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poisoning by benzodiazepines

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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
#1
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
#2
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
#3
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
#4
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
#5
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/27591717/post-mortem-concentrations-of-drugs-determined-in-femoral-blood-in-single-drug-fatalities-compared-with-multi-drug-poisoning-deaths
#6
Alan Wayne Jones, Anita Holmgren, Johan Ahlner
BACKGROUND: Reference concentrations of drugs in post-mortem femoral blood furnishes useful information when poisoning (intoxication) deaths are investigated. However, few publications compare the concentrations of drugs in single-drug fatalities with multi-drug intoxications. This article attempts to fill this gap in knowledge. METHODS: We searched a national forensic toxicology database (TOXBASE) and found N=13,963 deaths attributed by pathologists to intoxication by drugs (poisoning)...
October 2016: Forensic Science International
https://www.readbyqxmd.com/read/27560966/associations-of-adverse-clinical-course-and-ingested-substances-among-patients-with-deliberate-drug-poisoning-a-cohort-study-from-an-intensive-care-unit-in-japan
#7
Kanako Ichikura, Yasuyuki Okumura, Takashi Takeuchi
OBJECTIVES: Some patients with deliberate drug poisoning subsequently have an adverse clinical course. The present study aimed to examine whether the type of drugs ingested and psychiatric diagnoses were related to an adverse clinical course. METHODS: We conducted a cohort study of patients with deliberate drug poisoning admitted to the intensive care unit of a university hospital located in Tokyo, Japan, between September 2006 and June 2013. Intensive care unit (ICU) stay of ≥4 days was used as a primary outcome measure, while the incidence of aspiration pneumonitis was used as a secondary outcome measure...
2016: PloS One
https://www.readbyqxmd.com/read/27557947/medical-encounters-for-opioid-related-intoxications-in-southern-nevada-sociodemographic-and-clinical-correlates
#8
Jing Feng, Joseph P Iser, Wei Yang
BACKGROUND: Despite today's heightened concern over opioid overdose, the lack of population-based data examining clinical and contextual factors associated with opioid use represents a knowledge gap with relevance to prevention and treatment interventions. We sought to quantify rates of emergency department (ED) visits and inpatient hospitalizations for harmful opioid effects and their sociodemographic differentials as well as clinical correlates in Southern Nevada, using ED visit and hospital inpatient discharge records from 2011 to 2013...
2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27520885/understanding-opioid-overdose-characteristics-involving-prescription-and-illicit-opioids-a-mixed-methods-analysis
#9
Bobbi Jo H Yarborough, Scott P Stumbo, Shannon L Janoff, Micah T Yarborough, Dennis McCarty, Howard D Chilcoat, Paul M Coplan, Carla A Green
BACKGROUND: Opioid abuse and misuse are significant public health issues. The CDC estimated 72% of pharmaceutical-related overdose deaths in the US in 2012 involved opioids. While studies of opioid overdoses have identified sociodemographic characteristics, agents used, administration routes, and medication sources associated with overdoses, we know less about the context and life circumstances of the people who experience these events. METHODS: We analyzed interviews (n=87) with survivors of opioid overdoses or family members of decedents...
October 1, 2016: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/27491700/adverse-events-related-to-the-new-psychoactive-substance-3-fluorophenmetrazine-results-from-the-swedish-strida-project
#10
Matilda Bäckberg, Jenny Westerbergh, Olof Beck, Anders Helander
BACKGROUND: New psychoactive substances (NPS) are often poorly pharmacologically documented and the production is unregulated, implying high risks for toxic side effects. This report from the STRIDA project describes analytically confirmed non-fatal intoxications involving the phenmetrazine analogue 3-fluorophenmetrazine (3-FPM). STUDY DESIGN AND METHODS: Observational case series of patients with suspected acute NPS exposure requiring hospital care. Blood and urine samples were collected from patients presenting in emergency departments (ED) or intensive care units (ICU), after consultation with the Swedish Poisons Information Centre (PIC)...
