Fabric softener- classified into cationic and anionic fabric softeners. Quartenary ammonium cationic surfactants are the main active ingredient in the cationic fabric softeners while the salts of monoesters and diesters of phosphoric acid and fatty alcohols are the main ingredients in anionic fabric softeners. Toxicity includes an irritant dermatitis with dermal contact. Many are also flammable so that poses an additional risk.
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Typical heavy duty bathroom cleaners contain detergents, isopropyl alcohol, and benzalkonium chloride compounds which, when ingested, can lead to severe gastrointestinal burning, pain, nausea, vomiting, respiratory distress, shock and death. Benzalkonium chloride compounds are found in some cleaners in dilute concentrations for its surfactant properties but it can also cause severe skin and eye irritation. In July 2019, a nurse in Japan was recently arrested for suspected murder of 20 patients with benzalkonium chloride solution injections.
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Fireworks can lead to the formation of ambient air pollutants. The toxicity of this released particulate matter is based on size, shape, number and chemical composition of the firework airborne particles. In addition to respiratory irritation and bronchoconstriction, these firework particulates can trigger asthma attacks and COPD exacerbations in particularly susceptible patients. Children may be more susceptible than adults to the respiratory irritation. Image courtesy of Mostafa Sheshtawy, https://www.flickr.com/photos/msheshtawy/.
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Ferric Chloride 10% - Ferric chloride was historically utilized as a bedside testing reagent to assess for the presence of salicylates in urine. Direct toxicity of the compound and poor specificity as a test have resulted in limited clinical use of this reagent, with tests today commonly employing Trinder's reagent (mercuric chloride and hydrochloric acid).
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Flumazenil is a competitive benzodiazepine receptor antagonist. Its use in the role of reversal of an unknown overdose is limited due to its possible adverse effects of seizures and cardiac dysrhythmias in chronic benzodiazepines users. Flumazenil is ideally utilized in benzodiazepine-naive patients who have overdosed solely on a benzodiazepine or in reversal of these agents when given for procedural sedation. Flumazenil has no effect in reversing ethanol intoxication, but is effective for the non-benzodiazepine sleep agents such as zolpidem and zaleplon.
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Cardiac glycosides and related cardenolides are found in several plants, including Nerium oleander, Digitalis purpurea (Foxglove), Convallaria majalis (lily of the valley), red squill, and rhododendron and in toad venom (Bufo species).
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Fresh Start vitamin packet contains vitamin A, vitamin B complex (with inositol), vitamin C complex (with citrus bioflavonoids and quercetin), vitamin E, ginseng with bee pollen and royal jelly, flaxseed oil (with omega 3, 6, and 9 fatty acids), amino acid complex, "nutritional greens" (a blend of extracts from various vegetables), and a collection of minerals normally found in a multivitamin. Because the vitamins are present in quantities greater than 100% of the recommended daily value, toxicities could potentially occur in patients that consume other preparations of these vitamins at the same time or take multiple doses of this preparation. The ginseng with royal jelly and bee pollen component can introduce flower pollen allergens and may precipitate an allergic reaction or anaphylaxis.
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