Phenytoin Toxicity from Cocaine Adulteration

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Phenytoin Toxicity from Cocaine Adulteration

The use of phenytoin (PHT) as a cocaine adulterant was reported decades ago; that practice is still current. Ironically PHT has also been used for the treatment of cocaine dependence. A drug smuggler developed PHT toxicity after swallowing several rocks of crack. We investigated the current trends of PHT as a cocaine adulterant and its toxicological implications. We also reviewed the clinical u...

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Acute visual dysfunction following phenytoin-induced toxicity.

PURPOSE To report that acute phenytoin toxicity may result in acute visual dysfunction. METHODS A 19-year old man with cryptogenic simple partial and secondary generalized epilepsy developed blurred vision and xanthopsia after phenytoin loading for status epilepticus. Color blindness was found on testing with Ishihara's pseudo-isochromatic charts and visual fields (Goldmann perimeter) showed ...

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Mechanisms of acute cocaine toxicity.

Patients with acute cocaine poisoning present with life-threatening symptoms involving several organ systems. While the effects of cocaine are myriad, they are the result of a limited number of cocaine-protein interactions, including monoamine transporters, neurotransmitter receptors and voltage-gated ion channels. These primary interactions trigger a cascade of events that ultimately produce t...

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In-vitro lymphocyte toxicity to a phenytoin metabolite in phenytoin induced cutaneous adverse drug eruptions.

BACKGROUND Phenytoin, one of the most commonly used antiepileptic drug, is associated with a wide spectrum of adverse drug eruptions. It is metabolized by the hepatic microsomal enzymes. The intermediate metabolites are arene oxides which accumulate due to deficiency of the enzyme epoxide hydrolase. These are postulated to be associated with phenytoin induced hepatotoxicity and antiepileptic hy...

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Phenytoin toxicity associated with hypoalbuminemia in critically ill patients.

Four critically ill patients developed phenytoin toxicity. Hypoalbuminemia or concomitant displacing drugs resulted in an increased fraction of unbound drug. Clinical findings included gradual decrease in level of consciousness and cerebellar signs. Marked phenytoin toxicity can occur in critically ill patients with hypoalbuminemia and can often be detected only by direct measurement of free ph...

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ژورنال

عنوان ژورنال: Western Journal of Emergency Medicine

سال: 2014

ISSN: 1936-900X,1936-9018

DOI: 10.5811/westjem.2013.12.20010