Hydrazine toxicity - Revision history

Rossdonaldson1: /* Differential Diagnosis */

2024-07-17T20:06:34Z

Differential Diagnosis

← Older revision		Revision as of 20:06, 17 July 2024
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	==Differential Diagnosis==		==Differential Diagnosis==
			{{Space medicine}}
	{{Inhalation exposure}}		{{Inhalation exposure}}

Rossdonaldson1: /* Differential Diagnosis */

2024-05-29T22:25:10Z

Differential Diagnosis

← Older revision		Revision as of 22:25, 29 May 2024
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	==Differential Diagnosis==		==Differential Diagnosis==
			{{Inhalation exposure}}

	==Evaluation==		==Evaluation==

Ostermayer: /* Background */

2024-05-15T15:29:51Z

Background

← Older revision		Revision as of 15:29, 15 May 2024
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	* Used in rocket fuels, missile fuels, aircraft emergency power unit fuel (notably the F-16)		* Used in rocket fuels, missile fuels, aircraft emergency power unit fuel (notably the F-16)
	* Used in chemical manufacturing (intermediate for insecticides/herbicides/dyes, polymerization catalyst for making plastics, used to manufacture sodium azide [air bag propellant], used to make isoniazid and fluconazole		* Used in chemical manufacturing (intermediate for insecticides/herbicides/dyes, polymerization catalyst for making plastics, used to manufacture sodium azide [air bag propellant], used to make isoniazid and fluconazole
	*Hydrazine is used as a propellant ~~inthe~~ International Space Station		*Hydrazine is used as a propellant in the International Space Station

	===Toxic Dose===		===Toxic Dose===
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	* Metabolism of hydrazine produces free radical intermediates		* Metabolism of hydrazine produces free radical intermediates
	* Inhibits pyridoxine kinase as well as glutamic acid decarboxylase which results in decrease production of GABA neurotransmitter		* Inhibits pyridoxine kinase as well as glutamic acid decarboxylase which results in decrease production of GABA neurotransmitter

			[[Category:Toxicology]]
			[[Category:Space Medicine]]

	==Clinical Features==		==Clinical Features==

Ostermayer at 15:29, 15 May 2024

2024-05-15T15:29:16Z

← Older revision		Revision as of 15:29, 15 May 2024
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	* Used in rocket fuels, missile fuels, aircraft emergency power unit fuel (notably the F-16)		* Used in rocket fuels, missile fuels, aircraft emergency power unit fuel (notably the F-16)
	* Used in chemical manufacturing (intermediate for insecticides/herbicides/dyes, polymerization catalyst for making plastics, used to manufacture sodium azide [air bag propellant], used to make isoniazid and fluconazole		* Used in chemical manufacturing (intermediate for insecticides/herbicides/dyes, polymerization catalyst for making plastics, used to manufacture sodium azide [air bag propellant], used to make isoniazid and fluconazole
			*Hydrazine is used as a propellant inthe International Space Station

	===Toxic Dose===		===Toxic Dose===

ClaireLewis at 19:56, 1 October 2019

2019-10-01T19:56:35Z

← Older revision		Revision as of 19:56, 1 October 2019
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	** functional B6 deficiency results		** functional B6 deficiency results
	* Metabolism of hydrazine produces free radical intermediates		* Metabolism of hydrazine produces free radical intermediates
	* Inhibits ~~pryidoxine~~ kinase as well as glutamic acid decarboxylase which results in decrease production of GABA neurotransmitter		* Inhibits pyridoxine kinase as well as glutamic acid decarboxylase which results in decrease production of GABA neurotransmitter

