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poisoning by benzodiazepines

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https://www.readbyqxmd.com/read/28828702/-intoxication-with-psychotropic-drugs
#1
R Bellmann, M Joannidis
Psychotropic drugs are medications that are indicated for treatment of psychiatric disorders. Attempted suicide is the major reason for intoxication but inadvertent overdosing may also occur. Other psychotropic agents are taken because of their stimulating and hallucinogenic effects and many have a high addictive potential. Poisoning is usually due to accidental overdosing. For treatment of benzodiazepine and opioid intoxication, flumazenil and naloxone, respectively, are used as specific antagonists. For intoxication by tricyclic antidepressants, sodium bicarbonate is the treatment of choice...
August 21, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28753046/levetiracetam-in-toxic-seizures
#2
Ted Lee, Brandon J Warrick, Preeyaporn Sarangarm, Robert L Alunday, Silas Bussmann, Susan C Smolinske, Steven A Seifert
BACKGROUND/OBJECTIVES: The use of levetiracetam (LEV) in the management of drug-induced seizures has not been systematically investigated. Repetitive and continuous seizures that do not respond to benzodiazepines require second line therapy. Levetiracetam has a unique receptor binding site, rapid absorption, no known cardiac effects at therapeutic doses, and is theoretically a good candidate for use in drug-induced seizures. We evaluate the safety of LEV and its association with seizure cessation in this retrospective chart review of patients who received LEV as a control agent in drug-induced seizures...
July 28, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28739777/establishment-of-a-comprehensive-drug-overdose-fatality-surveillance-system-in-kentucky-to-inform-drug-overdose-prevention-policies-interventions-and-best-practices
#3
Sarah L Hargrove, Terry L Bunn, Svetla Slavova, Dana Quesinberry, Tracey Corey, William Ralston, Michael D Singleton, Van Ingram
BACKGROUND: According to the National Center for Health Statistics, Kentucky had the third highest drug overdose fatality rate in the nation in 2015 at 29.9 drug overdose fatalities per 100 000 population. OBJECTIVE: The elevated drug overdose fatality rate necessitated the development and implementation of a comprehensive multisource drug overdose fatality surveillance system (DOFSS). METHODS: DOFSS stakeholder work group members and data sources were identified, and memorandums of understanding were established...
July 24, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/28691148/entomotoxicology-in-burnt-bodies-a-case-of-maternal-filicide-suicide-by-fire
#4
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/28575013/adverse-drug-events-analysis-of-a-decade-a-portuguese-case-study-from-2004-to-2013-using-hospital-database
#5
Gianina Scripcaru, Ceu Mateus, Carla Nunes
PURPOSE: The goal of this study was to characterise adverse drug events (ADE), including both adverse drug reaction (ADR) and accidental poisoning by drugs (AP), considering age, gender, length of stay (LOS), number of deaths and year, during the period 2004-2013. Additionally distributions of the ten's most frequent ADR and AP were characterized, considering age-group and gender. METHODS: A retrospective descriptive nationwide study was conducted, based on the hospital discharges database in Portugal from 2004 to 2013, using ICD-9...
2017: PloS One
https://www.readbyqxmd.com/read/28566118/nbome-hallucinogenic-drug-exposures-reported-to-the-danish-poison-information-centre
#6
Gorm Roager Madsen, Tonny Studsgaard Petersen, Kim Peder Dalhoff
INTRODUCTION: N-benzylmethoxy (NBOMe) is a new class of hallucinogenic designer drugs sold on cheap blotter papers. They are potent 5-hydroxytryptamine-2A-receptor agonists, and since their recent entry into the drug market there have been worldwide reports of severe intoxications and even fatalities. This study reviews suspected NBOMe drug exposures reported to the Danish Poison Information Centre (DPIC). METHODS: Data from the DPIC database were extracted, including all enquiries with NBOMe exposures reported from 1 January 2013 to 30 June 2016...
June 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28542985/cholinesterase-reactivators-and-bioscavengers-for-pre-and-post-exposure-treatments-of-organophosphorus-poisoning
#7
REVIEW
Patrick Masson, Florian Nachon
Organophosphorus agents (OPs) irreversibly inhibit acetylcholinesterase (AChE) causing a major cholinergic syndrome. The medical counter-measures of OP poisoning have not evolved for the last 30 years with carbamates for pretreatment, pyridinium oximes-based AChE reactivators, antimuscarinic drugs and neuroprotective benzodiazepines for post-exposure treatment. These drugs ensure protection of peripheral nervous system and mitigate acute effects of OP lethal doses. However, they have significant limitations...
