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Overdose

Overdose Drug


Presentation

  • We present a case of multi-drug overdose including apixaban with associated apixaban concentrations.[ncbi.nlm.nih.gov]
  • The use of these biomarkers could help stratify patients for their risk of liver injury at hospital presentation.[ncbi.nlm.nih.gov]
  • Here, we present a case of an intentional overdose of a metformin- sitagliptin combination (70g metformin and 3500mg sitagliptin) in a suicide attempt by a young non-diabetic female who presented with severe lactic acidosis and was successfully treated[ncbi.nlm.nih.gov]
  • A 15-year-old non-diabetic Caucasian girl presented with sudden onset of seizures, unrecordable blood glucose readings and acute renal failure.[ncbi.nlm.nih.gov]
  • Clinical relevance: The purpose of this article is to supply dental practitioners with the knowledge to manage patients who present having taken an oral supra-therapeutic paracetamol overdose.[ncbi.nlm.nih.gov]
Congestive Heart Failure
  • CASE REPORT: A 71-year-old man with atrial fibrillation, aortic valve replacement, and congestive heart failure presented to the emergency department after an intentional ingestion of 97 (1940 mg total) rivaroxaban tablets in a suicide attempt.[ncbi.nlm.nih.gov]
  • This study was not designed to describe additional causes of death related to substance use, such as homicides, motor vehicle crashes, and long-term sequelae of substance use ( e.g. congestive heart failure, infectious disease).[ncbi.nlm.nih.gov]
  • Heart Failure (Baystate Incubator Fund-NON-industry, academic hospital funding) None None None None None Elizabeth Sinz Penn State Hershey Medical Center–Professor of Anesthesiology and Neurosurgery; AHA–Associate Science Editor None None None None None[doi.org]
Hypothermia
  • Part 12.9: Cardiac Arrest in Accidental Hypothermia Unintentional or accidental hypothermia is a serious and preventable health problem.[doi.org]
  • ., hyperthermia/hypothermia). Passing out or an unresponsive loss of consciousness. Skin color changes (e.g., pallor or bluish tint to skin if a respiratory depressant was used; ruddy or flushed after cardiovascular overstimulation).[americanaddictioncenters.org]
  • […] include : Mental changes, like confusion, fogginess, rambling or rapid speech, or hyper-attention Emotional changes, like depression, aggression, or euphoria Hallucinations, delusions of grandeur, or suicidal ideation Body temperature changes, either hypothermia[deserthopetreatment.com]
Pressured Speech
  • He had pressured speech and difficulty focusing on questioning. He had a heart rate of 110 bpm, but had an otherwise normal examination, with no clonus or extrapyramidal effects. He was unable to mobilize due to dizziness and ataxia.[ncbi.nlm.nih.gov]
Snoring
  • Don’t ignore snoring and gurgling. Snoring and gurgling can indicate that a person is having trouble breathing.[overdoseday.com]
  • Signs of an overdose Opioid or depressant overdose Slow and shallow breathing Very sleepy and unable to talk, or unconscious Blue lips or fingertips Snoring or gurgling sounds Amphetamine or another stimulant overdose Amphetamine-induced psychosis (paranoia[ddap.pa.gov]
Labored Breathing
  • The patient may have difficulty breathing, exhibit labored breathing or have very shallow breaths. This can lead to the appearance of blue skin, lips or fingernails. The breathing may become so shallow that it stops.[web.archive.org]
Hypotension
  • The typical presentation of a calcium channel blocker overdose is hypotension and decreased level of consciousness.[ncbi.nlm.nih.gov]
  • Methylene blue boluses were initiated when hypotension persisted despite conventional treatments. Refractory hypotension prompted the use of plasmapheresis in an attempt to lower serum amlodipine levels.[ncbi.nlm.nih.gov]
  • She was admitted to the pediatric intensive care unit for rapidly deteriorating hypotension (lowest blood pressure 47/19 mm Hg) refractory to aggressive fluid resuscitation and infusions of epinephrine and norepinephrine each at 0.5 mcg/kg/min.[ncbi.nlm.nih.gov]
  • Abstract Diltiazem overdose has a high mortality rate due to cardiotoxicity associated with bradycardia and hypotension.[ncbi.nlm.nih.gov]
