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https://www.readbyqxmd.com/read/29336990/failure-of-intracardiac-pacing-after-fatal-propafenone-overdose-a-case-report
#1
Ivan Zeljković, Nikola Bulj, Matea Kolačević, Vedran Čabrilo, Diana Delić Brkljačić, Šime Manola
BACKGROUND: Propafenone is a sodium-channel blocker, class IC antiarrhythmic drug, frequently used to manage supraventricular dysrhythmias, especially atrial fibrillation. We report a self mono-intoxication with propafenone. CASE REPORT: A 68-year-old woman presented with a decreased level of consciousness, hypotension, and electrocardiogram showing QRS widening with atrial asystole and extreme bradycardia < 20 beats/min. After initial stabilization with transcutaneous pacing, laboratory findings detected normal electrolyte ranges and metabolic acidosis, and her medical history revealed availability of propafenone due to paroxysmal atrial fibrillation and depressive syndrome, which led to the suspicion of intoxication...
January 11, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29336302/-cyclizine-is-sold-in-denmark-as-an-over-the-counter-drug-and-has-serious-side-effects-when-overdosed
#2
Kasper Petersen, Peter Hjorth
Cyclizine is sold in Denmark as an over-the-counter drug and affects not only histaminergic but also muscarinergic, serotonergic and α-adrenergic receptors, with side effects such as respiratory depression and cardiac arrhythmias, leading to fatalities. Due to the numerous side effects, it raises questions concerning the status of cyclizine as an over-the-counter drug. Data of healthcare contacts because of cyclizine intoxication in the 2014-2016 period should be analyzed to further illuminate the health risk of cyclizine poisoning...
January 15, 2018: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29333664/increased-non-fatal-overdose-risk-associated-with-involuntary-drug-treatment-in-a-longitudinal-study-with-people-who-inject-drugs
#3
Claudia Rafful, Ricardo Orozco, Gudelia Rangel, Peter Davidson, Dan Werb, Leo Beletsky, Steffanie A Strathdee
AIM: To assess the effect of involuntary drug treatment (IDT) on non-fatal overdose among people who inject drugs (PWID). DESIGN: Longitudinal study. SETTING: Tijuana, Mexico. PARTICIPANTS: Baseline sample of 671 PWID included 258 (38.4%) women and 413 (61.6%) men. MEASUREMENTS: Primary independent variables were reported recent (i.e., past 6 months) non-fatal overdose event (dependent variable) and IDT...
January 14, 2018: Addiction
https://www.readbyqxmd.com/read/29305727/using-population-based-hospitalization-data-to-monitor-increases-in-conditions-causing-morbidity-among-persons-who-inject-drugs
#4
Melissa G Collier, Mona Doshani, Alice Asher
Epidemics of opioid use and injection drug use (IDU) are associated with an increase in HIV and viral hepatitis infections and overdose deaths in the United States. Persons who inject drugs (PWID) are also at risk for serious infections caused by skin organisms introduced via IDU. We examined National Inpatient Sample hospital discharge data to determine trends in three serious infectious disease-associated conditions that primarily affect PWID in addition to HIV and viral hepatitis: infective endocarditis (IE), central nervous system (CNS) abscesses, and osteomyelitis...
January 5, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29278831/using-drugs-in-un-safe-spaces-impact-of-perceived-illegality-on-an-underground-supervised-injecting-facility-in-the-united-states
#5
Peter J Davidson, Andrea M Lopez, Alex H Kral
BACKGROUND: Supervised injection facilities (SIFs) are spaces where people can consume pre-obtained drugs in hygienic circumstances with trained staff in attendance to provide emergency response in the event of an overdose or other medical emergency, and to provide counselling and referral to other social and health services. Over 100 facilities with formal legal sanction exist in ten countries, and extensive research has shown they reduce overdose deaths, increase drug treatment uptake, and reduce social nuisance...
December 23, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29273031/knowledge-and-possession-of-take-home-naloxone-kits-among-street-involved-youth-in-a-canadian-setting-a-cohort-study
#6
Julia Goldman-Hasbun, Kora DeBeck, Jane A Buxton, Ekaterina Nosova, Evan Wood, Thomas Kerr
BACKGROUND: The distribution of take-home naloxone (THN) kits has been an important strategy in reducing overdose fatalities among people who use drugs. However, little is known about the use of THN among youth who are street-involved. The present study explores knowledge and possession of THN among street-involved youth in a Canadian setting. METHODS: Data were derived from the At-Risk Youth Study (ARYS), a prospective cohort of street-involved youth age 14-28 at enrollment in Vancouver, Canada...
December 22, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/29241143/perceptions-about-supervised-injection-facilities-among-people-who-inject-drugs-in-philadelphia
#7
Robert E Harris, Jessica Richardson, Rosemary Frasso, Evan D Anderson
BACKGROUND: People who inject drugs (PWID) are at high risk for infectious diseases, skin and soft tissue infections, and overdose. However, these harms are all avoidable when sterile injection equipment, hygienic places to inject, and medical care are accessible. Unfortunately, many PWID in the U.S lack these resources. The most vulnerable are forced to inject in public spaces, where individual risks are high and communal harms are sometimes many. Supervised Injection Facilities (SIFs) are an established intervention for reducing these harms...