May 21, 2017: Journal of Neurochemistry
https://www.readbyqxmd.com/read/28441901/patient-emergency-assessment-following-deliberate-self-poisoning-with-benzodiazepines-can-cognitive-markers-predict-recall-of-the-psychiatric-interview-a-pilot-study
#8
J Salles, J Pariente, C Dimeglio, P Gandia, B Lemesle, A Giron, N Franchitto, L Schmitt, E Very
STUDY HYPOTHESIS: In cases of deliberate self-poisoning (DSP), patients often ingest benzodiazepines (BZDs), known to alter memory. Experts recommend recovery of the patient's cognitive capacity before psychiatric assessment. Unfortunately, there is no validated tool in common practice to assess whether sufficient cognitive recovery has occurred after DSP with BZDs to ensure patient memory of the assessment. OBJECTIVE: The aim of the study was to identify cognitive functions and markers which predict preserved memory of the mental health care plan proposed at the emergency department after DSP...
October 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28332123/self-poisoning-suicide-deaths-in-people-with-bipolar-disorder-characterizing-a-subgroup-and-identifying-treatment-patterns
#9
Ayal Schaffer, Lauren M Weinstock, Mark Sinyor, Catherine Reis, Benjamin I Goldstein, Lakshmi N Yatham, Anthony J Levitt
OBJECTIVE: To characterize self-poisoning suicide deaths in BD compared to other suicide decedents. METHODS: Extracted coroner data from all suicide deaths (n = 3319) in Toronto, Canada from 1998 to 2012. Analyses of demographics, clinical history, recent stressors, and suicide details were conducted in 5 subgroups of suicide decedents: BD self-poisoning, BD other methods, non-BD self-poisoning, non-BD other methods, and unipolar depression self-poisoning. Toxicology results for lethal and present substances were also compared between BD and non-BD self-poisoning subgroups as well as between BD and unipolar depression self-poisoning subgroups...
December 2017: International Journal of Bipolar Disorders
https://www.readbyqxmd.com/read/28253466/self-poisoning-by-older-australians-a-cohort-study
#10
Peter I Pillans, Colin B Page, Sivarajah Ilango, Anna Kashchuk, Geoffrey K Isbister
OBJECTIVE: To examine the epidemiology and severity of self-poisoning by older people in Australia; to compare these data with those for overdoses in younger adults. DESIGN, SETTING, PARTICIPANTS: A cohort study of people presenting to a tertiary toxicology centre after self-poisoning over 26 years (1987-2012). MAIN OUTCOME MEASURES: Hospital length of stay (LOS); types of drug ingested; intensive care unit (ICU) admissions; in-hospital deaths...
March 6, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28242045/epidemiology-of-overdose-episodes-from-the-period-prior-to-hospitalization-for-drug-poisoning-until-discharge-in-japan-an-exploratory-descriptive-study-using-a-nationwide-claims-database
#11
Yasuyuki Okumura, Nobuo Sakata, Kunihiko Takahashi, Daisuke Nishi, Hisateru Tachimori
BACKGROUND: Little is known about the nationwide epidemiology of the annual rate, causative substance, and clinical course of overdose-related admission. We aimed to describe the epidemiology of overdose episodes from the period prior to hospitalization for drug poisoning until discharge to home. METHODS: We assessed all cases of admission due to overdose (21,663 episodes) in Japan from October 2012 through September 2013 using the National Database of Health Insurance Claims and Specific Health Checkups of Japan...
August 2017: Journal of Epidemiology
https://www.readbyqxmd.com/read/28160345/does-exposure-to-opioid-substitution-treatment-in-prison-reduce-the-risk-of-death-after-release-a-national-prospective-observational-study-in-england
#12
John Marsden, Garry Stillwell, Hayley Jones, Alisha Cooper, Brian Eastwood, Michael Farrell, Tim Lowden, Nino Maddalena, Chris Metcalfe, Jenny Shaw, Matthew Hickman
BACKGROUND AND AIMS: People with opioid use disorder (OUD) in prison face an acute risk of death after release. We estimated whether prison-based opioid substitution treatment (OST) reduces this risk. DESIGN: Prospective observational cohort study using prison health care, national community drug misuse treatment and deaths registers. SETTING: Recruitment at 39 adult prisons in England (32 male; seven female) accounting for 95% of OST treatment in England during study planning...
