Presentation
CONCLUSIONS: This study identified the increasing use of gabapentinoids in IDO, describing the profile and overdose characteristics of presentations. [ncbi.nlm.nih.gov]
Entire Body System
- Hypothermia
Symptoms of alcohol poisoning include: Mental confusion Vomiting Seizures Slow breathing (fewer than 8 breaths per minute) Irregular breathing (10 seconds or more between breaths) Hypothermia, bluish skin color, paleness The most common risk factors that [addictioncenter.com]
Clinical features: CNS: Ataxia, lethargy, slurred speech, drowsiness, vertigo and nystagmus followed by coma, hypotonia, hypothermia and respiratory arrest. [litfl.com]
Part 12.9: Cardiac Arrest in Accidental Hypothermia Unintentional or accidental hypothermia is a serious and preventable health problem. [doi.org]
Hypothermia is common in patients with deep coma, especially if the victim has ... [accessmedicine.mhmedical.com]
- Severe Pain
Chest pain and irregular heart rate. Too many stimulants can cause rapid heart rate, and lead to heart pain and cardiac arrest. An overly stressed heart can cause small muscle tears, resulting in bleeding and severe pain. [altamirarecovery.com]
Venous insufficiency and arterial occlusion resulting in severe pain, tissue ischemia and necrosis have both been described as being caused by bupropion [17]. [acep.org]
It is also administered to alleviate severe pain associated with terminal illnesses like cancer. The drug is up to 100 times more powerful than morphine. Just a small dose can be deadly. [edition.cnn.com]
As of July 2014, a total of 23 states have enacted laws establishing medical cannabis programs 6 and chronic or severe pain is the primary indication in most states. 7 - 10 Medical cannabis laws are associated with increased cannabis use among adults. [doi.org]
- Fatigue
Weak, or thready pulse Cold, clammy skin Unconsciousness and coma Blue-tinged skin Agitation and confusion Seizures Unconsciousness Agitation and confusion Delusions Seizures Unconsciousness Paranoia Anxiety Rapid heart rate and high blood pressure Fatigue [sbtreatment.com]
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]
Some symptoms or co-morbid conditions may include unintentional weight loss, feeling helpless, feeling alone, excessive fatigue, low self-esteem, presence of consistent mania, excessively talkative, intent on previously dormant goals, feel like one's [en.wikipedia.org]
Cessation of intake after prolonged or heavy use may produce a withdrawal syndrome, with depressed mood, fatigue, sleep disturbance, and increased dreaming. [who.int]
- 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]
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]
- Asymptomatic
After receiving treatment the patient was asymptomatic and had an uncomplicated hospital course. 5-FU poisoning must be recognized early as uridine triacetate is approved by the FDA for use within 96h following the end of 5-FU administration. [ncbi.nlm.nih.gov]
They can be discharged if they remain asymptomatic for 6 hours post ingestion. Adults as well can be monitored for 6 hours and if asymptomatic can be medically cleared. [litfl.com]
Patients who overdose on monoamine oxidase inhibitors (MAOIs) are classically asymptomatic for many hours post ingestion. [clinicaladvisor.com]
Respiratoric
- Snoring
Don’t ignore snoring and gurgling. Snoring and gurgling can indicate that a person is having trouble breathing. [overdoseday.com]
It is critical not to ignore snoring, even if the person is a known snorer, or gurgling. Snoring can be an indication of breathing trouble, and any obstruction of the breathing airways can be fatal. [dualdiagnosis.org]
Aceves was still walking around his cell at around 11 p.m., the report says, and his cellmate heard him snoring that night. Staff writer Sean Emery and City News Service contributed to this story. [ocregister.com]
Gastrointestinal
- Nausea
Nausea and vomiting. Often a person will aspirate during an overdose, causing the body to respond by vomiting contents out of the system. [altamirarecovery.com]
By now there is limited clinical trial experience regarding human overdose with vortioxetine and the maximum single dose tested was 75 mg in men associated with increased rates of nausea, dizziness, diarrhea, abdominal discomfort, generalized pruritus [ncbi.nlm.nih.gov]
