympathomimetics; Pilocarpine; Salicylates; Sodium; Sulfates; Vomiting

In the dog, the emetic ED50 for sodium salicylate was 256+/-113 mg/kg for the intravenous route with a mean latency of 10.4+/-3.96 min, and for the oral route 228+/-68 mg/kg with a mean latency of 18.2+/-2.63 min. Values are means with standard errors. Ablation of the emetic chemoreceptor trigger-zone gave complete protection against the emetic action of 300 mg of sodium salicylate intravenously but only partial protection against the emetic action of the same dose of sodium salicylate orally. Either the intravenous salicylate acted on the trigger-zone or ablation of the trigger-zone interfered with afferent nerves from peripheral receptors responding to intravenous salicylate and which were different from the receptors responding to oral salicylate. After supradiaphragmatic vagotomy, there was equal protection against intravenous and oral salicylate. Two explanations can be advanced. First, the receptors responding to intravenous and those responding to oral salicylate have a common path in the vagus nerves; or second, afferent fibres in the vagus nerve normally maintain the vomiting centre in a reactive state. When these fibres are cut any other afferent fibres become less effective in evoking vomiting. Spinal transection gave partial and spinal transection with vagotomy gave complete protection. It is concluded that further work is necessary to decide which of the two explanations obtained.

Topics: Animals; Dogs; Emetics; Medulla Oblongata; Pharmacology; Research; Salicylates; Sensory Receptor Cells; Sodium Salicylate; Vagotomy; Vagus Nerve; Vomiting

Topics: Salicylates; Stomach; Therapeutic Irrigation; Vomiting