December 10, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29220642/substance-use-patterns-associated-with-recent-exposure-to-fentanyl-among-people-who-inject-drugs-in-vancouver-canada-a-cross-sectional-urine-toxicology-screening-study
#8
Kanna Hayashi, M-J Milloy, Mark Lysyshyn, Kora DeBeck, Ekaterina Nosova, Evan Wood, Thomas Kerr
INTRODUCTION: Vancouver, Canada is experiencing an opioid overdose crisis where fentanyl, a potent, synthetic opioid contaminating the illicit drug supply, has been detected in the majority of fatal overdose cases. Despite its growing presence throughout North America, few studies have characterized exposure to fentanyl among people who use illicit drugs (PWUD). We sought to identify the prevalence and correlates of fentanyl exposure among PWUD in Vancouver. METHODS: Data were derived from cohort studies of PWUD in Vancouver...
December 5, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29220615/medication-assisted-treatment-mat-for-opioid-addiction-introduction-to-the-special-issue
#9
Karen McElrath, Herman Joseph
Several countries are experiencing public health crises as a result of opioid addiction. Fatal overdoses have reached record highs in many regions and Hepatitis C virus is the norm among people who inject drugs in several countries. Thus, providing for the global availability of medication-assisted treatment (MAT) for opioid addiction is more important than ever. In this article, we introduce readers to the collection of papers that appear in this special issue on MAT for opioid addiction. We describe the articles and commentaries thematically to include topics that address 1) the contemporary history of methadone maintenance, 2) the provision of and access and barriers to MAT, 3) compliance and outcomes of MAT, 4) health issues among MAT patients, 5) race, ethnicity, and social class backgrounds of MAT patients, 6) criminalization and stigma, and 7) challenges associated with the expansion of MAT...
December 8, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/29196879/the-feasibility-of-physiologically-based-pharmacokinetic-modeling-in-forensic-medicine-illustrated-by-the-example-of-morphine
#10
Nadine Schaefer, Daniel Moj, Thorsten Lehr, Peter H Schmidt, Frank Ramsthaler
In forensic medicine, expert opinion is often required concerning dose and time of intake of a substance, especially in the context of fatal intoxications. In the present case, a 98-year-old man died 4 days after admission to a hospital due to a femur neck fracture following a domestic fall in his retirement home. As he had obtained high morphine doses in the context of palliative therapy and a confusion of his supplemental magnesium tablets with a diuretic by the care retirement home was suspected by the relatives, a comprehensive postmortem examination was performed...
December 1, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/29186585/fatality-following-ingestion-of-tetrahydrofuranylfentanyl-u-49900-and-methoxy-phencyclidine
#11
Alex J Krotulski, Donna M Papsun, Melissa Friscia, Jennifer L Swartz, Brian D Holsey, Barry K Logan
Novel psychoactive substances (NPS), and specifically novel opioids, continue to cause adverse events, including death, within drug-using populations. As the number of opioid-related overdoses continues to increase, laboratories have identified the emergence of new fentanyl analogues and other synthetic opioid-related drugs. Tetrahydrofuranylfentanyl (THFF) has been identified in Europe and the United States as an emerging novel opioid, causing death in at least 15 drug-using individuals to date. THFF is structurally similar to furanylfentanyl, a previously characterized novel opioid responsible for numerous adverse events, including death...
November 24, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29179227/-on-the-risk-of-dependence-on-gabapentinoids
#12
Udo Bonnet, Norbert Scherbaum
In the last ten years, the prescriptions of the gabapentinoids gabapentin and pregabalin increased largely also in Germany. Since several national and international pharmacovigilance-databases have warned for abuse liabilities and overdose fatalities in association with both gabapentinoids, which moreover, became to be sold on internet and black-markets, their addictive power has been subject to an ongoing clinical debate. As pre- and post-approval clinical trials did not reveal significant signs of dependence on gabapentin or pregabalin, we systematically searched in PubMed and Scopus for clinical studies and case reports being associated with abuse of and dependence on these drugs...
November 27, 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/29176511/payer-policy-behavior-towards-opioid-pharmacotherapy-treatment-in-ohio
#13
Todd Molfenter, Carol Sherbeck, Sandy Starr, Jee-Seon Kim, Mark Zehner, Andrew Quanbeck, Nora Jacobson, Dennis McCarty
OBJECTIVE: Few studies examine how payers address the need for improved access to pharmacotherapy for opioid use disorders and the influence of environmental variables on access to opioid agonist and antagonist medications. METHOD: The 52 Ohio Addiction Drug Abuse and Mental Health Services (ADAMHS) Boards that disburse funds for treatment services for the uninsured and underinsured were surveyed to assess coverage for opioid agonist and antagonist treatment medications...
