Barium toxicity - Revision history

Elcatracho: /* Disposition */

2021-03-08T21:41:13Z

Disposition

← Older revision		Revision as of 21:41, 8 March 2021
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	*Asymptomatic after 6 hours of observation with a normal potassium can be discharged		*Asymptomatic after 6 hours of observation with a normal potassium can be discharged
	*Consult Toxicology or [[poison control]]		*Consult Toxicology or [[poison control]]

			==See Also==
			*[[Toxicology (main)]]

	==References==		==References==
	<references/>		<references/>

Elcatracho: /* Management */

2021-03-08T21:40:24Z

Management

← Older revision		Revision as of 21:40, 8 March 2021
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	==Management==		==Management==
	*Decontamination		*Decontamination
	**Activated charcoal ''not'' recommended		**[[Activated charcoal]] ''not'' recommended
	**NG lavage ''un''likely to benefit		**[[Gastric lavage]] ''un''likely to benefit
	**Oral sodium sulfate or [[magnesium sulfate]]		**Oral sodium sulfate or [[magnesium sulfate]]
	***Prevents absorption by precipitating barium ions into insoluble barium sulfate		***Prevents absorption by precipitating barium ions into insoluble barium sulfate
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	**Consider prophylactic antibiotics		**Consider prophylactic antibiotics
	**IV extravasation outcomes improved with aspiration of barium sulfate		**IV extravasation outcomes improved with aspiration of barium sulfate

	==Disposition==		==Disposition==
	*Symptomatic admit to ICU		*Symptomatic admit to ICU

ClaireLewis: /* Clinical Features */

2020-10-27T14:24:39Z

Clinical Features

← Older revision		Revision as of 14:24, 27 October 2020
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	*[[Lactic acidosis]]		*[[Lactic acidosis]]
	*[[Hypophosphatemia]]		*[[Hypophosphatemia]]
	*[[~~Rhabdomyolsis~~]]		*[[Rhabdomyolysis]]
	*Intravasation is rare but is most often seen with barium enemas causing bowel perforation		*Intravasation is rare but is most often seen with barium enemas causing bowel perforation

	==Differential Diagnosis==		==Differential Diagnosis==
	{{Heavy metals list}}		{{Heavy metals list}}

ClaireLewis at 14:24, 27 October 2020

2020-10-27T14:24:13Z

← Older revision		Revision as of 14:24, 27 October 2020
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	*Rapid onset		*Rapid onset
	*Within 1 hour of ingestion		*Within 1 hour of ingestion
	**Abdominal pain		**[[Abdominal pain]]
	**Nausea and vomiting		**[[Nausea and vomiting]]
	**Diarrhea		**[[Diarrhea]]
	*Hypokalemia		*[[Hypokalemia]]
	*Ventricular dysrhythmias		*[[Ventricular dysrhythmias]]
	*Hypotension		*[[Hypotension]]
	*Flaccid muscle weakness		*Flaccid muscle [[weakness]]
	*Respiratory failure		*[[Respiratory failure]]
	*Metabolic acidosis		*[[Metabolic acidosis]]
	*Lactic acidosis		*[[Lactic acidosis]]
	*Hypophosphatemia		*[[Hypophosphatemia]]
	*Rhabdomyolsis		*[[Rhabdomyolsis]]
	*Intravasation is rare but is most often seen with barium enemas causing bowel perforation		*Intravasation is rare but is most often seen with barium enemas causing bowel perforation
	==Differential Diagnosis==		==Differential Diagnosis==
Line 41:		Line 41:
	*BMP, including magnesium and phosphate		*BMP, including magnesium and phosphate
	*Serum barium >0.2mg/L is abnormal		*Serum barium >0.2mg/L is abnormal
	*EKG		*[[EKG]]
	*Cardiac monitor		*Cardiac monitor
	*CPK		*CPK
Line 49:		Line 49:
	==Management==		==Management==
	*Decontamination		*Decontamination
	**Activated charcoal not recommended		**Activated charcoal ''not'' recommended
	**NG lavage ~~unlikely~~ to benefit		**NG lavage ''un''likely to benefit
	**Oral sodium sulfate or magnesium sulfate		**Oral sodium sulfate or [[magnesium sulfate]]
	***Prevents absorption by precipitating barium ions into insoluble barium sulfate		***Prevents absorption by precipitating barium ions into insoluble barium sulfate
	***Do not give these medications IV as they will cause precipitation in renal tubules		***Do not give these medications IV as they will cause precipitation in renal tubules
	***Magnesium sulfate		***[[Magnesium sulfate]]
	****250mg/kg for children		****250mg/kg for children
	****30g for adults		****30g for adults
	*Supportive care		*Supportive care
	**Electrolyte repletion		**[[Electrolyte repletion]]
	**Ventilatory support as needed		**Ventilatory support as needed
	*Hemodialysis or CVVHDF		*[[Hemodialysis]] or CVVHDF
	**Both show increase elimination of barium		**Both show increase elimination of barium
	**CVVHDF showed to triple elimination with complete neurologic recovery in 24 hours in one case report <ref>Koch M, Appoloni O, Haufroid V, Vincent JL, Lheureux P. Acute barium intoxication and hemodiafiltration. J Toxicol Clin Toxicol. 2003;41:363-367.</ref>		**CVVHDF showed to triple elimination with complete neurologic recovery in 24 hours in one case report <ref>Koch M, Appoloni O, Haufroid V, Vincent JL, Lheureux P. Acute barium intoxication and hemodiafiltration. J Toxicol Clin Toxicol. 2003;41:363-367.</ref>

