Characteristics of acute adult poisoning cases admitted to a university                 hospital in Istanbul

Tüfekçi, Işıl Bavunoğlu; Çurgunlu, Aslı; Şirin, Feridun

doi:10.1191/0960327104ht460oa

Cited by 80 publications

(122 citation statements)

References 13 publications

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“…The proportion of patients admitted to ICU in our study was substantially higher than previously reported in the literature [5,6,13–16,18–21], probably as a result of the hospital geographic location and our patients’ socio-demographic characteristics. Despite the fact that our data is exclusively limited to results obtained from admissions during the autumn and winter, other related publications also showed a peak of ICU admissions during these seasons [21–23]. Although the majority of patients in this cohort were male, similarly to other related studies [5,6,24], our subjects were older when compared with other groups [5,6,16,18,19].…”

Section: Discussionsupporting

confidence: 56%

Clinical and epidemiological characteristics of patients with acute drug intoxication admitted to ICU

Orsini

Din

Elahi

et al. 2017

Journal of Community Hospital Internal Medicine Perspectives

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Background: Drug overdose continues to be the most common cause of acute poisoning worldwide. There has been a substantial increase in drug overdose incidence and prevalence over the past decade, probably as a result of the emergence of new synthetic designer drugs. The purpose of this study is to describe the clinical and epidemiological characteristics of patients with acute drug intoxication admitted to the Intensive Care Unit (ICU). Methods: A single center, prospective, observational study was conducted among all adult patients with clinical signs suggestive of acute drug intoxication admitted from the Emergency Department (ED) to ICU during a 6-month period (September to March). Results: Sixty-five patients were admitted. Their median age was 49 years (mean 48.2, range 20–72), and the majority were male (48, 74%). Median Sequential Organ Failure Assessment (SOFA) score on admission to ICU was 6 (mean 6, range 0–13). Fifty-five patients (85%) had a positive urine and/or serum toxicology screen. Most commonly detected substances were: opiates (18, 33%), cocaine (13, 24%), methadone (12, 22%), benzodiazepines (10, 18%), and marijuana (9, 16%). In 16 patients (29%), >1 substance was isolated. Twenty-three patients (35%) had negative urine toxicology screen. Ethyl alcohol was detected in the serum of 23 patients (35%). Five patients (8%) expired in ICU. Conclusion: Classic recreational drugs remain the most common substances involved in acute drug poisoning. More sensitive detection methods are warranted to identify new designer drugs of abuse such as synthetic cannabinoids.

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Section: Discussionsupporting

confidence: 56%

Clinical and epidemiological characteristics of patients with acute drug intoxication admitted to ICU

Orsini

Din

Elahi

et al. 2017

Journal of Community Hospital Internal Medicine Perspectives

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“…In evaluation of all age groups, intentional ingestion of sedativehypnotics for women was significantly higher than for men. Evaluating incidents of poisoning in terms of gender, it is striking to find out that the number of women is higher than that of men (51% versus 75%), although the rates may vary [2,12,14,15,18]. We found that the majority of patients were women (64.4% among children and 72.1% among adults).…”

Section: Discussionmentioning

confidence: 84%

“…It varied from 12 to 24 hr in other studies reporting all medication poisoning [12,18]. Several factors might have shortened the hospitalization period in our study, for example, a low rate of severe poisoning cases or extensive consulting of poisonings to DDPIC in EMDEU.…”

Section: Discussionmentioning

confidence: 87%

“…When the cause of poisoning is examined in various studies, it is seen that while adults ingest medication intentionally (suicidal attempt, abuse), the majority of children, still depending on the age group, ingest the medication accidentally [2,11,12,14,18]. In the 2004 report of AAPCC, it was reported that while there were more unintentional poisonings under 12 years, the intentional poisonings were constant for patients over 12 years [2].…”

Section: Discussionmentioning

confidence: 99%

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Sedative‐Hypnotic Medication Exposures and Poisonings in Izmir, Turkey*

