Clinical Toxicology Case 3
CLINICAL TOXICOLOGY LABORATORY
CONSON, JULIHRENE MICAR M. November 28, 2013
BS PHARMACY 4
CASE NO. 3. Jeh, a 21 year old female was brought to the ER in generalized seizures.
On query, she was found sprawled on the floor, unresponsive despite her dorm mate’s efforts to wake her by shaking her and slapping her cheeks. Vomitus and unknown white tablets (INH) were littered around her. It took 15 minutes to reach the ER. During transport, aides claimed she went into active seizures twice with upward rolling of eyeballs, stiffening of extremities followed by jerky movements and increased salivation. Upon entering the ER, she went into active seizures again. How do you manage the patient?
Initial Vital signs:
Blood pressure 140/90 Normal Valves
Circulatory rate 110
Respiratory rate 22
Temperature 37 oC
I. PROPERTIES: ISONIAZID
Odorless colorless or white crystals or white crystalline powder. Taste is slightly sweet at first and then bitter. pH (1% aqueous solution) 5.5-6.5. pH (5% aqueous solution) 6-8.
INH is a chemical synthetic molecule (Meyer and Nelly,1912), a pyridine derivative of nicotinamide.
Chemical name: isonicotinic acid hydrazide, Molecular formula: C6H7N3O, Molecular weight: 137.14
Solubility: 1 g in 8 g water, 1 g in 50 mL alcohol; slightly soluble in chloroform and very slightly soluble in ether. A 10% solution has a pH of 6.0 to 8.0.
The solution for parenteral injection is a clear, colourless liquid. The pH ranges between 5.6 and 6.0 (B.P. injection) or between 6.0 and 7.0 (U.S.P. injection).
It is recommended that sugars such as glucose, fructose and sucrose should not be used in INH preparations because the absorption of the drug is impaired by the formation of a condensation product. Sorbitol might be a suitable substitute.
Absorption: T max is 1 to 2 h. Distribution: Diffuses readily into cerebrospinal, pleural, and ascitic fluids, tissues, organs, saliva, sputum, feces, placental barrier, and in breast milk.
CONSON, JULIHRENE MICAR M. November 28, 2013
BS PHARMACY 4
CASE NO. 3. Jeh, a 21 year old female was brought to the ER in generalized seizures.
On query, she was found sprawled on the floor, unresponsive despite her dorm mate’s efforts to wake her by shaking her and slapping her cheeks. Vomitus and unknown white tablets (INH) were littered around her. It took 15 minutes to reach the ER. During transport, aides claimed she went into active seizures twice with upward rolling of eyeballs, stiffening of extremities followed by jerky movements and increased salivation. Upon entering the ER, she went into active seizures again. How do you manage the patient?
Initial Vital signs:
Blood pressure 140/90 Normal Valves
Circulatory rate 110
Respiratory rate 22
Temperature 37 oC
I. PROPERTIES: ISONIAZID
Odorless colorless or white crystals or white crystalline powder. Taste is slightly sweet at first and then bitter. pH (1% aqueous solution) 5.5-6.5. pH (5% aqueous solution) 6-8.
INH is a chemical synthetic molecule (Meyer and Nelly,1912), a pyridine derivative of nicotinamide.
Chemical name: isonicotinic acid hydrazide, Molecular formula: C6H7N3O, Molecular weight: 137.14
Solubility: 1 g in 8 g water, 1 g in 50 mL alcohol; slightly soluble in chloroform and very slightly soluble in ether. A 10% solution has a pH of 6.0 to 8.0.
The solution for parenteral injection is a clear, colourless liquid. The pH ranges between 5.6 and 6.0 (B.P. injection) or between 6.0 and 7.0 (U.S.P. injection).
It is recommended that sugars such as glucose, fructose and sucrose should not be used in INH preparations because the absorption of the drug is impaired by the formation of a condensation product. Sorbitol might be a suitable substitute.
Absorption: T max is 1 to 2 h. Distribution: Diffuses readily into cerebrospinal, pleural, and ascitic fluids, tissues, organs, saliva, sputum, feces, placental barrier, and in breast milk.