[Hypotensive cardio-circulatory failure and metabolic acidosis after suicidal intoxication with trimipramine and quetiapine. Case report and background]

A systematic review of cardiovascular effects after atypical antipsychotic medication overdose

As the use of atypical antipsychotic medications (AAPMs) increases, the number of overdoses continues to grow. Cardiovascular toxicity was common with older psychiatric medications but seems uncommon with AAPM. We conducted a systematic literature review to describe the cardiovascular effects reported after overdose of 5 common AAPM: aripiprazole, olanzapine, quetiapine, risperidone, and ziprasidone. We included case reports and case series describing overdose of these 5 medications identified in a search of MEDLINE, EMBASE, and abstracts from major toxicology meetings. We found 13 pediatric cases (age, <7 years), 22 adolescent cases (age, 7-16 years), and 185 adult cases. No pediatric case described a ventricular dysrhythmia or a cardiovascular death. In the adolescent and adult cases, we found numerous reports of prolonged corrected QT interval and hypotension, but there were only 3 cases of ventricular dysrhythmia and 3 deaths that may have been due to direct cardiovascular toxicity. The results from case series reports were similar to the single case report data. Our review suggests that overdose of AAPM is unlikely to cause significant cardiovascular toxicity.

Enhanced antioxidant bioactivity of Salvia miltiorrhiza (Danshen) products prepared using nanotechnology

The traditional Chinese medicine, Salvia miltiorrhiza (Danshen), promotes blood circulation and relieves blood stasis, also demonstrating good antioxidant activity. In the present study, therefore, the antioxidant activities of medicinal plant materials prepared using nanotechnology or traditional grinding methods were compared using three biological assays. It was found that the nanotechnology preparation had stronger antioxidant bioactivities. Complementary quantitative analysis of four active constituents, salvianolic acid B, cryptotanshinone, tanshinone I and tanshinone IIA, by HPLC revealed only marked differences for salvianolic acid B. The results indicate that the polar active constituent in the nanotechnology samples was released faster compared to the traditionally powdered samples.

Surface Modification of Silica Core−Shell Nanocapsules: Biomedical Implications

In this article we present the synthesis of oil core silica shell nanocapsules with different shell thicknesses. The surface of the nanocapsules was modified with polyethyleoxide (PEO) and succinic anhydride. Two biomedical tests were then used to study the biocompatibility properties of these nanocapsules with different surface treatments, hemolysis and thromboelastography (TEG). PEO surface modification greatly reduced the damaging interactions of nanocapsules with red blood cells (RBCs) and platelets and attenuated particle size effects. It was found that the blood toxicity of charged particles increased with the acid strength on the surface. Experiments toward the assessment of detoxification of these nanocapsules in model drug overdose concentrations are currently underway.

[Cholinesterase inhibitors. Importance in anaesthesia, intensive care medicine, emergency medicine and pain therapy]

Many drugs currently used in anaesthesia practice modify cholinergic transmission, therefore, acetylcholinesterase inhibitors are a part of anaesthetic pharmacology. Besides its well established use in the antagonism of neuromuscular blockades and the therapy of central anticholinergic syndrome (CAS), results of controlled studies and case reports suggest other favourable indications such as the prevention and therapy of postanaesthetic shivering and the treatment of various types of intoxication and delirium. Cholinesterase inhibitors may also have analgesic properties. This review summarises the pharmacological and physiological background and describes favourable indications of this class of drugs.