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Zhao X, Zhang R, Li W. A Strategy for Rescuing a Child From Clonazepam Poisoning: A Case Study. Ther Drug Monit 2024; 46:138-140. [PMID: 37876261 DOI: 10.1097/ftd.0000000000001148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/15/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND This report describes the successful rescue of a 12-year-old girl who ingested large quantities of clonazepam tablets. METHODS The patient was promptly treated with flumazenil and hemoperfusion to alleviate the symptoms of central depression. Therapeutic drug monitoring was used to evaluate detoxification efficacy. The authors analyzed the rescue protocol for clonazepam poisoning based on the pathophysiology, clinical manifestations, and pharmacokinetics of clonazepam overdose. RESULTS The patient responded well to the treatment and was discharged from the hospital without adverse events. CONCLUSIONS This case study demonstrated the effectiveness and safety of combining flumazenil with hemoperfusion as a treatment for clonazepam poisoning. This study aimed to provide insights into more effective methods for treating clonazepam overdose and contribute to the ongoing issue of managing this condition.
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Affiliation(s)
- Xuemei Zhao
- Department of Pharmacy, Qingdao West Coast New Area People's Hospital, Qingdao, China
| | - Rui Zhang
- Department of Pharmacy, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China; and
| | - Wenjing Li
- Department of Pharmacy, Children's Hospital of Nanjing Medical University, Nanjing, China
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Banaye Yazdipour A, Moshiri M, Dadpour B, Sarbaz M, Heydarian Miri H, Hajebi Khaniki S, Kimiafar K. The trend of top five types of poisonings in hospitalized patients based on ICD‐10 in the northeast of Iran during 2012–2018: A cross‐sectional study. Health Sci Rep 2022; 5:e587. [PMID: 35509401 PMCID: PMC9059223 DOI: 10.1002/hsr2.587] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 02/19/2022] [Accepted: 02/21/2022] [Indexed: 11/21/2022] Open
Abstract
Background and Aims Poisoning remains a major health issue in developing countries with high morbidity and mortality rates; also it is one of the most common causes of admission to hospitals. This study aimed to investigate the trend of the top five types of poisonings in hospitalized patients according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD‐10) in Imam Reza hospital, Mashhad, Iran. Methods This was a cross‐sectional study performed from March 20, 2012, until September 22, 2018. We collected data from all patients hospitalized for poisoning admitted to the poisoning center at Imam Reza hospital in northeast Iran. ICD‐10 was adopted to categorize all types of poisonings (T36‐T65). The results obtained were analyzed by SPSS 16. Results Thirty‐four thousand eight hundred and ten cases were included. The mean age of the patients was 29.64 ± 14.69 years, of them, 50.7% were males. Benzodiazepine poisoning (T42.4) has the highest frequency among other subcategories and it was more common among females (60.5%). Opium poisoning (T40.0) has the highest mortality rate (5.4%) among other subcategories that is more common in males (72.0%). The mortality associated with narcotics was the highest frequency (2.7%). Suicide (83.6%) was the most common cause of poisoning. Most poisonings occurred in summer (27.4%). Conclusion These findings could help health care managers and policymakers develop prevention and educational programs to reduce these poisonings and limit people's easy access to drugs and substances.
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Affiliation(s)
- Alireza Banaye Yazdipour
- Department of Health Information Management, School of Allied Medical Sciences Tehran University of Medical Sciences Tehran Iran
- Students' Scientific Research Center (SSRC) Tehran University of Medical Sciences Tehran Iran
- Department of Medical Records and Health Information Technology, School of Paramedical Sciences Mashhad University of Medical Sciences Mashhad Iran
| | - Mohammad Moshiri
- Medical Toxicology Research Center, School of Medicine Mashhad University of Medical Sciences Mashhad Iran
- Department of Pharmacodynamy and Toxicology, School of Pharmacy Mashhad University of Medical Sciences Mashhad Iran
| | - Bita Dadpour
- Medical Toxicology Research Center, School of Medicine Mashhad University of Medical Sciences Mashhad Iran
| | - Masoumeh Sarbaz
- Department of Medical Records and Health Information Technology, School of Paramedical Sciences Mashhad University of Medical Sciences Mashhad Iran
| | - Hamid Heydarian Miri
- Department of Epidemiology, School of Health Mashhad University of Medical Sciences Mashhad Iran
| | - Saeedeh Hajebi Khaniki
- Student Research Committee, Department of Biostatistics, Faculty of Health Mashhad University of Medical Sciences Mashhad Iran
| | - Khalil Kimiafar
- Department of Medical Records and Health Information Technology, School of Paramedical Sciences Mashhad University of Medical Sciences Mashhad Iran
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Becker S, Spiller HA, Badeti J, Funk AR, Casavant MJ, Zhu M, Michaels NL, Smith GA. Cocaine exposures reported to United States poison control centers, 2000-2020. Clin Toxicol (Phila) 2022; 60:827-837. [PMID: 35225107 DOI: 10.1080/15563650.2022.2042011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective: To investigate characteristics of cocaine exposures reported to US Poison Control Centers.Methods: Data from the National Poison Data System regarding cocaine-related calls to regional poison control centers from January 1, 2000 to December 31, 2020 were analyzed.Results: There were 59,466 first-ranked cocaine-related calls managed by poison control centers during the study period. Males accounted for more than two-thirds (70.3%) of these cases. The 20-29-year-old age group had the highest cocaine exposure rate, followed by 30-39-year-olds. Admission to a health care facility (HCF) occurred in 38.9% of cases and 41.1% of individuals had a serious medical outcome. Serious medical outcome (OR: 1.50, 95% CI: 1.39-1.61) and admission to a HCF (OR: 1.12, 95% CI: 1.06-1.19) were more likely to occur among individuals 13 years or older than among individuals <13 years old. Cocaine exposures involving additional substances were more likely to lead to a serious medical outcome (OR: 2.22, 95% CI: 2.14-2.29) and admission to a HCF (OR: 2.52, 95% CI: 2.43-2.61) than exposures to cocaine alone. Overall, the proportion of exposures resulting in a serious medical outcome increased from 39.9% in 2000 to 60.4% in 2020 (p < 0.0001). Likewise, the proportion of exposures resulting in admission to a HCF increased from 49.1% in 2000 to 54.4% in 2020 (p < 0.0001). There was also an increase in the rate of fatal cocaine cases from 2012 to 2020, driven by multiple-substance exposures.Conclusions: Cocaine exposures are a serious public health problem associated with substantial morbidity and mortality. The severity of cocaine exposures increased during the study period, reflected in an increased rate of fatal cocaine exposures since 2012 and increased proportions of serious medical outcomes and cases requiring admission to a health care facility. Additional efforts to prevent initiation of cocaine use and treat addiction among high-risk groups should be undertaken.
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Affiliation(s)
- Sarah Becker
- Center for Injury Research and Policy in The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Henry A Spiller
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.,Central Ohio Poison Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - Jaahnavi Badeti
- Center for Injury Research and Policy in The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Marcel J Casavant
- Center for Injury Research and Policy in The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.,Central Ohio Poison Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - Motao Zhu
- Center for Injury Research and Policy in The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Nichole L Michaels
- Center for Injury Research and Policy in The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Gary A Smith
- Center for Injury Research and Policy in The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.,Child Injury Prevention Alliance, Columbus, OH, USA
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