	==Clinical Features==		==Clinical Features==
	~~===Health Effects===~~		*Short term inhalation exposure may cause:
	* Short term inhalation exposure may cause ~~coughing~~, ~~irritation of throat~~/~~lungs, development of~~ pulmonary edema, ~~central nervous system depression, convulsions, tremors~~, ~~or seizures~~		**[[Cough]], oropharyngeal/pulmonary irritation
	* Long term inhalation exposure may cause liver and kidney damage		**[[Pulmonary edema]]
	* Ingestion ~~may cause nausea,~~ vomiting, ~~uncontrolled shaking~~, inflammation ~~of nerves, drowsiness~~, coma		**[[CNS Depression]], [[seizure]], [[tremor]]
	* ~~Short term contact~~ exposure ~~may cause dermatitis and/or~~ chemical ~~burn~~, can ~~also lead to~~ hemolytic anemia ~~once absorbed~~		*Long term inhalation exposure:
			**Above, plus may cause [[hepatic failure\|liver]] and [[renal failure\|kidney damage]]
	~~===Signs and Symptoms===~~		*Ingestion
	* Dizziness, nausea, itching, skin burning, tearing, coughing, excitement, tremors, polyneuritis, impaired cognition, lethargy, ~~convulsions~~		**[[Nausea/vomiting]]
			**Uncontrollable shaking, [[seizure]], nerve inflammation/polyneuritis, [[coma]]
			*Contact exposure
			**[[rash\|Dermatitis]], [[chemical burns]]
			**If absorbed systemically, can -> [[hemolytic anemia]], [[methemoglobinemia]]

	==Differential Diagnosis==		==Differential Diagnosis==

	==Evaluation==		==Evaluation==
	* ~~Monitor vital signs and mental status~~		*BMP
	* ~~Examination with emphasis on skin, lungs~~, ~~central nervous system~~		*[[LFTs]]
	* ~~Labs - serum electrolytes, renal function, urine analysis, complete blood count, liver function test, pH, lactate level, monitor methemoglobin levels~~		*CBC
	* ~~Ancillary testing - chest x-ray and pulmonary function testing~~ if ~~inhalation~~ exposure or ~~patient has~~ pulmonary symptoms		*[[UA]]
			*[[VBG]], MetHb
			*[[Lactate]]
			*[[CXR]] if inhalational exposure or pulmonary symptoms

	==Management==		==Management==
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	* Respiratory distress - secure airway and assist ventilation		* Respiratory distress - secure airway and assist ventilation
	* [[Methemoglobinemia]] - initiate oxygen therapy, give methylene blue if patient is symptomatic; Methylene blue dose 1 mg/kg IV over 5 to 30 minutes repeat dose may be given 1 hour after first if symptoms persist		* [[Methemoglobinemia]] - initiate oxygen therapy, give methylene blue if patient is symptomatic; Methylene blue dose 1 mg/kg IV over 5 to 30 minutes repeat dose may be given 1 hour after first if symptoms persist
	* Consider hemodialysis and acidification of urine if member has severe CNS depression		* Consider [[hemodialysis]] and acidification of urine if member has severe CNS depression
	* [[Hypoglycemia]] treat with D10 and thiamine		* [[Hypoglycemia]] treat with D10 and [[thiamine]]

	==Disposition==		==Disposition==
	* Home in cases of mild skin exposure without burns		* Home in cases of mild skin exposure without burns
	* Observation for patients with ~~inhalational~~ or ingestion exposure for at least 12 hours to ensure no serious symptoms develop		* Observation for patients with inhalation or ingestion exposure for at least 12 hours to ensure no serious symptoms develop
	* Admit patients with CNS symptoms or persistent pulmonary/gastrointestinal symptoms		* Admit patients with CNS symptoms or persistent pulmonary/gastrointestinal symptoms

Rossdonaldson1: /* Mild to Moderate Exposure */

2018-02-16T07:23:45Z

Mild to Moderate Exposure

← Older revision		Revision as of 07:23, 16 February 2018
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	* Treat [[chemical burns]] if present		* Treat [[chemical burns]] if present
	* Monitor pulmonary status		* Monitor pulmonary status
	* Monitor for development of [[~~methhemoglobinemia~~]]		* Monitor for development of [[methemoglobinemia]]

