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Sedative poisoning

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https://www.readbyqxmd.com/read/28768699/use-of-a-23-hour-emergency-department-observation-unit-for-the-management-of-patients-with-toxic-exposures
#1
Rupeng Mong, Gabriel Joseph Arciaga, Hock Heng Tan
BACKGROUND: A significant proportion of patients with toxic exposures presenting to the ED require admission. However, most will improve within 24 hours, and so could potentially be managed in a short-stay observation unit. We describe the management and outcomes of these patients in a 23-hour ED observation unit (EDOU). METHODS: A retrospective chart review of all patients with toxic exposures admitted to the EDOU in Singapore between 1 April 2013 and 31 March 2015 was performed...
August 2, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28691148/entomotoxicology-in-burnt-bodies-a-case-of-maternal-filicide-suicide-by-fire
#2
V Bugelli, L Papi, S Fornaro, F Stefanelli, S Chericoni, M Giusiani, S Vanin, C P Campobasso
One of the most common methods of maternal filicide is by fire. In this case study, a 40-year-old female and her children were found completely burned in a burnt out car. All bodies showed a degree of destruction by fire consisting to a level 3 of the Crow-Glassman Scale (CGS) and early stage of insect activity. Toxicological analyses were performed on soft tissues and body fluids still available. The results were positive for diazepam and its metabolites only for children with blood concentrations consistent with therapeutic doses of benzodiazepines...
July 9, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28575567/-psychosocial-characteristics-of-elderly-people-who-have-committed-suicide-attempts-poisoning
#3
V E Pashkovskiy, A G Sofronov, A E Dobrovolskaya, G A Prokopovich
The aim of this study is to identify psychosocial characteristics of older people who attempted suicide by self-poisoning. A total of 44 older people with suicide attempts by self-poisoning was examined, 12 of whom were male and 32 were female, their average age was 71,9+10,8. The comparison group consisted of 53 young people - 19 males and 34 females, their average age was 26,6+4,4. In both groups dominated deliberate self-poisoning with antiepileptic, sedative, soporific, Antiparkinson and psychotropic drugs (40,9 % vs 47,2 %, p>0,05)...
2017: Advances in Gerontology, Uspekhi Gerontologii
https://www.readbyqxmd.com/read/28357836/safety-of-hyperbaric-oxygen-therapy-in-mechanically-ventilated-patients
#4
Jacques Bessereau, Jérôme Aboab, Thomas Hullin, Anne Huon-Bessereau, Jean-Luc Bourgeois, Pierre-Marie Brun, Sylvie Chevret, Djillali Annane
BACKGROUND: To evaluate the epidemiology of patients who require mechanical ventilation during hyperbaric oxygen therapy. MATERIALS AND METHODS: One-hundred-fifty patients who required mechanical ventilation during hyperbaric oxygen therapy were prospectively studied during a 6-year period in a French university hyperbaric centre. We analysed the indication of hyperbaric oxygen therapy, agent used for sedation, presence of a chest tube, need for vasopressor agents and tolerance and appearance of side effects...
2017: International Maritime Health
https://www.readbyqxmd.com/read/28057198/comparison-of-poisonings-managed-at-military-and-veterans-administration-hospitals-reported-to-texas-poison-centers
#5
COMPARATIVE STUDY
M B Forrester
OBJECTIVES: There is little information on poisonings managed at military and Veterans Administration (VA) hospitals. This investigation described and compared poisonings reported to Texas poison centers that were managed at military and VA hospitals. STUDY DESIGN: Retrospective analysis of poison centre data. METHODS: Cases were poisonings among patients aged 18 years or more reported to Texas poison centers during 2000-2015 where management occurred at a military or VA hospital...
January 2017: Public Health
https://www.readbyqxmd.com/read/28007369/pentobarbital-in-the-context-of-possible-suicides-analysis-of-a-case
#6
Paula Melo, Pedro Costa, Maria José Quintas, André Castro, Sónia Tarelho, João Miguel Franco, Helena M Teixeira
Pentobarbital is a barbiturate, acting as a central nervous system depressant (CNS), being used for its anticonvulsant, sedative, hypnotic and anaesthetic properties. Barbiturates were replaced by benzodiazepines, leading to a decrease in poisoning cases with these compounds. However, pentobarbital is still used in many countries as an anaesthetic in veterinary medicine. Due to its properties, this compound is sought after by people who wish to commit suicide, acquiring it on the black market. The authors present an unusual fatal pentobarbital intoxication case, in a 37 years-old male salesperson, with no known connection with the veterinary field, being more difficult to obtain this compound...
May 2017: Forensic Science International
https://www.readbyqxmd.com/read/28004588/2015-annual-report-of-the-american-association-of-poison-control-centers-national-poison-data-system-npds-33rd-annual-report
#7
James B Mowry, Daniel A Spyker, Daniel E Brooks, Ashlea Zimmerman, Jay L Schauben
INTRODUCTION: This is the 33rd Annual Report of the American Association of Poison Control Centers' (AAPCC) National Poison Data System (NPDS). As of 1 January 2015, 55 of the nation's poison centers (PCs) uploaded case data automatically to NPDS. The upload interval was 9.52 [7.40, 13.6] (median [25%, 75%]) minutes, creating a near real-time national exposure and information database and surveillance system. METHODS: We analyzed the case data tabulating specific indices from NPDS...
