Source:http://www4.wiwiss.fu-berlin.de/dailymed/resource/dailymed/overdosage
| Subject | Object |
|---|---|
| dailymed-drugs:4127 |
None known.
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| dailymed-drugs:2 |
Chronic overdosage may result in signs/symptoms of hypercorticism (see PRECAUTIONS: General). Inhalation by healthy volunteers of a single dose of 4,000 mcg of fluticasone propionate inhalation powder or single doses of 1,760 or 3,520 mcg of fluticasone propionate inhalation aerosol was well tolerated. Doses of 1,320 mcg administered to healthy human volunteers twice daily for 7 to 15 days were also well tolerated. Repeat oral doses up to 80 mg daily for 10 days in healthy volunteers and repeat oral doses up to 20 mg dailyfor 42 days in patients were well tolerated. Adverse reactions were of mild or moderate severity, and incidences were similar in active and placebo treatment groups. The oral and subcutaneous median lethal doses in mice and rats were>1,000 mg/kg (>2,000 and>4,100 times, respectively, the maximum recommended daily inhalation dose in adults and>9,600 and>20,000 times, respectively, the maximum recommended daily inhalation dose in children on a mg/mbasis).
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| dailymed-drugs:3 |
Nadolol can be removed from the general circulation by hemodialysis. In addition to gastric lavage, the following measures should be employed, as appropriate. In determining the duration of corrective therapy, note must be taken of the long duration of the effect of nadolol.<br/>Excessive Bradycardia: Administer atropine (0.25 to 1 mg). If there is no response to vagal blockade, administer isoproterenol cautiously.<br/>Cardiac Failure: Administer a digitalis glycoside and diuretic. It has been reported that glucagon may also be useful in this situation.<br/>Hypotension: Administer vasopressors, e.g., epinephrine or norepinephrine. (There is evidence that epinephrine may be the drug of choice.)<br/>Bronchospasm: Administer a beta-stimulating agent and/or a theophylline derivative.
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| dailymed-drugs:4 |
The maximum amount of Kepivance that can be safely administered in a single dose has not been determined. Single doses of 250 mcg/kg have been administered intravenously to 8 healthy volunteers without severe or serious adverse effects. Five of 14 patients receiving six doses of 80 mcg/kg/day administered intravenously over 2 weeks (three doses preceding and three doses following myeloablative chemotherapy/TBI) experienced serious or severe adverse events. These events were consistent with those observed at the recommended dose but were generally more severe.
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| dailymed-drugs:5 |
Acute emergencies from local anesthetics are generally related to high plasma levels encountered during therapeutic use of local anesthetics or to unintended subarachnoid injection of local anesthetic solution.<br/>Management of Local Anesthetic Emergencies: The first consideration is prevention, best accomplished by careful and constant monitoring of cardiovascular and respiratory vital signs and the patient's state of consciousness after each local anesthetic injection. At the first sign of change, oxygen should be administered. The first step in the management of systemic toxic reactions, as well as underventilation or apnea due to unintentional subarachnoid injection of drug solution, consists of immediate attention to the establishment and maintenance of a patent airway and effective assisted or controlled ventilation with 100% oxygen with a delivery system capable of permitting immediate positive airway pressure by mask. This may prevent convulsions if they have not already occurred. If necessary, use drugs to control the convulsions. A 50 mg to 100 mg bolus IV injection of succinylcholine will paralyze the patient without depressing the central nervous or cardiovascular systems and facilitate ventilation. A bolus IV dose of 5 mg to 10 mg of diazepam or 50 mg to 100 mg of thiopental will permit ventilation and counteract central nervous system stimulation, but these drugs also depress central nervous system, respiratory, and cardiac function, add to postictal depression and may result in apnea. Intravenous barbiturates, anticonvulsant agents, or muscle relaxants should only be administered by those familiar with their use. Immediately after the institution of these ventilatory measures, the adequacy of the circulation should be evaluated. Supportive treatment of circulatory depression may require administration of intravenous fluids, and when appropriate, a vasopressor dictated by the clinical situation (such as ephedrine or epinephrine to enhance myocardial contractile force). Endotracheal intubation, employing drugs and techniques familiar to the clinician may be indicated after initial administration of oxygen by mask, if difficulty is encountered in the maintenance of patent airway or if prolonged ventilatory support (assisted or controlled) is indicated. Recent clinical data from patients experiencing local anesthetic induced convulsions demonstrated rapid development of hypoxia, hypercarbia, and acidosis within a minute of the onset of convulsions. These observations suggest that oxygen consumption and carbon dioxide production are greatly increased during local anesthetic convulsions and emphasize the importance of immediate and effective ventilation with oxygen which may avoid cardiac arrest. If not treated immediately, convulsions with simultaneous hypoxia, hypercarbia, and acidosis, plus myocardial depression from the direct effects of the local anesthetic may result in cardiac arrhythmias, bradycardia, asystole, ventricular fibrillation, or cardiac arrest. Respiratory abnormalities, including apnea, may occur. Underventilation or apnea due to unintentional subarachnoid injection of local anesthetic solution may produce these same signs and also lead to cardiac arrest if ventilatory support is not instituted. If cardiac arrest should occur, standard cardiopulmonary resuscitative measures should be instituted and maintained for a prolonged period if necessary. Recovery has been reported after prolonged resuscitative efforts. The supine position is dangerous in pregnant women at term because of aortocaval compression by the gravid uterus. Therefore, during treatment of systemic toxicity, maternal hypotension, or fetal bradycardia following regional block, the parturient should be maintained in the left lateral decubitus position if possible, or manual displacement of the uterus off the great vessels should be accomplished. The mean seizure dosage of mepivacaine in rhesus monkeys was found to be 18.8 mg/kg with mean arterial plasma concentration of 24.4��g/mL. The intravenous and subcutaneous LDin mice is 23 mg/kg to 35 mg/kg and 280 mg/kg respectively.
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| dailymed-drugs:6 |
With total doses exceeding 0.4 mg/kg of body weight for a single course, severe leukopenia, anemia, thrombocytopenia and a hemorrhagic diathesis with subsequent delayed bleeding may develop. Death may follow. The only treatment in instances of excessive dosage appears to be repeated blood product transfusions, antibiotic treatment of complicating infections and general supportive measures.The intravenous LDof MUSTARGEN is 2 mg/kg and 1.6 mg/kg in the mouse and rat, respectively.The oral LDfor mechlorethamine hydrochloride is 20 mg/kg and 10 mg/kg in the mouse and rat, respectively.
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| dailymed-drugs:7 |
There have been reports of overdosage with fluconazole. A 42-year-old patient infected with human immunodeficiency virus developed hallucinations and exhibited paranoid behavior after reportedly ingesting 8200 mg of fluconazole. The patient was admitted to the hospital, and his condition resolved within 48 hours. In the event of overdose, symptomatic treatment (with supportive measures and gastric lavage if clinically indicated) should be instituted. Fluconazole is largely excreted in urine. A three-hour hemodialysis session decreases plasma levels by approximately 50%. In mice and rats receiving very high doses of fluconazole, clinical effects in both species included decreased motility and respiration, ptosis, lacrimation, salivation, urinary incontinence, loss of righting reflex and cyanosis; death was sometimes preceded by clonic convulsions.
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| dailymed-drugs:557 |
There have been reports of overdosage with fluconazole. A 42-year-old patient infected with human immunodeficiency virus developed hallucinations and exhibited paranoid behavior after reportedly ingesting 8200 mg of fluconazole. The patient was admitted to the hospital, and his condition resolved within 48 hours. In the event of overdose, symptomatic treatment (with supportive measures and gastric lavage if clinically indicated) should be instituted. Fluconazole is largely excreted in urine. A three-hour hemodialysis session decreases plasma levels by approximately 50%. In mice and rats receiving very high doses of fluconazole, clinical effects in both species included decreased motility and respiration, ptosis, lacrimation, salivation, urinary incontinence, loss of righting reflex and cyanosis; death was sometimes preceded by clonic convulsions.
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| dailymed-drugs:586 |
There have been reports of overdosage with fluconazole. A 42-year-old patient infected with human immunodeficiency virus developed hallucinations and exhibited paranoid behavior after reportedly ingesting 8200 mg of fluconazole. The patient was admitted to the hospital, and his condition resolved within 48 hours. In the event of overdose, symptomatic treatment (with supportive measures and gastric lavage if clinically indicated) should be instituted. Fluconazole is largely excreted in urine. A three-hour hemodialysis session decreases plasma levels by approximately 50%. In mice and rats receiving very high doses of fluconazole, clinical effects in both species included decreased motility and respiration, ptosis, lacrimation, salivation, urinary incontinence, loss of righting reflex and cyanosis; death was sometimes preceded by clonic convulsions.
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| dailymed-drugs:617 |
There have been reports of overdosage with fluconazole. A 42-year-old patient infected with human immunodeficiency virus developed hallucinations and exhibited paranoid behavior after reportedly ingesting 8200 mg of fluconazole. The patient was admitted to the hospital, and his condition resolved within 48 hours. In the event of overdose, symptomatic treatment (with supportive measures and gastric lavage if clinically indicated) should be instituted. Fluconazole is largely excreted in urine. A three-hour hemodialysis session decreases plasma levels by approximately 50%. In mice and rats receiving very high doses of fluconazole, clinical effects in both species included decreased motility and respiration, ptosis, lacrimation, salivation, urinary incontinence, loss of righting reflex and cyanosis; death was sometimes preceded by clonic convulsions.
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| dailymed-drugs:1786 |
There have been reports of overdosage with fluconazole. A 42-year-old patient infected with human immunodeficiency virus developed hallucinations and exhibited paranoid behavior after reportedly ingesting 8200 mg of fluconazole. The patient was admitted to the hospital, and his condition resolved within 48 hours. In the event of overdose, symptomatic treatment (with supportive measures and gastric lavage if clinically indicated) should be instituted. Fluconazole is largely excreted in urine. A three-hour hemodialysis session decreases plasma levels by approximately 50%. In mice and rats receiving very high doses of fluconazole, clinical effects in both species included decreased motility and respiration, ptosis, lacrimation, salivation, urinary incontinence, loss of righting reflex and cyanosis; death was sometimes preceded by clonic convulsions.
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| dailymed-drugs:2210 |
There have been reports of overdosage with fluconazole. A 42-year-old patient infected with human immunodeficiency virus developed hallucinations and exhibited paranoid behavior after reportedly ingesting 8200 mg of fluconazole. The patient was admitted to the hospital, and his condition resolved within 48 hours. In the event of overdose, symptomatic treatment (with supportive measures and gastric lavage if clinically indicated) should be instituted. Fluconazole is largely excreted in urine. A three-hour hemodialysis session decreases plasma levels by approximately 50%. In mice and rats receiving very high doses of fluconazole, clinical effects in both species included decreased motility and respiration, ptosis, lacrimation, salivation, urinary incontinence, loss of righting reflex and cyanosis; death was sometimes preceded by clonic convulsions.
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| dailymed-drugs:2513 |
There have been reports of overdosage with fluconazole. A 42-year-old patient infected with human immunodeficiency virus developed hallucinations and exhibited paranoid behavior after reportedly ingesting 8200 mg of fluconazole. The patient was admitted to the hospital, and his condition resolved within 48 hours. In the event of overdose, symptomatic treatment (with supportive measures and gastric lavage if clinically indicated) should be instituted. Fluconazole is largely excreted in urine. A three-hour hemodialysis session decreases plasma levels by approximately 50%. In mice and rats receiving very high doses of fluconazole, clinical effects in both species included decreased motility and respiration, ptosis, lacrimation, salivation, urinary incontinence, loss of righting reflex and cyanosis; death was sometimes preceded by clonic convulsions.
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| dailymed-drugs:3539 |
There have been reports of overdosage with fluconazole. A 42-year-old patient infected with human immunodeficiency virus developed hallucinations and exhibited paranoid behavior after reportedly ingesting 8200 mg of fluconazole. The patient was admitted to the hospital, and his condition resolved within 48 hours. In the event of overdose, symptomatic treatment (with supportive measures and gastric lavage if clinically indicated) should be instituted. Fluconazole is largely excreted in urine. A three-hour hemodialysis session decreases plasma levels by approximately 50%. In mice and rats receiving very high doses of fluconazole, clinical effects in both species included decreased motility and respiration, ptosis, lacrimation, salivation, urinary incontinence, loss of righting reflex and cyanosis; death was sometimes preceded by clonic convulsions.
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| dailymed-drugs:3687 |
There have been reports of overdosage with fluconazole. A 42-year-old patient infected with human immunodeficiency virus developed hallucinations and exhibited paranoid behavior after reportedly ingesting 8200 mg of fluconazole. The patient was admitted to the hospital, and his condition resolved within 48 hours. In the event of overdose, symptomatic treatment (with supportive measures and gastric lavage if clinically indicated) should be instituted. Fluconazole is largely excreted in urine. A three-hour hemodialysis session decreases plasma levels by approximately 50%. In mice and rats receiving very high doses of fluconazole, clinical effects in both species included decreased motility and respiration, ptosis, lacrimation, salivation, urinary incontinence, loss of righting reflex and cyanosis; death was sometimes preceded by clonic convulsions.
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| dailymed-drugs:8 |
Overdosage will not ordinarily cause acute problems. If accidentally ingested, drink fluids to dilute.
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| dailymed-drugs:254 |
Overdosage will not ordinarily cause acute problems. If accidentally ingested, drink fluids to dilute.
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| dailymed-drugs:1230 |
Overdosage will not ordinarily cause acute problems. If accidentally ingested, drink fluids to dilute.
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| dailymed-drugs:1386 |
Overdosage will not ordinarily cause acute problems. If accidentally ingested, drink fluids to dilute.
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| dailymed-drugs:2162 |
Overdosage will not ordinarily cause acute problems. If accidentally ingested, drink fluids to dilute.
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| dailymed-drugs:9 |
In rats subcutaneous administration
of 250 to 500 times the recommended human dose, expressed on a per
body weight basis, resulted in dyspnea, decreased activity, and local
irritation at the injection site. There is no evidence that there
is a clinical counterpart of this phenomenon. In early clinical trials
using daily subcutaneous leuprolide acetate in patients with prostate
cancer, doses as high as 20 mg/day for up to two years caused no adverse
effects differing from those observed with the 1 mg/day dose.
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| dailymed-drugs:10 |
No information is available on overdosage with Betimol. Symptoms that might be expected with an overdose of a beta-adrenergic receptor blocking agent are bronchospasm, hypotension, bradycardia, and acute cardiac failure.
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| dailymed-drugs:11 |
Doses of 2300 mg/kg in the rat and 2400 mg/kg in the mouse produced ataxia, convulsions, labored respiration and frequently death. No case of overdosage has been reported in humans. Limited data indicate that succimer is dialyzable. In case of acute overdosage, induction of vomiting or gastric lavage followed by administration of an activated charcoal slurry and appropriate supportive therapy are recommended.
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| dailymed-drugs:12 |
Human Experience: There is very limited
experience with REMERON' (mirtazapine) Tablets overdose. In premarketing clinical
studies, there were eight reports of REMERON' overdose alone or in combination
with other pharmacological agents. The only drug overdose death reported while
taking REMERON' was in combination with amitriptyline and chlorprothixene in a
non-US clinical study. Based on plasma levels, theREMERON' dose taken was 30���45
mg, while plasma levels of amitriptyline and chlorprothixene were found to be at
toxic levels. All other premarketing overdose cases resulted in full recovery.
