1
|
Alnasser S, Alfadl A, Anaam MS, Alotaibi M. Eight-year epidemiological study for drug poisoning in Qassim, Saudi Arabia, 2008-2015. Drug Chem Toxicol 2024:1-6. [PMID: 38623685 DOI: 10.1080/01480545.2024.2338390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/29/2024] [Indexed: 04/17/2024]
Abstract
Literature reported drug poisoning as a major cause for visiting emergency departments, with various rates of occurrences across countries, regions, socioeconomic status, and cultures. Therefore, this study was conducted in Qassim to describe the sociodemographic patterns of acute drug poisoning as well as the most common drugs involved. A retrospective method of data collection was used employing medical record review for drug poisoning cases that occurred in the Qassim region during the 8 years from January 2008 to December 2015. Data was collected using a standardized, validated data collection sheet. The study failed to reveal any pattern (either decreasing or increasing) in the number of poisoning cases over time. Most cases (56.2%) of drug poisoning were accidental, caused by analgesics (35%), affected children younger than 5 years of age (41.4%), and occurred via ingestion (99.2%). It can be concluded that as most poisoning cases affected children, this highlights the importance of increasing awareness and educating families about the safe handling and storage of drugs out of reach of children.
Collapse
Affiliation(s)
- Sulaiman Alnasser
- Department of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | - Abubakr Alfadl
- Department of Pharmacy, Faculty of Medicine and Health Sciences, University of Science and Technology, Aden, Yemen
| | - Mohammed Saif Anaam
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, Saudi Arabia
| | - Meshal Alotaibi
- Department of Pharmacy Practice, College of Pharmacy, University of Hafr Albatin, Hafr Albatin, Saudi Arabia
| |
Collapse
|
2
|
Cowans C, Love A, Tangiisuran B, Jacob SA. Uncovering the Hidden Burden of Pharmaceutical Poisoning in High-Income and Low-Middle-Income Countries: A Scoping Review. PHARMACY 2023; 11:184. [PMID: 38133459 PMCID: PMC10747954 DOI: 10.3390/pharmacy11060184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/28/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
Pharmaceutical poisoning is a significant global public health concern, causing approximately 190,000 deaths annually. This scoping review aims to comprehensively map the available literature on pharmaceutical poisoning and compare patterns between high-income countries (HICs) and low-middle-income countries (LMICs). A systematic search was performed across the following databases: Embase, PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and CINAHL. Studies included were from 1 January 2011 to 31 December 2020, in English, with full text available. Seventy-nine articles were included in the study; 21 were from LMICs and 58 were from HICs. Toxic exposure was largely intentional (77%) in LMICs and accidental (68%) in HICs. Drugs acting on the nervous system were responsible for 95% of toxicities worldwide with analgesics accounting for the largest subtherapeutic group in both LMICs (40%) and HICs (58%). Notable statistics were that HICs accounted for 99% of opioid overdoses, and LMICs accounted for 19% of anti-epileptic-induced toxicities. Overall, the medical outcomes due to poisonings were generally worse in LMICs. The review provides possible interventions to target specific geographic locations, based on the trends identified, to reduce the burden worldwide. Many gaps within the literature were recognised, calling for more robust analytical research.
Collapse
Affiliation(s)
- Claire Cowans
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow G4 0RE, UK; (C.C.); (A.L.)
| | - Anya Love
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow G4 0RE, UK; (C.C.); (A.L.)
| | - Balamurugan Tangiisuran
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor 11800, Penang, Malaysia;
| | - Sabrina Anne Jacob
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow G4 0RE, UK; (C.C.); (A.L.)
