Christine Payen
Lyon College
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Featured researches published by Christine Payen.
Human & Experimental Toxicology | 2003
Christine Payen; A Dachraoui; Corine Pulce; Jacques Descotes
The association between paracetamol overdose and prolonged prothrombin time due to hepatic failure is well recognized. However, little is known of the possibility that paracetamol overdose can prolong the prothrombin time without overt hepatic failure. The few data from the literature suggest this is either due to a reduction in the functional levels of the vitamin K-dependent clotting factors by elevated doses of paracetamol, or a consequence of the administration of the antidote N-acetylcystein. The three reported cases provide further evidence that paracetamol overdose can be associated with a prolongation in the prothrombin time without overt hepatic failure. Even though the prothrombin time provides useful prognosis information, decisions regarding the management of these patients should not solely be based on this endpoint to avoid misinterpretation of the accuracy and the severity of liver failure.
Human & Experimental Toxicology | 2004
Christine Payen; P Frantz; O Martin; F Parant; M Moulsma; C Pulce; Jacques Descotes
As valpromide is a prodrug of valproic acid (valproate), the clinical presentation of overdoses with either valpromide or valproate sodium is generally considered similar. Whereas plasma peak levels and signs of central nervous system depression occur within a few hours after the acute ingestion of regular-release forms of valproate sodium, delayed toxicity and time to peak levels following valpromide ingestion can be seen as shown by the three reported cases. They were initially considered as mild because patients presented with no or only moderate symptoms and serum valproate levels were below or at therapeutic levels on admission more than 3 hours post-ingestion in two of the three patients. Serum valproate levels were not monitored until marked deterioration more than 10 hours after ingestion. At the time of deterioration, serum valproate was at toxic level in the three reported cases. Therefore, large intake of valpromide should be closely monitored because no or moderate symptoms together with low plasma levels in the first few hours after ingestion do not exclude a subsequent severe intoxication. Despite the usual favourable outcome and the poor correlation between plasma levels and toxic symptoms, patients should not be discharged until plasma levels are documented to remain at low levels for at least 10 hours after the ingestion of valpromide and the patient asymptomatic.
Human & Experimental Toxicology | 2011
Alexandra Boucher; Christine Payen; Christelle Garayt; Hervé Ibanez; Anne Dieny; Christophe Doche; Christine Chuniaud; Jacques Descotes
Salbutamol is a short-acting agonist of the β2 adrenergic receptors sometimes misused or abused, which can result in various cardiovascular adverse effects. We report one case of fatal salbutamol misuse or abuse in a 36-year-old poorly controlled female asthmatic patient with a past medical history of alcoholism and a recent smoking cessation. She died shortly after hospital admission following acute dyspnea and sudden collapse at home. Toxicological analyses evidenced salbutamol overdose, and necropsy showed acute lung edema and marked dysplasia of the right ventricle and revealed the patient was pregnant. The involvement of an initial disorder of the ventricular rhythm leading to cardiac failure is suggested by the presence of several combined pro-arrhythmogenic factors, such as arrhythmogenic right ventricle dysplasia, hypoxemia related to bronchospasm and salbutamol overdose.
Human & Experimental Toxicology | 2011
Christine Payen; Arnaud Dellinger; Corine Pulce; Vincent Cirimele; Vincent Carbonnel; Pascal Kintz; Jacques Descotes
Suicide by ingestion of barium is exceptionally rare. Adverse health effects depend on the solubility of the barium compound. Severe hypokalemia, which generally occurs within 2 hours after ingestion, is the predominating feature of acute barium toxicity, subsequently leading to adverse effects on muscular activity and cardiac automaticity. We report one case of acute poisoning with barium nitrate, a soluble barium compound. A 75-year-old woman was hospitalized after suicidal ingestion of a burrow mole fumigant containing 12.375 g of barium nitrate. About 1 hour post-ingestion, she was only complaining of abdominal pain. The ECG recording demonstrated polymorphic ventricular premature complexes (VPCs). Laboratory data revealed profound hypokalemia (2.1 mmol/L). She made a complete and uneventful recovery after early and massive potassium supplementation combined with oral magnesium sulphate to prevent barium nitrate absorption.
Clinical Toxicology | 2008
Christine Payen; Luc Monnin; Corine Pulce; Jacques Descotes
Acute poisonings involving chloroquine are common in sharp contrast to those involving proguanil, another antimalarial drug. A 39-year-old woman ingested a combination of 11.2 g chloroquine and 22.4 g proguanil (i.e., 112 tablets of the commercial product Savarine®). She presented with cardiovascular disorders typically associated with chloroquine overdose, but unexpectedly bone marrow aplasia developed on day 3 post-ingestion that required granulocyte-colony stimulating factor administration, and recovered on days 10–14. Toxicological analysis evidenced both chloroquine and proguanil in the patients serum and ruled out the involvement of any major myelotoxic drug. This is seemingly the first report of bone marrow aplasia following acute poisoning with chloroquine and proguanil. The antifolinic effect of proguanil is hypothesized to have potentiated the still debated myelotoxicity of chloroquine in this patient.
Archives De Pediatrie | 2011
Christine Payen; S. Cossa; D. Riethmuller; G. Picod; D. Clair; Jacques Descotes
Severe but regressive toxic liver damage was observed in a 30-week pregnant woman due to acetaminophen poisoning. A cesarean section was performed 1 week later for suspected chorioamniotitis and the patient gave birth to an infant who only experienced complications of preterm birth. The lack of fetal liver damage following acute maternal paracetamol poisoning seems to be the rule, as shown by a review of the literature.
Journal of Clinical Toxicology | 2014
Christine Payen; Jean-Marc Thouret; Jacques Descotes; Thierry Vial
Exenatide, a glucagon-like peptide-1 (GPL-1) receptor agonist, was quite recently approved as adjunctive therapy to improve glycemia control in type 2 diabetes patients. There is very limited information on overdose consequences. We report 3 cases of exenatide overdose involving 2 suicidal self-injections associated with psychotropic intake and one medication error. Two patients rapidly experienced gastro-intestinal symptoms and none of them presented severe hypoglycemia, which is in accordance with the known biological activity of GLP-1 that acts in a glucose-dependent manner and does not inhibit glucagon release in case of hypoglycemia. Interestingly one patient, who ingested large amounts of psychotropic drugs together with self-injection of a large dose (600 μg) of exenatide, presented unexpected delayed onset of central nervous system (CNS) symptoms whereas no hypoglycemia was experienced and no neurological feature is anticipated from exenatide exposure. Physicians should be aware of exenatide property to inhibit gastric emptying which can delay symptoms of acute poisoning due to co-ingested drugs.
American Journal of Emergency Medicine | 2010
Christine Payen; Christian Combe; Catherine Le Meur; Yvan Gaillard; Corine Pulce; Jacques Descotes
American Journal of Emergency Medicine | 2010
Charlotte Girard; Christine Payen; Xavier Tchenio; Laurent Holzapfel; Jacques Descotes
Therapie | 2007
Céline Zagagnoni; Sylvia Colomb; Bernard Claud; François Brenas; Anne-Marie Patat; Christine Payen; Patrick Frantz; Jacques Descotes