Signs and symptoms reported in association with overdose included disorientation,
drowsiness, impaired memory, and tachycardia. There were no reports of ECG
abnormalities, coma or convulsions following overdose with REMERON'
alone.<br/>Overdose Management: Treatment should consist of
those general measures employed in the management of overdose with any drug
effective in the treatment of major depressive disorder. Ensure an adequate
airway, oxygenation, and ventilation. Monitor cardiac rhythm and vital signs.
General supportive and symptomatic measures are also recommended. Induction of
emesis is not recommended. Gastric lavage with a large-bore orogastric tube with
appropriate airway protection, if needed, may be indicated if performed soon after
ingestion, or in symptomatic patients. Activated charcoal should
be administered. There is no experience with the use of forced diuresis, dialysis,
hemoperfusion or exchange transfusion in the treatment of mirtazapine overdosage.
No specific antidotes for mirtazapine are known. In managing overdosage,
consider the possibility of multiple-drug involvement. The physician should
consider contacting a poison control center for additional information on the
treatment of any overdose. Telephone numbers for certified poison control centers
are listed in the Physicians' Desk
Reference (PDR).
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| dailymed-drugs:15 |
Penicillin in overdosage has the potential to cause
neuromuscular hyperirritability or convulsive seizures.
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| dailymed-drugs:17 |
Deaths have been reported from overdose with Amantadine Hydrochloride. The lowest reported acute lethal dose was 1 gram. Because some patients have attempted suicide by overdosing with amantadine, prescriptions should be written for the smallest quantity consistent with good patient management. Acute toxicity may be attributable to the anticholinergic effects of amantadine. Drug overdose has resulted in cardiac, respiratory, renal or central nervous system toxicity. Cardiac dysfunction includes arrhythmia, tachycardia and hypertension. Pulmonary edema and respiratory distress (including adult respiratory distress syndrome���ARDS) have been reported; renal dysfunction including increased BUN, decreased creatinine clearance and renal insufficiency can occur. Central nervous system effects that have been reported include insomnia, anxiety, agitation, aggressive behavior, hypertonia, hyperkinesia, ataxia, gait abnormality, tremor, confusion, disorientation, depersonalization, fear, delirium, hallucinations, psychotic reactions, lethargy, somnolence and coma. Seizures may be exacerbated in patients with prior history of seizure disorders. Hyperthermia has also been observed in cases where a drug overdose has occurred. There is no specific antidote for an overdose of Amantadine Hydrochloride. However, slowly administered intravenous physostigmine in 1 and 2 mg doses in an adultat 1- to 2-hour intervals and 0.5 mg doses in a childat 5- to 10-minute intervals up to a maximum of 2 mg/hour have been reported to be effective in the control of central nervous system toxicity caused by amantadine hydrochloride. For acute overdosing, general supportive measures should be employed along with immediate gastric lavage or induction of emesis. Fluids should be forced, and if necessary, given intravenously. The pH of the urine has been reported to influence the excretion rate of Amantadine Hydrochloride. Since the excretion rate of Amantadine Hydrochloride increases rapidly when the urine is acidic, the administration of urine acidifying drugs may increase the elimination of the drug from the body. The blood pressure, pulse, respiration and temperature should be monitored. The patient should be observed for hyperactivity and convulsions; if required, sedation, and anticonvulsant therapy should be administered. The patient should be observed for the possible development of arrhythmias and hypotension; if required, appropriate antiarrhythmic and antihypotensive therapy should be given. Electrocardiographic monitoring may be required after ingestion, since malignant tachyarrhythmias can appear after overdose. Care should be exercised when administering adrenergic agents, such as isoproterenol, to patients with a Amantadine Hydrochloride overdose, since the dopaminergic activity of Amantadine Hydrochloride has been reported to induce malignant arrhythmias. The blood electrolytes, urine pH and urinary output should be monitored. If there is no record of recent voiding, catheterization should be done.
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| dailymed-drugs:18 |
In case of real or suspected overdose, seek medical attention or contact a Poison Control Center immediately. Careful medical management is essential. Based upon the known hemodynamic effects of dipyridamole, symptoms such as warm feeling, flushes, sweating, restlessness, feeling of weakness and dizziness may occur. A drop in blood pressure and tachycardia might also be observed. Symptomatic treatment is recommended, possibly including a vasopressor drug. Gastric lavage should be considered. Administration of xanthine derivatives (e.g., aminophylline) may reverse the hemodynamic effects of dipyridamole overdose. Since dipyridamole is highly protein bound, dialysis is not likely to be of benefit.
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| dailymed-drugs:20 |
Doses of 1440 to 4280 mg/kg of quinapril cause significant lethality in mice and rats. No specific information is available on the treatment of overdosage with quinapril. The most likely clinical manifestation would be symptoms attributable to severe hypotension. Laboratory determinations of serum levels of quinapril and its metabolites are not widely available, and such determinations have, in any event, no established role in the management of quinapril overdose. No data are available to suggest physiological maneuvers (e.g., maneuvers to change pH of the urine) that might accelerate elimination of quinapril and its metabolites. Hemodialysis and peritoneal dialysis have little effect on the elimination of quinapril and quinaprilat. Angiotensin II could presumably serve as a specific antagonist-antidote in the setting of quinapril overdose, but angiotensin II is essentially unavailable outside of scattered research facilities. Because the hypotensive effect of quinapril is achieved through vasodilation and effective hypovolemia, it is reasonable to treat quinapril overdose by infusion of normal saline solution.
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| dailymed-drugs:22 |
In the event of a fluid or solute overload during parenteral therapy, reevaluate the patient's condition and institute appropriate corrective treatment. In the event of overdosage with potassium-containing solutions, discontinue the infusion immediately and institute corrective therapy to reduce serum potassium levels. Treatment of hyperkalemia includes the following:
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| dailymed-drugs:23 |
Overdosage of
combination hormonal contraceptives may cause nausea, vomiting, vaginal
bleeding, or other menstrual irregularities. Given the nature and design
of NuvaRing' it is unlikely that overdosage will occur. If NuvaRing' is
broken, it does not release a higher dose of hormones. Serious ill
effects have not been reported following acute ingestion of large doses
of oral contraceptives by young children. There are no antidotes and
further treatment should be symptomatic.
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| dailymed-drugs:27 |
Human Experience:<br/>Overdose Management:
|
| dailymed-drugs:864 |
Human Experience:<br/>Overdose Management:
|
| dailymed-drugs:878 |
Human Experience:<br/>Overdose Management:
|
| dailymed-drugs:2594 |
Human Experience:<br/>Overdose Management:
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| dailymed-drugs:28 |
In the event of overhydration or solute overload, re-evaluate
the patient and institute appropriate corrective measures. See WARNINGS and
PRECAUTIONS.
|
| dailymed-drugs:245 |
In the event of overhydration or solute overload, re-evaluate
the patient and institute appropriate corrective measures. See WARNINGS and
PRECAUTIONS.
|
| dailymed-drugs:629 |
In the event of overhydration or solute overload, re-evaluate
the patient and institute appropriate corrective measures. See WARNINGS and
PRECAUTIONS.
|
| dailymed-drugs:902 |
In the event of overhydration or solute overload, re-evaluate
the patient and institute appropriate corrective measures. See WARNINGS and
PRECAUTIONS.
|
| dailymed-drugs:1253 |
In the event of overhydration or solute overload, re-evaluate
the patient and institute appropriate corrective measures. See WARNINGS and
PRECAUTIONS.
|
| dailymed-drugs:1329 |
In the event of overhydration or solute overload, re-evaluate
the patient and institute appropriate corrective measures. See WARNINGS and
PRECAUTIONS.
|
| dailymed-drugs:1494 |
In the event of overhydration or solute overload, re-evaluate
the patient and institute appropriate corrective measures. See WARNINGS and
PRECAUTIONS.
|
| dailymed-drugs:1877 |
In the event of overhydration or solute overload, re-evaluate
the patient and institute appropriate corrective measures. See WARNINGS and
PRECAUTIONS.
|
| dailymed-drugs:2008 |
In the event of overhydration or solute overload, re-evaluate
the patient and institute appropriate corrective measures. See WARNINGS and
PRECAUTIONS.
|
| dailymed-drugs:2710 |
In the event of overhydration or solute overload, re-evaluate
the patient and institute appropriate corrective measures. See WARNINGS and
PRECAUTIONS.
|
| dailymed-drugs:2982 |
In the event of overhydration or solute overload, re-evaluate
the patient and institute appropriate corrective measures. See WARNINGS and
PRECAUTIONS.
|
| dailymed-drugs:3083 |
In the event of overhydration or solute overload, re-evaluate
the patient and institute appropriate corrective measures. See WARNINGS and
PRECAUTIONS.
|
| dailymed-drugs:3301 |
In the event of overhydration or solute overload, re-evaluate
the patient and institute appropriate corrective measures. See WARNINGS and
PRECAUTIONS.
|
| dailymed-drugs:3919 |
In the event of overhydration or solute overload, re-evaluate
the patient and institute appropriate corrective measures. See WARNINGS and
PRECAUTIONS.
|
| dailymed-drugs:4256 |
In the event of overhydration or solute overload, re-evaluate
the patient and institute appropriate corrective measures. See WARNINGS and
PRECAUTIONS.
|
| dailymed-drugs:30 |
Overdose following clopidogrel
administration may lead to prolonged bleeding time and subsequent
bleeding complications. A single oral dose of clopidogrel at 1500
or 2000 mg/kg was lethal to mice and to rats and at 3000 mg/kg to
baboons. Symptoms of acute toxicity were vomiting (in baboons), prostration,
difficult breathing, and gastrointestinal hemorrhage in all species.<br/>Recommendations About Specific Treatment:: Based on biological
plausibility, platelet transfusion may be appropriate to reverse the
pharmacological effects of PLAVIX if quick reversal is required.
|
| dailymed-drugs:32 |
There have been cases, some fatal, of amiodarone overdose. Effects of an inadvertent overdose of amiodarone are hypotension, cardiogenic shock, bradycardia, AV block, and hepatotoxicity. Hypotension and cardiogenic shock should be treated by slowing the infusion rate or with standard therapy: vasopressor drugs, positive inotropic agents, and volume expansion. Bradycardia and AV block may require temporary pacing. Hepatic enzyme concentrations should be monitored closely. Amiodarone is not dialyzable.
|
| dailymed-drugs:33 |
Oral doses of nystatin in excess of five million units daily have caused nausea and gastrointestinal upset. There have been no reports of serious toxic effects of superinfections .
|
| dailymed-drugs:3163 |
Oral doses of nystatin in excess of five million units daily have caused nausea and gastrointestinal upset. There have been no reports of serious toxic effects of superinfections .
|
| dailymed-drugs:3629 |
Oral doses of nystatin in excess of five million units daily have caused nausea and gastrointestinal upset. There have been no reports of serious toxic effects of superinfections .
|
| dailymed-drugs:35 |
Symptoms following acute NSAID overdose are usually limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, which are generally reversible with supportive care. Gastrointestinal bleeding can occur and coma has occurred following massive ibuprofen or mefenamic-acid overdose. Hypertension, acute renal failure, and respiratory depression may occur but are rare. Anaphylactoid reactions have been reported with therapeutic ingestion of NSAIDs, and may occur following overdose. Patients should be managed by symptomatic and supportive care following an NSAID overdose. There are no specific antidotes. Emesis and/or activated charcoal (60 to 100 g in adults, 1 to 2 g/kg in children) and/or osmotic cathartic may be indicated in patients seen within 4 hours of ingestion with symptoms or following a large overdose (5 to 10 times the usual dose). Forced diuresis, alkalinization of the urine, hemodialysis, or hemoperfusion would probably not be useful due to etodolac's high protein binding.
|
| dailymed-drugs:1359 |
Symptoms following acute NSAID overdose are usually limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, which are generally reversible with supportive care. Gastrointestinal bleeding can occur and coma has occurred following massive ibuprofen or mefenamic-acid overdose. Hypertension, acute renal failure, and respiratory depression may occur but are rare. Anaphylactoid reactions have been reported with therapeutic ingestion of NSAIDs, and may occur following overdose. Patients should be managed by symptomatic and supportive care following an NSAID overdose. There are no specific antidotes. Emesis and/or activated charcoal (60 to 100 g in adults, 1 to 2 g/kg in children) and/or osmotic cathartic may be indicated in patients seen within 4 hours of ingestion with symptoms or following a large overdose (5 to 10 times the usual dose). Forced diuresis, alkalinization of the urine, hemodialysis, or hemoperfusion would probably not be useful due to etodolac's high protein binding.
|
| dailymed-drugs:2757 |
Symptoms following acute NSAID overdose are usually limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, which are generally reversible with supportive care. Gastrointestinal bleeding can occur and coma has occurred following massive ibuprofen or mefenamic-acid overdose. Hypertension, acute renal failure, and respiratory depression may occur but are rare. Anaphylactoid reactions have been reported with therapeutic ingestion of NSAIDs, and may occur following overdose. Patients should be managed by symptomatic and supportive care following an NSAID overdose. There are no specific antidotes. Emesis and/or activated charcoal (60 to 100 g in adults, 1 to 2 g/kg in children) and/or osmotic cathartic may be indicated in patients seen within 4 hours of ingestion with symptoms or following a large overdose (5 to 10 times the usual dose). Forced diuresis, alkalinization of the urine, hemodialysis, or hemoperfusion would probably not be useful due to etodolac's high protein binding.
|
| dailymed-drugs:36 |
Geocillin is generally nontoxic. Geocillin when taken in excessive amounts may produce mild gastrointestinal irritation. The drug is rapidly excreted in the urine and symptoms are transitory. The usual symptoms of anaphylaxis may occur in hypersensitive individuals. Carbenicillin blood levels achievable with Geocillin are very low, and toxic reactions as a function of overdosage should not occur systematically. The oral LDin mice is 3,600 mg/kg, in rats 2,000 mg/kg, and in dogs is in excess of 500 mg/kg. The lethal human dose is not known. Although never reported, the possibility of accumulation of indanyl should be considered when large amounts of Geocillin are ingested. Free indole, which is a phenol derivative, may be potentially toxic. In general 8���15 grams of phenol, and presumably a similar amount of indole, are required orally before toxicity (peripheral vascular collapse) may occur. The metabolic by products of indole are nontoxic. In patients with hepatic failure it may be possible for unmetabolized indole to accumulate. The metabolic by-products of Geocillin, indanyl sulfate and glucuronide, as well as free carbenicillin, are dialyzable.
|
| dailymed-drugs:38 |
In U.S. phase 1 trials, single doses of up to 345 mg/mof irinotecan were administered to patients with various cancers. Single doses of up to 750 mg/mof irinotecan have been given in non-U.S. trials. The adverse events in these patients were similar to those reported with the recommended dosage and regimen. There have been reports of overdosage at doses up to approximately twice the recommended therapeutic dose, which may be fatal. The most significant adverse reactions reported were severe neutropenia and severe diarrhea. There is no known antidote for overdosage of Irinotecan Hydrochloride Injection. Maximum supportive care should be instituted to prevent dehydration due to diarrhea and to treat any infectious complications.
|
| dailymed-drugs:39 |
No studies on overdosage have been conducted in humans. In the case of overdosage, PROMETRIUM Capsules should be discontinued and the patient should be treated symptomatically.
|
| dailymed-drugs:40 |
There is no known antidote to TIKOSYN; treatment of overdose should therefore be symptomatic and supportive. The most prominent manifestation of overdosage is likely to be excessive prolongation of the QT interval. In cases of overdose cardiac monitoring should be initiated. Charcoal slurry may be given soon after overdosing but has been useful only when given within 15 minutes of TIKOSYN administration. Treatment of torsade de pointes or overdose may include administration of isoproterenol infusion, with or without cardiac pacing. Administration of intravenous magnesium sulfate may be effective in the management of torsade de pointes. Close medical monitoring and supervision should continue until the QT interval returns to normal levels. Isoproterenol infusion into anesthetized dogs with cardiac pacing rapidly attenuates the dofetilide-induced prolongation of atrial and ventricular effective refractory periods in a dose-dependent manner. Magnesium sulfate, administered prophylactically either intravenously or orally in a dog model, was effective in the prevention of dofetilide-induced torsade de pointes ventricular tachycardia. Similarly, in man, intravenous magnesium sulfate may terminate torsade de pointes, irrespective of cause. TIKOSYN overdose was rare in clinical studies; there were two reported cases of TIKOSYN overdose in the oral clinical program. One patient received very high multiples of the recommended dose (28 capsules), was treated with gastric aspiration 30 minutes later, and experienced no events. One patient inadvertently received two 500 mcg doses one hour apart and experienced ventricular fibrillation and cardiac arrest 2 hours after the second dose. In the supraventricular arrhythmia population only 38 patients received doses greater than 500 mcg BID, all of whom received 750 mcg BID irrespective of creatinine clearance. In this very small patient population the incidence of torsade de pointes was 10.5% (4/38 patients), and the incidence of new ventricular fibrillation was 2.6% (1/38 patients).
|
| dailymed-drugs:41 |
In the event of overhydration or solute overload,
re-evaluate the patient and institute appropriate corrective measures.
