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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: PhD, Pharmacist Lotte C.G. Høgberg, Bispebjerg Hospital, Denmark
- Second opponent: Associate Professor Arne Helland, NTNU - Norwegian University of Science and Technology
- Third member and chair of the evaluation committee: PhD, Senior Consultant Gudrun Høiseth, University of Oslo
Chair of the Defence
Professor II Theis Tønnessen, University of Oslo
Principal Supervisor
PhD, Senior Consultant Knut Erik Hovda, Oslo University Hospital
Summary
Antidotes are one important part of the treatment of poisonings. For some poisonings, it is time-critical and therefore necessary that the treatment is available when needed.
The morbidity and mortality after poisoning with the toxic alcohols methanol and ethylene glycol are high. Methanol poisonings often occur as large outbreaks with many affected after ingestion of alcohol also containing methanol, for example, homemade alcohol. Early diagnosis can improve the prognosis if treatment is given.
The aim of this thesis was to describe the antidote preparedness in Norwegian hospitals, further focusing on toxic alcohol poisoning in terms of cause, diagnosis and management.
We found that the antidote availability in Norwegian hospitals was variable and only one out five hospitals followed the national recommendations. Analysis of homemade alcohol from rice showed that the production process did not produce toxic amounts of methanol. This indicates that poisoning after consuming this is due to other reasons then the production process.
A modified formate oxidase enzyme had a high sensitivity and specificity for detection of formate, the toxic metabolite of methanol. A point of care model with this enzyme had a good specificity. This work is important for the further development of a bedside test for the diagnosis of methanol poisoning.
A prospective observation study of patients with toxic alcohol poisoning treated with the antidote fomepizole and continuous renal replacement therapy was performed to evaluate whether the dose recommendations achieved the desired plasma concentration. We found that 98 % of plasma samples were above the minimum level that inhibits toxic metabolite formation.
Additional information
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