Poisoning with Drugs of Abuse: Identification and Management

Incidence of rhabdomyolysis occurrence in psychoactive substances intoxication: a systematic review and meta-analysis

Rhabdomyolysis is a potentially life-threatening condition induced by diverse mechanisms including drugs and toxins. We aimed to investigate the incidence of rhabdomyolysis occurrence in intoxicated patients with psychoactive substances. In this review, three databases (PubMed, Scopus, Web of Science) and search engine (Google Scholar) were searched by various keywords. After the screening of retrieved documents, related data of included studies were extracted and analyzed with weighted mean difference (WMD) in random effect model. The highest incidence of rhabdomyolysis was observed in intoxication with heroin (57.2 [95% CI 22.6-91.8]), amphetamines (30.5 [95% CI 22.6-38.5]), and cocaine (26.6 [95% CI 11.1-42.1]). The pooled effect size for blood urea nitrogen (WMD = 8.78, p = 0.002), creatinine (WMD = 0.44, p < 0.001), and creatinine phosphokinase (WMD = 2590.9, p < 0.001) was high in patients with rhabdomyolysis compared to patients without rhabdomyolysis. Our results showed a high incidence of rhabdomyolysis induced by psychoactive substance intoxication in ICU patients when compared to total wards. Also, the incidence of rhabdomyolysis occurrence was high in ICU patients with heroin and amphetamine intoxication. Therefore, clinicians should anticipate this complication, monitor for rhabdomyolysis, and institute appropriate treatment protocols early in the patient's clinical course.

Acute poisoning in children: Etiology, structure, treatment tactics and outcomes

Introduction: Acute poisoning is often observed in children and can have serious consequences since it is characterized by rapid development of symptoms and obvious disfunction of vital organs.

Materials and methods: Retrospective analysis of the case histories of the children with acute poisoning admitted to Voronezh Regional Children’s Clinical Hospital No. 1 in 2016–2019 was carried out. Anamnesis, clinical and laboratory studies and effective treatment criteria were entered into electronic spreadsheets and served as the basis for a database on children’s poisoning.

Results and discussion: Analysis of 183 case histories of children with intoxication aged 4 months to 17 years old was performed. Distribution per age showed bimodal peaks at 1–2 years and 13–14 years. Poisoning was accidental in 96.2% of the cases, and 3.8% of the adolescents reported suicide cases. In the group of young children, acute drug poisoning is more frequent in girls (P &lt; 0.05). In the older groups, there is no gender difference in frequency of poisoning cases.

Early call for medical help is typical for the adolescent age group. Correlation between time of help-seeking and children’s age is statistically significant (correlation coefficient r = 0.38, P &lt; 0.05).

Conclusion: Study of poisoning issue in children will allow to carry out targeted preventive measures to reduce the number of poisoning cases, prevent their consequences and to determine the most rational modus operandi for medical personnel for effective and safe pharmacotherapy.

Graphical abstract

In pediatric practice, intoxication by poisons and drugs is among the most common reasons for seeking medical help and hospitalization in intensive care units. It is important to study and record dynamics, structure and frequency of acute poisoning with subsequent development of prevention and treatment methods.

Drug and Chemical Poisoning Patterns in Makkah Region, Saudi Arabia

This research reveals that drugs and chemicals poisoning have been reported to have severe and fetal side effects on health provided by doctors in statistics and periodical records. This work aimed to explore the interaction among drug and chemical poisoning patterns concerning risk factors, especially gender, age, exposure circumstances, and outcomes in the Makkah region. A retrospective analysis was of clinical drug and chemical poisoning cases (2014-2015). The data were retrieved from the Department of Environmental and Occupational Health, Ministry of Health, Makkah, Saudi Arabia. The Saudi Arabia Ministry of Health received 1216 reports of drug and chemical poisoning during 2014-2015 in Makkah. This study has found that, the most affected gender was that of males (65%). The most affected age category with drug poisoning was over 15 years old (67%), but under 5 years for chemical poisoning (60%). The majority of drug poisoning cases are unknown drugs (42%), which accidental poisoning was a minority compared with other drug causes (27%). Chemical poisoning accidents were the majority causes of the recorded cases (63%). We reported healthy recovered without complications for most patients from drug and chemical poisoning (85-95%). Antidotes were administered in only (5%) of cases, and fatalities were reported (0.5% of cases). We have shown a flagrant increase in the number of people poisoned by drugs and chemical agents during 2015. Increases poisoning cases involved both genders and all studied age categories, especially males over 15 years up to 25 (drugs) and < 5 years (chemicals). Most cases were accidental (chemicals) and reported healthy recovery for most patients.