Antipsychotic Exposures in an Emergency Department

Arici, M. Aylin; Şahin, Ali; Oray, Neşe Çolak; Bayram, Başak; Tunçok, Yeşim

doi:10.5152/jbachs.2017.121

Cited by 2 publications

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“…Concerning major outcome measures reported in the current study including seizures, ICU admission, need for ventilation assistance, and in-hospital mortality were also registered in previous studies (Magdalan et al, 2004;Ngo et al, 2008;Hammad et al, 2016 andArici et al, 2017). The present study revealed that 14% of cases suffered from seizures, 39.5% were admitted to ICU, 11.6% needed ventilation assistance and 7% died.…”

Section: Discussionsupporting

confidence: 88%

“…Interestingly, neither ECG grading nor QTc interval were significantly associated with the type of the antipsychotics or the ingested dose. Observations from previous studies revealed that, atypical antipsychotics exposure was not safer than typical antipsychotics (Ciranni et al, 2009 andArici et al, 2017). Additionally, antipsychotics can affect ionic cardiac channels with prolongation of the action potential.…”

Section: Discussionmentioning

confidence: 92%

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ECG Changes as a Predictive Tool of Outcomes in Antipsychotics Poisoned Patients

El-Gharbawy

Ghonem

2018

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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Background: Antipsychotics are a class of medications that are primarily used for treatment of psychosis especially schizophrenia. The most common cardio-toxic features of antipsychotics overdose are tachycardia, hypotension, and prolonged corrected QT interval. Aim: This study aimed at assessment of ECG changes utilization as a predictor of major outcome events in antipsychotic poisoned patients. Patients and methods: This prospective observational study was conducted at Tanta Poison Control Unit on 43 patients of both sexes with antipsychotics poisoning. For each patient, socio-demographic and toxicological data were collected, physical examination was performed, and routine investigations were measured. Electrocardiogram was done, and corrected QT was calculated. The severity of symptoms and signs of antipsychotics poisoning and related ECG changes were graded according to poisoning severity score. Results: This study revealed significant association between ECG grading and each of seizures, ICU admission, and in-hospital mortality. Significant association was also detected between corrected QT interval and ICU admission. Conclusion: It was concluded that, ECG changes could be used to predict mortality and major outcome events in antipsychotics intoxicated patients.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 92%

ECG Changes as a Predictive Tool of Outcomes in Antipsychotics Poisoned Patients

El-Gharbawy

Ghonem

2018

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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A nomogram proposal for early prediction of intensive care unit admission in patients with acute antipsychotic poisoning

El-Gharbawy,

Kabbash,

Ghonem

2023

Toxicology Research

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Background Early identification of antipsychotic poisoned patients who may have a potential risk for intensive care unit (ICU) admission is crucial especially when resources are limited. Nomograms were previously used as a practical tool to predict prognosis and planning the treatment of some diseases including some poisoning conditions. However, they were not previously investigated in antipsychotic poisoning. Aim The current study aimed to construct a nomogram to predict the need for ICU admission in acute antipsychotic poisoning. Patients and methods: This 2-year study included 140 patients acutely intoxicated with antipsychotics and admitted at Tanta University Poison Control Centre throughout July 2019 to June 2021. Personal and toxicological data, findings of clinical examination and electrocardiography, as well as, results of laboratory investigations at time of admission were recorded. According to the outcome, patients were divided into ICU-admitted and ICU-not admitted groups. Results The results of this study provided a proposed nomogram that included five significant independent predictors for ICU admission in acute antipsychotic intoxications; the presence of seizures (OR: 31132.26[108.97-Inf]), corrected QT interval (OR: 1.04[1.01–1.09]), mean arterial blood pressure (OR: 0.83[0.70–0.92]), oxygen saturation (OR: 0.62[0.40 to 0.83)], and Glasgow Coma Scale (OR: 0.25 [0.06–0.56]). Conclusion It could be concluded that the developed nomogram is a promising tool for easy and rapid decision making to predict the need for ICU admission in acute antipsychotic poisoning.

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Antipsychotic Exposures in an Emergency Department

Cited by 2 publications

References 0 publications

ECG Changes as a Predictive Tool of Outcomes in Antipsychotics Poisoned Patients

ECG Changes as a Predictive Tool of Outcomes in Antipsychotics Poisoned Patients

A nomogram proposal for early prediction of intensive care unit admission in patients with acute antipsychotic poisoning

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