keyword
Keywords "Toxicology" AND "Overdose" AN...

"Toxicology" AND "Overdose" AND "Emergency"

https://read.qxmd.com/read/38529697/has-the-rescheduling-of-modified-release-paracetamol-in-australia-affected-the-frequency-of-overdoses
#1
JOURNAL ARTICLE
Michaela J Ryan, Andis Graudins, Nicole O'Shea, Firouzeh Noghrehchi, Anselm Wong
OBJECTIVES: In June 2020, modified-release paracetamol (paracetamol-MR) preparations were up-scheduled from schedule-2 (available in pharmacy) to schedule-3 (available by request to a pharmacist only). The present study aims to ascertain whether up-scheduling affected the frequency of paracetamol-MR overdoses. METHODS: This is a retrospective cohort study of two data sets from 1 June 2017 to 31 May 2022. Monash Health data were extracted using the diagnosis of paracetamol overdose coding and electronic medical records data...
March 26, 2024: Emergency Medicine Australasia: EMA
https://read.qxmd.com/read/38517223/performance-of-fentanyl-immunoassays-in-an-ed-patient-population
#2
JOURNAL ARTICLE
Catherine M Mills, Parker C Dryja, Elizabeth Champion-Lyons, Charles Keppler, Nikolina Babic
BACKGROUND: Fentanyl is a synthetic opioid fueling the current opioid crisis in the United States. While emergency department (ED) visits due to opioid-related overdoses, injection complications, and withdrawals become increasingly more frequent, fentanyl is not detected in routine toxicology testing. We evaluated 2 FDA-approved fentanyl immunoassays in a sampled ED population. METHODS: De-identified, remnant urine specimens (n = 213) collected from patients presenting to a large ED were analyzed using ARK Fentanyl II (ARK II) and Immunalysis SEFRIA (SEFRIA) fentanyl immunoassays on an Architect c16000 (Abbott) analyzer...
March 22, 2024: Journal of Applied Laboratory Medicine
https://read.qxmd.com/read/38481307/older-adult-drug-overdose-an-application-of-latent-class-analysis-to-identify-prevention-opportunities
#3
JOURNAL ARTICLE
Maryann Mason, Kaveet Pandya, Alexander Lundberg
BACKGROUND: Older adult overdose death rates have increased significantly in recent years. However, research for prevention of drug overdose death specific to older adults is limited. Our objective is to identify profiles based on missed intervention points (touchpoints) to inform prevention of future older adult unintentional overdose deaths. METHODS: We used latent class analysis methods to identify profiles of decedents aged 55 + years in the Illinois Statewide Unintentional Drug Overdose Reporting System...
March 13, 2024: Harm Reduction Journal
https://read.qxmd.com/read/38463635/psychostimulant-drug-co-ingestion-in-non-fatal-opioid-overdose
#4
JOURNAL ARTICLE
Siri Shastry, Joshua Shulman, Kim Aldy, Jeffrey Brent, Paul Wax, Alex F Manini
INTRODUCTION: In 2019, there were over 16,000 deaths from psychostimulant overdose with 53.5% also involving an opioid. Given the substantial mortality stemming from opioid and psychostimulant co-exposure, evaluation of clinical management in this population is critical but remains understudied. This study aims to characterize and compare clinical management and outcomes in emergency department (ED) overdose patients with analytically confirmed exposure to both opioids and psychostimulants with those exposed to opioids alone...
March 2024: Drug Alcohol Depend Rep
https://read.qxmd.com/read/38461132/emergency-department-take-home-naloxone-improves-access-compared-with-pharmacy-dispensed-naloxone
#5
JOURNAL ARTICLE
Jeremy Hardin, Justin Seltzer, Henrik Galust, Adriann Deguzman, Ian Campbell, Nathan Friedman, Gabriel Wardi, Richard F Clark, Daniel Lasoff
BACKGROUND: Opioid overdose is a major cause of mortality in the United States. In spite of efforts to increase naloxone availability, distribution to high-risk populations remains a challenge. OBJECTIVE: To assess the effects of multiple different naloxone distribution methods on patient obtainment of naloxone in the emergency department (ED) setting. METHODS: Naloxone was provided to patients in three 12-month phases between February 2020 and February 2023...