February 4, 2017: Addiction
https://www.readbyqxmd.com/read/28160051/characterization-and-identification-of-eight-designer-benzodiazepine-metabolites-by-incubation-with-human-liver-microsomes-and-analysis-by-a-triple-quadrupole-mass-spectrometer
#13
Souleiman El Balkhi, Maxime Chaslot, Nicolas Picard, Sylvain Dulaurent, Martine Delage, Olivier Mathieu, Franck Saint-Marcoux
Designer benzodiazepines (DBZDs) have become of particular importance in the past few years. The metabolite monitoring of DBZD in biological fluids could be of great interest in clinical and forensic toxicology. However, DBZD metabolites are not known or not commercially available. The identification of some DBZD metabolites has been mostly explored by self-administration studies or by in vitro studies followed by high-resolution mass spectrometry. The question arose whether a unit resolution instrument could be efficient enough to allow the identification of DBZD metabolites...
July 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28073114/a-study-of-acute-poisoning-cases-admitted-to-the-university-hospital-emergency-department-in-tabriz-iran
#14
Mehdi Oraie, Mir-Jamal Hosseini, Mina Islambulchilar, Seyed-Hasan Hosseini, Mehdi Ahadi-Barzoki, Habib Sadr, Hashem Yaghoubi
Chemical substances have an important threat due to extensive use in medicine, agriculture, industry and environment. In this retrospective study, etiological and demographic characteristics of acute poisoning cases admitted to a hospital in Iran were investigated. We compared these data with those reported from other parts of the country and the international experiences to evaluate any difference if exists. 7 052 poisoned cases admitted to the hospital from April 2006 to March 2013, by data collected from the medical record in poison center section...
March 2017: Drug Research
https://www.readbyqxmd.com/read/28007369/pentobarbital-in-the-context-of-possible-suicides-analysis-of-a-case
#15
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/27753564/a-3-year-comparison-of-overdoses-treated-in-a-military-emergency-department-complications-admission-rates-and-health-care-resources-consumed
#16
Victoria J Ganem, Alejandra G Mora, Nina Nnamani, Vikhyat S Bebarta
BACKGROUND: Drug overdose has become a leading cause of death in the United States and is a growing issue in civilian and military populations. Increasing prescription drug misuse and poisonings translate into greater utilization of medical resources. Our objective was to describe the incidences of overdoses and their associated events and outcomes following emergency department consult. METHODS: We performed a retrospective cohort study on cases evaluated in 2 military hospital emergency departments over 3 years...
October 2016: Military Medicine
https://www.readbyqxmd.com/read/27749797/adolescent-intentional-abuse-ingestions-overall-10-year-trends-and-regional-variation
#17
David C Sheridan, Robert G Hendrickson, Gillian Beauchamp, Amber Laurie, Rongwei Fu, B Zane Horowitz
OBJECTIVE: Adolescent intentional ingestions remain a significant public health problem in the United States with little research to date on the over-the-counter or prescription medicines that adolescents abuse. These data are important for anticipatory guidance by primary care providers, preventive health, and poison center outreach. METHODS: This was an observational study using the American Association of Poison Control Centers National Poison Data System. The study population consisted of all cases of patients aged 13 to 19 years from 2004 to 2013 with a coding of "intentional abuse...
October 4, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27741141/a-subtle-mimicker-in-emergency-department-illustrated-case-reports-of-acute-drug-induced-dystonia
#18
Maria Vittoria De Angelis, Roberta Di Giacomo, Antonio Di Muzio, Marco Onofrj, Laura Bonanni
BACKGROUND: Movement disorder emergencies include any movement disorder which develops over hours to days, in which failure to appropriately diagnose and manage can result in patient morbidity or mortality.Movement disorder emergencies include acute dystonia: sustained or intermittent muscle contractions causing abnormal, often repetitive, movements. Acute dystonia is a serious challenge for emergency room doctors and neurologists, because of the high probability of misdiagnosis, due to the presence of several mimickers including partial seizures, meningitis, localized tetanus, serum electrolyte level abnormalities, strychnine poisoning, angioedema, malingering, catatonia, and conversion...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27642738/-consciousness-disorders-from-toxicological-view
#19
Lukas Bündgens, Frank Tacke, Christian Trautwein, Alexander Koch
Poisoning with impaired mental state is a frequent cause for hospital admission. The initial management includes assessment of vital functions and airway management followed by focussed diagnostics. Poison Emergency Centers can provide valuable assistance in acute intoxications. Clinically important agents causing mental state alterations include opiates, benzodiazepines, tricyclic antidepressants, alcohol, methanol and ethylene glycol, carbon monoxide and salicylates. Most important therapeutic measures comprise supportive care, decontamination or elimination...
September 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27641627/mechanisms-of-tramadol-related-neurotoxicity-in-the-rat-does-diazepam-tramadol-combination-play-a-worsening-role-in-overdose
#20
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
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