The aim of this retrospective epidemiological study was to investigate the demographical, etiological and clinical characteristics of acute drug poisonings in Iasi County, Romania. All patients were referred and admitted in the Toxicology Clinic of “Sf. Ioan” Emergency Clinic Hospital Iasi, Romania. Between 2003 and 2009, 811 cases of acute drug poisonings were recorded, counting for 28.43% from the total number of poisonings. The majority of these poisonings resulted in mild (51.94%) and medium (28.35%) clinical forms, while 19.71% were coma situations. In all, 63.51% of patients originated from urban areas, 39.94% were unemployed and the patients were predominantly women (66.46%). A high percentage (97.27%) were suicide attempts, using only one type of drug (65.88%) and the 21–30 years group (29.8%) records the highest incidence, for both women and men. The most frequently involved drugs were benzodiazepines 13.69%, anticonvulsive drugs 8.63%, barbiturates 8.51% and cardiovascular drugs 5.92%. Drugs combinations were recorded in 32.92% of cases and 1.2% were combinations between drugs and other substances. Mortality was the outcome in 0.3% of the total registered number of acute drug poisonings. This study underlines that in order to provide a proper management of these situations, a Regional Poison Information Center is absolutely necessary.

Ketoprofen (Ket) was intercalated into layered double hydroxides (ZnAlLDH and MgAlLDH) using the ionic exchange method. The drug intercalation was confirmed by X-ray diffraction (XRD) and FTIR spectroscopy. Ket release from the inorganic matrix was studied at pH 7.4 in continuous regime with a flow rate of 0.5 and respectively 1.0 ml/min. The kinetical data were interpreted using the Ritger and Peppas model. The data prove that the release kinetics and mechanism depend on the eluent flow rate. Quantification of gastric tolerance shows that the ulcerogenic effect of the intercalated drug is lower than the one of the raw Ket. The antinociceptive effect of both formulations was studied by the hot-plate method performed on mice. The MgAlLDH_Ket formulation shows a tendency towards a stronger antinociceptive effect than its ZnAlLDH_Ket counterpart during the 210 min recorded period.

Access to the necessary medications for palliative care, especially opioids, is an essential part in the development of a national palliative care program. In November 2005, Romania's Parliament adopted new legislation concerning the medical use of opioids and psychotropic substances to replace the old and restrictive legislation of 1969. The new law and regulations are the result of a four-year project in which governmental authorities collaborated with health care professionals and international experts. The World Health Organization "Achieving Balance in National Opioids Control Policy--Guidelines for Assessment" was used to propose balanced legislation that would facilitate modern pain management and provide adequate control of these substances with the potential for abuse. A national education program to facilitate the implementation of the new legislation has been organized. The training started in November 2006 and will continue throughout 2007. It is anticipated that at least 3,000 doctors and 500 pharmacists will attend these courses.

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