Halise Akça

Evaluation of the Colchicine Poisoning Cases in a Pediatric Intensive Care Unit: Five Year Study

BACKGROUNDnColchicine poisoning is an uncommon but serious form of drug intoxication. It may produce life-threatening systemic effects. In toxic doses it produces nausea and vomiting and bone marrow suppression, often leading to sepsis, hypocalcemia, adult respiratory distress syndrome, and direct cardiotoxic effects.nnnOBJECTIVEnThe aim of this study was to describe demographic features and the outcome of patients poisoned with colchicine.nnnMETHODSnA retrospective study of the pediatric intensive care unit database was performed for patients ≤18xa0years of age who had colchicine poisoning between July 2008 and July 2013.nnnRESULTSnThe total number of patients with drug poisoning in the study period was 144. Nine of 144 were related to colchicine poisoning. The median age was 4xa0years (range 20xa0months to 16xa0years) and the number of females was five. Six of the nine cases presented after ingesting <0.5xa0mg/kg, whereas two patients had consumed 0.5 to 0.8xa0mg/kg. One patient had received colchicine >0.8xa0mg/kg. Three patients died.nnnCONCLUSIONSnAmong drug intoxications, colchicines can lead to severe clinical conditions. All patients suspected of having colchicine intoxication should be managed in the pediatric intensive care unit regardless of the actual degree of poisoning.

Nebulized Epinephrine Treatment in Pediatric Emergency Department

Epinephrine, first isolated around 1900, is the main sympathomimetic agent released by the adrenal gland. It plays an integral role in the treatment of several diseases in the emergency department. It effects on alpha and beta adrenergic receptors. In lower doses, it usually causes systemic and pulmonary vasodilatation, with some increase in heart rate and stroke volume. A high dose causes intense systemic vasoconstriction. Its metabolism is rapid and half-life is less than 5 minutes.