Poison Center, MacKay Memorial Hospital: kidney

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2024年10月2日星期三

Name: Xylene (二甲苯)
Common Uses: Solvent in chemical industries and de-waxing agent in pathology labs.

Primary Systems Affected: Central Nervous System (CNS), Respiratory System, Skin, Liver, Kidneys

Acute Exposure:
- Low Concentration (50 ppm or less): Mild symptoms like headache, dizziness, and nausea.
- Moderate Concentration (50–200 ppm): CNS symptoms, reduced concentration, drowsiness, respiratory irritation (sore throat, cough).
- High Concentration (>200 ppm): Severe CNS depression, dizziness, ataxia, fainting, liver and kidney stress.
- Skin Exposure: Dry skin, dermatitis, possible burns from high concentrations.
- Ingestion: CNS suppression, gastrointestinal irritation, coma, and respiratory depression.
Chronic Exposure:
- Nervous System: Memory loss, difficulty concentrating, mood changes.
- Liver & Kidneys: Metabolic burden leading to damage.
- Reproductive Toxicity: Decreased sperm count, menstrual irregularities in women.

No specific antidote.
Treatment involves supportive care, including oxygen therapy for inhalation exposure, decontamination of skin, and monitoring of liver and kidney function.

Treatment and Monitoring: Symptomatic management including IV fluids, monitoring for CNS, respiratory, liver, and kidney damage. Active charcoal 1 gm/kg may be administered if ingested.

Edited by Yu-Jang Su 2 Oct, 2024.

Naloxone	Situation	Concern	References
Pregnancy	Category C		[1] [2]
Contraindicated	Allergy
controversial	Seizure	Naloxone alone reduced the number and duration of seizures but increased the number of mild seizures	[3 [4][5][6]
controversial	Alcohol intoxicated	Lacks effectiveness in ethylic coma	[7]
Precautions	Bronchospasm	Hypoxia risk	[8]
Precautions	COPD	Hypoxia risk	[2]
Precautions	Respiratory failure/ distress	Hypoxia risk	[2]
Precautions	Lung edema, non-cardiogenic	Hypoxia risk	[2]
Adverse effect	BPH	Acute urinary retention. (AUR)	[9]
Adverse effect	Acute abdomen, pancreatitis	Induced.	[10]
Treatment	Acute abdomen, IBD	Efective and safe, and could be considered for the treatment of therapy refractory IBD patients	[11]
Precautions	Liver, renal impaired function	Hepatitis	[2]
Contraindicated	hypothyroidism	Increment oxygen consumption, but not ventilation.	[12]