	===Severe Exposure===		===Severe Exposure===

Rossdonaldson1: /* Management */

2018-02-16T07:23:26Z

Management

← Older revision		Revision as of 07:23, 16 February 2018
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	* Ensure patient has been decontaminated		* Ensure patient has been decontaminated
	* Irrigate eyes with normal saline or water if exposed		* Irrigate eyes with normal saline or water if exposed
	* Treat chemical burns if present		* Treat [[chemical burns]] if present
	* Monitor pulmonary status		* Monitor pulmonary status
	* Monitor for development of methhemoglobinemia		* Monitor for development of [[methhemoglobinemia]]

	===Severe Exposure===		===Severe Exposure===
	* Seizures - pyridoxine 25 mg/kg IM or IV up to 5 grams plus benzodiazepine		* [[Seizures]] - [[pyridoxine]] 25 mg/kg IM or IV up to 5 grams plus [[benzodiazepine]]
	* Respiratory distress - secure airway and assist ventilation		* Respiratory distress - secure airway and assist ventilation
	* Methemoglobinemia - initiate oxygen therapy, give methylene blue if patient is symptomatic; Methylene blue dose 1 mg/kg IV over 5 to 30 minutes repeat dose may be given 1 hour after first if symptoms persist		* [[Methemoglobinemia]] - initiate oxygen therapy, give methylene blue if patient is symptomatic; Methylene blue dose 1 mg/kg IV over 5 to 30 minutes repeat dose may be given 1 hour after first if symptoms persist
	* Consider hemodialysis and acidification of urine if member has severe CNS depression		* Consider hemodialysis and acidification of urine if member has severe CNS depression
	* Hypoglycemia treat with D10 and thiamine		* [[Hypoglycemia]] treat with D10 and thiamine

	==Disposition==		==Disposition==

Rossdonaldson1: /* Management */

2018-02-16T07:22:35Z

Management

← Older revision		Revision as of 07:22, 16 February 2018
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	==Management==		==Management==
	===Mild to Moderate Exposure===		===Mild to Moderate Exposure===
	** Ensure patient has been decontaminated		* Ensure patient has been decontaminated
	** Irrigate eyes with normal saline or water if exposed		* Irrigate eyes with normal saline or water if exposed
	** Treat chemical burns if present		* Treat chemical burns if present
	** Monitor pulmonary status		* Monitor pulmonary status
	** Monitor for development of methhemoglobinemia		* Monitor for development of methhemoglobinemia
	* Severe Exposure
	** Seizures - pyridoxine 25 mg/kg IM or IV up to 5 grams plus benzodiazepine		===Severe Exposure===
	** Respiratory distress - secure airway and assist ventilation		* Seizures - pyridoxine 25 mg/kg IM or IV up to 5 grams plus benzodiazepine
	** Methemoglobinemia - initiate oxygen therapy, give methylene blue if patient is symptomatic; Methylene blue dose 1 mg/kg IV over 5 to 30 minutes repeat dose may be given 1 hour after first if symptoms persist		* Respiratory distress - secure airway and assist ventilation
	** Consider hemodialysis and acidification of urine if member has severe CNS depression		* Methemoglobinemia - initiate oxygen therapy, give methylene blue if patient is symptomatic; Methylene blue dose 1 mg/kg IV over 5 to 30 minutes repeat dose may be given 1 hour after first if symptoms persist
	** Hypoglycemia treat with D10 and thiamine		* Consider hemodialysis and acidification of urine if member has severe CNS depression
			* Hypoglycemia treat with D10 and thiamine

	==Disposition==		==Disposition==

Rossdonaldson1: /* Management */

2018-02-16T07:22:15Z

Management

← Older revision		Revision as of 07:22, 16 February 2018
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	==Management==		==Management==
	* Mild to Moderate Exposure		===Mild to Moderate Exposure===
	** Ensure patient has been decontaminated		** Ensure patient has been decontaminated
	** Irrigate eyes with normal saline or water if exposed		** Irrigate eyes with normal saline or water if exposed

Rossdonaldson1: Rossdonaldson1 moved page Hydrazine to Hydrazine toxicity

2018-02-16T07:21:31Z

Rossdonaldson1 moved page Hydrazine to Hydrazine toxicity

← Older revision	Revision as of 07:21, 16 February 2018
(No difference)