December 3, 2023: Journal of Emergency Medicine
https://read.qxmd.com/read/38426636/a-multicentre-case-series-of-analytically-confirmed-gamma-hydroxybutyrate-intoxications-in-western-australian-emergency-departments-pre-hospital-circumstances-co-detections-and-clinical-outcomes
#6
JOURNAL ARTICLE
Jennifer L Smith, Shaun Greene, David McCutcheon, Courtney Weber, Ellie Kotkis, Jessamine Soderstrom, Bianca Douglas, Simon Lenton, Jodie Grigg, Paul Dessauer, Nadine Ezard, Daniel M Fatovich
INTRODUCTION: Gamma-hydroxybutyrate (GHB) use is associated with high risk of accidental overdose. This study examined the pre-hospital circumstances, demographic characteristics and clinical outcomes of analytically confirmed GHB emergency department (ED) presentations in Western Australia (WA). METHODS: This case series was conducted across three WA EDs involved in the Emerging Drugs Network of Australia, from April 2020 to July 2022. Patient demographics, pre-hospital drug exposure circumstances and ED presentation and outcome characteristics were collected from ambulance and hospital medical records of GHB-confirmed cases...
March 1, 2024: Drug and Alcohol Review
https://read.qxmd.com/read/38364689/the-presence-of-abdominal-pain-associated-with-acetaminophen-overdose-does-not-predict-severity-of-liver-injury
#7
JOURNAL ARTICLE
Chen Wang, Anselm Wong
AIM: Whilst it is known that abdominal pain is a common symptom in patients with acetaminophen overdose, its association with severity of liver injury has not been clearly defined. This study investigates the association between the symptom of abdominal pain on presentation to hospital and the degree of liver injury post-acetaminophen overdose. METHODS: Admissions with acetaminophen poisoning, requiring treatment with acetylcysteine were identified and reviewed from a search of a large Australian tertiary hospital network from February 20th, 2014, to August 30th, 2018...
February 10, 2024: American Journal of Emergency Medicine
https://read.qxmd.com/read/38361719/clinical-and-epidemiological-study-of-poisoning-cases-presenting-to-the-emergency-department-of-a-tertiary-care-center-in-central-india
#8
JOURNAL ARTICLE
Sanjay Samaria, Vinay Pandit, Swapnil Akhade, Subhabrata Biswal, Pankaj K Kannauje
Objective To analyze the clinical and epidemiological characteristics of acute cases of poisoning and the pre-hospital measures that the patient receives before seeking care in an emergency department at a tertiary care center in Central India. Methods An observational prospective study was carried out over 18 months, and the relevant findings were documented using a predesigned data collection form. All patients who presented to the emergency department and were 18 years of age or older were recruited, and consent was sought...
January 2024: Curēus
https://read.qxmd.com/read/38353737/n-desethyl-isotonitazene-detected-in-polydrug-users-admitted-to-hospital-in-birmingham-united-kingdom
#9
JOURNAL ARTICLE
Mark Pucci, Gurpreet Singh Jutley, Jonathan Looms, Loretta Ford
INTRODUCTION: Nitazenes are potent synthetic opioids and N-desethyl isotonitazene, a metabolite of isotonitazene, has emerged as a drug in its own right. METHODS: This is an observational case series of patients with suspected or declared substance use who were admitted to hospitals in the Sandwell and West Birmingham National Health Service Trust between July and October 2023. All patients were found on toxicological screening to have been exposed to N-desethyl isotonitazene...
January 2024: Clinical Toxicology
https://read.qxmd.com/read/38344520/benzodiazepine-and-zolpidem-induced-bradycardia-a-case-report
#10
Ivan Ivanov, Rachel Kirzhner, Brenda Sokup, Yan Sun
Benzodiazepines and zolpidem are commonly used in suicide attempts. They have previously been thought to have very few side effects outside of central nervous system depression, and are considered relatively safe even in overdoses. Cardiovascular manifestations of these overdoses are exceedingly rare. We depict a case where an unknown woman appearing to be in her 50s presented to our emergency department somnolent after a large ingestion of alprazolam, clonazepam, and zolpidem. During the evaluation, the patient became bradycardic to 35 beats per minute on the monitor, which responded to atropine administration...