  • Calcium channel blockers (CCBs) are a commonly prescribed medication that, at toxic levels, are capable of causing severe refractory hypotension, hypoxic respiratory failure and cardiotoxicity.[ncbi.nlm.nih.gov]
Facial Numbness
  • We present a case of a 64-year-old woman who presented with acute onset headache, bilateral tinnitus, and left-sided facial numbness and tingling in the setting of accidentally overdosing on hydroxychloroquine.[ncbi.nlm.nih.gov]
Confusion
  • According to The New York Times Health Guide, symptoms of a beta-blocker overdose include difficulty breathing, wheezing, blurred vision, irregular heartbeat, double vision, lightheadedness, shock, heart failure, slow or rapid heartbeat, confusion, coma[livestrong.com]
  • Treatment (or methods): Both patients developed acute neurotoxicity with confusion, pain and seizures. Intravenous dexamethasone and folinic acid (leucovorin) was given. Exchange of cerebrospinal fluid was performed.[ncbi.nlm.nih.gov]
  • A 39-year-old homeless man was found confused and incoherent after ingesting an estimated total of 200 tablets of various medications. He presented to the emergency department with delirium, tachycardia, clonus and hyperthermia of 38.0 C.[ncbi.nlm.nih.gov]
  • People who become tolerant to or addicted to stimulants can also take too much of the medication in desperation if they miss a dose or feel withdrawal effects like extreme fatigue, confusion, or even psychosis.[deserthopetreatment.com]
  • Extremely paranoid, agitated and/or confused. It is not necessary for someone to have all of these signs or symptoms for them to be overdosing. Exhibiting one or two could still mean they are in trouble and need emergency help.[overdoseday.com]
Altered Mental Status
  • A 62-year-old man with a medical history of AF was admitted to our emergency department for altered mental status.[ncbi.nlm.nih.gov]
  • CASE REPORT A 24-year-old male was transferred to our medical intensive care unit with hypotension and altered mental status after an overdose of fluoxetine, cyproheptadine, trazodone, olanzapine, risperidone, and bupropion.[ncbi.nlm.nih.gov]
  • Symptoms of overdose include altered mental status, high blood sugar, slow heartbeat and very low blood pressure. Lactic acidosis, a buildup of lactic acid in the body, can also occur as the result of a calcium channel blocker overdose.[livestrong.com]
  • mental status, the patient is suicidal, or there is a lack of time to explain treatment alternatives. 219 The majority of questions addressing cardiac arrest due to drug toxicity remain unanswered.[doi.org]
Stupor
  • Common Symptoms Sleepiness Nausea or vomiting Dizziness Fever Confusion Rapid heartbeat Agitation Shakiness Severe Symptoms Fainting Heart problems Changes in blood pressure (higher or lower than normal) Seizures Delirium Hallucinations Stupor Mania Inflammation[verywell.com]
  • […] drugs include: Central nervous system (CNS) depressants: shallow breathing, weak pulse, clammy skin, coma, death from respiratory arrest Hallucinogens: psychotic features, agitation, delirium Inhalants: marked CNS depression, loss of consciousness, stupor[americanaddictioncenters.org]
  • […] rapid speech, or hyper-attention Emotional changes, like depression, aggression, or euphoria Hallucinations, delusions of grandeur, or suicidal ideation Body temperature changes, either hypothermia or hyperthermia Nausea and vomiting Extreme sleepiness Stupor[deserthopetreatment.com]
  • The opium alkaloids and their synthetic analogues also cause stupor, coma, and respiratory depression in high doses.[who.int]
Lethargy
  • Physical examination revealed bilateral pupils dilatation, lethargy, slurred speech, and ataxia. Computer-aided tomographic scan of the brain revealed no definite evidence of intracranial lesions.[ncbi.nlm.nih.gov]
  • Signs of intoxication include belligerence, assaultiveness, lethargy, psychomotor impairment, euphoria, impaired judgement, dizziness, nystagmus, blurred vision or diplopia, slurred speech, tremors, unsteady gait, hyperreflexia, muscle weakness, stupor[who.int]
Agitated Delirium
  • Some signs of overdose for the following types of drugs include: Central nervous system (CNS) depressants: shallow breathing, weak pulse, clammy skin, coma, death from respiratory arrest Hallucinogens: psychotic features, agitation, delirium Inhalants[americanaddictioncenters.org]

