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At least 19 recordsLinked to original sources
PubMed1990

Pharmacokinetics of drug overdose.

Drugs ingested in overdose can have altered pharmacokinetics of absorption, distribution, and elimination. The pathophysiologic consequences of overdose can also change a drug's pharmacokinetic properties. Many toxicologic interventions are based on modifying the drug's pharmacokinetics (e.g., impairing absorption or enhancing elimination). Serum drug monitoring, even with its limitations, does have a role in managing the patient who has taken an overdose.

Absorption↗
PubMed1979

Drug overdoses: a comparison of drug-dependent and nondependent individuals attending London casualty departments.

During a 1-month prospective study of patients presenting to 62 London Casualty Departments with drug-related problems, 395 drug-dependent individuals were identified. A comparison of these drug-dependent and nondependent patients attending casualty during the same period with the same presenting problem of drug overdose showed statistically significant differences in demographic characteristics and patterns of drug use between the two groups. The importance of identifying previously unrecognized drug-dependent individuals during their casualty attendance is discussed.

Adult↗
PubMed1976

The reduction of coma time in lipophilic drug overdose using castor oil.

A clinical trial of castor oil in overdoses of lipophilic drugs gave a strong clinical impression that it was effective in speeding up recovery. Therefore, animal experiments were undertaken to confirm that castor oil acts as a ligand in Ethchlorvynol poisoning and that its use reduces coma time. Serial serum levels of Ethchlorvynol were obtained from dogs given Ethchlorvynol 150 mg/kg alone, and the same dose dissolved in castor oil 15 ml/kg in a crossover fashion. The result was a reduction of peak serum levels and of the half-life of the drug when the castor oil solution was used. In order to mimic the clinical situation more closely, a further crossover study was undertaken using Ethchlorvynol 300 mg/kg alone and the same dose followed by castor oil 15 ml/kg repeated q12h. This showed no delay in reaching peak serum concentration and no reduction of peak levels. However, it did show a 31 per cent reduction in the half-life of the drug. This change is statistically significant, and supports the continued use of castor oil in lipophilic drug overdose.

Animals↗
PubMed1976

Drug overdose emergency room admissions.

The incidence and patterns of drug overdose admissions to the University of Michigan Medical Center Emergency Suite were studied for the first 3 months of each year from 1956 to 1970. Among variables investigated with regard to age, sex, and time comparisons were types of drugs used, purpose of ingestions, medical condition on arrival, disposition after emergency care, and history of treatment for emotional problems. The continuing escalation in drug overdose emergencies, primarily related to intentional self-poisoning, reflects the growing social health problems of drug use proliferation and rise in suicide attempts over the past two decades. Emergency room resources are being increasingly taxed by the psychological and medical care needs of these cases. Renewed effort toward primary prevention is essential.

Age Factors↗
PubMed1976

Six unusual cases of drug overdose.

Six patients out of a total of 1,137 adults treated for drug overdose died during the period May, 1968 to June, 1973. Their case histories are summarized, and the conclusion drawn that, whilst death from drug overdose is unusual, increased vigilance particularly for the unsuspected secondary diagnosis or complication, is needed if there is to be any further reduction in the already small mortality rate.

Adult↗
PubMed1978

Fixed-bed charcoal hemoperfusion. Treatment of drug overdose.

Fixed-bed activated charcoal cartridges were used for hemoperfusion in the treatment of 54 patients with overdose of one or more drugs, including barbiturate, glutethimide, ethchloryvnol, meprobamate, methyprylon, methaqualone, salicylate, and diazepam. The most dramatic improvement was noticed in patients with phenobarbitol intoxication; they were admitted in stage 3-4 coma and were either awake or arousable by verbal communication at the end of 1 1/2 to 3 1/2 hours of hemoperfusion. Other intoxications improved slowly and required longer duration of treatment. The clearance rates of the drugs with hemoperfusion were greater than those usually achieved with hemodialysis. The data demonstrate the efficacy and usefulness of charcoal hemoperfusion for the management of drug overdose.

Adolescent↗
PubMed1975

Severe drug overdose: results of treatment.

The incidence and management of severe drug overdose patients over a five-year period is presented, together with results and complications. Emphasis is placed on the importance of conservative measures with minimal need for more aggressive methods of treatment.

Adult↗
PubMedDate not supplied

Post-extubation pulmonary function tests in detection of upper airway obstruction in drug-overdosed patients.

A relatively high percentage of hypnotic-sedative drug-overdosed (HSDO) patients suffer post-extubation upper airway obstruction. Since early detection and treatment of these lesions is desirable, we studied 20 recently extubated (within 24 hours) as well as 11 non-intubated HSDO patients employing flow-volume loops and spirometry. Abnormalities in tests for upper airway obstruction were common in both groups but only in the four post-extubation patients with clinically suspected upper airway obstruction was an inspiratory plateau by flow volume loops found. In addition, three of these four patients had mid-VC ratios greater than 1.25. We conclude that the Inspiratory flow volume loop and the mid-VC ratio may help in detecting post-extubation upper airway obstruction in lethargic, HSDO patients.

