RESUMEN
Six cases of toxic ingestion of clonidine hydrochloride are reviewed. Apnea, respiratory depression, and rhythm disturbances were more frequent in our patients than in those previously reported; hypotension and bradycardia occurred at a similar frequency. Satisfactory management consisted of close attention to vital signs and judicious treatment of specific physiologic abnormalities. Atropine effectively corrected bradycardia. Tolazoline was found to be ineffective in reversing symptoms and signs of clonidine overdosage. Hypotension was managed by volume expansion, and if necessary, by a continuous infusion of dopamine. Naloxone, although not used in our patients, may be of both diagnostic and therapeutic value in treating clonidine overdosage.
Asunto(s)
Clonidina/envenenamiento , Atropina/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Carbón Orgánico/uso terapéutico , Preescolar , Coma/inducido químicamente , Coma/terapia , Dopamina/uso terapéutico , Urgencias Médicas , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Lactante , Ipeca/uso terapéutico , Masculino , Norepinefrina/uso terapéutico , Respiración/efectos de los fármacos , Sulfitos/uso terapéutico , Tolazolina/uso terapéuticoRESUMEN
Twenty preterm infants recovering from respiratory distress syndrome at 1 week of age were randomized in this study either to a control or a treatment group. Those treated received a single daily dose of furosemide (1 mg/kg) intravenously. Pulmonary compliance was observed to improve significantly at two hours in the treated group, as compared with that in the controls. The calculated alveolar-arterial oxygen gradient was noted to decrease two hours after furosemide and to remain decreased over the four-day period in the treated group. This improvement in lung function was not secondary to diuresis in the infants treated with furosemide. We conclude that furosemide may have a direct pulmonary effect and improve lung function acutely as well as with chronic administration.
Asunto(s)
Furosemida/uso terapéutico , Síndrome de Dificultad Respiratoria del Recién Nacido/tratamiento farmacológico , Humanos , Recién Nacido , Rendimiento Pulmonar/efectos de los fármacos , Distribución Aleatoria , Respiración/efectos de los fármacosRESUMEN
Twenty-five children with the diagnosis of acute glomerulonephritis were treated with oral or intravenous doses of furosemide. The intravenous administration of 1 mg/kg or greater resulted in an increase in urine volume in all patients. Oral doses of less than 2 mg/kg were not as effective, but there was wide variation in diuretic response to the drug. In 13 patients, plasma concentrations of furosemide were measured. The plasma half-life varied from 2.3 to 4.4 hours after intravenous administration of the drug. The plasma concentration of furosemide did not correlate with diuretic response.