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, Selangor, Malaysia
| |
Collapse
|
3
|
Chidiac AS, Buckley NA, Noghrehchi F, Cairns R. Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease. Expert Opin Drug Metab Toxicol 2023; 19:297-317. [PMID: 37436926 DOI: 10.1080/17425255.2023.2223959] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/05/2023] [Indexed: 07/14/2023]
Abstract
INTRODUCTION Paracetamol is one of the most used medicines worldwide and is the most common important poisoning in high-income countries. In overdose, paracetamol causes dose-dependent hepatotoxicity. Acetylcysteine is an effective antidote, however despite its use hepatotoxicity and many deaths still occur. AREAS COVERED This review summarizes paracetamol overdose and toxicity (including mechanisms, risk factors, risk assessment, and treatment). In addition, we summarize the epidemiology of paracetamol overdose worldwide. A literature search on PubMed for poisoning epidemiology and mortality from 1 January 2017 to 26 October 2022 was performed to estimate rates of paracetamol overdose, liver injury, and deaths worldwide. EXPERT OPINION Paracetamol is widely available and yet is substantially more toxic than other analgesics available without prescription. Where data were available, we estimate that paracetamol is involved in 6% of poisonings, 56% of severe acute liver injury and acute liver failure, and 7% of drug-induced liver injury. These estimates are limited by lack of available data from many countries, particularly in Asia, South America, and Africa. Harm reduction from paracetamol is possible through better identification of high-risk overdoses, and better treatment regimens. Large overdoses and those involving modified-release paracetamol are high-risk and can be targeted through legislative change.
Collapse
Affiliation(s)
- Annabelle S Chidiac
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, Australia
- New South Wales Poisons Information Centre, The Children's Hospital at Westmead, Sydney, Australia
| | - Nicholas A Buckley
- New South Wales Poisons Information Centre, The Children's Hospital at Westmead, Sydney, Australia
- Faculty of Medicine and Health, School of Medical Sciences, Discipline of Biomedical Informatics and Digital Health, The University of Sydney, Sydney, Australia
| | - Firouzeh Noghrehchi
- Faculty of Medicine and Health, School of Medical Sciences, Discipline of Biomedical Informatics and Digital Health, The University of Sydney, Sydney, Australia
| | - Rose Cairns
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, Australia
- New South Wales Poisons Information Centre, The Children's Hospital at Westmead, Sydney, Australia
| |
Collapse
|
4
|
Jhh O, Tf G, Mt S. Estimates of Paracetamol Poisoning in Brazil: Analysis of Official Records From 1990s to 2020. Front Pharmacol 2022; 13:829547. [PMID: 35350767 PMCID: PMC8957898 DOI: 10.3389/fphar.2022.829547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/14/2022] [Indexed: 02/05/2023] Open
Abstract
Objective: To assess the cases of paracetamol poisoning in Brazil. METHODS Analysis of official records of deaths between 1996 and 2019 from the Brazil Mortality Information System (SIM), admissions between 2008 and 2020 from the Hospital Information System (SIH), and cases of poisoning between 2017 and 2020 in health services, reported to the Brazilian Notifiable Diseases Surveillance System (SINAN). In SIM and SIH, records with ICD-10 were included: F55, T39, X40, X60, and Y10. In SINAN, commercial products containing paracetamol were identified. Records were stratified by age, sex, and intentionality. Mean and standard error were calculated for each stratum based on the annual data, by federation unit. Poisoning reports by 1,000,000 inhabitants were calculated from each state and compared to the national average. RESULTS In total, 492 deaths, 5,666 hospital admissions, and 17,031 cases of paracetamol poisoning were recorded in the period. Deaths occurred mostly among adults (71.3% ± 3.0) and in suicide attempts (37.3% ± 2.7). Hospital admissions were more frequent in adults (69.7% ± 1.4), women (57.1% ± 2.5), and unintentional poisoning (80.2% ± 4.2). Poisoning reports was more also frequent among adults (71.4% ± 1.2), women (74.2% ± 0.6), and due to accidents (79.6% ± 1.8). The South and Southeast regions of the country presented the highest frequencies in all outcomes, above the national average. CONCLUSION Paracetamol exposure is a concern for preventable poisonings, hospital admissions and deaths. More accurate data about paracetamol poisoning are required to support surveillance actions and the development of mechanisms to reduce poisoning, particularly related to adults, women and suicide attempts.