November 15, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29168263/incidence-and-predictors-of-mental-health-disorder-diagnoses-among-people-who-inject-drugs-in-a-canadian-setting
#14
Hudson Reddon, Tyler Pettes, Evan Wood, Ekaterina Nosova, Michael-John Milloy, Thomas Kerr, Kanna Hayashi
INTRODUCTION AND AIMS: Limited attention has been given to the predictors of mental health diagnoses among people who inject drugs (PWID) in community settings. Therefore, we sought to longitudinally examine the prevalence, incidence and predictors of mental disorder diagnosis among a community-recruited cohort of PWID. DESIGN AND METHODS: Data were derived from two prospective cohort studies of PWID (VIDUS and ACCESS) in Vancouver, Canada between December 2005 and May 2015...
November 22, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/29162122/overdose-prevention-training-with-naloxone-distribution-in-a-prison-in-oslo-norway-a-preliminary-study
#15
Aase Grønlien Petterson, Desiree Madah-Amiri
BACKGROUND: Prison inmates face a ten times increased risk of experiencing a fatal drug overdose during their first 2 weeks upon release than their non-incarcerated counterparts. Naloxone, the antidote to an opioid overdose, has been shown to be feasible and effective when administered by bystanders. Given the particular risk that newly released inmates face, it is vital to assess their knowledge about opioid overdoses, as well as the impact of brief overdose prevention training conducted inside prisons...
November 21, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/29129552/clinical-characteristics-of-suicidal-behavior-in-an-intensive-care-unit-at-a-university-hospital-in-japan-a-7-year-observational-study
#16
Takashi Takeuchi, Yasuyuki Okumura, Akihito Uezato, Toru Nishikawa
BACKGROUND: Suicidal behavior accounts for at least 40,000 admissions per year to emergency departments in Japan; however, little is known about emergency admissions owing to suicidal behavior in metropolitan areas. Therefore, we examined the clinical characteristics of suicidal behavior using psychosocial assessments performed by experienced psychiatrists in an intensive care unit. METHODS: Participants were 971 patients admitted to a university hospital's intensive care unit for suicidal behavior between July 2006 and June 2013...
November 7, 2017: Asian Journal of Psychiatry
https://www.readbyqxmd.com/read/29128652/differences-in-combinations-and-concentrations-of-drugs-of-abuse-in-fatal-intoxication-and-driving-under-the-influence-cases
#17
Hilde Erøy Edvardsen, Torill Tverborgvik, Joachim Frost, Sidsel Rogde, Inge Morild, Helge Waal, Thomas Clausen, Lars Slørdal, Vigdis Vindenes
BACKGROUND: In toxicology, international classification systems focus on single intoxicants as the cause of death. It is, however, well known that very few drug related deaths are caused by a single substance and that information concerning the drug concentrations as well as the combinations of drugs are essential in order to ascertain the cause of death. The aim of the study was to assess whether those prone to fatal intoxications differ significantly from chronic drug users - in terms of demographics and drug exposure patterns...
November 6, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29123931/rapid-ascending-sensorimotor-paralysis-hearing-loss-and-fatal-arrhythmia-in-a-multimorbid-patient-due-to-an-accidental-overdose-of-fluoxetine
#18
Matthew Herrmann, Prissilla Xu, Antonio Liu
Background: Common side effects of selective serotonin reuptake inhibitors (SSRIs) include tachycardia, drowsiness, tremor, nausea, and vomiting. Although SSRIs have less toxic side effects compared to more traditional antidepressants, serious and life threatening cases of SSRI overdose have been reported. We describe a 24-year-old multimorbid female who presented to the emergency department with rapid onset ascending sensorimotor paralysis, complicated by respiratory and cardiac arrest, found to have fatal levels of fluoxetine by toxicological analysis, not taken in a suicidal act...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29123869/drug-induced-anaphylaxis-in-the-emergency-room
#19
REVIEW
Tomonori Takazawa, Kiyohiro Oshima, Shigeru Saito
Anaphylaxis is a life-threatening, systemic allergic reaction that presents unique challenges for emergency care practitioners. Anaphylaxis occurs more frequently than previously believed. Therefore, proper knowledge regarding the epidemiology, mechanisms, symptoms, diagnosis, and treatment of anaphylaxis is essential. In particular, the initial treatment strategy, followed by correct diagnosis, in the emergency room is critical for preventing fatal anaphylaxis, although making a diagnosis is not easy because of the broad and often atypical presentation of anaphylaxis...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29095168/deaths-associated-with-brotizolam-poisoning-from-a-single-drug-overdose-four-reported-cases
#20
Kentaro Sakai, Kazuyuki Saito, Aya Takada, Wakako Hikiji, Yosuke Kikuchi, Tatsushige Fukunaga
Brotizolam is a short-acting hypnotic in the benzodiazepine family, and fatal poisonings by an overdose of brotizolam are rare. This report describes 4 cases of deaths associated with brotizolam poisoning from a single drug overdose. The ages ranged from 51 to 90 years, and the postmortem interval between death and tissue sampling was 1.5 to 2.5 days. These deaths were classified as 1 homicide and 3 suicides. The concentration of the brotizolam ranged from 0.05 to 0.21 mg/L in the blood samples. Ethanol, which could cause mild alcohol intoxication, was detected in the blood samples from 2 cases...
November 1, 2017: American Journal of Forensic Medicine and Pathology
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