CURRENT CONTENTS:
Antifreeze poisoning
Chemotherapy drugs, cardiotoxicity
Chelation
Danbury shakes (mad hatter syndrome)
Digitalis toxicity
Drugs of abuse
Authors' Note: Poisoning with sweet-smelling ethylene glycol is a common toxic problem for humans and pets owing to its wide commercial distribution in products including antifreeze and windshield washer fluid.
Discovered in 1958, denatonium benzoate (sold under various tradenames, including Bitrex), tastes unbearably bitter to most mammals, even in low concentations, but is not apparently harmful otherwise. It has been used to prevent ingestion of a variety of consumer products. In 2012, all American manufacturers of antifreeze voluntarily agreed to add denatonium to these liquids in order to reduce fatal poisonings.
Learn more about this topic on the web at these sites:
Author's Note: Anthracycline antibiotics, e.g. doxorubicin (adriamycin) are among the most effective chemotherapy agents; they have been profitably incorporated in multidrug chemotherapy treatment routines for many types of cancer. These advantages are partially offset by a relatively unique adverse effect — the possibility of cardiotoxicity, permanent impairment of the systolic (contracting) function of ventricular heart muscle.
Development of this side effect can be minimized by pharmacological manipulations and by monitoring cardiac function periodically during longterm treatment.
Nuclear medicine techniques have classically been used, but echocardiography may also be of value (see the verse ‘Ejection Fraction’) in monitoring cardiac function.
Authors' Note:
(KEE-layt) / (kee-LAY-shun) Treatment with chelates or chelating agents, has several well-recognized uses in medicine. These include removal of toxic metals from the body, e.g. lead in cases of acute or chronic poisoning, and treatment of iron overload in patients who have received repeated blood transfusions to treat their chronic anemias. The search for drugs of this type which are safer and easier to use is ongoing.
Authors' Note: Erethismus (irritation) mercurialis, synonym for mercurialism, was well-known by Lewis Carroll's time, as signs of chronic poisoning had become common among workers in the hatting industry in which salts of mercury were used in the felting of furs; his character, the 'Mad Hatter' reflects the prevalent stereotype.
In the US, hat-making was centered in the Connecticut town of Danbury, where the majority of long-term workers were subject to the 'Danbury shakes' as well as other neuropsychiatric manifestations. The plant continued in operation, including the dumping of wastewater effluent, until the early 1940s. It closed at that time due to staffing shortages and the need for mercury in the armaments industry.
In 2020, a study of fish populations in Danbury's Still River showed alarming levels of mercury; the persistence of this toxic residue reflects, in part, the concept of biomagnification.
Authors' Note:
(di-JOK-sin)
Digoxin, a cardiac glycoside derived initially from the garden plant digitalis (foxglove), has been used to treat chronic congestive heart failure and to control the heart rate in atrial fibrillation. During the author's professional lifetime, there has been a major reduction in the death-rate and in the incidence of hospital admissions for digoxin poisoning, also known as digitoxicity. This improvement is due to more judicious assessment of factors, e.g. decreasing kidney function, that may result in increasing blood levels of the drug, but also to limitation of the drug's use as alternatives have become available.
Authors' Note: Occasionally, the shock of reality may help a victim of substance abuse, like Seth, to focus on his plight. A more professional discussion of drug addiction by SheilaB may be enlightening.
