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Factory calendars are used throughout the system An easy way to understand them is to use them to specify which days are work days at a location These calendars may be used by the business to determine when a delivery must take place in order for it to reach the customer s site on a day when people are at work and can receive the delivery We also used factory calendars in consolidated invoicing That is, we specified that only one day a week was a working day for our customer and thus the billing documents were only to be created for that one day each week, causing many delivery documents from the whole week to be consolidated into one billing document We will focus on the creation and maintenance of the customer s shipping calendar

Ethanol blocks metabolism of the parent compounds by competing for the enzyme alcohol dehydrogenase The desired serum ethanol concentration is 100 mg/dL To achieve this, administer a loading dose of approximately 750 mg/kg orally or in a dilute intravenous solution (available from the pharmacy in 5% and 10% solution), and then provide a maintenance infusion of 100 150 mg/kg/h The infusion will have to be increased to about 175 250 mg/kg/h during hemodialysis to replace dialysis elimination of ethanol Fomepizole (4-methylpyrazole; Antizol) blocks alcohol dehydrogenase and can be used instead of ethanol A regional poison control center (800-222-1222) should be contacted for indications and dosing

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De Brabander N et al Fomepizole as a therapeutic strategy in paediatric methanol poisoning A case report and review of the literature Eur J Pediatr 2005 Mar;164(3):158 61 [PMID: 15578220] Leth PM et al Ethylene glycol poisoning Forensic Sci Int 2005 Dec 20;155(2 3):179 84 [PMID: 16226155] Megarbane B et al Current recommendations for treatment of severe toxic alcohol poisonings Intensive Care Med 2005 Feb;31(2):189 95 [PMID: 15627163] Pizon AF et al Hyperosmolality: another indication for hemodialysis following acute ethylene glycol poisoning Clin Toxicol (Phila) 2006;44(2):181 3 [PMID: 16615677] Takayesu JK et al Case records of the Massachusetts General Hospital Case 7-2006 A 47-year-old man with altered mental status and acute renal failure N Engl J Med 2006 Mar 9; 354(10):1065 72 [PMID: 16525144]

Methanol (wood alcohol) is commonly found in a variety of products, including solvents, duplicating fluids, record cleaning solutions, and paint removers It is sometimes ingested intentionally by alcoholic patients as a substitute for ethanol and may also be found as a contaminant in bootleg whiskey Ethylene glycol is the major constituent in most antifreeze compounds The toxicity of both agents is caused by metabolism to highly toxic organic acids methanol to formic acid; ethylene glycol to glycolic and oxalic acids

A large number of chemical agents are capable of oxidizing ferrous hemoglobin to its ferric state (methemoglobin), a form that cannot carry oxygen Drugs and chemicals known to cause methemoglobinemia include benzocaine (a local anesthetic found in some topical anesthetic sprays and a variety of nonprescription products), aniline, propanil, nitrites, nitrogen oxide gases, nitrobenzene, dapsone, phenazopyridine (Pyridium), and many others Dapsone has a long elimination half-life and may produce prolonged or recurrent methemoglobinemia

Shortly after ingestion of either of these agents, patients usually appear drunk The serum osmolality (measured with the freezing point device) is usually increased, but acidosis is often absent early After several hours, metabolism to toxic organic acids leads to a severe anion gap metabolic acidosis, tachypnea, confusion, convulsions, and coma Methanol intoxication frequently causes visual disturbances, while ethylene glycol often produces oxalate crystalluria and renal failure

For patients presenting within 30 60 minutes after ingestion, empty the stomach by gastric lavage (see p 1362) Charcoal is not very effective but should be administered if other poisons or drugs have also been ingested

Methemoglobinemia reduces oxygen-carrying capacity and may cause dizziness, nausea, headache, dyspnea, confusion, seizures, and coma The severity of symptoms depends on the percentage of hemoglobin oxidized to methemoglobin; severe poisoning is usually present when methemoglobin fractions are greater than 40 50% Even at low levels (15 20%), victims appear cyanotic because of the chocolate brown color of methemoglobin, but they have normal PO2 results on arterial blood gas determinations Pulse oximetry gives inaccurate oxygen saturation measurements; the reading is often between 85% and 90% Severe metabolic acidosis may be present Hemolysis may occur, especially in patients susceptible to oxidant stress (ie, those with glucose-6-phosphate dehydrogenase deficiency)

Partners | Shipping | Define Customer Calendars You ll see the screen shown in Figure 10-24 Two calendars must be maintained the holiday calendar initially, followed by the factory calendar, which is created on the basis of the holiday calendar

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