November 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27448790/near-death-from-a-novel-synthetic-opioid-labeled-u-47700-emergence-of-a-new-opioid-class
#11
Aaron Schneir, Imir G Metushi, Christian Sloane, David J Benaron, Robert L Fitzgerald
BACKGROUND: In the last decade there has been a worldwide surge in the recreational abuse of novel psychoactive substances, particularly amphetamine derivatives and synthetic cannabinoids. Synthetic opioids such as AH-7921, MT-45, and U-47700, with structures distinct from those ever used therapeutically or described recreationally, have also recently emerged. CASE DETAILS: We report a patient who suffered respiratory failure and depressed level of consciousness after recreationally using a novel synthetic opioid labeled U-47700...
July 22, 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27418198/characterization-of-edible-marijuana-product-exposures-reported-to-united-states-poison-centers
#12
Dazhe Cao, Sahaphume Srisuma, Alvin C Bronstein, Christopher O Hoyte
CONTEXT: Edible marijuana products are sold as brownies, cookies, and candies, which may be indistinguishable from counterparts without marijuana and are palatable to children and adults. The consumption of an entire product containing multiple dose-units may result in overdose. OBJECTIVE: To characterize edible marijuana exposures reported to US poison centers with subgroup analysis by age. METHODS: We analyzed single substance, human exposure calls coded to marijuana brownies, candies, cookies, beverages, or other foods reported to the National Poison Data System from January 2013 to December 2015...
November 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27412885/toxicity-evaluation-of-%C3%AE-pyrrolidinovalerophenone-%C3%AE-pvp-results-from-intoxication-cases-within-the-strida-project
#13
Olof Beck, Lisa Franzén, Matilda Bäckberg, Patrick Signell, Anders Helander
CONTEXT: An increasing number of new psychoactive substances (NPS) of different chemical classes have become available through marketing and sale over the Internet. This report from the Swedish STRIDA project presents the prevalence, laboratory results, and clinical features in a series of intoxications involving the stimulant NPS α-pyrrolidinovalerophenone (α-PVP), a potent dopamine re-uptake inhibitor, over a 4-year period. STUDY DESIGN: Observational case series of consecutive patients with admitted or suspected intake of NPS presenting to hospitals in Sweden from 2012 to 2015...
August 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27249421/increase-in-self-injury-as-a-method-of-self-harm-in-ghent-belgium-1987-2013
#14
Nikita Vancayseele, Gwendolyn Portzky, Kees van Heeringen
BACKGROUND: Self-harm is a major health care problem and changes in its prevalence and characteristics can have important implications for suicide prevention. The objective was to describe trends in the epidemiology of self-harm based on emergency department (A&E departments) visits over a 26-year period in Ghent, Belgium. METHODS: We analyzed data on all self-harm presentations from the three large general hospitals in Ghent between 1987 and 2013. We investigated trends in prevalence (events by year per 100...
2016: PloS One
https://www.readbyqxmd.com/read/27249075/benzodiazepine-use-and-risk-of-mortality-among-patients-with-schizophrenia-a-retrospective-longitudinal-study
#15
Cynthia A Fontanella, John V Campo, Gary S Phillips, Danielle L Hiance-Steelesmith, Helen Anne Sweeney, Kwok Tam, Douglas Lehrer, Robert Klein, Mark Hurst
OBJECTIVE: This study examined the association between benzodiazepine use alone or in combination with antipsychotics and risk of mortality in patients with schizophrenia. METHODS: A retrospective longitudinal analysis was performed using Medicaid claims data merged with death certificate data for 18,953 patients (aged 18-58 years) with ICD-9-diagnosed schizophrenia followed from July 1, 2006, to December 31, 2013. Cox proportional hazard analyses were used to estimate the risk of all-cause mortality associated with benzodiazepine use; adjustment was made for a wide array of fixed and time-varying confounders, including demographics, psychiatric and medical comorbidities, and other psychotropic medications...