Rossdonaldson1: Text replacement - "Poison Control Center" to "poison control"

2018-08-14T01:47:46Z

Text replacement - "Poison Control Center" to "poison control"

← Older revision		Revision as of 01:47, 14 August 2018
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	*Symptomatic admit to ICU		*Symptomatic admit to ICU
	*Asymptomatic after 6 hours of observation with a normal potassium can be discharged		*Asymptomatic after 6 hours of observation with a normal potassium can be discharged
	*Consult Toxicology or ~~Poison Control Center~~		*Consult Toxicology or [[poison control]]
	==References==		==References==
	<references/>		<references/>

Rossdonaldson1: /* Differential Diagnosis */

2018-08-12T20:43:34Z

Differential Diagnosis

@@ Line 36: / Line 36: @@
 *Intravasation is rare but is most often seen with barium enemas causing bowel perforation
 ==Differential Diagnosis==
-===[[Heavy metal]] toxicity===
+{{Heavy metals list}}
-*[[Aluminum toxicity]]
 ==Evaluation==
 *BMP, including magnesium and phosphate

Rossdonaldson1: /* Toxicokinetics */

2018-08-10T02:51:33Z

Toxicokinetics

← Older revision		Revision as of 02:51, 10 August 2018
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	**Rarely causes unintentional toxicity		**Rarely causes unintentional toxicity
	**When they occur typically seen with oral contrast and barium enemas		**When they occur typically seen with oral contrast and barium enemas
	==Toxicokinetics==		===Toxicokinetics===
	*Toxicity seen with as little as 200mg of barium salt		*Toxicity seen with as little as 200mg of barium salt
	*Lethal dose ranges from 1-30 g of barium salt		*Lethal dose ranges from 1-30 g of barium salt
Line 17:		Line 17:
	*Mostly eliminated via GI tract		*Mostly eliminated via GI tract
	**10-28% renal elimination		**10-28% renal elimination
	*Barium induces hypokalemia by causing extracellular potassium to shift intracellularly		*Barium induces hypokalemia by causing extracellular potassium to shift intracellularly

	==Clinical Features==		==Clinical Features==
	*Rapid onset		*Rapid onset

Therriac at 18:53, 9 August 2018

2018-08-09T18:53:54Z

@@ Line 1: / Line 1: @@
 ==Background==
+*Uses
 ==Toxicokinetics==
+*Toxicity seen with as little as 200mg of barium salt
 ==Clinical Features==
+*Rapid onset
 ==Differential Diagnosis==
 ===[[Heavy metal]] toxicity===
@@ Line 31: / Line 60: @@
 *[[Zinc toxicity]]
 ==Evaluation==
+*BMP, including magnesium and phosphate
 ==Management==
 *Decontamination
 ==Disposition==
 *Consult Toxicology or Poison Control Center
 ==References==

Therriac: Created page with "==Background== ==Toxicokinetics== ==Clinical Features== ==Differential Diagnosis== ===Heavy metal toxicity=== Aluminum toxicity Antimony toxicity *Arsenic t..."

2018-08-09T17:53:45Z

Created page with "==Background== ==Toxicokinetics== ==Clinical Features== ==Differential Diagnosis== ===Heavy metal toxicity=== *Aluminum toxicity *Antimony toxicity *Arsenic t..."

New page

==Background==

==Toxicokinetics==

==Clinical Features==

==Differential Diagnosis==
===[[Heavy metal]] toxicity===
*[[Aluminum toxicity]]
*[[Antimony toxicity]]
*[[Arsenic toxicity]]
*[[Barium toxicity]]
*[[Bismuth toxicity]]
*[[Cadmium toxicity]]
*[[Chromium toxicity]]
*[[Cobalt toxicity]]
*[[Copper toxicity]]
*[[Gold toxicity]]
*[[Iron toxicity]]
*[[Lead toxicity]]
*[[Lithium toxicity]]
*[[Manganese toxicity]]
*[[Mercury toxicity]]
*[[Nickel toxicity]]
*[[Phosphorous toxicity]]
*[[Platinum toxicity]]
*[[Selenium toxicity]]
*[[Silver toxicity]]
*[[Thallium toxicity]]
*[[Tin toxicity]]
*[[Zinc toxicity]]
==Evaluation==
*
==Management==
*Decontamination
==Disposition==
*Consult Toxicology or Poison Control Center
==References==
<references/>
Dawson, A. Barium. In: Goldfrank's Toxicologic Emergencies. 9th Ed. New York: McGraw-Hill; 2011: 1434-1436

[[Category:Toxicology]]