See WARNINGS and PRECAUTIONS.
|
| dailymed-drugs:154 |
In the event of overhydration or solute overload,
re-evaluate the patient and institute appropriate corrective measures.
See WARNINGS and PRECAUTIONS.
|
| dailymed-drugs:3032 |
In the event of overhydration or solute overload,
re-evaluate the patient and institute appropriate corrective measures.
See WARNINGS and PRECAUTIONS.
|
| dailymed-drugs:42 |
Reports of acute
toxicity and/or death following overdosage of glucocorticoids are rare.
In the event of overdosage, no specific antidote is available; treatment
is supportive and symptomatic. The oral
LDof dexamethasone in female mice was 6.5 g/kg. The
intravenous LDof dexamethasone sodium phosphate in female
mice was 794 mg/kg.
|
| dailymed-drugs:43 |
Acute emergencies from local anesthetics are generally
related to high plasma levels encountered during therapeutic use of
local anesthetics or to unintended subarachnoid injection of local
anesthetic solution. (See ADVERSE REACTIONS, WARNINGS, and PRECAUTIONS.) Management of Local Anesthetic
Emergencies: The first consideration is prevention, best
accomplished by careful and constant monitoring of cardiovascular
and respiratory vital signs and the patient's state of consciousness
after each local anesthetic injection. At the first sign of change,
oxygen should be administered. The first step in the management of systemic toxic
reactions, as well as underventilation or apnea due to unintentional
subarachnoid injection of drug solution, consists of immediate attention
to the establishment and maintenance of a patent airway and effective
assisted or controlled ventilation with 100% oxygen with a delivery
system capable of permitting immediate positive airway pressure by mask. This may prevent
convulsions if they have not already occurred. If necessary, use drugs to control the convulsions. A 50 mg to 100
mg bolus IV injection of succinylcholine will paralyze the patient
without depressing the central nervous or cardiovascular systems and
facilitate ventilation. A bolus IV dose of 5 mg to 10 mg of diazepam
or 50 mg to 100 mg of thiopental will permit ventilation and counteract
central nervous system stimulation, but these drugs also depress central
nervous system, respiratory, and cardiac function, add to postictal
depression and may result in apnea. Intravenous barbiturates, anticonvulsant
agents, or muscle relaxants should only be administered by those familiar
with their use. Immediately after the institution of these ventilatory
measures, the adequacy of the circulation should be evaluated. Supportive
treatment of circulatory depression may require administration of
intravenous fluids, and when appropriate, a vasopressor dictated by
the clinical situation (such as ephedrine or epinephrine to enhance
myocardial contractile force). Endotracheal
intubation, employing drugs and techniques familiar to the clinician,
may be indicated after initial administration of oxygen by mask if
difficulty is encountered in the maintenance of a patent airway, or
if prolonged ventilatory support (assisted or controlled) is indicated. Recent clinical data from patients experiencing local
anesthetic-induced convulsions demonstrated rapid development of hypoxia,
hypercarbia, and acidosis with bupivacaine within a minute of the
onset of convulsions. These observations suggest that oxygen consumption
and carbon dioxide production are greatly increased during local anesthetic
convulsions and emphasize the importance of immediate and effective
ventilation with oxygen which mayavoid cardiac arrest. If not treated immediately, convulsions with simultaneous
hypoxia, hypercarbia, and acidosis plus myocardial depression from
the direct effects of the local anesthetic may result in cardiac arrhythmias,
bradycardia, asystole, ventricular fibrillation, or cardiac arrest.
Respiratory abnormalities, including apnea, may occur. Underventilation
or apnea due to unintentional subarachnoid injection of local anesthetic
solution may produce these same signs and also leadto cardiac arrest
if ventilatory support is not instituted. If cardiac arrest should occur, successful outcome may require prolonged resuscitative efforts. The supine position is dangerous in pregnant
women at term because of aortocaval compression by the gravid uterus.
Therefore during treatment of systemic toxicity, maternal hypotension
or fetal bradycardia following regional block, the parturient should
be maintained in the left lateral decubitus position if possible,
or manual displacement of the uterus off the great vessels be accomplished. The mean seizure dosage of bupivacaine in rhesus monkeys
was found to be 4.4 mg/kg with mean arterial plasma concentration
of 4.5 mcg/mL. The intravenous and subcutaneous LDin
mice is 6 mg/kg to 8 mg/kg and 38 mg/kg to 54 mg/kg respectively.
|
| dailymed-drugs:45 |
Human Experience: Worldwide exposure to fluoxetine hydrochloride is estimated to be over 38 million patients (circa 1999). Of the 1578 cases of overdose involving fluoxetine hydrochloride, alone or with other drugs, reported from this population, there were 195 deaths. Among 633 adult patients who overdosed on fluoxetine hydrochloride alone, 34 resulted in a fatal outcome, 378 completely recovered, and 15 patients experienced sequelae after overdosage, including abnormal accommodation, abnormal gait, confusion, unresponsiveness, nervousness, pulmonary dysfunction, vertigo, tremor, elevated blood pressure, impotence, movement disorder, and hypomania. The remaining 206 patients had an unknown outcome. The most common signs and symptoms associated with nonfatal overdosage were seizures, somnolence, nausea, tachycardia, and vomiting. The largest known ingestion of fluoxetine hydrochloridein adult patients was 8 grams in a patient who took fluoxetine alone and who subsequently recovered. However, in an adult patient who took fluoxetine alone, an ingestion as low as 520 mg has been associated with lethal outcome,
but causality has not been established. Among pediatric patients (ages 3 months to 17 years), there were 156 cases of overdose involving fluoxetine alone or in combination with other drugs. Six patients died, 127 patients completely recovered, one patient experienced renal failure, and 22 patients had an unknown outcome. One of the six fatalities was a 9 year old boy who had a history of OCD, Tourette's syndrome with tics, attention deficit disorder, and fetal alcohol syndrome. He had been receiving 100 mg of fluoxetine daily for 6 months in addition to clonidine, methylphenidate, and promethazine. Mixed-drug ingestion or other methods of suicide complicated all six overdoses in children that resulted in fatalities. The largest ingestion in pediatric patients was3 grams which was nonlethal. Other important adverse events reported with fluoxetine overdose (single or multiple drugs) include coma, delirium, ECG abnormalities (such as QT interval prolongation and ventricular tachycardia, including Torsades de pointes-type arrhythmias), hypotension, mania, neuroleptic malignant syndrome-like events, pyrexia, stupor, and syncope.<br/>Animal Experience: Studies in animals do not provide precise or necessarily valid information about the treatment of human overdose. However, animal experiments can provide useful insights into possible treatment strategies. The oral median lethal dose in rats and mice was found to be 452 and 248 mg/kg, respectively. Acute high oral doses produced hyperirritability and convulsions in several animal species. Among six dogs purposely overdosed with oral fluoxetine, five experienced grand mal seizures. Seizures stopped immediately upon the bolus intravenous administration of a standard veterinary dose of diazepam. In this short-term study, the lowest plasma concentration at which a seizure occurred was only twice the maximum plasma concentration seen in humans taking 80 mg/day, chronically. In a separate single-dose study, the ECG of dogs given high doses did not reveal prolongation of the PR, QRS, or QT intervals. Tachycardia and an increase in blood pressure were observed. Consequently, the value of the ECG in predicting cardiac toxicity is unknown. Nonetheless, the ECG should ordinarily be monitored in cases of human overdose .<br/>Management of Overdose: Treatment should consist of those general measures employed in the management of overdosage with any drug effective in the treatment of major depressive disorder. Ensure an adequate airway, oxygenation, and ventilation. Monitor cardiac rhythm and vital signs. General supportive and symptomatic measures are also recommended. Induction of emesis is not recommended. Gastric lavage with a large-bore orogastric tube with appropriate airway protection, if needed, may be indicated if performed soon after ingestion, or in symptomatic patients. Activated charcoal should be administered. Due to the large volume of distribution of this drug, forced diuresis, dialysis, hemoperfusion, and exchange transfusion are unlikely to be of benefit. No specific antidotes for fluoxetine are known. A specific caution involves patients who are taking or have recently taken fluoxetine and might ingest excessive quantities of a TCA. In such a case, accumulation of the parent tricyclic and/or an active metabolite may increase the possibility of clinically significant sequelae and extend the time needed for close medical observation . Based on experience in animals, which may not be relevant to humans, fluoxetine-induced seizures that fail to remit spontaneously may respond to diazepam. In managing overdosage, consider the possibility of multiple drug involvement. The physician should consider contacting a poison control center for additional information on the treatment of any overdose. Telephone numbers for certified poison control centers are listed in the Physicians' Desk Reference (PDR).
|
| dailymed-drugs:46 |
There is no specific treatment for granisetron hydrochloride overdosage. In case of overdosage, symptomatic treatment should be given. Overdosage of up to 38.5 mg of granisetron hydrochloride injection has been reported without symptoms or only the occurrence of a slight headache.
|
| dailymed-drugs:827 |
There is no specific treatment for granisetron hydrochloride overdosage. In case of overdosage, symptomatic treatment should be given. Overdosage of up to 38.5 mg of granisetron hydrochloride injection has been reported without symptoms or only the occurrence of a slight headache.
|
| dailymed-drugs:47 |
At dosage levels of diatrizoate sodium above a level containing 45 g of iodine, the incidence of unpleasant side effects increases. At total dosage equivalent to 80 gI or 90 gI administered over a short period of time (eg, 30 minutes), clinical signs of systemic intolerance appear (mostly related to hyperosmolar effects) and are manifest as tremors, irritability, and tachycardia. Above these maximal tolerated dosage levels in otherwise healthy adults, an increasing incidence and severity of dyspnea and pulmonary edema should be expected. Four cases of overdosage in infants, during urography, are reported. Three of the infants died within 19 hours of the injection. The overdose ranged from slightly above the recommended pediatric dosage to a dose exceeding 19 g/kg. The symptoms of overdosage appeared between 10 minutes to several hours after injection of the contrast medium. Adverse effects were life-threatening, affecting mainly the pulmonary and cardiovascular systems. The symptoms included: cyanosis, bradycardia, acidosis, pulmonary hemorrhage, convulsions, coma, and cardiac arrest. All infants showed a poor visualization of the kidneys and a diffuse opacification of all the tissues and vasculature. Autopsy findings showed acute pulmonary damage and/or edema of subcutaneous tissues. Treatment of an overdose of injectable radiopaque contrast media is directed toward the support of all vital functions, and prompt institution of symptomatic therapy. The acute intravenous LD50 of diatrizoate sodium in mice is equivalent in iodine content of 5.3 gI/kg to 8.0 gI/kg and seem to be directly proportional to the rate of injection. Diatrizoate sodium is dialyzable.
|
| dailymed-drugs:48 |
Overdoses of Axid have been reported rarely. The following is provided to serve as a guide should such an overdose be encountered. Signs and Symptoms���There is little clinical experience with overdosage of Axid in humans. Test animals that received large doses of nizatidine have exhibited cholinergic-type effects, including lacrimation, salivation, emesis, miosis, and diarrhea. Single oral doses of 800 mg/kg in dogs and of 1,200 mg/kg in monkeys were not lethal. Intravenous median lethal doses in the rat and mouse were 301 mg/kg and 232 mg/kg respectively. Treatment���To obtain up-to-date information about the treatment of overdose, a good resource is your certified Regional Poison Control Center. Telephone numbers of certified Poison Control Centers are listed in the Physicians' Desk Reference (PDR). In managing overdosage, consider the possibility of multiple drug overdoses, interaction among drugs, and unusual drug kinetics in your patient. If overdosage occurs, use of activated charcoal, emesis, or lavage should be considered along with clinical monitoring and supportive therapy. The ability of hemodialysis to remove nizatidine from the body has not been conclusively demonstrated; however, due to its large volume of distribution, nizatidine is not expected to be efficiently removed from the body by this method.
|
| dailymed-drugs:51 |
There have been only a few instances of deliberate or accidental overdosage with minoxidil tablets. One patient recovered after taking 50 mg of minoxidil together with 500 mg of a barbiturate. When exaggerated hypotension is encountered, it is most likely to occur in association with residual sympathetic nervous system blockade from previous therapy (guanethidine-like effects or alpha-adrenergic blockage), which prevents the usual compensatory maintenance of blood pressure. Intravenous administration of normal saline will help to maintain blood pressure and facilitate urine formation in these patients. Sympathomimetic drugs such as norepinephrine or epinephrine should be avoided because of their excessive cardiac stimulating action. Phenylephrine, angiotensin II, vasopressin, and dopamine all reverse hypotension due to minoxidil, but should only be used if underperfusion of a vital organ is evident. Radioimmunoassay can be performed to determine the concentration of minoxidil in the blood. At the maximum adult dose of 100 mg/day, peak blood levels of 1641 ng/mL and 2441 ng/mL were observed in two patients, respectively. Due to patient-to-patient variation in blood levels, it is difficult to establish an overdosage warning level. In general, a substantial increase above 2000 ng/mL should be regarded as overdosage, unless the physician is aware that the patient has taken no more than the maximum dose. Oral LDin rats has ranged from 1321-3492 mg/kg; in mice, 2456-2648 mg/kg.
|
| dailymed-drugs:52 |
The lethal dose in children is not known. The lethal dose in adults is estimated to be 2 to 5 grams. The initial symptoms are
nystagmus, ataxia and dysarthria. Other signs are tremor, hyperflexia, lethargy, slurred speech, nausea, vomiting. The patient may become comatose and hypertensive. Death is due to
respiratory and circulatory depression. There are marked variations among individuals with respect to phenytoin plasma levels where toxicity may occur. Nystagmus, on lateral gaze, usually appears at 20 mcg/mL, ataxia at 30 mcg/mL, dysarthria and lethargy appear when the plasma
concentration is over 40 mcg/mL, but as high a concentration as 50 mcg/mL has been reported without evidence of toxicity. As much as 25 times the therapeutic dose has been taken to
result in a serum concentration over 100 mcg/mLwith complete recovery.<br/>Treatment: Treatment is nonspecific since there is no known antidote. The adequacy of the respiratory and circulatory systems should be carefully observed and appropriate supportive measures
employed. Hemodialysis can be considered since phenytoin is not completely bound to plasma proteins. Total exchange transfusion has been used in the treatment of severe intoxication
in pediatric patients. In acute overdosage, the possibility of other CNS depressants, including alcohol, should be borne in mind.
