https://ogma.newcastle.edu.au/vital/access/ /manager/Index en-au 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:14545 Wed 11 Apr 2018 10:59:06 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7558 Sat 24 Mar 2018 08:42:05 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7361 100) occurred on 44 occasions (56%) and hypotension only twice. There were no seizures, dysrhythmias or deaths. Multivariate analysis of 215 presentations (in 181 patients) where dose of promethazine ingested was known demonstrated that dose, administration of charcoal within 2 h and co-ingestants predicted whether patients developed delirium. No relationship was shown for sex and age. A plot of probability that a patient will develop delirium vs. dose was constructed which showed the probability of delirium for 250 mg was 31%, 500 mg was 42% and for 1 g was 55% for promethazine alone overdoses. Conclusion: The main feature of promethazine toxicity is delirium, the probability of which can be predicted from the dose ingested. The administration of charcoal and the presence of co-ingestants appears to reduce the probability of delirium in a predictable manner.]]> Sat 24 Mar 2018 08:40:19 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7163 Sat 24 Mar 2018 08:34:20 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:14405 1000 U/L) and treatment (single dose-activated charcoal [SDAC] and NAC) were analysed. Data were analysed within a repeated measures logistic regression framework using NONMEM (ver 7.2). The primary outcome was administration of NAC, which was determined based on a serum paracetamol concentration greater than the nomogram line. Result.: There were 1571 admissions in 1303 patients, with a median age of 27 years (12–96 years) and 1140 (73%) were females. The median dose was 10 g (1–100 g). The paracetamol concentration was above the nomogram line in 337 of 1571 (22%) patients. Patients presenting later (first paracetamol concentration between 7 and 16 h post-overdose) compared to those presenting earlier (4–7 h post-overdose) were more likely to have hepatotoxicity (5.5% vs. 0.4%; p < 0.0001), have a toxic paracetamol concentration (34% vs. 18%; p  0.0001) and receive NAC (48% vs. 23%; p < 0.0001). SDAC reduced the probability of the paracetamol concentration being above the nomogram. Based on SDAC not being administered there was a 5% probability of requiring NAC at a dose of 6–9 g, a 10% chance of requiring NAC at a dose of 13–16 g, a 50% chance of requiring NAC at a dose of 30–34 g and a 90% chance for needing NAC at 48–50 g. Conclusion. Reported dose was a good predictor of a toxic paracetamol concentration and SDAC reduced the probability of the concentration being above the nomogram. These predictions may assist in determining which patients could be started on NAC immediately.]]> Sat 24 Mar 2018 08:24:53 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:14378 1 Despite the availability of numerous methods for assessing the risk of TdP on the basis of the presence of QT prolongation,^2-5few studies have investigated the direct relationship between the magnitude of QT prolongation and the risk of TdP. Previous studies have generally considered the presence or absence of QT prolongation as a marker of the potential risk for TdP. In addition, they investigated data arising from a range of different drugs, with differing intrinsic cardiotoxic effects. This carries the potential for confounding of the relationship between the magnitude of prolongation of the QT interval and the inherent cardiotoxicity of the drug. Amisulpride is an atypical antipsychotic drug used to treat both the positive and negative symptoms of schizophrenia. It has affinity for limbic D₂ and D₃ receptors and only slight affinity for serotonergic, cholinergic, adrenergic, and histaminergic receptors.⁶ An overdose of the drug has been reported to cause QT prolongation and TdP.⁷ The aim of this study was to investigate whether the magnitude of QT prolongation is a better predictor of TdP than either the occurrence of QT prolongation per se or the dose of the drug. This was investigated in a case series of drug overdose events involving amisulpride.]]> Sat 24 Mar 2018 08:23:08 AEDT ]]>