May 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/27222239/retrospective-case-series-analysis-of-characteristics-and-trends-in-unintentional-pharmaceutical-drug-poisoning-by-methadone-opioid-analgesics-antidepressants-and-benzodiazepines-in-clark-county-nv-2009-13
#16
Tamara Bruno, Jennifer R Pharr
BACKGROUND: Poisoning has become the leading cause of injury death in the USA-with opioid analgesic involved in more fatal poisonings than any other drug, including cocaine and heroin. The epidemic of prescription drug poisonings is a public health concern. This study aimed to define potential high-risk groups for unintentional prescription drug poisoning by methadone, opioid analgesics, antidepressants or benzodiazepines. METHODS: A hospital-based retrospective case series analysis of admissions related to prescription drug poisonings associated with methadone, opioid analgesics, antidepressants or benzodiazepines for hospitals in Clark County, Nevada between 2009 and 2013 was employed...
May 24, 2016: Journal of Public Health
https://www.readbyqxmd.com/read/27206472/outpatient-treatment-of-acute-poisoning-by-substances-of-abuse-a-prospective-observational-cohort-study
#17
Odd Martin Vallersnes, Dag Jacobsen, Øivind Ekeberg, Mette Brekke
BACKGROUND: Procedures for the clinical assessment of acute poisoning by substances of abuse should identify patients in need of hospital admission and avoid hazardous discharges, while keeping the observation time short. We assess the safety of a systematic procedure developed at the Oslo Accident and Emergency Outpatient Clinic (OAEOC). METHODS: All patients 12 years and older treated for acute poisoning by substances of abuse at the OAEOC were included consecutively from October 2011 to September 2012...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27185085/severe-and-fatal-pharmaceutical-poisoning-in-young-children-in-the-uk
#18
Mark Anderson, Leonard Hawkins, Michael Eddleston, John P Thompson, J Allister Vale, Simon H L Thomas
OBJECTIVE: Accidental poisoning in young children is common, but severe or fatal events are rare. This study was performed to identify the number of such events occurring in the UK and the medications that were most commonly responsible. DESIGN: Analysis of national data sets containing information relating to severe and fatal poisoning in children in the UK. DATA SOURCES: Office of National Statistics mortality data for fatal poisoning; Paediatric Intensive Care Audit Network admissions database and the National Poisons Information Service for severe non-fatal poisoning; Hospital Episode Statistics for admission data for implicated agents...
July 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27180426/serum-antioxidant-parameters-in-patients-poisoned-by-different-xenobiotics
#19
COMPARATIVE STUDY
Piotr Hydzik, Mirosław Krośniak, Renata Francik, Ewa Gomółka, Ebru Derici Ebru, Paweł Zagrodzki
There is a great diversity of the acute drugs overdose cases in clinical toxicology. Clinical situation is complicated by the coexistence of factors predisposing to the development of adverse drug reactions (chronic use of drugs, polypharmacy, alcohol or drugs dependence, nutritional disorders) and by the presence of chronic organ damage, especially the liver and the kidney. The aim of this study was to evaluate whether there are sensitive plasma markers belonging to the antioxidant system in patients exposed to various xenobiotics...
March 2016: Acta Poloniae Pharmaceutica
https://www.readbyqxmd.com/read/27142356/the-effects-of-intravenous-aminophylline-on-level-of-consciousness-in-acute-intentional-benzodiazepines-poisoning-in-comparison-to-flumazenil
#20
A Aghabiklooei, J Sangsefidi
AIM: Acute intentional benzodiazepine poisoning is marked by a significant loss of consciousness, aspiration pneumonia, and increased rates of mortality and morbidity, especially in older patients with underlying heart or lung disease. These patients may need flumazenil to reverse the respiratory effects of benzodiazepines. The positive effects of aminophylline on respiration and neonatal apnea improvement have been shown previously. However, its possible effects on increasing the level of consciousness have never been evaluated...
May 2, 2016: Human & Experimental Toxicology
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