|
| dailymed-drugs:53 |
Long-term clinical trials have been conducted with dosages up to 200 mg of CASODEX daily and these dosages have been well tolerated. A single dose of CASODEX that results in symptoms of an overdose considered to be life-threatening has not been established. There is no specific antidote; treatment of an overdose should be symptomatic. In the management of an overdose with CASODEX, vomiting may be induced if the patient is alert. It should be remembered that, in this patient population, multiple drugs may have been taken. Dialysis is not likely to be helpful since CASODEX is highly protein bound and is extensively metabolized. General supportive care, including frequent monitoring of vital signs and close observation of the patient, is indicated.
|
| dailymed-drugs:54 |
Signs and Symptoms: Nausea, vomiting, abdominal pain, pruritus, headache, and increasing lethargy will probably occur within a short time after ingestion; unconsciousness may occur when there is severe hepatic disease. Transient increases in liver enzymes and/or bilirubin may occur. Brownish-red or orange discoloration of the skin, urine, sweat, saliva, tears, and feces will occur, and its intensity is proportional to the amount ingested. Facial or periorbital edema has also been reported in pediatric patients. Hypotension, sinus tachycardia, ventricular arrhythmias, seizures and cardiac arrest were reported in some fatal cases.<br/>Acute Toxicity: The LDof rifampin is approximately 885 mg/kg in the mouse, 1720 mg/kg in the rat, and 2120 mg/kg in the rabbit. The minimum acute lethal or toxic dose is not well established. However, nonfatal acute overdoses in adults have been reported with doses ranging from 9 to 12 gm rifampin. Fatal acute overdoses in adults have been reported with doses ranging from 14 to 60 gm. Alcohol or a history of alcohol abuse was involved in some of the fatal and nonfatal reports. Nonfatal overdoses in pediatric patients ages 1 to 4 years old of 100 mg/kg for one to two doses has been reported.<br/>Treatment: Intensive support measures should be instituted and individual symptoms treated as they arise. Since nausea and vomiting are likely to be present, gastric lavage is probably preferable to induction of emesis. Following evacuation of the gastric contents, the instillation of activated charcoal slurry into the stomach may help absorb any remaining drug from the gastrointestinal tract. Antiemetic medication may be required to control severe nausea and vomiting. Active diuresis (with measured intake and output) will help promote excretion of the drug. Hemodialysis may be of value in some patients.
|
| dailymed-drugs:187 |
Signs and Symptoms: Nausea, vomiting, abdominal pain, pruritus, headache, and increasing lethargy will probably occur within a short time after ingestion; unconsciousness may occur when there is severe hepatic disease. Transient increases in liver enzymes and/or bilirubin may occur. Brownish-red or orange discoloration of the skin, urine, sweat, saliva, tears, and feces will occur, and its intensity is proportional to the amount ingested. Facial or periorbital edema has also been reported in pediatric patients. Hypotension, sinus tachycardia, ventricular arrhythmias, seizures and cardiac arrest were reported in some fatal cases.<br/>Acute Toxicity: The LDof rifampin is approximately 885 mg/kg in the mouse, 1720 mg/kg in the rat, and 2120 mg/kg in the rabbit. The minimum acute lethal or toxic dose is not well established. However, nonfatal acute overdoses in adults have been reported with doses ranging from 9 to 12 gm rifampin. Fatal acute overdoses in adults have been reported with doses ranging from 14 to 60 gm. Alcohol or a history of alcohol abuse was involved in some of the fatal and nonfatal reports. Nonfatal overdoses in pediatric patients ages 1 to 4 years old of 100 mg/kg for one to two doses has been reported.<br/>Treatment: Intensive support measures should be instituted and individual symptoms treated as they arise. Since nausea and vomiting are likely to be present, gastric lavage is probably preferable to induction of emesis. Following evacuation of the gastric contents, the instillation of activated charcoal slurry into the stomach may help absorb any remaining drug from the gastrointestinal tract. Antiemetic medication may be required to control severe nausea and vomiting. Active diuresis (with measured intake and output) will help promote excretion of the drug. Hemodialysis may be of value in some patients.
|
| dailymed-drugs:55 |
Signs and Symptoms���Symptoms of oral overdose may include nausea, vomiting, epigastric distress, diarrhea, and hematuria. If other symptoms are present, it is probably secondary to an underlying disease state, an allergic reaction, or toxicity due to ingestion of a second medication. Treatment���To obtain up-to-date information about the treatment of overdose, a good resource is your certified Regional Poison Control Center. Telephone numbers of certified poison control centers are listed in the Physicians' Desk Reference (PDR). In managing overdosage, consider the possibility of multiple drug overdoses, interaction among drugs, and unusual drug kinetics in your patient. Unless 5 to 10 times the normal dose of cephalexin has been ingested, gastrointestinal decontamination should not be necessary. Protect the patient's airway and support ventilation and perfusion. Meticulously monitor and maintain, within acceptable limits, the patient's vital signs, blood gases, serum electrolytes, etc. Absorption of drugs from the gastrointestinal tract may be decreased by giving activated charcoal, which, in many cases, is more effective than emesis or lavage; consider charcoal instead of or in addition to gastric emptying. Repeated doses of charcoal over time may hasten elimination of some drugs that have been absorbed. Safeguard the patient's airway when employing gastric emptying or charcoal. Forced diuresis, peritoneal dialysis, hemodialysis, or charcoal hemoperfusion have not been established as beneficial for an overdose of cephalexin; however, it would be extremely unlikely that one of these procedures would be indicated. The oral median lethal dose of cephalexin in rats is>5,000 mg/kg.
|
| dailymed-drugs:56 |
Experience with nifedipine overdosage is limited. Generally, overdosage with nifedipine leading to pronounced hypotension calls for active cardiovascular support including monitoring of cardiovascular and respiratory function, elevation of extremities, judicious use of calcium infusion, pressor agents and fluids. Clearance of nifedipine would be expected to be prolonged in patients with impaired liver function. Since nifedipine is highly protein-bound, dialysis is not likely to be of any benefit. There has been one reported case of massive overdosage with nifedipine extended-release tablets. The main effects of ingestion of approximately 4800 mg of nifedipine extended-release in a young man attempting suicide as a result of cocaine-induced depression was initial dizziness, palpitations, flushing, and nervousness. Within several hours of ingestion, nausea, vomiting, and generalized edema developed. No significant hypotension was apparent at presentation, 18 hours post-ingestion. Electrolyte abnormalities consisted of a mild, transient elevation of serum creatinine, and modest elevations of LDH and CPK, but normal SGOT. Vital signs remained stable, no electrocardiographic abnormalities were noted and renal function returned to normal within 24 to 48 hours with routine supportive measures alone. No prolonged sequelae were observed. The effect of a single 900 mg ingestion of nifedipine immediate-release capsules in a depressed anginal patient also on tricyclic antidepressants was loss of consciousness within 30 minutes of ingestion, and profound hypotension, which responded to calcium infusion, pressor agents, and fluid replacement. A variety of ECG abnormalities were seen in this patient with a history of bundle branch block, including sinus bradycardia and varying degrees of AV block. These dictated the prophylactic placement of a temporary ventricular pacemaker, but otherwise resolved spontaneously. Significant hyperglycemia was seen initially in this patient, but plasma glucoselevels rapidly normalized without further treatment. A young hypertensive patient with advanced renal failure ingested 280 mg of nifedipine immediate-release capsules at one time, with resulting marked hypotension responding to calcium infusion and fluids. No AV conduction abnormalities, arrhythmias, or pronounced changes in heart rate were noted, nor was there any further deterioration in renal function.
|
| dailymed-drugs:58 |
Glipizide: Overdosage of sulfonylureas, including glipizide, can produce hypoglycemia. Mild hypoglycemic symptoms, without loss of consciousness or neurological findings, should be treated aggressively with oral glucose and adjustments in drug dosage and/or meal patterns. Close monitoring should continue until the physician is assured that the patient is out of danger. Severe hypoglycemic reactions with coma, seizure, or other neurological impairment occur infrequently, but constitute medical emergencies requiring immediate hospitalization. If hypoglycemic coma is diagnosed or suspected, the patient should be given a rapid intravenous injection of concentrated (50%) glucose solution. This should be followed by a continuous infusion of a more dilute (10%) glucose solution at a rate that will maintain the blood glucose at a level above 100 mg/dL. Patients should be closely monitored for a minimum of 24 to 48 hours, since hypoglycemia may recur after apparent clinical recovery. Clearance of glipizide from plasma would be prolonged in persons with liver disease. Because of the extensive protein binding of glipizide, dialysis is unlikely to be of benefit.<br/>Metformin Hydrochloride: Among cases of overdosage of metformin hydrochloride, including ingestion of amounts greater than 100 grams, hypoglycemia was reported in approximately 10%, but no causal association with metformin hydrochloride has been established, although lactic acidosis has occurred in such circumstances (see WARNINGS). Metformin is dialyzable with a clearance of up to 170 mL/min under good hemodynamic conditions. Therefore, hemodialysis may be useful for removal of accumulated drug from patients in whom metformin overdosage is suspected.
|
| dailymed-drugs:59 |
There is no known antidote to BUSULFEX other than hematopoietic progenitor cell transplantation. In the absence of hematopoietic progenitor cell transplantation, the recommended dosage for BUSULFEX would constitute an overdose of busulfan. The principal toxic effect is profound bone marrow hypoplasia/aplasia and pancytopenia, but the central nervous system, liver, lungs, and gastro intestinal tract may be affected. The hematologic status should be closely monitored and vigorous supportive measures instituted as medically indicated. Survival after a single 140 mg dose of Myleran' Tablets in an 18 kg, 4-year old child has been reported. Inadvertent administration of a greater than normal dose of oral busulfan (2.1 mg/kg; total dose of 23.3 mg/kg) occurred in a 2-year old child prior to a scheduled bone marrow transplant without sequelae. An acute dose of 2.4 g was fatal in a 10-year old boy. There is one report that busulfan is dialyzable, thus dialysis should be considered in the case of overdose. Busulfan is metabolized by conjugation with glutathione, thus administration of glutathione may be considered.
|
| dailymed-drugs:60 |
Magnesium intoxication is manifested by a sharp drop in blood
pressure and respiratory paralysis. Disappearance of the patellar reflex is
a useful clinical sign to detect the onset of magnesium intoxication. In the
event of overdosage artificial ventilation must be provided until a calcium
salt can be injected intravenously to antagonize the effects of magnesium. In
adults intravenous administration of 5 to 10 mEq of 10% calcium gluconate
will usually reverse respiratory depression or heart block due to magnesium
intoxication. In extreme cases, peritoneal or hemodialysis may be required. Hypermagnesemia
in the newborn may require resuscitation and assisted ventilation via endotracheal
intubation or intermittent positive pressure ventilation as well as intravenous
calcium.
|
| dailymed-drugs:61 |
Human Experience: Since the introduction of paroxetine hydrochloride in the United States, 342 spontaneous cases of deliberate or accidental overdosage during paroxetine treatment have been reported worldwide (circa 1999). These include overdoses with paroxetine alone and in combination with other substances. Of these, 48 cases were fatal and of the fatalities, 17 appeared to involve paroxetine alone. Eight fatal cases that documented the amount of paroxetine ingested were generally confounded by the ingestion of other drugs or alcohol or the presence of significant comorbid conditions. Of 145 non-fatal cases with known outcome, most recovered without sequelae. The largest known ingestion involved 2,000 mg of paroxetine (33 times the maximum recommended daily dose) in a patient who recovered. Commonly reported adverse events associated with paroxetine overdosage include somnolence, coma, nausea, tremor, tachycardia, confusion, vomiting, and dizziness. Other notable signs and symptoms observed with overdoses involving paroxetine (alone or with other substances) include mydriasis, convulsions (including status epilepticus), ventricular dysrhythmias (including torsade de pointes), hypertension, aggressive reactions, syncope, hypotension, stupor, bradycardia, dystonia, rhabdomyolysis, symptoms of hepatic dysfunction (including hepatic failure, hepatic necrosis, jaundice, hepatitis, and hepatic steatosis), serotonin syndrome, manic reactions, myoclonus, acute renal failure, and urinary retention.<br/>Overdosage Management: Treatment should consist of those general measures employed in the management of overdosage with any drugs effective in the treatment of major depressive disorder. Ensure an adequate airway, oxygenation, and ventilation. Monitor cardiac rhythm and vital signs. General supportive and symptomatic measures are also recommended. Induction of emesis is not recommended. Gastric lavage with a large-bore orogastric tube with appropriate airway protection, if needed, may be indicated if performed soon after ingestion, or in symptomatic patients. Activated charcoal should be administered. Due to the large volume of distribution of this drug, forced diuresis, dialysis, hemoperfusion and exchange transfusion are unlikely to be of benefit. No specific antidotes for paroxetine are known. A specific caution involves patients who are taking or have recently taken paroxetine who might ingest excessive quantities of a tricyclic antidepressant. In such a case, accumulation of the parent tricyclic and/or an active metabolite may increase the possibility of clinically significant sequelae and extend the time needed for close medical observation (see PRECAUTIONS, Drugs Metabolized by CYP2D6). In managing overdosage, consider the possibility of multiple drug involvement. The physician should consider contacting a poison control center for additional information on the treatment of any overdose. Telephone numbers for certified poison control centers are listed in the Physicians' Desk Reference (PDR).
|
| dailymed-drugs:63 |
Human Experience: Since the introduction of paroxetine in the United States, 342 spontaneous cases of deliberate or accidental overdosage during paroxetine treatment have been reported worldwide (circa 1999). These include overdoses with paroxetine alone and in combination with other substances. Of these, 48 cases were fatal and of the fatalities, 17 appeared to involve paroxetine alone. Eight fatal cases that documented the amount of paroxetine ingested were generally confounded by the ingestion of other drugs or alcoholor the presence of significant comorbid conditions. Of 145 non-fatal cases with known outcome, most recovered without sequelae. The largest known ingestion involved 2,000 mg of paroxetine (33 times the maximum recommended daily dose) in a patient who recovered. Commonly reported adverse events
associated with paroxetine overdosage include somnolence, coma, nausea, tremor,
tachycardia, confusion, vomiting, and dizziness. Other notable signs and symptoms
observed with overdoses involving paroxetine (alone or with other substances)
include mydriasis, convulsions (including status epilepticus), ventricular
dysrhythmias (including torsade de pointes), hypertension, aggressive reactions,
syncope, hypotension, stupor, bradycardia, dystonia, rhabdomyolysis, symptoms
of hepatic dysfunction (including hepatic failure, hepatic necrosis, jaundice,
hepatitis, and hepatic steatosis), serotonin syndrome, manic reactions, myoclonus,
acute renal failure, and urinary retention.<br/>Overdosage Management: Treatment should consist of those general measures employed in the management of overdosage with any drugs effective in the treatment of major depressive disorder. Ensure an adequate airway, oxygenation, and ventilation. Monitor cardiac rhythm and vital signs. General supportive and symptomatic measures are also recommended. Induction of emesis is not recommended. Gastric lavage with a large-bore orogastric tube with appropriate airway protection, if needed, may be indicated if performed soon after ingestion, or in symptomatic patients. Activated charcoal should be administered. Due to the large volume of distribution of this drug, forced diuresis, dialysis, hemoperfusion, and exchange transfusion are unlikely to be of benefit. No specific antidotes for paroxetine are known. A specific caution involves patients who are taking or have recently taken paroxetine who might ingest excessive quantities of a tricyclic antidepressant. In such a case, accumulation of the parent tricyclic and/or an active metabolite may increase the possibility of clinically significant sequelae and extend the time needed for close medical observation (see
PRECAUTIONS
-
Drugs Metabolized by Cytochrome CYP2D6). In managing overdosage, consider the possibility of multiple drug involvement. The physician should consider contacting a poison control center for additional information on the treatment of any overdose. Telephone numbers for certified poison control centers are listed in the Physicians' Desk Reference (PDR).