January 2024: Curēus
https://read.qxmd.com/read/38344049/calcium-channel-blocker-overdose
#11
JOURNAL ARTICLE
Jessica G Andrusaitis, Alan Givertz
AUDIENCE: Emergency medicine residents and medical students on emergency medicine rotation. BACKGROUND: Calcium channel blocker (CCB) overdoses can be severe with potentially serious adverse outcomes. CCBs work by blocking the calcium channels on smooth and cardiac muscle tissue. At low dose ranges, dihydropyridine CCBs (such as nifedipine, amlodipine, and nicardipine) block the L-type calcium receptors in the peripheral vasculature, whereas non-dihydropyridine CCBs (such as: verapamil and diltiazem) affect the L-type calcium receptors in the myocardium...
January 2024: Journal of education & teaching in emergency medicine
https://read.qxmd.com/read/38183731/a-fatal-case-of-aspiration-due-to-consumption-of-the-hallucinogenic-tryptamine%C3%A2-derivative-dipropyltryptamine-dpt
#12
JOURNAL ARTICLE
Merja A Neukamm, Stefan Pollak, Vanessa Thoma, Susanne Vogt, Laura M Huppertz, Volker Auwärter
BACKGROUND AND AIM: This case involves a 20-year-old man with prior hallucinogen-use experience, who sniffed an unknown amount of dipropyltryptamine in an apartment. Dipropyltryptamine, a hallucinogenic compound belonging to the tryptamine class is recognized for inducing effects similar to dimethyltryptamine (DMT) but with a longer duration. Ten to fifteen minutes later he experienced visual hallucinations, followed by increasing apathy. Two hours post consumption he developed abdominal pain, leading to collapse, seizure, and vomiting...
January 2, 2024: Journal of Pharmaceutical and Biomedical Analysis
https://read.qxmd.com/read/38123961/trip-killers-a-concerning-practice-associated-with-psychedelic-drug-use
#13
JOURNAL ARTICLE
Gregory Yates, Emily Melon
No abstract text is available yet for this article.
December 19, 2023: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/38071697/youth-fatal-drug-overdose-and-suicide-trends-in-connecticut-2019-2021
#14
JOURNAL ARTICLE
Yifrah Kaminer, Rebecca Burke, Simon Zhornitsky, James Gill, Kristyn Zajac, Victor Hesselbrock
BACKGROUND AND OBJECTIVES: Increasing rates of fatal drug overdose (FDO) among youth since 2016 have been driven by fentanyl and polysubstance use. Suicide by youth also increased steadily since 2007. The manner of FDO may be accidental (i.e., unintentional) or suicidal (i.e., intentional). This report examines the rate of youth intentional and unintentional FDO as well as specific drug toxicology in Connecticut, between the years 2019 and 2021, compared to a 2016-2018 report. METHODS: We reviewed N = 286 consecutive FDO files of youth, <26 years of age dated for 2019-2021 from the Connecticut Medical Examiner's office...
December 10, 2023: American Journal on Addictions
https://read.qxmd.com/read/38046561/toxicology-test-results-for-public-health-surveillance-of-the-opioid-epidemic-retrospective-analysis
#15
JOURNAL ARTICLE
Titus Schleyer, Bill Robinson, Samir Parmar, Diane Janowiak, P Joseph Gibson, Val Spangler
BACKGROUND: Addressing the opioid epidemic requires timely insights into population-level factors, such as trends in prevalence of legal and illegal substances, overdoses, and deaths. OBJECTIVE: This study aimed to examine whether toxicology test results of living individuals from a variety of sources could be useful in surveilling the opioid epidemic. METHODS: A retrospective analysis standardized, merged, and linked toxicology results from 24 laboratories in Marion County, Indiana, United States, from September 1, 2018, to August 31, 2019...
2023: Online Journal of Public Health Informatics
https://read.qxmd.com/read/38044125/a-case-of-pulmonary-edema-due-to-guanfacine-intoxication-with-measurement-of-serum-guanfacine-concentrations
#16
JOURNAL ARTICLE
Ryo Ayata, Motoki Fujita, Kayoko Harada, Yusuke Esaki, Yasutaka Koga, Yukari Hisamoto, Maki Asami-Noyama, Saki Takeda, Kazuki Harada, Ryosuke Tsuruta
Guanfacine hydrochloride extended-release (GXR) is used to treat attention deficit hyperactivity disorder. It is a selective α2A-adrenorecepor agonist that was reported to cause QT prolongation and hypotension in the event of overdosing. We report the case of a 17-year-old man who took 226 tablets of GXR 3 mg for attempted suicide. He was found complaining of dyspnea, and emergency medical services were called. When the patient was transferred to our hospital, his Glasgow coma scale was 12 (E4V3M5). He was agitated and hypoxemic...