Other gastrointestinal symptoms of an opiate overdose can include nausea or vomiting. A loss of appetite or spasms of the stomach or intestines may also occur with an overdose. [web.archive.org]
[…] hot skin, blisters, rash Violent or aggressive behavior Death Drug withdrawal symptoms also vary widely, depending on the specific drug used, but may include: Abdominal cramping Agitation, restlessness Cold sweat Delusions, hallucinations Depression Nausea [medlineplus.gov]
Diuretic overdose symptoms include slow breathing, confusion, drowsiness, fever, muscle cramps, skin sensitivity to sunlight, seizures, pale urine, weakness, vomiting, coma, dizziness, fainting, low blood pressure, nausea, rash, frequent urination, vision [livestrong.com]
- Abdominal Pain
Tamara McCorkindale had been plagued by mysterious abdominal pains for nine years but doctors were never able to establish what was wrong with her. [thesun.co.uk]
Symptoms of liver failure include abdominal pain and yellowing of the skin, or jaundice. Some patients may exhibit changes in thinking, mood or personality. [drugrehab.com]
Several of these medications are given on a short-term basis for post-surgical pain or other types of pain that go away with time; however, some opioid pain medications, such as OxyContin, are prescribed to individuals who suffer chronic pain from conditions [deserthopetreatment.com]
Chest pain is possible and can be caused by heart or lung damage. Shortness of breath may occur. Breathing may get rapid, slow, deep, or shallow. Abdominal pain, nausea, vomiting, and diarrhea are possible. [webmd.com]
Cardiovascular
- Hypotension
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]
Hypotension from a TCA overdose should first be treated with intravenous crystalloid fluid resuscitation. [clinicaladvisor.com]
- Hypertension
Consequently, the patient developed clinical symptoms including tremors, hypertension, visual hallucinations, vertigo, fever, and acute renal failure. A series of four TPEs was emergently initiated, resulting in complete resolution of most symptoms. [ncbi.nlm.nih.gov]
Any early hypertension should ideally not be treated unless severe. If profound hypertension occurs, it should be treated with a short-acting agent, such as nipride or esmolol. [clinicaladvisor.com]
[…] sudden onset of high fever Rapidly increasing pulse Loss of consciousness or being in-and-out of consciousness Seizures or convulsions Chest pain Severe headaches Excessive sweating Irritability and/or agitation Disorientation or mental confusion Severe hypertension [addictioncenter.com]
Eyes
- Miosis
[…] half of all opioid overdose deaths were related to prescription opioid analgesics.11 An opioid overdose can reliably be identified by the presence of three clinical signs and symptoms referred to as the “opioid overdose triad”: (1) pinpoint pupils (miosis [dentalcare.com]
It is not always easy to discern overdose symptoms from mere drug use, because some of the drug’s innate effects—for example, pupillary miosis or constriction with opioids—will be present in both situations. [americanaddictioncenters.org]
Musculoskeletal
- Muscle Twitch
Sedative withdrawal syndromes have many features in common with alcohol withdrawal, but may also include muscle aches and twitches, perceptual distortions, and distortions of body image. [who.int]
Psychiatrical
- Addictive Behavior
May also denote cessation of addictive behavior, such as gambling, over-eating, etc. Abuse. Harmful use of a specific psychoactive substance. The term also applies to one category of psychoactive substance use disorder. [web.archive.org]
Addictive Behaviors. March 19, 2018. https://www.sciencedirect.com/... 34. [drugwarfacts.org]
Neurologic
- Confusion
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]
Confusion and disorientation/violent behavior. Confusion and disorientation, accompanied by severe anxiety can also exhibit signs that a person is overdosing. [altamirarecovery.com]
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]
They may also be confused.14 Seizures Overdose from certain drugs such as stimulants and alcohol are associated with seizure risk.5,14 If someone is experiencing a seizure, call 911 and stay with the person until medical personnel arrive. [sunrisehouse.com]
- Headache
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]
They’re also prescribed for headaches and sleep if other medications have not worked. However, barbiturates are still misused through illicit access. Illegal use has led to overdose deaths because the medications are dangerous for self-treatment. [healthline.com]