Oray¹,

Hocaoğlu

Oray

et al. 2008

Basic Clin Pharma Tox

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The aim of this study was to analyse intoxications concerning sedative-hypnotic medication patients admitted to the Department of Emergency Medicine in Dokuz Eylul University Hospital (EMDEU) between 1993 and 2005. Demographics of the patients, characteristics of sedative-hypnotic exposures, performed treatment attempts and outcome of the poisoned patients were recorded on standard data forms that were later entered into a computerized database programme. Related to the sedative-hypnotic exposures, 686 poisoning cases were admitted to the EMDEU. Mean age was 10.8 ± 6.5 years among the paediatric age group (<17 years old, 169, 24.6%) and 30.3 ± 12.8 years among the adult group (>17 years old, 509, 74.2%). The most common sedative-hypnotic agents were benzodiazepines (286, 35.8%), alprazolam accounted for 41.6% of them (119). Most of the patients admitted to EMDEU were asymptomatic (61.7%). Observation alone was recommended in 53.9% of EMDEU cases. Although prescription of benzodiazepines is restricted, benzodiazepine was the most common cause of sedative-hypnotic medication exposures. As only a minority of patients (3%) had clinically serious signs and symptoms, most of the overdoses might be under toxic levels or the decontamination methods might be efficient. In this study, the clinical outcome of the patients is relatively better than previous results described in literature.Sedative-hypnotic medications have sedative (tranquilizing) effects when ingested in small amounts; however, if used in larger doses, they act as hypnotics. Despite the fact that a great majority of these medications are prescribed by the physicians, they have recently been much abused and incidents of sedative-hypnotic-related poisoning exposures have increased dramatically. Sedative-hypnotic ingestion at high doses may result in death without appropriate and adequate treatment [1]. With regard to the data gathered from all poison control centres all over the world, it has been stated that 56.6 -69.1% of poisoning incidents have occurred as a result of ingestion of medications [2,3]. Among all medication-related poisonings, almost 5.3% of them are caused by sedative-hypnotic antipsychotics. Sedative-hypnotic antipsychotics are considered as causative agents for adult poisonings and all poisoning-induced deaths, ranking the second place (11.7%) [2].Benzodiazepines are generally used in the treatment of anxiety, insomnia, seizures, medication-related agitation and alcohol withdrawal syndrome. Overdose of pure benzodiazepines very rarely results in death. However, concomitant ingestion of sedative-hypnotics with alcohol or other sedativehypnotic medications may result in severe poisoning and death [4]. In addition, in therapeutic doses, benzodiazepines have many side effects on the cardiovascular, central nervous, endocrine, respiratory, metabolic, gastrointestinal, haematological, genitourinary systems [5].No sufficient epidemiologic research is available concerning the frequency and severity of sedative-hypnotic medicationrelated...

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“…Signs and symptoms were found to be significantly more prevalent in adults than in children (χ 2 =8.22, p<0.01). Serum potassium levels were measured in 31.7% (13) of patients admitted to EMDEU. In our laboratory, the normal range of serum potassium was 3.5-5.1 mmol/L.…”

Section: Methodsmentioning

confidence: 99%

Demographic and Clinical Characteristics of Theophylline Exposures between 1993 and 2011

Hocaoğlu¹,

Yildiztepe²,

Bayram³

et al. 2014

Balkan Med J

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Theophylline, a member of the xanthine family, has been used in the treatment of asthma, chronic obstructive pulmonary disease and apnoea (1, 2). Because of the narrow therapeutic index of theophylline, therapeutic drug monitoring is indicated for safe and effective treatment (3). Clinical manifestations of theophylline toxicity include nausea, vomiting, hypokalaemia, hyperglycaemia, metabolic acidosis, tachycardia, cardiac arrhythmias, and seizures (3, 4). Although its clinical use has decreased remarkably because safer and more effective drugs have been introduced, theophylline use continues to result in potentially life-threatening toxicity (1, 4).The aim of this study was to investigate aetiological, demographic and clinical characteristics of the patients with theophylline exposure reported to the Dokuz Eylül University Drug and Poison Information Center (DPIC), in Turkey, in a 19-year period. There is no comprehensive descriptive research study available concerning theophylline toxicity in Turkey. The results of our study may therefore improve cliniBackground: Acute and chronic exposure to theophylline can cause serious signs and symptoms of poisoning. Additionally, with a narrow therapeutic range, toxicity could be observed even with therapeutic doses of theophylline. Epidemiological data on theophylline exposures in our country are extremely limited. The results of our study may improve the clinical management of theophylline poisoning in our country and elsewhere. Aims: To present aetiological and demographic features, clinical findings and treatment attempts with regard to theophylline exposures reported to Dokuz Eylül University Drug and Poison Information Center (DPIC), between 1993 and 2011. Study Design: Descriptive study. Methods: The data regarding demographics, date, time, type of exposure, route of and reason for exposure, signs and symptoms upon admission, clinical management and outcome were retrospectively evaluated. Results:The DPIC recorded 88,562 poisoning calls between 1993 and 2011; 354 (0.4%) of them were due to theophylline exposure. The mean age of all cases was 24.1±15.4 (range between 1 month and 90 years). Females dominated all age groups (72.6%, 257 females). Intentional exposure was significantly higher in women than in men (88.2% vs. 68.2% for all age groups; p<0.001 for children; p<0.001 for adults; p<0.001 for all age groups). While 60.5% of the cases had no symptoms, severe signs of toxicity were present in 1.9% of theophylline exposure cases during the telephone inquiry. Signs and symptoms were found to be significantly more prevalent in adults than in children (p<0.01). The serum theophylline level was regarded as toxic in 74% (65 toxic levels) of theophylline measured cases. Clinical signs and symptoms were found to be significantly prevalent in cases with toxic theophylline levels (p<0.001). The rate of gastrointestinal decontamination procedures was higher than that of recommended gastrointestinal decontamination procedures by DPIC (83% and 66%, respectively). There wer...

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Characteristics of acute adult poisoning cases admitted to a university hospital in Istanbul

Cited by 80 publications

References 13 publications

Clinical and epidemiological characteristics of patients with acute drug intoxication admitted to ICU

Clinical and epidemiological characteristics of patients with acute drug intoxication admitted to ICU

Sedative‐Hypnotic Medication Exposures and Poisonings in Izmir, Turkey*

Demographic and Clinical Characteristics of Theophylline Exposures between 1993 and 2011

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