Collapse
Affiliation(s)
- Okuyama Jhh
- Graduate Program in Pharmaceutical Sciences, Universidade de Sorocaba, Sorocaba, Brazil
| | - Galvao Tf
- School of Pharmaceutica Sciences, Universidade Estadual de Campinas, Campinas, Brazil
| | - Silva Mt
- Graduate Program in Pharmaceutical Sciences, Universidade de Sorocaba, Sorocaba, Brazil
| |
Collapse
|
5
|
Tobaiqy M, Asiri BA, Sholan AH, Alzahrani YA, Alkatheeri AA, Mahha AM, Alzahrani SS, MacLure K. Frequency and Management of Acute Poisoning Among Children Attending an Emergency Department in Saudi Arabia. PHARMACY 2020; 8:pharmacy8040189. [PMID: 33066543 PMCID: PMC7711722 DOI: 10.3390/pharmacy8040189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 11/26/2022] Open
Abstract
Background: Acute poisoning is one of the common medical emergencies in children that leads to morbidity and mortality. Medications and chemical agents play a major role in these adverse events resulting in social, economic, and health consequences. Aims of the study: This study aimed to evaluate the frequency and management of acute poisoning among children attending the emergency room at East Jeddah Hospital, Jeddah city, Saudi Arabia. Methods: This study was a retrospective chart review of all acute pediatric poisoning incidences in children (0–16 years of age) from October-21-2016 to March-03-2020 who were attending the emergency department. Data were analyzed via SPSS software. Results: A total of 69 incidences of acute poisoning in children who attended the emergency department at East Jeddah Hospital; males (n = 38, 55.1%). Most children were aged 5 years or younger (n = 41, 59.4%). Unintentional poisoning occurred among 56.5% of observed cases of which 52.2% occurred in children younger than 5 years; 7.20% (n = 5) of patients were 12 to 16 years of age and had deliberate self-poisoning. The association between type of poisoning and age groups was statistically significant (chi-square = 28.5057, p = 0.0001). Most incidences occurred at home (n = 64, 92.8%). Medicines were the most common cause of poisoning (n = 53, 76.8%). An excessive dose of prescribed medicine poisoning accidents was reported in 10.1% cases. Analgesics such as paracetamol were the most documented medication associated with poisoning (39.1%) followed by anticonvulsants and other central nervous system acting medicines (18.8%). The most common route of poisoning was oral ingestion (81.2%). One mortality case was documented. Conclusion: Although not common, accidental and deliberate acute poisoning in children does occur. More can be done to educate parents on safe storage of medicines, household cleaning and other products associated with acute poisoning in children. Likewise, children can be taught more about the risks of poisoning from an early age. As importantly, clinicians need to include more detailed notes in the electronic medical records (EMR) or the system needs to be improved to encourage completeness to more accurately inform the research evidence-base for future service design, health policy and strategy.
Collapse
Affiliation(s)
- Mansour Tobaiqy
- Department of Pharmacology, College of Medicine, University of Jeddah, Jeddah 21512, Saudi Arabia
- Correspondence:
| | - Bandar A. Asiri
- College of Applied Medical Sciences, University of Jeddah, Jeddah 21512, Saudi Arabia; (B.A.A.); (A.H.S.)
- Inspection Department, Saudi Food and Drug Authority, Jeddah 21512, Saudi Arabia
| | - Ahmed H. Sholan
- College of Applied Medical Sciences, University of Jeddah, Jeddah 21512, Saudi Arabia; (B.A.A.); (A.H.S.)
| | - Yahya A. Alzahrani
- Department of Pharmacy, East Jeddah Hospital, Jeddah 22253, Ministry of Health, Saudi Arabia; (Y.A.A.); (A.A.A.)
| | - Ayed A. Alkatheeri
- Department of Pharmacy, East Jeddah Hospital, Jeddah 22253, Ministry of Health, Saudi Arabia; (Y.A.A.); (A.A.A.)
- Department of Pharmacology, College of Medicine, Umm al Qura University, Makkah 24381 8073, Saudi Arabia
| | - Ahmed M. Mahha
- Department of Emergency, East Jeddah Hospital, Ministry of Health, Jeddah 22253, Saudi Arabia; (A.M.M.); (S.S.A.)
| | - Shamsia S. Alzahrani
- Department of Emergency, East Jeddah Hospital, Ministry of Health, Jeddah 22253, Saudi Arabia; (A.M.M.); (S.S.A.)
| | | |
Collapse
|