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| dailymed-drugs:64 |
Symptoms: Bleeding
is the chief sign of heparin overdosage. Nosebleeds, blood in urine or tarry
stools may be noted as the first sign of bleeding. Easy bruising or petechial
formations may precede frank bleeding. Treatment: Neutralization of heparin effect. When clinical
circumstances (bleeding) require reversal of heparinization, protamine sulfate
(1% solution) by slow infusion will neutralize heparin sodium. No
more than 50 mg should be administered, very
slowly in any 10 minute period. Each mg of protamine sulfate neutralizes
approximately 100 USP heparin units. The amount of protamine required decreases
over time as heparin is metabolized. Although the metabolism of heparin is
complex, it may, for the purpose of choosing a protamine dose, be assumed
to have a half-life of about 1/2 hour after intravenous injection. Administration
of protamine sulfate can cause severe hypotensive and anaphylactoid reactions.
Because fatal reactions often resembling anaphylaxis have been reported, the
drug should be given only when resuscitation techniques and treatment of anaphylactoid
shock are readily available. For additional information,
the labeling of Protamine Sulfate Injection, USP products should be consulted. In
the event of overhydration or solute overload, re-evaluate the patient and
institute appropriate corrective measures. See WARNINGS and PRECAUTIONS.
|
| dailymed-drugs:764 |
Symptoms: Bleeding
is the chief sign of heparin overdosage. Nosebleeds, blood in urine or tarry
stools may be noted as the first sign of bleeding. Easy bruising or petechial
formations may precede frank bleeding. Treatment: Neutralization of heparin effect. When clinical
circumstances (bleeding) require reversal of heparinization, protamine sulfate
(1% solution) by slow infusion will neutralize heparin sodium. No
more than 50 mg should be administered, very
slowly in any 10 minute period. Each mg of protamine sulfate neutralizes
approximately 100 USP heparin units. The amount of protamine required decreases
over time as heparin is metabolized. Although the metabolism of heparin is
complex, it may, for the purpose of choosing a protamine dose, be assumed
to have a half-life of about 1/2 hour after intravenous injection. Administration
of protamine sulfate can cause severe hypotensive and anaphylactoid reactions.
Because fatal reactions often resembling anaphylaxis have been reported, the
drug should be given only when resuscitation techniques and treatment of anaphylactoid
shock are readily available. For additional information,
the labeling of Protamine Sulfate Injection, USP products should be consulted. In
the event of overhydration or solute overload, re-evaluate the patient and
institute appropriate corrective measures. See WARNINGS and PRECAUTIONS.
|
| dailymed-drugs:65 |
There have been no reports of toxicity from levocarnitine overdosage.<br/>Metabolic Disorders: Levocarnitine is easily removed from plasma by dialysis. The intravenous LDof levocarnitine in rats is 5.4 g/kg and the oral LDof levocarnitine in mice is 19.2 g/kg. Large doses of levocarnitine may cause diarrhea.
|
| dailymed-drugs:66 |
In the event of a fluid or solute overload during parenteral
therapy, re-evaluate the patient's condition and institute appropriate
corrective treatment. See WARNINGS and PRECAUTIONS.
|
| dailymed-drugs:67 |
Itraconazole is not removed by dialysis. There are limited data on the outcomes of patients ingesting high doses of itraconazole. In patients taking either 1000 mg of SPORANOX (itraconazole) Oral Solution or up to 3000 mg of SPORANOX Capsules, or b.i.d. dosing for four days with SPORANOX Injection, the adverse event profile was similar to that observed at recommended doses.
|
| dailymed-drugs:68 |
Doses of 500, 750, 1,000, and 1,250 mg/m(total dose per cycle over 5 days) have been evaluated clinically in patients. Dose-limiting toxicity was hematologic and was reported with any dose but is expected to be more severe at higher doses. An overdose of 2,000 mg per day for 5 days was taken by one patient and the adverse events reported were pancytopenia, pyrexia, multi-organ failure, and death. There are reports of patients who have taken more than 5 days of treatment (up to 64 days) with adverse events reported including bone marrow suppression, which in some cases was severe and prolonged, and infections and resulted in death. In the event of an overdose, hematologic evaluation is needed. Supportive measures should be provided as necessary.
|
| dailymed-drugs:70 |
Overdosage with colistimethate sodium can cause neuromuscular
blockade characterized by paresthesia, lethargy, confusion, dizziness, ataxia,
nystagmus, disorders of speech and apnea. Respiratory muscle paralysis may
lead to apnea, respiratory arrest and death. Overdosage with the drug can
also cause acute renal failure, manifested as decreased urine output and increases
in serum concentrations of BUN and creatinine. As in
any case of overdose, colistimethate sodium therapy should be discontinued
and general supportive measures should be utilized. It
is unknown whether colistimethate sodium can be removed by hemodialysis or
peritoneal dialysis in overdose cases.
|
| dailymed-drugs:71 |
Human Experience: In clinical trials of citalopram, there were reports of citalopram overdose, including overdoses of up to 2000 mg, with no associated fatalities. During the postmarketing evaluation of citalopram, citalopram overdoses, including overdoses of up to 6000 mg, have been reported. As with other SSRIs, a fatal outcome in a patient who has taken an overdose of citalopram has been rarely reported. Symptoms most often accompanying citalopram overdose, alone or in combination with other drugs and/or alcohol, included dizziness, sweating, nausea, vomiting, tremor, somnolence, and sinus tachycardia. In more rare cases, observed symptoms included amnesia, confusion, coma, convulsions, hyperventilation, cyanosis, rhabdomyolysis, and ECG changes (including QTcprolongation, nodal rhythm, ventricular arrhythmia, and very rare cases of torsades de pointes). Acute renal failure has been very rarely reported accompanying overdose.<br/>Management of Overdose: Establish and maintain an airway to ensure adequate ventilation and oxygenation. Gastric evacuation by lavage and use of activated charcoal should be considered. Careful observation and cardiac and vital sign monitoring are recommended, along with general symptomatic and supportive care. Due to the large volume of distribution of citalopram, forced diuresis, dialysis, hemoperfusion, and exchange transfusion are unlikely to be of benefit. There are no specific antidotes for citalopram. In managing overdosage, consider the possibility of multiple-drug involvement. The physician should consider contacting a poison control center for additional information on the treatment of any overdose.
|
| dailymed-drugs:72 |
Signs and symptoms of overdosage with promethazine HCl range from mild depression of the central nervous system and cardiovascular system to profound hypotension, respiratory depression, unconsciousness, and sudden death. Other reported reactions include hyperreflexia, hypertonia, ataxia, athetosis, and extensor-plantar reflexes (Babinski reflex). Stimulation may be evident, especially in children and geriatric patients. Convulsions may rarely occur. A paradoxical-type reaction has been reported in children receiving single doses of 75 mg to 125 mg orally, characterized by hyperexcitability and nightmares. Atropine-like signs and symptoms-dry mouth, fixed, dilated pupils, flushing, as well as gastrointestinal symptoms, may occur.<br/>Treatment: Treatment of overdosage is essentially symptomatic and supportive. Only in cases of extreme overdosage or individual sensitivity to vital signs, including respiration, pulse, blood pressure, temperature, and EKG, need to be monitored. Activated charcoal orally or by lavage may be given, or sodium or magnesium sulfate orally as a cathartic. Attention should be given to the reestablishment of adequate respiratory exchange through provision of a patent airway and used to control convulsions. Acidosis and electrolyte losses should be corrected. Note that any depressant effects of promethazine HCl are not reversed by naloxone. Avoid analeptics which may cause convulsions. The treatment of choice for resulting hypotension is administration of intravenous fluids, accompanied by repositioning if indicated. In the event that vasopressors are considered for the management of severe hypotension which does not respond to intravenous fluids and repositioning, the administration of norepinephrine or phenylephrine should be considered. EPINEPHRINE SHOULD NOT BE USED, since its use in patients with partial adrenergic blockade may further lower the blood pressure. Extrapyramidal reactions may be treated with anticholinergic antiparkinson agents, diphenhydramine, or barbiturates. Oxygen may also be administered. Limited experience with dialysis indicates that it is not helpful.
|
| dailymed-drugs:75 |
No specific information is available on the treatment
of overdosage with Trecator. If it should occur, standard procedures
to evacuate gastric contents and to support vital functions should
be employed.
|
| dailymed-drugs:76 |
Overdosage by topical
application of ZOVIRAX Cream is unlikely because of minimal systemic
exposure (see CLINICAL PHARMACOLOGY).
|
| dailymed-drugs:77 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:114 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:373 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:619 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:1032 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:1245 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:1384 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:1413 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:1579 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:1597 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:1727 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:1763 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:1914 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:2045 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:2107 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:2430 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:2432 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:2449 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:2524 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:2766 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:3011 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:3072 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:3098 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:3120 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:3343 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:3535 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:3917 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:3926 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:4013 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:4093 |
Topically applied corticosteroids can be absorbed in sufficient amounts to produce systemic effects.
|
| dailymed-drugs:78 |
Topically applied fluticasone propionate ointment can be absorbed in sufficient amounts to produce systemic effects .
|
| dailymed-drugs:4292 |
Topically applied fluticasone propionate ointment can be absorbed in sufficient amounts to produce systemic effects .
|
| dailymed-drugs:79 |
There is limited experience with overdosage. Acute ingestion of up to 20 grams of REBETOL' Capsules, INTRON' A ingestion of up to 120 million units, and subcutaneous doses of INTRON A up to 10 times the recommended doses have been reported. Primary effects that have been observed are increased incidence and severity of the adverse events related to the therapeutic use of INTRON A and REBETOL. However, hepatic enzyme abnormalities, renal failure, hemorrhage, and myocardial infarction have been reported with administration of single subcutaneous doses of INTRON A that exceed dosing recommendations. There is no specific antidote for INTRON A or REBETOL overdose, and hemodialysis and peritoneal dialysis are not effective for treatment of overdose of either agent.
|
| dailymed-drugs:80 |
Human Overdose Experience: Isolated cases of overdose with oxcarbazepine have been reported. The maximum dose taken was approximately 24,000 mg. All patients recovered with symptomatic treatment.<br/>Treatment and Management: There is no specific antidote. Symptomatic and supportive treatment should be administered as appropriate. Removal of the drug by gastric lavage and/or inactivation by administering activated charcoal should be considered.
|
| dailymed-drugs:81 |
Acute mucocutaneous toxicity has been reported in patients receiving
hydroxyurea at dosages several times the therapeutic dose. Soreness, violet
erythema, edema on palms and soles followed by scaling of hands and feet,
severe generalized hyperpigmentation of the skin, and stomatitis have also
been observed.
|
| dailymed-drugs:82 |
The lethal dose in pediatric patients is not known. The lethal dose in adults is estimated to be 2 to 5 grams. The initial symptoms are nystagmus, ataxia, and dysarthria. Other signs are tremor, hyperreflexia, lethargy, slurred speech, nausea, vomiting. The patient may become comatose and hypotensive. Death is due to respiratory and circulatory depression. There are marked variations among individuals with respect to phenytoin plasma levels where toxicity may occur. Nystagmus, on lateral gaze, usually appears at 20 mcg/mL, ataxia at 30 mcg/mL; dysarthria and lethargy appear when the plasma concentration is over 40 mcg/mL, but as high a concentration as 50 mcg/mL has been reported without evidence of toxicity. As much as 25 times the therapeutic dose has been taken to result in a serum concentration over 100 mcg/mL with complete recovery.<br/>Treatment: Treatment is nonspecific since there is no known antidote. The adequacy of the respiratory and circulatory systems should be carefully observed and appropriate supportive measures employed. Hemodialysis can be considered since phenytoin is not completely bound to plasma proteins. Total exchange transfusion has been used in the treatment of severe intoxication in pediatric patients. In acute overdosage the possibility of other CNS depressants, including alcohol, should be borne in mind.
|
| dailymed-drugs:156 |
The lethal dose in pediatric patients is not known. The lethal dose in adults is estimated to be 2 to 5 grams. The initial symptoms are nystagmus, ataxia, and dysarthria. Other signs are tremor, hyperreflexia, lethargy, slurred speech, nausea, vomiting. The patient may become comatose and hypotensive. Death is due to respiratory and circulatory depression. There are marked variations among individuals with respect to phenytoin plasma levels where toxicity may occur. Nystagmus, on lateral gaze, usually appears at 20 mcg/mL, ataxia at 30 mcg/mL; dysarthria and lethargy appear when the plasma concentration is over 40 mcg/mL, but as high a concentration as 50 mcg/mL has been reported without evidence of toxicity. As much as 25 times the therapeutic dose has been taken to result in a serum concentration over 100 mcg/mL with complete recovery.<br/>Treatment: Treatment is nonspecific since there is no known antidote. The adequacy of the respiratory and circulatory systems should be carefully observed and appropriate supportive measures employed. Hemodialysis can be considered since phenytoin is not completely bound to plasma proteins. Total exchange transfusion has been used in the treatment of severe intoxication in pediatric patients. In acute overdosage the possibility of other CNS depressants, including alcohol, should be borne in mind.
|
| dailymed-drugs:85 |
Penicillin in overdosage has the potential to cause neuromuscular hyperirritability. In case of overdosage discontinue medication, treat symptomatically, and institute supportive measures as required. Penicillin G is hemodialyzable.
