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Sedative poisoning

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
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
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
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
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
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
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
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
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]
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
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
Snezana Djordjević, Jasmina Jović-Stosić, Vesna Kilibarda, Zoran Segrt, Natasa Perković-Vukcević
BACKGOUND/AIM: Flumazenil is benzodiazepine receptor antagonist. It has been studied for a various indications, including reversal of sedation after surgery or diagnostic procedures, awakening of comatose patients in benzodiazepine overdose, or for symptomatic treatment of hepatic encephalopathy. Some drugs, like theophylline, may prolong its elimination half-life. Considering the long half-life of diazepam and its metabolites, concomitant use of theophylline may reduce the need for repeated dosing of flumazenil in patients with acute diazepam poisoning...
February 2016: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Maxwell T Spadafore, Zeeshan Syed, Ilan S Rubinfeld
To enable automated maintenance of patient sedation in an intensive care unit (ICU) setting, more robust, quantitative metrics of sedation depth must be developed. In this study, we demonstrated the feasibility of a fully computational system that leverages low-quality electrocardiography (ECG) from a single lead to detect the presence of benzodiazepine sedatives in a subject's system. Starting with features commonly examined manually by cardiologists searching for evidence of poisonings, we generalized the extraction of these features to a fully automated process...
2015: AMIA ... Annual Symposium Proceedings
Michael Levine, Robert S Hoffman, Valéry Lavergne, Christine M Stork, Andis Graudins, Ryan Chuang, Samuel J Stellpflug, Martin Morris, Andrea Miller-Nesbitt, Sophie Gosselin
BACKGROUND: The use of intravenous lipid emulsion (ILE) therapy for the treatment of lipophilic drug toxicity is increasing. Despite this, the evidence for its effect in non-local anesthetic toxicity remains sparse. Furthermore, many case reports describe ILE use for substances in which no clear efficacy data exists. The American Academy of Clinical Toxicology established a lipid emulsion workgroup. The aim of this group is to review the available evidence regarding the effect of ILE in non-LA drug poisoning and develop consensus-based recommendations on the use of this therapy...
March 2016: Clinical Toxicology
Dorota Owsianik, Marek Wojtaszek, Elzbieta Mach-Lichota, Bartosz Korczowski
INTRODUCTION: Drug poisoning is a frequent cause of hospitalization in children and youth. The aim of the study was to evaluate the prevalence of drug poisoning in children in the region of Rzeszów city. MATERIAL AND METHODS: Medical records of paediatric patients hospitalized in The Regional Hospital No. 2 in Rzeszow between 2010 and 2014 was reviewed and data were collected using scientific protocol. The following factors were analyzed: type of medication causing intoxication, the causality of the event, duration and seasonality of hospitalization as well as demographic data, such as the patient's age and sex...
2015: Przegla̧d Lekarski
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...
2016: Population Health Metrics
Joanna Bhaskaran, Eric Johnson, James M Bolton, Jason R Randall, Natalie Mota, Cara Katz, Claudio Rigatto, Kurt Skakum, Dan Roberts, Jitender Sareen
OBJECTIVE: To examine population trends in serious intentional overdoses leading to admission to intensive care units (ICUs) in Winnipeg, Manitoba, Canada. METHOD: Participants consisted of 1,011 individuals presenting to any of the 11 ICUs in Winnipeg, Canada, with deliberate self-poisonings from January 2000 to December 2010. Eight categories of substances were created: poisons, over-the-counter medications, prescription medications, tricyclic antidepressants (TCAs), sedatives and antidepressants, anticonvulsants, lithium, and cocaine...
December 2015: Journal of Clinical Psychiatry
Yong-zhi Zhang, Hong-yuan He, Cai-meng She, Jie Lian
The Z-drugs (zolpidem, zopiclone, and zaleplon), as the innovative hypnotics, have an improvement over the traditional benzodiazepines in the management of insomnia. Z-drugs have significant hypnotic effects by reducing sleep latency and improving sleep quality, though duration of sleep may not be significantly increased. As benzodiazepines, Z-drugs exert their effects through increasing the transmission of γ-aminobutyric acid. Z-drugs overdose are less likely to be fatal, more likely would result in poisoning...
August 2015: Fa Yi Xue za Zhi
G A Beauchamp, S L Giffin, B Z Horowitz, A L Laurie, R Fu, R G Hendrickson
Patients may be intubated after exposure to a variety of substances because of respiratory failure, CNS sedation, pulmonary pathology, or cardiovascular instability. However, there is little data describing the types of substances that are associated with endotracheal intubation or the rates of intubation after these exposures. Evaluation of this association may inform future research on intubation after exposures to specific substances and guide poison prevention education. Our objective was to determine which exposures were commonly associated with intubation using the data from National Poison Data System (NPDS)...
June 2016: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
James B Mowry, Daniel A Spyker, Daniel E Brooks, Naya McMillan, Jay L Schauben
BACKGROUND: This is the 32nd Annual Report of the American Association of Poison Control Centers' (AAPCC) National Poison Data System (NPDS). As of 1 January 2014, 56 of the nation's poison centers (PCs) uploaded case data automatically to NPDS. The upload interval was 7.82 [7.02, 11.17] (median [25%, 75%]) minutes, creating a near real-time national exposure and information database and surveillance system. METHODOLOGY: We analyzed the case data tabulating specific indices from NPDS...
2015: Clinical Toxicology
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