Workup

Chlamydia
  • Patient-delivered therapy for chlamydia: putting research into practice. Sex Transm Dis. 2003;30(6):509–511. PubMed CrossRef Google Scholar 53. New York State Assembly.[doi.org]
Ischemic Changes
  • CONCLUSIONS: Valproic acid overdose is a relatively rare and electrocardiographic changes usually consist of tachycardia and nonspecific changes, but ischemic changes may occur and usually transient and require only recognition.[ncbi.nlm.nih.gov]

Treatment

  • Treatment with uridine triacetate was arranged in the emergency department.[ncbi.nlm.nih.gov]
  • Pediatric exposure to prazosin is unusual because it is most commonly indicated for the treatment of hypertension.[ncbi.nlm.nih.gov]
  • There is limited evidence in the literature describing the refractory treatment modalities utilized in this patient. This report is unique as it describes the clinical course of a patient when a multitude of unique treatments were combined.[ncbi.nlm.nih.gov]
  • ., drowsiness, coma) were selected for treatment with l-arginine.[ncbi.nlm.nih.gov]
  • Patients who needed intravenous acetylcysteine treatment for paracetamol overdose had circulating biomarkers measured at hospital presentation.[ncbi.nlm.nih.gov]

Prognosis

  • Hence, prognosis should not be decided on an isolated parameter, especially if the dynamic is atypical after a new prescription, even for well-known drugs.[ncbi.nlm.nih.gov]
  • What Is the Prognosis for a Drug Overdose? The prognosis for drug overdose can vary. In many cases, a person who overdoses generally recovers completely and without lasting physical disability.[emedicinehealth.com]
  • The presence of a low plasma magnesium concentration has been associated with poor prognosis in cardiac arrest patients. 208, 213 – 216 Hypermagnesemia Hypermagnesemia is defined as a serum magnesium concentration 2.2 mEq/L (normal: 1.3 to 2.2 mEq/L).[doi.org]
  • The presence of a low plasma magnesium concentration has been associated with poor prognosis in cardiac arrest patients. 208 , 213 – 216 Hypermagnesemia Hypermagnesemia is defined as a serum magnesium concentration 2.2 mEq/L (normal: 1.3 to 2.2 mEq/L)[doi.org]

Etiology

  • We speculate that an adulterating agent may be the underlying etiology in these cases.[ncbi.nlm.nih.gov]
  • For example, when two miners fell ill with Marburg hemorrhagic fever at the Kitaka mine in Uganda in early August 2007, CDC staff worked with the Ugandan Ministry of Health to quickly identify the etiology, contain the outbreak, and act on a rare opportunity[web.archive.org]
  • Non-ethanol components of alcoholic beverages may be involved in the etiology.[who.int]
  • However, the guidelines recommend that healthcare providers tailor the sequence based upon the presumed etiology of the arrest.[doi.org]

Epidemiology

  • ., Providence, RI 02903, USA. 3 Department of Epidemiology, Brown University School of Public Health, 121 South Main St., Providence, RI 02903, USA. 4 Center for Health Equity Research, University of North Carolina at Chapel Hill, 335 S.[ncbi.nlm.nih.gov]
  • USA 2 Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Ave, NY, NY 10029, USA 3 Department of Psychiatry, Weill Medical College, Cornell University, 525 E. 68th St, NY, NY 10021 USA 4 Department of Epidemiology, School[web.archive.org]
  • 3 Department of Preventive Medicine (Biostatistics), Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 4 Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. 5 Department of Epidemiology[ncbi.nlm.nih.gov]
  • Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2016. Available at Centers for Disease Control and Prevention.[web.archive.org]
  • AIM: To investigate the epidemiology and outcomes of cardiac arrests associated with opioid overdoses.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Several consensus groups have developed excellent guidelines for the management of asthma that are available on the World Wide Web: Pathophysiology The pathophysiology of asthma consists of 3 key abnormalities: Bronchoconstriction Airway inflammation[doi.org]

Prevention

  • Tertiary prevention includes treating opioid use disorders and providing naloxone to prevent overdose death.[ncbi.nlm.nih.gov]
  • OVERDOSE PREVENTION INTERVENTIONS: There are few examples of overdose prevention interventions in housing environments. In BC, for example, there are peer-led naloxone training and distribution programs targeted at some housing environments.[ncbi.nlm.nih.gov]
  • CDC’s work focuses on: Building prevention efforts by equipping states with resources, improving data collection, and supporting the use of evidence-based prevention strategies.[cdc.gov]
  • In October 2010, at least 188 local opioid overdose prevention programs that distributed naloxone existed.[cdc.gov]
  • Abstract The objectives were to analyze the knowledge about overdose prevention, the use of naloxone, and the number of fatal overdoses after the implementation of Systematic Training in Overdose Prevention (STOOP) program.[ncbi.nlm.nih.gov]

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