Favorable Outcome of Severe Acute Methadone Poisoning (Clinical Case)

Ливанов, Г. А.; Лодягин, А. Н.; Разина, А. А.; Глушков, С. И.; Иванова, А. А.; Volchkova, E. V.; Батоцыренов, Б. В.

doi:10.15360/1813-9779-2018-5-25-31

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…Poisonings hold one of the leading positions among causes of violent death [1][2][3][4][5][6][7]. A considerable number of baclofen (trade names Lioresal and Baklosan) poisoning have been observed.…”

Section: Introductionmentioning

confidence: 99%

Baclofen: Therapeutic and Toxic Mechanisms of Action (Review)

Romanova¹,

Благонравов²,

Кислов³

2020

Obŝaâ reanimatologiâ

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Section: Introductionmentioning

confidence: 99%

Baclofen: Therapeutic and Toxic Mechanisms of Action (Review)

Romanova¹,

Благонравов²,

Кислов³

2020

Obŝaâ reanimatologiâ

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Lung Histopathology in Baclofen Intoxication

Romanova

Сундуков

Голубев³

et al. 2021

Obŝaâ reanimatologiâ

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The aim of the study: to assess the lung histopathology in acute intoxication with baclofen alone and its combination with alcohol (in the same dose) 3 hours after the ingestion.Materials and methods. The study was performed on 15 male Wistar rats weighing 290-350 g and aged 20 weeks. The animals were divided into 3 groups, 5 animals each: control group that included intact rats; Group 1 composed of rats received baclofen alone; Group 2 that included rats received a combination of baclofen and ethanol. Baclofen was administered orally at a dose of 85 mg/kg animal weight under anesthesia (chloralose), and 40% ethanol, 7 ml/kg animal weight, was orally administered along with baclofen at the same dose. Animals of all groups were sacrificed after 3 hours by overdosing anesthetic agent. Lung tissue samples were examined by light microscopy using a video system at x400 magnification. The following histological characteristics were evaluated: circulatory disorders (engorged capillaries and venules, hemorrhages in interalveolar septa and alveoli, sludge), atelectasis (including partial), emphysema, cellular response (increased WBCs in the interalveolar septal area), thickening of interalveolar septa due to edema, epithelial desquamation into bronchial lumen. The diameter of alveoli and thickness of interalveolar septa were measured.Results. Three hours after the baclofen administration, circulatory disorders in the lungs (engorged venules and capillaries, hemorrhages in the interalveolar septa, sludge), emphysema, atelectasis (complete and partial) as well as cellular response (leucocyte infiltration of interalveolar septa) were detected. In the Group 2, baclofen resulted in circulatory disorders (engorged venules and capillaries, sludge), emphysema, atelectasis (complete and incomplete), cellular response (infiltration with leukocytes), as well as fluid in the lumen of bronchioles. In Group 1, the alveolar diameter was significantly larger than in the control group and Group 2, while the thickness of the interalveolar septa was lower. In group 2, alveolar diameter was significantly less than in group 1, but still greater than in the control group. The thickness of the interalveolar septa in group 2 was significantly greater than in the control group and group 1.Conclusion. After administration of baclofen alone and in combination with ethanol, the following alterations were found in the lungs: circulation disorders (venular and capillary engorgement, sludge), increased vascular permeability because of developing hypoxia, leukocyte infiltration of interalveolar septa. The monitoring of morphological alterations may aid in evaluating the severity of pathological processes in intoxication with baclofen alone and in combination with ethanol and in determining the method of intoxication (baclofen alone or in combination with ethanol).

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Damage to neurons of the cerebral cortex in acute poisoning with baclofen and its combination with ethanol

Romanova

Голубев

Churiliv

et al. 2022

Russian Journal of Forensic Medicine

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The aim of the study was to identify and quantify cerebral cortex neuron damage in baclofen and baclofen ethanol poisoning. Material and methods.A histological study of 25 rat cerebral cortex was performed. The animals were divided into 5 groups. The controls received neither baclofen nor ethanol. Groups 1 and 3 received baclofen (85 mg/kg), groups 2 and 4 received baclofen (85 mg/kg) and ethanol (7 ml/kg). Group 1 and 3 animals were euthanized 4 hours, group 2 and 4 animals -24 hours after the drug administration. Histological sections were stained with hematoxylin and eosin and by Nissl method. We examined the sections by light microscopy (magnification 400x) and calculated the number of damaged neurons. Statistical processing was performed by nonparametric Mann-Whitney method. The share of neurons with reversible and irreversible changes in the controls was 13% and 9%. 4 hours after baclofen administration the share of neurons with reversible changes and irreversible changes was 22% and 21%. 4 hours after baclofen and ethanol administration we observed an increase in the share of reversible (24%) and irreversible (29%) changes of neurons. 24 hours after baclofen administration the share of reversible and irreversible changes was 25% and 37%. Baclofen and ethanol administration caused an increase in the share of neurons with reversible (27%) and irreversible (41%) changes. The difference s between group 3 (4 hours) and controls was significant; in group 4 (24 hours) the difference was significant in comparison to controls and to group 3 (4 hours). Understanding the processes occurring in the brain during baclofen and baclofen ethanol administration will allow to provide medical care to this category of patients more effectively. The identified signs of brain neuron damage, along with the results of forensic chemical analysis, can be used to establish the immediate cause of death.

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Favorable Outcome of Severe Acute Methadone Poisoning (Clinical Case)

Cited by 3 publications

References 10 publications

Baclofen: Therapeutic and Toxic Mechanisms of Action (Review)

Baclofen: Therapeutic and Toxic Mechanisms of Action (Review)

Lung Histopathology in Baclofen Intoxication

Damage to neurons of the cerebral cortex in acute poisoning with baclofen and its combination with ethanol

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