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Glacial acetic acid is a dangerous chemical that has been associated with several adverse drug events involving patients over recent years. When diluted to the proper concentration, acetic acid solutions have a variety of medicinal uses. Unfortunately, despite warnings, the improper dilution of concentrated glacial acetic acid has resulted in severe burns and other related morbidities. We report on 2 additional case reports of adverse drug events involving glacial acetic acid as well as a review of the literature. A summary of published case reports is provided, including the intended and actual concentration of glacial acetic acid involved, the indication for use, degree of exposure, and resultant outcome. Strategies that have been recommended to improve patient safety are summarized within the context of the key elements of the medication use process.

A young adult male patient presented with an excessively prolonged prothrombin time (greater than 90 sec) following approximately two weeks of therapy with oral warfarin sodium, in doses between 2.5 and 5 mg/d. Repeated administration of vitamin K and fresh frozen plasma was required to reverse the anticoagulation and maintain a normalized prothrombin time. Serial warfarin plasma concentration measurements were used to interpret the apparently unusual prothrombin time response profile and to detect the possibility of covert drug ingestion.

An experimental technique that permits the extraction of orbit-averaged, differential energy spectra of trapped radiation belt protons using simple passive detectors is described. An inversion technique is used for the data analysis. The basic principle of the described system is measurement of the energy deposited in six thermoluminescent (TLD) detector assemblies behind various spherical absorbers. The technique has been applied to a detector assembly flown on four Shuttle flights. Although severe restraints were placed on the flight package, the differential energy spectra derived from these measurements are in good agreement with analytical results using a modified trapped proton environment model. The technique shows good promise for measuring the spectra in low inclination orbits where the flux of high energy galactic cosmic rays protons is small. Modifications to the detector assembly to improve the accuracy and to extend the range of the system to higher energies are suggested.