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

Abstract

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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Analysis of the Year 2007 Data of Dokuz Eylül University Drug and Poison Information Center, Turkey

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