Acute drug poisonings leading to hospitalization

Abstract

Knowledge about current trends and epidemiology in poisonings is important to maintain quality in diagnostics, treatment and prevention. We performed a cross-sectional study of all cases (n = 261) admitted with drug poisoning to Aalborg University Hospital during 1 year in 2017-2018. Median age was 30 (22-49) years, and 58% were female. Fifty percent were suicide attempts. In most cases, involved drugs were identified by history taking; blood analysis barely revealed any additional paracetamol and salicylicate poisonings. Drugs prescribed to the patient or available over the counter were involved in nearly two thirds of cases. Weak analgesics dominated by paracetamol (n = 91, 35%) was the most frequently involved group of drugs followed by opioids and benzodiazepines. Gender differences were observed with respect to involvement of weak analgesics and central stimulants. A higher prevalence of unidentified involved drugs was observed in 26 cases (10%) in which the length of admission exceeded 2 days and/or intensive care was needed. No deaths, cardiac arrhythmias or physical complications occurred. Thus, current handling of the acute poisoning seems effective in most cases. However, a more tailored use of blood analyses including a toxicological screen in selected cases may represent an opportunity for improvement.

Combined effects of quetiapine and opioids: A study of autopsy cases, drug users and sedation in rats

“…This is in line with other studies showing an increase in the number of calls concerning quetiapine to a poisoning centre and deaths related to quetiapine 12 . In fact, in a recent Danish study, quetiapine was the third most frequently involved generic in acute drug poisonings leading to hospitalization 29 . Due to the absent association of quetiapine concentrations or presence with lower concentrations of methadone or morphine, our data did not suggest an additive effect.…”

“…12 In fact, in a recent Danish study, quetiapine was the third most frequently involved generic in acute drug poisonings leading to hospitalization. 29 Due to the absent association of quetiapine concentrations or presence with lower concentrations of methadone or morphine, our data did not suggest an additive effect. Compared with pure ethanol poisonings, lower post-mortem ethanol concentrations have been observed in ethanol poisonings where sedative medications were present, 30 indicating that post-mortem blood concentrations can be informative to elucidate additive toxic effects of drug combinations.…”

Deaths caused by medication in persons not using illicit narcotic drugs: An autopsy study from Western Denmark

“…9 Weak analgesics, especially paracetamol accounts for a large part of hospitalizations due to acute poisonings. 17 However, in the present study, fatalities caused by weak analgesics were rare. This may be due to a high success rate of treating paracetamol poisonings in hospital as shown in a recent Icelandic study 27 in which the mortality rate was 1.2%.…”

“…Weak analgesics, especially paracetamol accounts for a large part of hospitalizations due to acute poisonings 17 . However, in the present study, fatalities caused by weak analgesics were rare.…”

“…A significant role of opioids in both single and multiple substance related deaths is in line with a relatively frequent presentation of acute opioid poisonings requiring hospitalization, 17,18 a major part of fatal poisonings caused by opioids in PUIDs in the Nordic countries, 3 and in general in New Zealand 19 and United States 20 . Tramadol and morphine are the most frequently prescribed opioids in Denmark, tramadol being used approximately twice as much as morphine as measured in number of used defined daily doses (DDD) per 1000 inhabitants per day 21 .…”