|
| dailymed-drugs:87 |
Deaths may occur from overdosage with this class of drugs. Multiple drug ingestion (including alcohol) is common in deliberate tricyclic overdose. As the management is complex and changing, it is recommended that the physician contact a poison control center for current information on treatment. Signs and symptoms of toxicity develop rapidly after tricyclic overdose. Therefore, hospital monitoring is required as soon as possible.<br/>Human Experience: In U.S. clinical trials, 2 deaths occurred in 12 reported cases of acute overdosage with ClomiPRAMINE either alone or in combination with other drugs. One death involved a patient suspected of ingesting a dose of 7000 mg. The second death involved a patient suspected of ingesting a dose of 5750 mg. The 10 nonfatal cases involved doses of up to 5000 mg, accompanied by plasma levels of up to 1010 ng/mL. All 10 patients completely recovered. Among reports from other countries of ClomiPRAMINE overdose, the lowest dose associated with a fatality was 750 mg. Based upon postmarketing reports in the United Kingdom, ClomiPRAMINE's lethality in overdose is considered to be similar to that reported for closely related tricyclic compounds marketed as antidepressants.<br/>Manifestations: Signs and symptoms vary in severity depending upon factors such as the amount of drug absorbed, the age of the patient, and the time elapsed since drug ingestion. Critical manifestations of overdose include cardiac dysrhythmias, severe hypotension, convulsions, and CNS depression including coma. Changes in the electrocardiogram, particularly in QRS axis or width, are clinically significant indicators of tricyclic toxicity. Other CNS manifestations may include drowsiness, stupor, ataxia, restlessness, agitation, delirium, severe perspiration, hyperactive reflexes, muscle rigidity, and athetoid and choreiform movements. Cardiac abnormalities may include tachycardia, signs of congestive heart failure, and in very rare cases, cardiac arrest. Respiratorydepression, cyanosis, shock, vomiting, hyperpyrexia, mydriasis, and oliguria or anuria may also be present.<br/>Management: Obtain an ECG and immediately initiate cardiac monitoring. Protect the patient's airway, establish an intravenous line, and initiate gastric decontamination. A minimum of 6 hours of observation with cardiac monitoring and observation for signs of CNS or respiratory depression, hypotension, cardiac dysrhythmias and/or conduction blocks, and seizures is necessary. If signs of toxicity occur at any time during this period, extended monitoring is required. There are case reports of patients succumbing to fatal dysrhythmias late after overdose; these patients had clinical evidence of significant poisoning prior to death and most received inadequate gastrointestinal decontamination. Monitoring of plasma drug levels should not guide management of the patient.<br/>Gastrointestinal Decontamination: All patients suspected of tricyclic overdose should receive gastrointestinal decontamination. This should include large volume gastric lavage followed by activated charcoal. If consciousness is impaired, the airway should be secured prior to lavage. Emesis is contraindicated.<br/>Cardiovascular: A maximal limb-lead QRS duration of���0.10 seconds may be the best indication of the severity of the overdose. Intravenous sodium bicarbonate should be used to maintain the serum pH in the range of 7.45 to 7.55. If the pH response is inadequate, hyperventilation may also be used. Concomitant use of hyperventilation and sodium bicarbonate should be done with extreme caution, with frequent pH monitoring. A pH>7.60 or a pCO<20 mmHg is undesirable. Dysrhythmias unresponsive to sodium bicarbonate therapy/hyperventilation may respond to lidocaine, bretylium, or phenytoin. Type 1A and 1C antiarrhythmics are generally contraindicated (e.g., quinidine, disopyramide, and procainamide). In rare instances, hemoperfusion may be beneficial in acute refractory cardiovascular instability in patients with acute toxicity. However, hemodialysis, peritoneal dialysis, exchange transfusions, and forced diuresis generally have been reported as ineffective in tricyclic poisoning.<br/>CNS: In patients with CNS depression, early intubation is advised because of the potential for abrupt deterioration. Seizures should be controlled with benzodiazepines, or if these are ineffective, other anticonvulsants (e.g., phenobarbital, phenytoin). Physostigmine is not recommended except to treat life-threatening symptoms that have been unresponsive to other therapies, and then only in consultation with a poison control center.<br/>Psychiatric Follow-up: Since overdosage is often deliberate, patients may attempt suicide by other means during the recovery phase. Psychiatric referral may be appropriate.<br/>Pediatric Management: The principles of management of child and adult overdosages are similar. It is strongly recommended that the physician contact the local poison control center for specific pediatric treatment.
|
| dailymed-drugs:90 |
Human experience:In clinical trials, survival has been reported in acute overdoses of up to 30 grams of quetiapine. Most patients who overdosed experienced no adverse events or recovered fully from the reported events. Death has been reported in a clinical trial following an overdose of 13.6 grams of quetiapine alone. In general, reported signs and symptoms were those resulting from an exaggeration of the drug's known pharmacological effects, ie, drowsiness and sedation, tachycardia and hypotension. Patients with pre-existing severe cardiovascular disease may be at an increased risk of the effects of overdose One case, involving an estimated overdose of 9600 mg, was associated with hypokalemia and first degree heart block. In post-marketing experience, there have been very rare reports of overdose of SEROQUEL alone resulting in death, coma, or QTc prolongation.<br/>Management of Overdosage:: In case of acute overdosage, establish and maintain an airway and ensure adequate oxygenation and ventilation. Gastric lavage (after intubation, if patient is unconscious) and administration of activated charcoal together with a laxative should be considered. The possibility of obtundation, seizure or dystonic reaction of the head and neck following overdose may create a risk of aspiration with induced emesis. Cardiovascular monitoring should commence immediately and should include continuous electrocardiographic monitoring to detect possible arrhythmias. If antiarrhythmic therapy is administered, disopyramide, procainamide and quinidine carry a theoretical hazard of additive QT-prolonging effects when administered in patients with acute overdosage of SEROQUEL. Similarly it is reasonable to expect that the alpha-adrenergic-blocking properties of bretylium might be additive to those of quetiapine, resulting in problematic hypotension. There is no specific antidote to SEROQUEL. Therefore appropriate supportive measures should be instituted. The possibility of multiple drug involvement should be considered. Hypotension and circulatory collapse should be treated with appropriate measures such as intravenous fluids and/or sympathomimetic agents (epinephrine and dopamine should not be used, since beta stimulation may worsen hypotension in the setting of quetiapine-induced alpha blockade). In cases of severe extrapyramidal symptoms, anticholinergic medication should be administered. Close medical supervision and monitoring should continue until the patient recovers.
|
| dailymed-drugs:91 |
In an acute toxicology study in rats, death frequently occurred at doses equal to or greater than 10,000 mg/kg.
|
| dailymed-drugs:92 |
Significant mortality was observed in mice at an intravenous dose of 855 mg/kg and in rats at an oral or subcutaneous dose of approximately 2618 mg/kg. In the mice, convulsions and depression were observed. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum.
|
| dailymed-drugs:331 |
Significant mortality was observed in mice at an intravenous dose of 855 mg/kg and in rats at an oral or subcutaneous dose of approximately 2618 mg/kg. In the mice, convulsions and depression were observed. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum.
|
| dailymed-drugs:460 |
Significant mortality was observed in mice at an intravenous dose of 855 mg/kg and in rats at an oral or subcutaneous dose of approximately 2618 mg/kg. In the mice, convulsions and depression were observed. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum.
|
| dailymed-drugs:476 |
Significant mortality was observed in mice at an intravenous dose of 855 mg/kg and in rats at an oral or subcutaneous dose of approximately 2618 mg/kg. In the mice, convulsions and depression were observed. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum.
|
| dailymed-drugs:559 |
Significant mortality was observed in mice at an intravenous dose of 855 mg/kg and in rats at an oral or subcutaneous dose of approximately 2618 mg/kg. In the mice, convulsions and depression were observed. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum.
|
| dailymed-drugs:2858 |
Significant mortality was observed in mice at an intravenous dose of 855 mg/kg and in rats at an oral or subcutaneous dose of approximately 2618 mg/kg. In the mice, convulsions and depression were observed. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum.
|
| dailymed-drugs:3051 |
Significant mortality was observed in mice at an intravenous dose of 855 mg/kg and in rats at an oral or subcutaneous dose of approximately 2618 mg/kg. In the mice, convulsions and depression were observed. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum.
|
| dailymed-drugs:3801 |
Significant mortality was observed in mice at an intravenous dose of 855 mg/kg and in rats at an oral or subcutaneous dose of approximately 2618 mg/kg. In the mice, convulsions and depression were observed. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum.
|
| dailymed-drugs:3808 |
Significant mortality was observed in mice at an intravenous dose of 855 mg/kg and in rats at an oral or subcutaneous dose of approximately 2618 mg/kg. In the mice, convulsions and depression were observed. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum.
|
| dailymed-drugs:4242 |
Significant mortality was observed in mice at an intravenous dose of 855 mg/kg and in rats at an oral or subcutaneous dose of approximately 2618 mg/kg. In the mice, convulsions and depression were observed. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum.
|
| dailymed-drugs:93 |
In cases of overdosage with mefloquine, the symptoms mentioned under ADVERSE REACTIONS may be more pronounced. The following procedure is recommended in case of overdosage: Induce vomiting or perform gastric lavage, as appropriate. Monitor cardiac function (if possible by ECG) and neuropsychiatric status for at least 24 hours. Provide symptomatic and intensive supportive treatment as required, particularly for cardiovascular disturbances.
|
| dailymed-drugs:1041 |
In cases of overdosage with mefloquine, the symptoms mentioned under ADVERSE REACTIONS may be more pronounced. The following procedure is recommended in case of overdosage: Induce vomiting or perform gastric lavage, as appropriate. Monitor cardiac function (if possible by ECG) and neuropsychiatric status for at least 24 hours. Provide symptomatic and intensive supportive treatment as required, particularly for cardiovascular disturbances.
|
| dailymed-drugs:94 |
Symptoms/Treatment: There is no known antidote for ARIXTRA Injection.
Overdose of ARIXTRA may lead to hemorrhagic complications. Overdosage
associated with bleeding complications should lead to treatment discontinuation
and initiation of appropriate therapy. Data
obtained in patients undergoing chronic intermittent hemodialysis
suggest that clearance of ARIXTRA can increase by 20% during hemodialysis.
|
| dailymed-drugs:95 |
The acute oral LD50 for auranofin is 310 mg/kg in adult mice and 265 mg/ kg in adult rats. The minimum lethal dose in rats is 30 mg/kg. In case of acute overdosage, immediate induction of emesis or gastric lavage and appropriate supportive therapy are recommended. Ridaura overdosage experience is limited. A 50-year-old female, previously on 6 mg Ridaura daily, took 27 mg (9 capsules) daily for 10 days and developed an encephalopathy and peripheral neuropathy. Ridaura was discontinued and she eventually recovered. There has been no experience with treating Ridaura overdosage with modalities such as chelating agents. However, they have been used with injectable gold and may be considered for Ridaura overdosage.
|
| dailymed-drugs:96 |
Acute overdosage by intranasal administration is unlikely since ipratropium bromide is not well absorbed systemically after intranasal or oral administration. Following administration of a 20 mg oral dose (equivalent to ingesting more than four bottles of Ipratropium Bromide Nasal Spray 0.03%) to 10 male volunteers, no change in heart rate or blood pressure was noted. Following a 2 mg intravenous infusion over 15 minutes to the same 10 male volunteers, plasma ipratropium concentrations of 22 to 45 ng/mL were observed (>100 times the concentrations observed following intranasal administration). Following intravenous infusion these 10 volunteers had a mean increase of heart rate of 50 bpm and less than 20 mmHg change in systolic or diastolic blood pressure at the time of peak ipratropium levels. Oral median lethal doses of ipratropium bromide were greater than 1,000 mg/kg in mice (approximately 16,000 and 9,500 times the maximum recommended daily intranasal dose in adults and children, respectively, on a mg/mbasis), 1,700 mg/kg in rats (approximately 55,000 and 32,000 times the maximum recommended daily intranasal dose in adults and children, respectively, on a mg/mbasis), and 400 mg/kg in dogs (approximately 43,000 and 25,000 times the maximum recommended daily intranasal dose in adults and children, respectively, on a mg/mbasis).
|
| dailymed-drugs:97 |
Overdosage can lead to acute profound water loss, volume and electrolyte depletion, dehydration, reduction of blood volume and circulatory collapse with a possibility of vascular thrombosis and embolism. Electrolyte depletion may be manifested by weakness, dizziness, mental confusion, anorexia, lethargy, vomiting and cramps. Treatment consists of replacement of fluid and electrolyte losses by careful monitoring of the urine and electrolyte output and serum electrolyte levels.
|
| dailymed-drugs:542 |
Overdosage can lead to acute profound water loss, volume and electrolyte depletion, dehydration, reduction of blood volume and circulatory collapse with a possibility of vascular thrombosis and embolism. Electrolyte depletion may be manifested by weakness, dizziness, mental confusion, anorexia, lethargy, vomiting and cramps. Treatment consists of replacement of fluid and electrolyte losses by careful monitoring of the urine and electrolyte output and serum electrolyte levels.
|
| dailymed-drugs:2590 |
Overdosage can lead to acute profound water loss, volume and electrolyte depletion, dehydration, reduction of blood volume and circulatory collapse with a possibility of vascular thrombosis and embolism. Electrolyte depletion may be manifested by weakness, dizziness, mental confusion, anorexia, lethargy, vomiting and cramps. Treatment consists of replacement of fluid and electrolyte losses by careful monitoring of the urine and electrolyte output and serum electrolyte levels.
|
| dailymed-drugs:98 |
Acute Toxicity: No deaths due to acute poisoning have been reported. Highest known dose survived: adults, 10 g orally. Oral LDin rats: 173 and 187 mg/kg. Signs and Symptoms: Signs and symptoms of overdosage include hypotension, tachycardia, headache, and generalized skin flushing. Complications can include myocardial ischemia and subsequent myocardial infarction, cardiac arrhythmia, and profound shock. Treatment: There is no specific antidote. The gastric contents should be evacuated, taking adequate precautions against aspiration and for protection of the airway. An activated charcoal slurry may be instilled if conditions permit. These manipulations may have to be omitted or carried out after cardiovascular status has been stabilized, since they might precipitate cardiac arrhythmias or increase the depth of shock. Support of the cardiovascular system is of primary importance. Shock should be treated with plasma expanders. If possible, vasopressors should not be given, but if a vasopressor is required, care should be taken not to precipitate or aggravate cardiac arrhythmia. Tachycardia responds to beta blockers. Digitalization may be necessary, and renal function should be monitored and supported as required. No experience has been reported with extracorporeal or peritoneal dialysis.
|
| dailymed-drugs:100 |
Overdose of metformin hydrochloride has occurred, including ingestion of amounts greater than 50 grams. Hypoglycemia was reported in approximately 10% of cases, but no causal association with metformin hydrochloride has been established. Lactic acidosis has been reported in approximately 32% of metformin overdose cases (see WARNINGS). Metformin is dialyzable with a clearance of up to 170 mL/min under good hemodynamic conditions. Therefore, hemodialysis may be useful for removal of accumulated drug from patients in whom metformin overdosage is suspected.
|
| dailymed-drugs:1314 |
Overdose of metformin hydrochloride has occurred, including ingestion of amounts greater than 50 grams. Hypoglycemia was reported in approximately 10% of cases, but no causal association with metformin hydrochloride has been established. Lactic acidosis has been reported in approximately 32% of metformin overdose cases (see WARNINGS). Metformin is dialyzable with a clearance of up to 170 mL/min under good hemodynamic conditions. Therefore, hemodialysis may be useful for removal of accumulated drug from patients in whom metformin overdosage is suspected.
|
| dailymed-drugs:101 |
Signs of overdose may include confusion, drowsiness, continuing headache, problems with passing urine and rapid weight gain due to fluid retention. In case of overdosage, the dose should be reduced, frequency of administration decreased, or the drug withdrawn according to the severity of the condition. There is no known specific antidote for desmopressin acetate or DDAVP Nasal Spray. An oral LDhas not been established. An intravenous dose of 2 mg/kg in mice demonstrated no effect.
|
| dailymed-drugs:105 |
Overdosage will not ordinarily cause acute problems. If diclofenac sodium ophthalmic solution is accidentally ingested, fluids should be taken to dilute the medication.