2023: Journal of Toxicological Sciences
https://read.qxmd.com/read/38039052/american-college-of-medical-toxicology-and-the-american-academy-of-clinical-toxicology-position-statement-nalmefene-should-not-replace-naloxone-as-the-primary-opioid-antidote-at-this-time
#17
JOURNAL ARTICLE
Andrew I Stolbach, Maryann E Mazer-Amirshahi, Lewis S Nelson, Jon B Cole
BACKGROUND: Nalmefene is a potent opioid antagonist that has recently been reintroduced in the United States to treat known or suspected opioid overdose. NALMEFENE CLINICAL TRIAL DATA: The injection formulation, which had been withdrawn in 2008, was reintroduced in 2022, and in 2023 the United States Food and Drug Administration approved a new intranasal formulation of nalmefene. Because nalmefene had been previously approved for use in 1995 via injection, the new intranasal formulation did not require new clinical data as it was approved under an Abbreviated New Drug Application...
December 1, 2023: Clinical Toxicology
https://read.qxmd.com/read/37989071/comprehensive-evaluation-of-drug-cases-in-seoul-and-its-metropolitan-areas-2022
#18
JOURNAL ARTICLE
Jihyun Kim, Hyesun Yum, Seojin Kang, Nahyun Lee, June Song, Yuran Park, Sanggil Choe, Meejung Park
In order to prepare a response strategy for future drug analyses, the number and results of drug cases handled by the Seoul Institute of National Forensic Service were comprehensively evaluated, with a focus on Seoul and its metropolitan areas. In 2022, the Seoul Institute received approximately 12,150 requests for drug testing related to drug abuse and possession, and the urine samples were tested for approximately 16,000 drug species. The most frequently requested test was for cannabis (Δ-9-THC and Δ-8-THC), followed by methamphetamine, MDMA, ketamine, and synthetic cannabinoids...
November 4, 2023: Forensic Science International
https://read.qxmd.com/read/37964569/the-need-to-rethink-harm-reduction-for-people-using-drugs-alone-to-reduce-overdose-fatalities
#19
JOURNAL ARTICLE
Vaishali S Deo, Manreet K Bhullar, Thomas P Gilson, Daniel J Flannery, Sarah E Fulton
Background : During the ongoing opioid epidemic, Cuyahoga County (second largest in Ohio) reported overdose mortality rates (54/per 100,000) higher than the national average. Prior research demonstrates that people who use drugs often use alone but there is minimal research on people who died of overdose while using alone. The objective of this study is to examine sociodemographic, toxicologic, and injury characteristics, and emergency medical response to overdose decedents who died using drugs alone. Method : Data from the Cuyahoga County Medical Examiner's Office (2016-2020, N  = 2944) on unintentional overdose deaths in adults was tabulated including socio-demographic, toxicologic, and injury-related information...
November 15, 2023: Substance Use & Misuse
https://read.qxmd.com/read/37941108/pharmacobezoar-related-fatalities-a-case-report-and-a-review-of-the-literature
#20
JOURNAL ARTICLE
Guillaume Drevin, Stéphane Malbranque, Nathalie Jousset, Séverine Férec, Donca Zabet, Antoine Baudriller, Marie Briet, Chadi Abbara
Pharmacobezoars develop after an acute overdose or during routine drug administration. Here, the authors present a case of fatal multidrug overdose involving a 62-year-old woman. Her usual treatment included tramadol extended-release, citalopram, and mirtazapine. Furthermore, she self-medicated and misused her husband's medications. The autopsy revealed the presence of a voluminous medication bezoar in the stomach. No mechanical complication was noted. Toxicologic analyses were performed using gas chromatography with flame ionization detection, liquid chromatography with diode array detection, gas chromatography with mass spectrometry detection, and liquid chromatography coupled to tandem mass spectrometry...
November 8, 2023: Therapeutic Drug Monitoring
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