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person:hoffmr05
A case report of chronic bupivacaine toxicity [Meeting Abstract]
Farmer, BM; Hoffman, RS; Nelson, LS
ISI:000256917000060
ISSN: 1556-3650
CID: 86870
Rapid diagnosis of metabolic acidosis: Improving bedside detection of urine beta-hydroxybutyrate [Meeting Abstract]
Smith, SW; Manini, AF; Szekely, T; Hoffman, RS
ISI:000256917000276
ISSN: 1556-3650
CID: 86871
High lead levels with minimal signs of encephalopathy [Meeting Abstract]
Odujebe, OA; Hoffman, RS; Nelson, LS
ISI:000256917000296
ISSN: 1556-3650
CID: 86872
Citalopram overdose: late presentation of torsades de pointes (TdP) with cardiac arrest [Case Report]
Tarabar, Asim F; Hoffman, Robert S; Nelson, Lewis
INTRODUCTION: Citalopram overdose may produce bradycardia, QT prolongation, and torsades de pointes (TdP). A cardiotoxic metabolite may be responsible for the delayed onset of cardiotoxicity. Although some authorities recommend a minimum of 24 hours of observation following citalopram overdose, a recent analysis suggested that dysrhythmias rarely occur beyond 13 hours post-ingestion. We present a case of citalopram overdose with a substantially delayed onset of cardiac toxicity. CASE REPORT: A 36-year-old woman complained of shakiness, numbness in the arms, and palpitations that began approximately 32 hours after ingesting 50 (20-mg) tablets of citalopram. Her initial vital signs were: blood pressure, 84/44 mmHg; pulse, 102-150/minute; respirations, 17/min; temperature, 99.3 degrees F (37.3 degrees C). Her initial ECG showed sinus rhythm with a prolonged corrected QT interval (572 msec) with paroxysmal, self-limited runs of wide-complex tachycardia that appeared multifocal in nature. Approximately 20 minutes after presentation, she experienced self-terminating TdP, with transient hypotension and loss of consciousness. Her serum citalopram concentration (33 hours post-ingestion) was 477 ng/mL (therapeutic: 40-110 ng/mL); desmethylcitalopram concentration was 123.2 ng/mL (therapeutic: 14-40 ng/mL). She was treated with magnesium and lidocaine, and her corrected QT interval remained abnormal for 24 hours after presentation. DISCUSSION: Citalopram overdose can produce life-threatening cardiac toxicity with a clinical onset that may be delayed beyond a routine observation period of 6 hours. Once the QT interval is prolonged, it seems prudent to prolong the observation period
PMCID:3550142
PMID: 18570170
ISSN: 1556-9039
CID: 96665
Alcoholic ketoacidosis in an 11-year-old boy [Case Report]
Manini, Alex F; Hoffman, Robert S; Nelson, Lewis S
A history of ethanol consumption combined with vomiting, anion gap metabolic acidosis, and altered mental status is consistent with a broad differential diagnosis, which requires a systematic approach. Alcoholic ketoacidosis is rare after binge drinking in the naive individual and typically occurs in patients with heavy, chronic use. We present the case of an 11-year-old boy with acute ethanol intoxication and a clinical course that is most consistent with alcoholic ketoacidosis. Alcoholic ketoacidosis should be considered in the differential diagnosis of children with unexplained ketoacidosis when there is history or evidence of ethanol consumption combined with the appropriate clinical presentation
PMID: 18347497
ISSN: 1535-1815
CID: 76868
Cocaine and beta-blockers: should the controversy continue? [Editorial]
Hoffman, Robert S
PMID: 17889405
ISSN: 1097-6760
CID: 135321
Comment: Limited efficacy of gastrointestinal decontamination in severe slow-release carbamazepine overdose [Letter]
Odujebe, Oladapo A; Kato, Yoichi; Hoffman, Robert S
PMID: 18094337
ISSN: 1542-6270
CID: 139351
Use of antipsychotics to treat cocaine toxicity? [Letter]
Wu, Stanley; Pearl-Davis, Michelle S; Manini, Alex F; Hoffman, Robert S
PMID: 18211326
ISSN: 1553-2712
CID: 133604
Preparing for chemical terrorism: A study of the stability of expired 2-PAM [Meeting Abstract]
Hoffman, RS; Mercurio-Zappala, M; Bouchard, NC; Ravikumar, PR
ISI:000256917000098
ISSN: 1556-3650
CID: 107322
A medicine safety needs assessment conducted with directors of programs for older adults [Meeting Abstract]
Schwartz, L; Martinez, L; Louie, J; Mercurio-Zappala, M; Howland, MA; Hoffman, RS
ISI:000258052900015
ISSN: 1556-3650
CID: 107323