|
| dailymed-drugs:107 |
Signs observed at the highest doses following studies to determine LDin animals were respiratory difficulties and convulsions. Acute overdosage in humans has not been reported. In a study of advanced metastatic cancer patients which specifically determined the maximum tolerated dose of NOLVADEX in evaluating the use of very high doses to reverse multidrug resistance, acute neurotoxicity manifested by tremor, hyperreflexia, unsteady gait and dizziness were noted. These symptoms occurred within 3-5 days of beginning NOLVADEX and cleared within 2-5 days after stopping therapy. No permanent neurologic toxicity was noted. One patient experienced a seizure several days after NOLVADEX was discontinued and neurotoxic symptoms had resolved. The causal relationship of the seizure to NOLVADEX therapy is unknown. Doses given in these patients were all greater than 400 mg/mloading dose, followed by maintenance doses of 150 mg/mof NOLVADEX given twice a day. In the same study, prolongation of the QT interval on the electrocardiogram was noted when patients were given doses higher than 250 mg/mloading dose, followed by maintenance doses of 80 mg/mof NOLVADEX given twice a day. For a woman with a body surface area of 1.5 mthe minimal loading dose and maintenance doses given at which neurological symptoms and QT changes occurred were at least 6 fold higher in respect to the maximum recommended dose. No specific treatment for overdosage is known; treatment must be symptomatic.
|
| dailymed-drugs:108 |
The acute oral LD50 doses in male and female mice
and male and female rats are over 8,000 mg/kg. Overdosage may
cause severe hypotension, bradycardia, cardiac insufficiency, cardiogenic
shock, and cardiac arrest. Respiratory problems, bronchospasms, vomiting,
lapses of consciousness, and generalized seizures may also occur. The patient should be placed in a supine position and,
where necessary, kept under observation and treated under intensive-care
conditions. Gastric lavage or pharmacologically induced emesis may
be used shortly after ingestion. The following agents may be administered: For excessive bradycardia: atropine, 2 mg IV. To support cardiovascular function: glucagon,
5 to 10 mg IV rapidly over 30 seconds, followed by a continuous
infusion of 5 mg/hour; sympathomimetics (dobutamine, isoprenaline,
adrenaline) at doses according to body weight and effect. If peripheral vasodilation dominates, it may be necessary
to administer adrenaline or noradrenaline with continuous monitoring
of circulatory conditions. For therapy-resistant bradycardia, pacemaker
therapy should be performed. For bronchospasm,��-sympathomimetics
(as aerosol or IV) or aminophylline IV should be given. In the event
of seizures, slow IV injection of diazepam or clonazepam is recommended. NOTE: In the event of severe intoxication where there
are symptoms of shock, treatment with antidotes must be continued
for a sufficiently long period of time consistent with the 7- to 10-hour
half-life of carvedilol. There is no experience
of overdosage with COREG CR. Cases of overdosage with carvedilol
alone or in combination with other drugs have been reported. Quantities
ingested in some cases exceeded 1,000 milligrams. Symptoms experienced
included low blood pressure and heart rate. Standard supportive treatment
was provided and individuals recovered.
|
| dailymed-drugs:109 |
Serious ill effects have not been reported following acute ingestion of large doses of other oral contraceptives by young children. Overdosage may cause nausea, and withdrawal bleeding may occur in females. Drospirenone, however, is a spironolactone analogue which has antimineralocorticoid properties. Serum concentration of potassium and sodium, and evidence of metabolic acidosis, should be monitored in cases of overdose.
|
| dailymed-drugs:110 |
There is no information on intentional overdose of telbivudine, but one subject experienced an unintentional and asymptomatic overdose. Healthy subjects who received telbivudine doses up to 1800 mg/day for 4 days had no increase in or unexpected adverse events. A maximum tolerated dose for telbivudine has not been determined. In the event of an overdose, telbivudine should be discontinued, the patient must be monitored for evidence of toxicity, and appropriate general supportive treatment applied as necessary. In case of overdosage, hemodialysis may be considered. Within 2 hours, following a single 200-mg dose of telbivudine, a 4-hour hemodialysis session removed approximately 23% of the telbivudine dose.
|
| dailymed-drugs:113 |
There is limited experience with meloxicam overdose. Four cases have taken 6 to 11 times the highest recommended dose; all recovered. Cholestyramine is known to accelerate the clearance of meloxicam. Symptoms following acute NSAID overdose are usually limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, which are generally reversible with supportive care. Gastrointestinal bleeding can occur. Severe poisoning may result in hypertension, acute renal failure, hepatic dysfunction, respiratory depression, coma, convulsions, cardiovascular collapse, and cardiac arrest. Anaphylactoid reactions have been reported with therapeutic ingestion of NSAIDs, and may occur following an overdose. Patients should be managed with symptomatic and supportive care following an NSAID overdose. In cases of acute overdose, gastric lavage followed by activated charcoal is recommended. Gastric lavage performed more than one hour after overdose has little benefit in the treatment of overdose. Administration of activated charcoal is recommended for patients who present 1-2 hours after overdose. For substantial overdose or severely symptomatic patients, activated charcoal may be administered repeatedly. Accelerated removal of meloxicam by 4 gm oral doses of cholestyramine given three times a day was demonstrated in a clinical trial. Administration of cholestyramine may be useful following an overdose. Forced diuresis, alkalinization of urine, hemodialysis, or hemoperfusion may not be useful due to high protein binding.
|
| dailymed-drugs:1210 |
There is limited experience with meloxicam overdose. Four cases have taken 6 to 11 times the highest recommended dose; all recovered. Cholestyramine is known to accelerate the clearance of meloxicam. Symptoms following acute NSAID overdose are usually limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, which are generally reversible with supportive care. Gastrointestinal bleeding can occur. Severe poisoning may result in hypertension, acute renal failure, hepatic dysfunction, respiratory depression, coma, convulsions, cardiovascular collapse, and cardiac arrest. Anaphylactoid reactions have been reported with therapeutic ingestion of NSAIDs, and may occur following an overdose. Patients should be managed with symptomatic and supportive care following an NSAID overdose. In cases of acute overdose, gastric lavage followed by activated charcoal is recommended. Gastric lavage performed more than one hour after overdose has little benefit in the treatment of overdose. Administration of activated charcoal is recommended for patients who present 1-2 hours after overdose. For substantial overdose or severely symptomatic patients, activated charcoal may be administered repeatedly. Accelerated removal of meloxicam by 4 gm oral doses of cholestyramine given three times a day was demonstrated in a clinical trial. Administration of cholestyramine may be useful following an overdose. Forced diuresis, alkalinization of urine, hemodialysis, or hemoperfusion may not be useful due to high protein binding.
|
| dailymed-drugs:2067 |
There is limited experience with meloxicam overdose. Four cases have taken 6 to 11 times the highest recommended dose; all recovered. Cholestyramine is known to accelerate the clearance of meloxicam. Symptoms following acute NSAID overdose are usually limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, which are generally reversible with supportive care. Gastrointestinal bleeding can occur. Severe poisoning may result in hypertension, acute renal failure, hepatic dysfunction, respiratory depression, coma, convulsions, cardiovascular collapse, and cardiac arrest. Anaphylactoid reactions have been reported with therapeutic ingestion of NSAIDs, and may occur following an overdose. Patients should be managed with symptomatic and supportive care following an NSAID overdose. In cases of acute overdose, gastric lavage followed by activated charcoal is recommended. Gastric lavage performed more than one hour after overdose has little benefit in the treatment of overdose. Administration of activated charcoal is recommended for patients who present 1-2 hours after overdose. For substantial overdose or severely symptomatic patients, activated charcoal may be administered repeatedly. Accelerated removal of meloxicam by 4 gm oral doses of cholestyramine given three times a day was demonstrated in a clinical trial. Administration of cholestyramine may be useful following an overdose. Forced diuresis, alkalinization of urine, hemodialysis, or hemoperfusion may not be useful due to high protein binding.
|
| dailymed-drugs:2186 |
There is limited experience with meloxicam overdose. Four cases have taken 6 to 11 times the highest recommended dose; all recovered. Cholestyramine is known to accelerate the clearance of meloxicam. Symptoms following acute NSAID overdose are usually limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, which are generally reversible with supportive care. Gastrointestinal bleeding can occur. Severe poisoning may result in hypertension, acute renal failure, hepatic dysfunction, respiratory depression, coma, convulsions, cardiovascular collapse, and cardiac arrest. Anaphylactoid reactions have been reported with therapeutic ingestion of NSAIDs, and may occur following an overdose. Patients should be managed with symptomatic and supportive care following an NSAID overdose. In cases of acute overdose, gastric lavage followed by activated charcoal is recommended. Gastric lavage performed more than one hour after overdose has little benefit in the treatment of overdose. Administration of activated charcoal is recommended for patients who present 1-2 hours after overdose. For substantial overdose or severely symptomatic patients, activated charcoal may be administered repeatedly. Accelerated removal of meloxicam by 4 gm oral doses of cholestyramine given three times a day was demonstrated in a clinical trial. Administration of cholestyramine may be useful following an overdose. Forced diuresis, alkalinization of urine, hemodialysis, or hemoperfusion may not be useful due to high protein binding.
|
| dailymed-drugs:115 |
To date, there have been no reports of acute overdosage with this drug. Due to the risk of vascular spasm, exceeding the recommended dosages of dihydroergotamine mesylate injection is to be avoided. Excessive doses of dihydroergotamine may result in peripheral signs and symptoms of ergotism. Treatment includes discontinuance of the drug, local application of warmth to the affected area, the administration of vasodilators, and nursing care to prevent tissue damage. In general, the symptoms of an acute dihydroergotamine mesylate injection overdose are similar to those of an ergotamine overdose, although there is less pronounced nausea and vomiting with dihydroergotamine mesylate injection. The symptoms of an ergotamine overdose include the following: numbness, tingling, pain, and cyanosis of the extremities associated with diminished or absent peripheral pulses; respiratory depression; an increase and/or decrease in blood pressure, usually in that order, confusion, delirium, convulsions, and coma; and/or some degree of nausea, vomiting, and abdominal pain. In laboratory animals, significant lethality occurs when dihydroergotamine is given at IV doses of 44 mg/kg in mice, 130 mg/kg in rats, and 37 mg/kg in rabbits. Up-to-date information about the treatment of overdosage can often be obtained from a certified Regional Poison Control Center. Telephone numbers of certified Poison Control Centers are listed in the Physician's Desk Reference' (PDR).*
|
| dailymed-drugs:116 |
Studies in animals indicate that toxic doses are associated with respiratory failure and tachycardia that may be controlled by assisted respiration and the administration of a beta-blocker. Reported acute ingestions orally of up to 20 grams have been associated with transient adverse effects similar to those encountered in normal clinical experience. The usual measures to remove unabsorbed material from the gastrointestinal tract, clinical monitoring, and supportive therapy should be employed. There have been reports of severe CNS symptoms, including unresponsiveness, following ingestion of between 20 and 40 grams of cimetidine, and extremely rare reports following concomitant use of multiple CNS-active medications and ingestion of cimetidine at doses less than 20 grams. An elderly, terminally ill dehydrated patient with organic brain syndrome receiving concomitant antipsychotic agents and cimetidine 4800 mg intravenously over a 24 hour period experienced mental deterioration with reversal on cimetidine discontinuation. There have been two deaths in adults who were reported to have ingested over 40 grams orally on a single occasion.
|
| dailymed-drugs:117 |
There is no experience to date with deliberate overdosage. Oral doses of up to 640 mg/day have been given to adult patients with pathological hypersecretory conditions with no serious adverse effects. In the event of overdosage, treatment should be symptomatic and supportive. Unabsorbed material should be removed from the gastrointestinal tract, the patient should be monitored, and supportive therapy should be employed. The oral LDof famotidine in male and female rats and mice was greater than 3000 mg/kg and the minimum lethal acute oral dose in dogs exceeded 2000 mg/kg. Famotidine did not produce overt effects at high oral doses in mice, rats, cats and dogs, but induced significant anorexia and growth depression in rabbits starting with 200 mg/kg/day orally. The intravenous LDof famotidine for mice and rats ranged from 254-563 mg/kg and the minimum lethal single I.V. dose in dogs was approximately 300 mg/kg. Signs of acute intoxication in I.V. treated dogs were emesis, restlessness, pallor of mucous membranes or redness of mouth and ears, hypotension, tachycardia and collapse.
|
| dailymed-drugs:118 |
The following symptoms may be observed following
overdosage: nausea, vomiting, intense headache, dizziness, mental
confusion, disorientation, or lethargy. There have been reports of
paresthesias, numbness, and convulsions. Treatment
is symptomatic and supportive. The stomach should be emptied as quickly
as possible if the ingestion is recent. If vomiting has not occurred
spontaneously, the patient should be induced to vomit with syrup of
ipecac. If the patient is unable to vomit, gastric lavage should be
performed. Once the stomach has been emptied, 25 or 50 g of activated
charcoal may be given. Depending on the condition of the patient,
close medical observation and nursing care may be required. The patient
should be followed for several days because gastrointestinal ulceration
and hemorrhage have been reported as adverse reactions of indomethacin.
Use of antacids may be helpful. The oral LDof indomethacin in mice and rats (based on 14 day mortality
response) was 50 and 12 mg/kg, respectively.
|
| dailymed-drugs:120 |
There is no known antidote for overdoses of Vinorelbine. Overdoses involving quantities up to 10 times the recommended dose (30 mg/m) have been reported. The toxicities described were consistent with those listed in the ADVERSE REACTIONS section including paralytic ileus,
stomatitis, and esophagitis. Bone marrow aplasia, sepsis, and paresis have also been reported.