Adult↗
PubMed1991

A review of the management of oral drug overdose in the Accident and Emergency Department of the Royal Brisbane Hospital.

Two-hundred and eighty-nine patients who made a total of 323 presentations to the Royal Brisbane Hospital Accident and Emergency Department with a known or suspected oral drug overdose were reviewed. The majority of patients (76%) could be managed in a 24 h Accident and Emergency observation unit. Activated charcoal given orally or via a nasogastric tube was the recommended method of preventing further absorption of an ingested drug. The use of syrup of ipecac was not encouraged and orogastric lavage was used in only specific situations. The morbidity and mortality of these patients when compared with other studies, was not adversely affected by this protocol which dramatically reduced the indications for the use of orogastric lavage and syrup of ipecac.

Administration, Oral↗
PubMed1975

Drug overdoses: Is one stomach washing enough?

Naso-gastric tube aspirates were taken from patients with drug overdoses who had been given a gastric lavage and admitted to the resuscitation ward. Although care was taken to conduct thorough washouts, it was found that these were not always efficient. In several cases an amount equivalent to a therapeutic dose of drug was recovered in later aspirates. There was no correlation between the amount of drug recovered in the initial stomach washings and that found in the aspirates. It was concluded that routine aspiration of gastric contents at hourly intervals after admission was of considerable value in removing any residual drugs.

Amitriptyline↗
PubMed1992

Toxicity awareness and unintended suicide in drug overdoses.

The objective of this paper is to determine patients awareness of the toxicity of the drugs they overdose with, the source of these drugs, and whether they would have taken them had they been fully aware of their toxicity, and to examine the implications for prevention. A prospective review of one hundred consecutive overdoses admitted through an A&E department was carried out. Awareness was scored by a ranking questionnaire and intent by response to a standard question when toxicity was explained. Paracetamol was most the most frequently taken drug (39 cases). Overall awareness of toxicity was low. Twenty-eight patients (30%) said they would not have overdosed if they had been aware of the toxicity of what they had taken. Forty-nine per cent of patients took someone elses tablets. There is a rise in analgesic poisoning from 1976. Higher toxicity awareness may reduce the incidence of drug overdose. Smaller prescriptions and over the counter preparations especially paracetamol and limited access to toxic drugs, especially in high-risk homes, should reduce both the number and severity of overdoses. It is possible that a number of deaths from deliberate drug overdose may be unintentional as 30% of survivors in this study did not intend the toxic effects of the drug taken.

Accident Prevention↗
PubMed1991

Changes in arterial oxygen tension after gastric lavage for drug overdose.

1. Changes in arterial oxygen tension after gastric lavage were investigated in a prospective study of 55 patients admitted for drug overdose. 2. A significantly greater decrease was observed in smokers compared to non-smokers. 3. A correlation was found between the tricyclic antidepressant serum level and the observed oxygen tension decrease. 4. The usefulness, as well as the safety of the lavage procedure, in managing tricyclic antidepressants overdoses is controversial.

Adolescent↗
PubMed1992

Drug overdose--reducing the load.

OBJECTIVE: To review available information about various methods for reducing gastrointestinal absorption of a poison or drug. DATA SOURCES: Articles on overdose and accidental poisoning generated by the Australian Medlars Service and concentrating on the period between 1985 and 1990 were surveyed. Earlier studies were included if relevant. STUDY SELECTION AND DATA EXTRACTION: English language articles with an emphasis on studies using objective methods to measure individual and comparative efficacy of gastrointestinal decontamination techniques were selected. A total of 65 articles were reviewed. DATA SYNTHESIS: Gastric emptying procedures (gastric lavage or emesis caused by syrup of ipecac) are only effective if performed within one hour of drug ingestion. Gastric lavage is superior to syrup of ipecac. Oral administration of activated charcoal is more effective than either gastric emptying procedure, and is recommended for most cases of poisoning. Cathartics (sorbitol) can be used with activated charcoal. Whole bowel lavage with polyethylene glycol is indicated in selected cases of potentially lethal overdose where the toxic substance cannot be absorbed by charcoal and has passed the pylorus. CONCLUSIONS: Children--syrup of ipecac can be given at home to children older than 12 months. Most children who reach hospital can be treated by charcoal alone. ADULTS--Most patients are managed with supportive care and, in the absence of contraindications, a single dose of activated charcoal if seen within four hours of ingestion of the poison or drug. Gastric lavage is used if the patient presents within one hour of ingestion and has clinical features of toxicity.

Adult↗