December 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27977534/acute-mercury-poisoning-in-a-group-of-school-children
#8
Olcay Güngör, Ahmet Kağan Özkaya, Serkan Kirik, Tahir Dalkiran, Gülay Güngör, Sedat Işikay, Mehmet Davutoğlu, Cengiz Dilber
OBJECTIVE: Elemental mercury is a toxic liquid element that is used widely in the home, medicine, agriculture, and industry. It is readily vaporized and inhaled at room temperature. Thereby, inhalation can cause acute or chronic poisoning. Mercury can be found in environmental naturally find but some dangers sources give rise to contaminations. It can be very dangerous to all living organisms, especially children. METHODS: This study presents the features of mercury poisoning in a group of pediatric cases...
December 12, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27942054/effect-of-melatonin-on-duration-of-delirium-in-organophosphorus-compound-poisoning-patients-a-double-blind-randomised-placebo-controlled-trial
#9
H N Vijayakumar, K Ramya, Devika Rani Duggappa, Km Veeranna Gowda, K Sudheesh, S S Nethra, R S Raghavendra Rao
BACKGROUND AND AIMS: Organophosphate compound poisoning (OPCP) is associated with high incidence of delirium. Melatonin has been tried in the treatment of delirium and has shown a beneficial effect in OPCP. This study was conducted to know the effect of melatonin on duration of delirium and recovery profile in OPCP patients. METHODS: Double-blind randomised placebo control trial in which 56 patients of OPCP confirmed by history and syndrome of OPCP with low plasma pseudocholinesterase, aged >18 years and weighing between 50 and 100 kg, and Acute Physiology and Chronic Health Evaluation II score of <20 were studied...
November 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27905940/drug-poisoning-deaths-in-the-united-states-1999-2012-a-statistical-adjustment-analysis
#10
Christopher J Ruhm
BACKGROUND: Drug poisoning mortality in the US has risen rapidly but the drugs involved are frequently unspecified on death certificates. METHODS: Reported and adjusted proportions of specific drug types involved in fatal drug poisonings were calculated using vital statistics mortality data from 1999 to 2012. The adjusted proportions were those predicted to occur if at least one specific type of drug had been identified on the death certificates of all poisoning fatalities...
January 15, 2016: Population Health Metrics
https://www.readbyqxmd.com/read/27871720/-guidelines-for-the-prescription-of-mood-stabilizers-for-adolescents-a-literature-review
#11
G Munch, N Godart
INTRODUCTION: Adolescence is a unique phase of the human developmental process. In adolescents, psychotropic medications may have different efficacy and tolerance profiles compared to those at other stages of the lifespan. Mood stabilizers are a complex pharmacological category including lithium, some anticonvulsants, and some second generation antipsychotics. Focusing on this class of pharmacological agents, we aim to answer the following questions: in which indications and according to which modalities should mood stabilizers be prescribed during adolescence? METHODS: Information was sought from the websites of the French Haute Autorité de santé (HAS) and Agence nationale de sécurité du médicament et des produits de santé (ANSM), the American Food and Drug Administration (FDA) and the British National Institute for Health and Clinical Excellence (NICE)...
November 18, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27641627/mechanisms-of-tramadol-related-neurotoxicity-in-the-rat-does-diazepam-tramadol-combination-play-a-worsening-role-in-overdose
#12
Camille Lagard, Lucie Chevillard, Isabelle Malissin, Patricia Risède, Jacques Callebert, Laurence Labat, Jean-Marie Launay, Jean-Louis Laplanche, Bruno Mégarbane
Poisoning with opioid analgesics including tramadol represents a challenge. Tramadol may induce respiratory depression, seizures and serotonin syndrome, possibly worsened when in combination to benzodiazepines. Our objectives were to investigate tramadol-related neurotoxicity, consequences of diazepam/tramadol combination, and mechanisms of drug-drug interactions in rats. Median lethal-doses were determined using Dixon-Bruce's up-and-down method. Sedation, seizures, electroencephalography and plethysmography parameters were studied...
November 1, 2016: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/27480352/endotracheal-intubation-for-toxicologic-exposures-a%C3%A2-retrospective-review-of-toxicology-investigators-consortium%C3%A2-toxic-cases
#13
Gillian A Beauchamp, Robert G Hendrickson, Benjamin W Hatten
BACKGROUND: Endotracheal intubation remains a cornerstone of early resuscitation of the poisoned patient, but little is known about which substances are associated with intubation. OBJECTIVES: Our objective was to describe patient exposures to substances reported to the American College of Medical Toxicology (ACMT) Toxicology Investigators Consortium (ToxIC) that were managed with intubation between 2010 and 2014. METHODS: We performed a retrospective review of cases managed with endotracheal intubation in the ACMT ToxIC Registry from January 1, 2010 through December 31, 2014...