Fatalities have occurred following overdose of Vinorelbine. If overdosage occurs, general supportive measures together with appropriate blood transfusions, growth factors, and antibiotics should be instituted as deemed necessary by the physician.
|
| dailymed-drugs:122 |
There is limited clinical experience with naltrexone overdosage in humans. In one study, subjects who received 800 mg daily naltrexone hydrochloride for up to one week showed no evidence of toxicity. In the mouse, rat and guinea pig, the oral LDwere 1,100 to 1,550 mg/kg; 1,450 mg/kg; and 1,490 mg/kg; respectively. High doses of naltrexone hydrochloride (generally���1,000 mg/kg) produced salivation, depression/reduced activity, tremors, and convulsions. Mortalities in animals due to high-dose naltrexone administration usually were due to clonic-tonic convulsions and/or respiratory failure. Treatment Of Overdosage: In view of the lack of actual experience in the treatment of naltrexone hydrochloride overdose, patients should be treated symptomatically in a closely supervised environment. Physicians should contact a poison control center for the most up-to-date information.
|
| dailymed-drugs:123 |
There are no data on overdosage in the two clinical studies. There is no known antidote for dexrazoxane.
|
| dailymed-drugs:124 |
Overdosage of cephalosporins can cause cerebral irritation leading to convulsions. Serum levels of cefuroxime can be reduced by hemodialysis and peritoneal dialysis.
|
| dailymed-drugs:1399 |
Overdosage of cephalosporins can cause cerebral irritation leading to convulsions. Serum levels of cefuroxime can be reduced by hemodialysis and peritoneal dialysis.
|
| dailymed-drugs:125 |
Isoproterenol: The oral LDvalues are as follows: mouse, 1260 mg/kg; rabbit, 3070 mg/kg; male rat, 2230 mg/kg; female rat, 2840 mg/kg; and dog, 600 mg/kg. The intravenous LDvalues are as follows: mouse, 126 mg/kg; rabbit, 27 mg/kg; male rat, 96 mg/kg; female rat, 112 mg/kg; and dog, 50 mg/kg. Phenylephrine: The oral LDvalues are as follows: rat, 350 mg/kg; and mouse, 120 mg/kg. The intravenous LDvalues are as follows: rat, 6.8 mg/kg; and mouse, 21 mg/kg. Symptoms: The individual patient's sensitivity to either drug will dictate the overdosage signs. There is reason to believe, however, that the overdosage effects of either drug are antagonized by the other drug in the combination. Severe symptoms of overdosage are more likely to result from parenteral administration of isoproterenol rather than from oral inhalation of isoproterenol and phenylephrine in an aerosol. Manifestations of acute overdosage include chest pain, dizziness, headache, irregular heartbeat, fast or pounding heartbeat, brady��cardia, nausea or vomiting, restlessness, weakness, flushing, decreased diastolic pressure, convulsions, cerebral hemorrhage, or hypertension. Treatment: Discontinued dosing allows rapid reversal of adverse effects. Blood pressure and ECG may be monitored and the following treatment used, as appropriate: Tachycardia in asthmatic patients may be treated with cardioselective beta-blockers (meto��prolol or atenolol, but use cautiously since cardioselectivity may not be absolute) and in nonasthmatics with propranolol; brady��cardia may be treated with atropine; blood pressure may be regulated with rapid-acting vasodilators (nitrites, sodium nitro��prusside) or alpha-blocking agents (quinidine, phentolamine). It is not known if isoproterenol or phenylephrine are dialyzable.
|
| dailymed-drugs:126 |
Several overdosages with orally administered nicardipine have been reported. One adult patient allegedly ingested 600 mg of nicardipine [standard (immediate release) capsules], and another patient, 2160 mg of the sustained release formulation of nicardipine. Symptoms included marked hypotension, bradycardia, palpitations, flushing, drowsiness, confusion and slurred speech. All symptoms resolved without sequelae. An overdosage occurred in a one-year-old child who ingested half of the powder in a 30 mg nicardipine standard capsule. The child remained asymptomatic. Based on results obtained in laboratory animals, lethal overdose may cause systemic hypotension, bradycardia (following initial tachycardia) and progressive atrioventricular conduction block. Reversible hepatic function abnormalities and sporadic focal hepatic necrosis were noted in some animal species receiving very large doses of nicardipine. For treatment of overdosage, standard measures including monitoring of cardiac and respiratory functions should be implemented. The patient should be positioned so as to avoid cerebral anoxia. Frequent blood pressure determinations are essential. Vasopressors are clinically indicated for patients exhibiting profound hypotension. Intravenous calcium gluconate may help reverse the effects of calcium entry blockade.
|
| dailymed-drugs:128 |
In postmarketing experience, overdose with lorazepam has occurred predominantly in combination with alcohol and/or other drugs. Therefore, in the management of overdosage, it should be borne in mind that multiple agents may have been taken.<br/>Symptoms: Overdosage of benzodiazepines is usually manifested by varying degrees of central nervous system depression ranging from drowsiness to coma. In mild cases, symptoms include drowsiness, mental confusion, paradoxical reactions, dysarthria and lethargy. In more serious cases, and especially when other drugs or alcohol were ingested, symptoms may include ataxia, hypotonia, hypotension, cardiovascular depression, respiratory depression, hypnotic state, coma, and, death.<br/>Management: General supportive and symptomatic measures are recommended; vital signs must
be monitored and the patient closely observed. When there is a risk of aspiration,
induction of emesis is not recommended. Gastric lavage may be indicated if performed
soon after ingestion or in symptomatic patients. Administration of activated
charcoal may also limitdrug absorption. Hypotension, though unlikely, usually may
be controlled with norepinephrine bitartrate injection. Lorazepam is poorly dialyzable.
Lorazepam glucuronide, the inactive metabolite, may be highly dialyzable. The benzodiazepine antagonist flumazenil may be used in hospitalized patients as an adjunct to, not as a substitute for, proper management of benzodiazepine overdose. The prescriber should be aware of a risk of seizure in association with flumazenil treatment, particularly in long-term benzodiazepine users and in cyclic antidepressant overdose. The complete flumazenil package insert includingCONTRAINDICATIONS, WARNINGS, and PRECAUTIONS should be consulted prior to use.
|
| dailymed-drugs:129 |
Overdosage with ERTACZO Cream, 2%, has not been reported to date. ERTACZO Cream, 2%, is intended for topical dermatologic use only. It is not for oral, ophthalmic, or intravaginal use.
|
| dailymed-drugs:132 |
No specific information on emergency treatment of overdosage is available. Therefore, on the basis of the pharmacologic actions of Visken (pindolol), the following general measures should be employed as appropriate in addition to gastric lavage: Excessive Bradycardia: administer atropine; if there is no response to vagal blockade, administer isoproterenol cautiously. Cardiac Failure: digitalize the patient and/or administer diuretic. It has been reported that glucagon may be useful in this situation. Hypotension: administer vasopressors, e.g., epinephrine or levarterenol, with serial monitoring of blood pressure. (There is evidence that epinephrine may be the drug of choice.) Bronchospasm: administer a betastimulating agent such as isoproterenol and/or a theophylline derivative. A case of an acute overdosage has been reported with an intake of 500 mg of Visken (pindolol) by a hypertensive patient. Blood pressure increased and heart rate was���80 beats/min. Recovery was uneventful. In another case, 250 mg of Visken (pindolol) was taken with 150 mg diazepam and 50 mg nitrazepam, producing coma and hypotension. The patient recovered in 24 hours.
|
| dailymed-drugs:134 |
There has been limited experience with overdosage.
Reported acute ingestions of up to 18 g orally have been associated
with transient adverse effects similar to those encountered in normal
clinical experience (see ADVERSE REACTIONS). In addition, abnormalities
of gait and hypotension have been reported. When overdosage occurs, the usual measures to remove unabsorbed
material from the gastrointestinal tract, clinical monitoring, and
supportive therapy should be employed. Studies
in dogs receiving dosages of ZANTAC in excess of 225 mg/kg per
day have shown muscular tremors, vomiting, and rapid respiration.
Single oral doses of 1,000 mg/kg in mice and rats were not lethal.
Intravenous LDvalues in mice and rats were 77 and
83 mg/kg, respectively.
|
| dailymed-drugs:135 |
Experience in patients taking
very high doses of pantoprazole is limited. There have been spontaneous
reports of overdosage with pantoprazole, including a suicide in which
pantoprazole 560 mg and undetermined amounts of chloroquine and
zopiclone were also ingested. There have also been spontaneous reports
of patients taking similar amounts of pantoprazole (400 mg and 600 mg)
with no adverse effects. Pantoprazole is not removed by hemodialysis. In case of overdosage,
treatment should be symptomatic and supportive. Single oral doses of pantoprazole at 709 mg/kg, 798 mg/kg,
and 887 mg/kg were lethal to mice, rats, and dogs, respectively.
The symptoms of acute toxicity were hypoactivity, ataxia, hunched
sitting, limb-splay, lateral position, segregation, absence of ear
reflex, and tremor.
|
| dailymed-drugs:1797 |
Experience in patients taking
very high doses of pantoprazole is limited. There have been spontaneous
reports of overdosage with pantoprazole, including a suicide in which
pantoprazole 560 mg and undetermined amounts of chloroquine and
zopiclone were also ingested. There have also been spontaneous reports
of patients taking similar amounts of pantoprazole (400 mg and 600 mg)
with no adverse effects. Pantoprazole is not removed by hemodialysis. In case of overdosage,
treatment should be symptomatic and supportive. Single oral doses of pantoprazole at 709 mg/kg, 798 mg/kg,
and 887 mg/kg were lethal to mice, rats, and dogs, respectively.
The symptoms of acute toxicity were hypoactivity, ataxia, hunched
sitting, limb-splay, lateral position, segregation, absence of ear
reflex, and tremor.
|
| dailymed-drugs:136 |
Clinical Experience: Overdosage reports with alprazolam tablets are limited. Manifestations of alprazolam overdosage include somnolence, confusion, impaired coordination, diminished reflexes, and coma. Death has been reported in association with overdoses of alprazolam by itself, as it has with other benzodiazepines. In addition, fatalities have been reported in patients who have overdosed with a combination of a singlebenzodiazepine, including alprazolam, and alcohol; alcohol levels seen in some of these patients have been lower than those usually associated with alcohol-induced fatality. Animal experiments have suggested that forced diuresis or hemodialysis are probably of little value in treating overdosage.<br/>General Treatment of Overdose: As in all cases of drug overdosage, respiration, pulse rate, and blood pressure should be monitored. General supportive measures should be employed, along with immediate gastric lavage. Intravenous fluids should be administered and an adequate airway maintained. If hypotension occurs, it may be combated by the use of vasopressors. Dialysis is of limited value. As with the management of intentional overdosing with any drug, it should be borne in mind that multipleagents may have been ingested. Flumazenil, a specific benzodiazepine receptor antagonist, is indicated for the complete or partial reversal of the sedative effects of benzodiazepines and may be used in situations when an overdose with a benzodiazepine is known or suspected. Prior to the administration of flumazenil, necessary measures should be instituted to secure airway, ventilation, and intravenous access. Flumazenil is intended as an adjunct to, not as a substitute for, proper management of benzodiazepine overdose. Patients treated with flumazenil should be monitored for re-sedation, respiratory depression, and other residual benzodiazepine effects for an appropriate period after treatment. The prescriber should be aware of a risk of seizure in association with flumazenil treatment, particularly in long-term benzodiazepine users and in cyclic antidepressant overdose. The complete flumazenil package insert including CONTRAINDICATIONS, WARNINGS, and PRECAUTIONS should be consulted prior to use.
|
| dailymed-drugs:137 |
Human Experience: Since the introduction of paroxetine in the United States, 342
spontaneous cases of deliberate or accidental overdosage during paroxetine
treatment have been reported worldwide (circa 1999). These include overdoses
with paroxetine alone and in combination with other substances. Of these,
48 cases were fatal and of the fatalities, 17 appeared to involve paroxetine
alone. Eight fatal cases that documented the amount of paroxetine ingested
were generally confounded by the ingestion of other drugs or alcohol or the
presence of significant comorbid conditions. Of 145 non-fatal cases with known
outcome, most recovered withoutsequelae. The largest known ingestion involved
2,000 mg of paroxetine (33 times the maximum recommended daily dose) in a
patient who recovered. Commonly reported adverse events
associated with paroxetine overdosage include somnolence, coma, nausea, tremor,
tachycardia, confusion, vomiting, and dizziness. Other notable signs and symptoms
observed with overdoses involving paroxetine (alone or with other substances)
include mydriasis, convulsions (including status epilepticus), ventricular
dysrhythmias (including torsade de pointes), hypertension, aggressive reactions,
syncope, hypotension, stupor, bradycardia, dystonia, rhabdomyolysis, symptoms
of hepatic dysfunction (including hepatic failure, hepatic necrosis, jaundice,
hepatitis, and hepatic steatosis), serotonin syndrome, manic reactions, myoclonus,
acute renal failure, and urinary retention.<br/>Overdosage Management: Treatment should consist
of those general measures employed in the management of overdosage with any
drugs effective in the treatment of major depressive disorder. Ensure
an adequate airway, oxygenation, and ventilation. Monitor cardiac rhythm and
vital signs. General supportive and symptomatic measures are also recommended.
Induction of emesis is not recommended. Gastric lavage with a large-bore orogastric
tube with appropriate airway protection, if needed, may be indicated if performed
soon after ingestion, or in symptomatic patients. Activated
charcoal should be administered. Due to the large volume of distribution of
this drug, forced diuresis, dialysis, hemoperfusion, and exchange transfusion
are unlikely to be of benefit. No specific antidotes for paroxetine are known. A
specific caution involves patients who are taking or have recently taken paroxetine
who might ingest excessive quantities of a tricyclic antidepressant. In such
a case, accumulation of the parent tricyclic and/or an active metabolite may
increase the possibility of clinically significant sequelae and extend the
time needed for close medical observation (see PRECAUTIONS���Drugs Metabolized by Cytochrome CYP2D6). In
managing overdosage, consider the possibility of multiple drug involvement.
The physician should consider contacting a poison control center for additional
information on the treatment of any overdose. Telephone numbers for certified
poison control centers are listed in the Physicians'
Desk Reference (PDR).
|
| dailymed-drugs:140 |
In the event of a fluid or solute overload during parenteral therapy, reevaluate the patient's condition and institute appropriate corrective treatment.
|
| dailymed-drugs:377 |
In the event of a fluid or solute overload during parenteral therapy, reevaluate the patient's condition and institute appropriate corrective treatment.
|
| dailymed-drugs:1967 |
In the event of a fluid or solute overload during parenteral therapy, reevaluate the patient's condition and institute appropriate corrective treatment.
|
| dailymed-drugs:2169 |
In the event of a fluid or solute overload during parenteral therapy, reevaluate the patient's condition and institute appropriate corrective treatment.
|
| dailymed-drugs:3192 |
In the event of a fluid or solute overload during parenteral therapy, reevaluate the patient's condition and institute appropriate corrective treatment.
|
| dailymed-drugs:3897 |
In the event of a fluid or solute overload during parenteral therapy, reevaluate the patient's condition and institute appropriate corrective treatment.
|
| dailymed-drugs:4103 |
In the event of a fluid or solute overload during parenteral therapy, reevaluate the patient's condition and institute appropriate corrective treatment.
|
| dailymed-drugs:142 |
The toxic symptoms following an overdose of cefaclor may include nausea, vomiting, epigastric distress, and diarrhea. The severity of the epigastric distress and the diarrhea are dose-related. Absorption of drugs from the gastrointestinal tract may be decreased by giving activated charcoal, which, in many cases, is more effective than emesis or lavage. Consider charcoal instead of or in addition to gastric emptying. Repeated doses of charcoal over time may hasten elimination of some drugs that have been absorbed. Although cefaclor is considered dialyzable, neither forced diuresis, peritoneal dialysis, hemodialysis, nor charcoal hemoperfusion have been demonstrated to be beneficial in an overdose of cefaclor.
|
| dailymed-drugs:144 |
No cases of overdose with ribavirin tablets have been reported in clinical trials. Hypocalcemia and hypomagnesemia have been observed in persons administered greater than the recommended dosage of ribavirin. In most of these cases, ribavirin was administered intravenously at dosages up to and in some cases exceeding four times the recommended maximum oral daily dose.
|
| dailymed-drugs:145 |
In the event of overhydration or solute overload,
re-evaluate the patient and institute appropriate corrective measures.
See WARNINGS, PRECAUTIONS, and ADVERSE REACTIONS.
|
| dailymed-drugs:238 |
In the event of overhydration or solute overload,
re-evaluate the patient and institute appropriate corrective measures.
See WARNINGS, PRECAUTIONS, and ADVERSE REACTIONS.
|
| dailymed-drugs:1036 |
In the event of overhydration or solute overload,
re-evaluate the patient and institute appropriate corrective measures.
See WARNINGS, PRECAUTIONS, and ADVERSE REACTIONS.
|
| dailymed-drugs:1825 |
In the event of overhydration or solute overload,
re-evaluate the patient and institute appropriate corrective measures.
See WARNINGS, PRECAUTIONS, and ADVERSE REACTIONS.
|
| dailymed-drugs:2053 |
In the event of overhydration or solute overload,
re-evaluate the patient and institute appropriate corrective measures.
See WARNINGS, PRECAUTIONS, and ADVERSE REACTIONS.
|
| dailymed-drugs:2077 |
In the event of overhydration or solute overload,
re-evaluate the patient and institute appropriate corrective measures.
See WARNINGS, PRECAUTIONS, and ADVERSE REACTIONS.
|