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At least 127 records · Page 7Linked to original sources
PubMed2004

Best evidence topic report. Gastric lavage in aspirin and non-steroidal anti-inflammatory drug overdose.

A short cut review was carried out to establish whether gastric lavage was better than activated charcoal alone at reducing toxicity after aspirin or other non-steroidal anti-inflammatory drug (NSAID) overdose. Altogether 72 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. A further relevant paper was found on scanning the references of papers identified. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2001

Trends in deaths from drug overdose and poisoning in England and Wales 1993-1998.

BACKGROUND: The study examines time trends and sociodemographic aspects of drug poisoning deaths in England and Wales. METHODS: Socio-demographic data from the four drug groups most commonly used in poisoning were extracted, and annual age- and sex-specific mortality rates calculated. Enumeration districts were ranked into five groups on the basis of their Carstairs scores, and the number of deaths in each of the five groups was calculated. RESULTS: There were 15720 deaths from drug poisoning between 1993 and 1998. More deaths occurred in men than in women (10 223 versus 5497). Opiates were the most commonly used drugs in deaths from drug poisoning (32 per cent of deaths); mortality rates increased twofold for these drugs. Males had higher number of deaths from opiate poisoning than females (4523 versus 1221). Highest mortality rates from opiate poisoning (77.4 per million) occurred in men aged 24-35 years. Deaths from drug poisoning were strongly associated with deprivation. CONCLUSION: There are substantial socio-demographic differences in mortality rates from drug poisoning.

Acetaminophen↗
PubMed2006

Diabetic ketoacidosis--a possible complicating factor in deaths associated with drug overdose: two case reports.

Two cases are described where diabetic ketoacidosis was found in conjunction with significant levels of prescription drugs. Case 1: A 45-year-old woman with a history of insulin-dependent diabetes mellitus was found to have Armanni-Ebstein nephropathy characteristic of hyperglycaemia with a vitreous humour glucose level of 63.1 mmol/L and a beta-hydroxybutyrate level of 14.25 mmol/L. Ancillary toxicological evaluation revealed a lethal level of sertraline (2.5 mg/L), with an elevated level of methadone (0.23mg/L). Death was due to diabetic ketoacidosis complicating mixed drug toxicity. Case 2: A 27-year-old man with a history of insulin-dependent diabetes mellitus was found to have Armanni-Ebstein nephropathy with a vitreous humour glucose level of 51.7 mmol/L and a beta-hydroxybutyrate level of 18.6mmol/L. Ancillary toxicological evaluation revealed a potentially lethal level of methadone of 0.39mg/L. Death was attributed to diabetic ketoacidosis complicating methadone toxicity. These cases demonstrate a situation where drug toxicity led to diabetic ketoacidosis resulting in death most likely from a combination of factors. Measuring vitreous humour glucose and beta-hydroxybutyrate levels is important in individuals with histories, or scene evidence, of insulin-dependent diabetes mellitus, in addition to toxicological screening when there is evidence of possible drug taking. It appears that drug intoxication in both cases had impaired the ability to administer insulin, resulting in the development over time of diabetic ketoacidotic states. Lethal mechanisms were, therefore, more complex than simple drug toxicity or diabetic ketoacidosis in isolation.

Adult↗
PubMed1999

Therapeutic drug monitoring in drug overdose.

The treatment of poisoned patients is still largely defined by history, clinical assessment and interpretation of ancillary investigations. Measurement of drug concentrations is clinically important for relatively few compounds. Most measurements form an adjunct to and should not be considered a substitute for clinical assessment. Drug concentrations are particularly important for those compounds where the concentration is predictive of serious toxicity in an otherwise asymptomatic patient.

Acetaminophen↗
PubMed2001

Therapeutic drug monitoring in drug overdose.

The treatment of poisoned patients is still largely defined by history, clinical assessment and interpretation of ancillary investigations. Measurement of drug concentrations is clinically important for relatively few compounds. Most measurements form an adjunct to and should not be considered a substitute for clinical assessment. Drug concentrations are particularly important for those compounds where the concentration is predictive of serious toxicity in an otherwise asymptomatic patient.

Acetaminophen↗
PubMed1994

[Epidemiology of attempted suicide by drug overdose in Vienna].

We studied 361 Viennese patients (m = 111, f = 250) admitted to our observation ward after attempted suicide by drug ingestion over a two-year period. Age and sex distribution, social status, time of attempt, motives, and drugs used were documented, as well as the therapeutic management of the cases. The patients were divided into 4 age groups: 57 juveniles, 179 young adults, 80 middle-aged adults and 45 geriatric patients. These groups were compared with each other in manifold respects. Our analysis showed that the geriatric patients who had attempted suicide by drug ingestion differed from those of other groups insofar as there was a lack of exogenous influence with regard to motives and methods. They may represent a separate entity more akin to suicide than to attempted suicide. Vienna data on attempted suicide by drug ingestion did not differ markedly from international data.

Adolescent↗
PubMed1990

[HIV-1 prevalence in deaths caused by drug overdose in various large cities of West Germany and West Berlin between 1985 and 1988].

The development of the HIV-1-prevalence among drug deaths (n = 753) in several German cities (West Berlin, Frankfurt, Munich, Hamburg, Bremen, Cologne and Stuttgart) from 1985 to 1988 was evaluated; in 1988 43% of 674 deceased drug addicts were examined. The regional prevalence rate was between 15 and 25%; only in Berlin 42% of the drug deaths were HIV-infected (cumulated data of all cities over the 4-year-period: 26%). There was no uniform or steady regional development of HIV-1-prevalence in the different cities. The ratio men/women among drug deaths was 3:1. The HIV-1-prevalence among males was 22%, among females 40%. HIV-infected individuals were 2-3 years older than seronegatives. Predictions concerning the trend of prevalence rates are not possible up to now. Continuous monitoring of the HIV-status of drug deaths seems to be a worthful method to evaluate the spread of this disease among the risk group of intravenous drug addicts.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Drug overdose. Prevention, management and post mortem.

The author's purpose is to bring to the attention of general practitioners the present thinking on drug overdosage and, in general terms, to update and refresh their knowledge. The article includes extensive lists of potentially hazardous products found in most homes. Recent changes in attitude to the use of activated charcoal are noted as these are relevant to early management by family physicians.

Adult↗