Journal of The Korean Society of Clinical Toxicology

A Case of Treatment with QRS Widening in Electrocardiogram after Glyphosate Herbicide Poisoning: Joo Hwan Lee; J Korean Soc Clin Toxicol. 2019;17(1):28-31. Published online June 30, 2019; DOI: https://doi.org/10.22537/jksct.2019.17.1.28

Abstract PDF: Glyphosate herbicides, which are widely used worldwide, are known to have low toxicity. However, excessive intake may cause serious life-threatening complications; therefore, caution is needed when using them. A 51-year-old man visited the hospital after ingesting glyphosate herbicide. At the time of admission, his vital signs were 80/60 mmHg-115/min-20/min-$37.3^{circ}C$. Electrocardiogram (ECG) showed QRS widening and corrected QT (QTc) prolongation, and blood tests showed metabolic acidosis. Treatment with gastric lavage, activated charcoal, sodium bicarbonate and intravenous lipid emulsion therapy was performed. After 2 hours, his blood pressure increased to 130/90 mg, and no QRS widening was observed on ECG.

A Case of Seizure in Diphenhydramine Overdose: Jung-Soo Park, Hoon Kim, Suk-Woo Lee; J Korean Soc Clin Toxicol. 2009;7(1):23-25. Published online June 30, 2009

Abstract PDF: A 21-year-old woman ingested 1,250 mg of diphenhydramine in a single overdose. Diphenhydramine, a rare ingredient in over-the-counter medication, is used to treat insomnia in Korea. Toxicity is usually limited to anticholinergic symptoms. The standard approach to therapy for the treatment of diphenhydramine overdose is supportive care, including physostigmines and sodium bicarbonates. Here, we review the literature and for the first time report a case of acute diphenhydramine overdosage in Korea, complicated with seizures.

A Case of Fatal Arrhythmia after Propafenone Overdose: Yeon-Young Kyong, Kyoung-Ho Choi; J Korean Soc Clin Toxicol. 2008;6(2):123-129. Published online December 31, 2008

Abstract PDF: A 36-year-old female was transferred to our emergency medical center with decreased mental status after a 6.0 g propafenone overdose because of domestic disturbance. She had no previous history of epilepsy, diabetes mellitus, hypertension or psychiatric illness. Before presenting to our center, gastrointestinal decontamination, charcoal administration, and endotracheal intubation due to bradycardia and generalized seizure had been performed. Soon after hospital arrival, at 5 h after ingestion, she collapsed into shock and fatal arrhythmia. We successfully resuscitated the patient with amiodarone, sodium bicarbonate, a large volume of normal saline, calcium, and ventilator care. At 23 h after ingestion, she was fully recovered and had no subjective signs or symptoms. To our knowledge, this is the first case report of intentional propafenone overdose in Korea, which we report with reviews of the previous literature.

Survey of the Antidote Stocking in the Emergency Medical Centers in Korea: Je-Sung You, Eui-Chung Kim, Hahn-Shick Lee, Seung-Ho Kim, Sung-Pil Chung; J Korean Soc Clin Toxicol. 2007;5(2):106-111. Published online December 31, 2007

Abstract PDF: Purpose: Inadequate hospital stocking and unavailability of essential antidotes is a worldwide problem. The purpose of this study was to determine the adequacy of antidote stocks in Korean hospitals based on a modified version of US antidote stocking guidelines. Methods: Both written and telephone surveys to collect information on hospital demographics and antidote stocking were given to the emergency departments or hospital pharmacies of 117 hospitals with emergency medical centers. The twenty antidotes included in the survey were taken from year 2000 US antidote stocking guidelines, except for activated charcoal and black widow spider antivenin. Antidote stocks were compared by hospital size, geographic location, and type of emergency medical center. Results: Complete responses were received from all hospitals. A mean of $12.4{pm}2.9$ antidotes were adequately stocked per hospital. All hospitals stocked atropine, $CaCl_2$ naloxone, and sodium bicarbonate. However, digoxin Fab fragment (16%), cyanide kits (15%), EDTA (10%), BAL (9%), and fomepizole (1%) were not uniformly stocked. Large and teaching hospitals were significantly more likely to stock greater numbers of antidotes. Conclusions: Korean hospitals as a group do not have adequate antidote stocks. Korean stocking guidelines and an antidote management system are recommended in order to correct these deficiencies.

Hypokalemic Muscular Paralysis Causing Acute Respiratory Failure in a Chronic Glue Sniffer: Yoon-Hee Choi, Dong-Hoon Lee, Eun-Kyung Eo; J Korean Soc Clin Toxicol. 2005;3(1):63-66. Published online June 30, 2005

Abstract PDF: Toluene is an aromatic hydrocarbon found in glues, cements, and solvents. It is known to be toxic to the nervous system, hematopoietic system, and causes acid-base and electrolyte disorders. Acute respiratory failure with hypokalemia and rhabdomyolysis with acute renal failure should be considered as potential events in protracted glue sniffing. We reported the case of 26-year-old woman was admitted to the emergency department with the development of respiratory failure and altered mentality due to hypokalemia after chronic glue sniffing. She was weaned from the ventilator 3 days later after potassium and sodium bicarbonate replacement and was discharged without respiratory symptoms and other complications.

Two Cases of Sodium Bicarbonate Inhalation Therapy in Chlorine Gas Intoxication: Dong-Hoon Lee, Eun-Kyung Eo; J Korean Soc Clin Toxicol. 2004;2(1):49-53. Published online June 30, 2004

Abstract PDF: A chlorine gas is a common irritant and when exposed, it result in mild occular, oropharyngeal, or respiratory symptoms. In severe case, however, it may result in pulmonary edema, interstitial pneumonia, or respiratory failure. We report the case of 29-year-old and 46-year-old men is accidentally exposed to chlorine gas during cleaning water. The patients complained dyspnea, chest tightness, cough and both eye pain. During hospitalization, they were treated with inhalation of humidified oxygen, beta-adrenergic agonist and $2\%$ sodium bicarbonate. After several days, patients were discharged without respiratory symptoms and complication. In treatment of chlorine gas toxicity the inhalation of sodium bicarbonate is a possible initial therapy can improve respiratory symptoms in spite of lack of evidence.

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