October 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27473444/xylazine-exposures-reported-to-texas-poison-centers
#14
Mathias B Forrester
BACKGROUND: Xylazine is a sedative, analgesic, anesthetic, and central muscle relaxant approved for animals but not humans. Although xylazine is an emerging drug of abuse, there are limited data on potentially adverse exposures to the drug. OBJECTIVES: The intent of this study was to describe potentially adverse xylazine exposures reported to a large poison center system. METHODS: All xylazine exposures reported to Texas poison centers between 2000 and 2014 were included...
October 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27367575/cyanide-suicide-after-deep-web-shopping-a-case-report
#15
Erwan Le Garff, Yann Delannoy, Vadim Mesli, Delphine Allorge, Valéry Hédouin, Gilles Tournel
Cyanide is a product that is known for its use in industrial or laboratory processes, as well as for intentional intoxication. The toxicity of cyanide is well described in humans with rapid inhibition of cellular aerobic metabolism after ingestion or inhalation, leading to severe clinical effects that are frequently lethal. We report the case of a young white man found dead in a hotel room after self-poisoning with cyanide ordered in the deep Web. This case shows a probable complex suicide kit use including cyanide, as a lethal tool, and dextromethorphan, as a sedative and anxiolytic substance...
September 2016: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/27366514/successful-management-of-aluminium-phosphide-poisoning-resulting-in-cardiac-arrest
#16
Sedat Hakimoğlu, İsmail Dikey, Ali Sarı, Leyla Kekeç, Kasım Tuzcu, Murat Karcıoğlu
Aluminum phosphide has high toxicity when it is ingested, and in case of contact with moisture, phosphine gas is released. Aluminum phosphide poisoning causes metabolic acidosis, arrhythmia, acute respiratory distress syndrome and shock, and there is no specific antidote. A 17-year-old male patient was referred to our hospital because of aluminum phosphide poisoning with 1500 mg of aluminum phosphide tablets. The patient's consciousness was clear but he was somnolent. Vital parameters were as follows: blood pressure: 85/56 mmHg, pulse: 88 beats/min, SpO2: 94%, temperature: 36...
August 2015: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27178268/skeletal-muscle-lactate-overproduction-during-metformin-intoxication-an-animal-study-with-reverse-microdialysis
#17
Alessandro Protti, Paolo Properzi, Sandra Magnoni, Alessandro Santini, Thomas Langer, Silvia Guenzani, Stefano Ferrero, Giulia Bassani, Nino Stocchetti, Luciano Gattinoni
Lactic acidosis during metformin intoxication is classically mainly attributed to diminished lactate clearance through liver gluconeogenesis. Here we studied 6 healthy, sedated and mechanically ventilated pigs to clarify whether high dose of metformin also increases skeletal muscle lactate production. Each animal had two microdialysis catheters inserted in gluteus muscles, one per side. One catheter was infused with saline (control) while the other one was infused with metformin diluted in saline (1M), both at a rate of 0...
July 25, 2016: Toxicology Letters
https://www.readbyqxmd.com/read/27117368/-dose-optimization-of-lipid-infusionin-treatment-of-patients-with-acute-dexmedetomidinepoisoning
#18
J P Wang, X W Huang, B J Zheng, Y Y Weng
OBJECTIVE: To optimize the dose of lipid infusion in treatment of patients with acute dexmedetomidinepoisoning, in order to further guide the rational use of medication in clinical practice. METHODS: A total of 80 patients with acute dexmedetomidinepoisoning were admitted in this study from January 2012 to October 2014 at our hospital and divided into three groups based on the intensity of poisoning, including: slight poisoning (28 cases), moderate poisoning (32 cases) and severe poisoning (20 cases)...
April 19, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27104813/pediatric-ingestions-emergency-department-management
#19
REVIEW
Stacy M Tarango Md, Deborah R Liu Md
Pediatric ingestions present a common challenge for emergency clinicians. Each year, more than 50,000 children aged less than 5 years present to emergency departments with concern for unintentional medication exposure, and nearly half of all calls to poison centers are for children aged less than 6 years. Ingestion of magnetic objects and button batteries has also become an increasing source of morbidity and mortality. Although fatal pediatric ingestions are rare, the prescription medications most responsible for injury and fatality in children include opioids, sedative/hypnotics, and cardiovascular drugs...
April 2016: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/27086450/-on-the-history-of-barbiturates
#20
Svend Norn, Henrik Permin, Edith Kruse, Poul R Kruse
Throughout the history of humanity, numerous therapeutic agents have been employed for their sedative and hypnotic properties such as opium, henbane (Hyoscyamus niger) and deadly nightshade (Atropa belladonna), but also alcohol and wine. In the 19th century potassium bromide was introduced as a sedative - and antiepileptic drug and chloral hydrate as sedative-hypnotics. A new era was reached by the introduction of barbiturates. The story started with the chemist Adolf von Baeyer. His breakthrough in the synthesis of new agents as barbituric acid and indigo and his education of young chemists was of great importance for the science of organic chemistry and the development of the dye and medicine industry in the late 19th century...
2015: Dansk Medicinhistorisk årbog
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