Poisoning

Evaluate the impact of hospital types on the availability of antidotes for the management of acute toxic exposures and poisonings in Malaysia

INTRODUCTION

The availability of antidotes may be considered essential and lifesaving in the management of certain poisonings. Surveys carried out in a number of countries have demonstrated inadequate availability of a variety of poisoning antidotes.

OBJECTIVES

The purpose of this study was to determine the availability of antidote stocking at hospitals, based on published guidelines for antidote stocking, and to evaluate the impact of hospital types on the availability of antidotes for the management of acute toxic exposures and poisonings in Malaysia.

METHODS

A questionnaire on the availability of antidotes was sent to all government accident and emergency departments in Malaysia. The list of commonly required antidotes and essential drugs was compiled from published guidelines. Collected data were analysed in SPSS version 16 using descriptive and comparative analysis.

RESULTS

The response rate was 59.06%. None of the responding hospitals stocked all of the antidotes on the lists. In relation to hospital type, there was great variability in the availability of antidotes (there were significant differences between hospitals for 13 antidotes). The availabilities of most antidotes were far better in the General Hospitals and the District Hospitals with specialists compared to District Hospitals without specialists. Calcium gluconate, sodium bicarbonate, atropine sulphate, naloxone, flumazenil, vitamin K, and pyridoxine were available at all general hospitals. Atropine sulphate and naloxone were available at all district hospitals with specialists.

CONCLUSION

Most Malaysian government hospitals stocked some important antidotes. Raising awareness of the importance of antidotes by education, regular review of antidote storage, distribution plans, and appropriate legislation might provide solutions. Coordination between Malaysian hospitals and the National Poison Centre at Universiti Sains Malaysia is also important.

Adsorption of Paracetamol and Acetylsalicylic Acid onto Commercial Activated Carbons

The adsorption of paracetamol (PAR) and acetylsalicylic acid (ASA) onto high-surface-area, commercial activated carbons was investigated at 26°C via adsorption isotherms at different pH values, including pH 1.5 to simulate conditions existing in the stomach. A wide-ranging characterization of the carbons, including analysis of their morphology and surface chemistry, was undertaken, with the actual surface areas of the carbons available for PAR and ASA adsorption being estimated by taking the molecular sizes of the drugs into account. This provided an understanding of the differences in the drug adsorption behaviour of the carbons.