Levamisole toxicity: Difference between revisions
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*an antihelminthic and immunomodulator that has been withdrawn from the U.S. and Canadian markets, due to the risk of serious side effects | *an antihelminthic and immunomodulator that has been withdrawn from the U.S. and Canadian markets, due to the risk of serious side effects | ||
*Increasingly used as a cutting agent in cocaine sold around the globe | *Increasingly used as a cutting agent in cocaine sold around the globe | ||
**69% of DEA seized cocaine contained levamisole (2009) | |||
*Results in Levamisole induced necrosis syndrome<ref>http://www.ncbi.nlm.nih.gov/pubmed/20668440</ref> | *Results in Levamisole induced necrosis syndrome<ref>http://www.ncbi.nlm.nih.gov/pubmed/20668440</ref> | ||
Revision as of 01:38, 16 December 2014
Background
- an antihelminthic and immunomodulator that has been withdrawn from the U.S. and Canadian markets, due to the risk of serious side effects
- Increasingly used as a cutting agent in cocaine sold around the globe
- 69% of DEA seized cocaine contained levamisole (2009)
- Results in Levamisole induced necrosis syndrome[1]
Clinical Features
- agranulocytosis
- neutropenia
- levamisole induced necrosis syndrome
- Necrotic patches anywhere on skin (especially ears and legs)
Differential Diagnosis
Workup
- CBC
Management
- Neutropenia
- Consider neupogen
- Observation for neutropenic fever
- Necrosis
- Aggressive supportive care
- Burn care if significant necrosis
- Avoid cocaine re-exposure
- 27% of pts had symptom recurrence with cocaine re-exposure[2]
Disposition
Admission
See Also
External Links
Sources
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/20668440
- ↑ Larocque, L. Hoffman, R. Clinical Toxicology: Levamisole in cocaine: Unexpected news from an old acquaintance. (2012), 50, 231-234