Treatment of Bromide Intoxication with Ethacrynic Acid and Mannitol Diuresis
Authors: JAMES S. ADAMSON
Journal: Annals of Internal Medicine (1966)

Case Studies1 October 1966Treatment of Bromide Intoxication with Ethacrynic Acid and Mannitol DiuresisJAMES S. ADAMSON JR., M.D., WILLIAM J. FLANIGAN, M.D., GEORGE L. ACKERMAN, M.D.JAMES S. ADAMSON JR., M.D.Search for more papers by this author, WILLIAM J. FLANIGAN, M.D.Search for more papers by this author, GEORGE L. ACKERMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-65-4-749 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAlthough bromides are rarely prescribed as sedatives or anticonvulsants, bromide intoxication remains a significant clinical problem because the drug is readily available in nonprescription compounds. In a recent study it was found that 10% of patients admitted to a psychiatric hospital had detectable blood bromide levels, and 2% were considered to have clinically significant bromism (1). For this latter group prolonged hospitalization is required, and death occurs in rare instances. In patients with severe toxic manifestations numerous means of therapy have been used, including salt loading (2), diuretics (3), gastric aspiration (4), and hemodialysis (5, 6). This paper reports the...References1. EWINGGRANT JAWJ: The bromide hazard. Southern Med. J. 58: 148, 1965. CrossrefMedlineGoogle Scholar2. WOHLROBERTSON MGHF: Bromide in toxication: some observations on its treatment with sodium chloride and desoxycorticosterone. Penn. Med. J. 47: 802, 1944. Google Scholar3. HUSSARHOLLEY AEHL: Treatment of bromide intoxication with mercurial diuretics. Amer. J. Med. 20: 100, 1956. CrossrefMedlineGoogle Scholar4. SHEILSDYKE WSRW: Bromism treated by gastric stimulation and aspiration. Arch. Intern. Med. (Chicago) 114: 71, 1964. CrossrefMedlineGoogle Scholar5. MERRILLWELLER JPJM: Treatment of bromism with the artificial kidney. Ann. Intern. Med. 37: 186, 1952. LinkGoogle Scholar6. 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CrossrefMedlineGoogle Scholar12. BODANSKYMODELL OWK: The differential excretion of bromide and chloride ions and its role in bromide retention. J. Pharmacol. Exp. Ther. 73: 51, 1951. Google Scholar13. WOLFEADIE RLGS: Reabsorption of bromides by kidney. Amer. J. Physiol. 163: 436, 1950. CrossrefMedlineGoogle Scholar14. SÖREMARK R: The biological half-life of bromide ions in human blood. Acta Physiol. Scand. 50: 119, 1960. CrossrefGoogle Scholar15. FLANIGANACKERMAN WJGL: Site of action of ethacrynic acid. Arch. Intern. Med. (Chicago) 118: 117, 1966. CrossrefMedlineGoogle Scholar16. GOLDBERGMCCURDYFOLTZBLUEMLE MDKELLW: Effects of ethacrynic acid (a new saluretic agent) on renal diluting and concentrating mechanisms: evidence for site of action in the loop of Henle. J. Clin. Invest. 43: 201, 1964. CrossrefMedlineGoogle Scholar17. BERGSTRÖM J: Muscle electrolytes in man: determined by neutron activation analysis on needle biopsy specimens; a study on normal subjects, kidney patients, and patients with chronic diarrhoea. Scand. J. Clin. Lab. Invest. 14 (suppl. 68): 1, 1962. Google Scholar18. ULLBERGAPPELGRENCLEMEDSONERICSSONEWALDSSONSÖRBOSÖREMARK SLCJYBBR: A comparison of the distribution of some halide ions in the body. Biochem. Pharmacol. 13: 407, 1964. CrossrefMedlineGoogle Scholar19. SENSENBACH W: Bromide intoxication. JAMA 125: 769, 1944. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Little Rock, ArkansasFrom the Department of Medicine, University of Arkansas School of Medicine, Little Rock, Ark.This work was supported in part by grant FR-49, Division of Research Facilities and Resources, the U. S. Public Health Service, Washington, D. C.Requests for reprints should be addressed to William J. Flanigan, M.D., Department of Medicine, University of Arkansas School of Medicine, Little Rock, Ark. 72205.*Kindly supplied by Dr. William H. Wilkinson, Merck Sharp & Dohme Research Laboratory, West Point, Pa. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byUnexplained Bromide Toxicity Presenting as Hyperchloremia and a Negative Anion GapPseudonormalization of the Serum Anion Gap in a Patient with Ketoacidosis Caused by Bromvalerylurea IntoxicationBromoderma mimicking pyoderma gangrenosum caused by commercial sedativesCase files of the medical toxicology fellowship at the New York City Poison Control: Bromism: Forgotten, but not goneAtaxia associated with spurious hyperchloremia: the one behind the sceneElimination of nonspecific radioactivity from [76Br]bromide in PET study with [76Br]bromodeoxyuridineBromism from Excessive Cola ConsumptionThe Toxicology of Bromide IonToxin DisordersSerum Bromide After General Anaesthesia with HalothaneTHE TREATMENT OF NONBARBITURATE SEDATIVE OVERDOSAGEEthacrynic acid and furosemideDiuretic synergy in the treatment of acute experimental cerebral edemaClinical pharmacology furosemide and ethacrynic acid 1 October 1966Volume 65, Issue 4Page: 749-752KeywordsAnticonvulsantsHospitalizationsIntoxicationIsotonicityMannitolMedical servicesResearch facilitiesResearch laboratoriesSaltsSedatives ePublished: 1 December 2008 Issue Published: 1 October 1966 PDF downloadLoading ...