Signs and symptoms of an overdose may vary depending on the substance, but can include: severe headache chest pain or heart palpitations difficulty breathing confusion or paranoia seizure hallucinations or delusions heavy sweating pale or blue skin low [kidshelpphone.ca]
Call 911 immediately if a person has: A seizure A severe headache Chest pain Trouble breathing Signs of extreme confusion or agitation Lost consciousness There are cases of overdose where people involved think that the overdosed person is fine because [dualdiagnosis.org]
- Slurred Speech
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 Overdose Signs and symptoms of drug overdose vary according to the drug(s) taken but may include the following: Abnormal breathing Slurred speech Lack of coordination Overly slow or rapid pulse Overly low or high temperature Overly big or small [caps.ucsc.edu]
Lethargy, slurred speech, nystagmus, and ataxia are common with mild to moderate intoxication. With higher doses, hypotension, coma, and respiratory arrest commonly occur. [accessmedicine.mhmedical.com]
speech Sluggishness Staggering Excessive and long-term use of barbiturates, such as phenobarbital, may produce the following chronic symptoms: Changes in alertness Decreased functioning Irritability Memory loss The health care provider will monitor the [medlineplus.gov]
- Stupor
Negative side effects from mixing these two drugs include lack of sleep, incoherence, confusion, paranoia, and stupor. [treatmentsolutions.com]
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]
- 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]
Any patient with an altered mental status should have a capillary glucose determined. [clinicaladvisor.com]
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]
Severe asthma exacerbations are commonly associated with hypercarbia and acidemia, hypotension due to decreased venous return, and depressed mental status, but the most common cause of death is asphyxia. [doi.org]
Treatment
She had previously declined conventional medical treatment for cancer and had made an advance decision stating that she wished to avoid hospital admission and refusing life-prolonging treatment. [ncbi.nlm.nih.gov]
Diversion, Treatment and Criminal Penalties Defendants who may not qualify for Good Samaritan immunity as described above may be eligible for entry into a drug diversion program or drug treatment court for defendants identified as having substance use [ncsl.org]
It covers patient assessment, treatment planning, and recovery care. The manual also offers guidance for medication-assisted treatment for methadone and buprenorphine, and overdose and relapse prevention. [store.samhsa.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]
The person may receive: Activated charcoal (in extreme cases) Blood and urine tests Medicines to treat symptoms Outlook (Prognosis) Serious symptoms are very unlikely. [mountsinai.org]
Prognosis In general, patients who arrive alive at health care facilities have a very good prognosis. Most deaths from these agents occur in the prehospital period. Thus, if an individual survives to hospital admission, the prognosis is quite good. [clinicaladvisor.com]
In medical circles, DIC is often referred to as “death is coming,” because it signals a poor prognosis. Multiple organ failure usually follows. [drugrehab.com]
The prognosis for drug overdose can vary. In many cases, a person who overdoses generally recovers completely and without lasting physical disability. Some serious drug overdoses are fatal, even with appropriate and timely treatment. [emedicinehealth.com]
Etiology
We speculate that an adulterating agent may be the underlying etiology in these cases. [ncbi.nlm.nih.gov]
Diagnostic approach History is the essential in determining the etiology of the symptoms. Certainly aggressive supportive care is key, and patient care should not be delayed while trying to obtain a history. [clinicaladvisor.com]
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]
[…] set out to determine a course of early detection for suicidal ideation in teens stating that "risks associated with suicidality require an immediate focus on diminishing self-harming cognitions so as to ensure safety before attending to the underlying etiology [en.wikipedia.org]
Epidemiology
Columbia St., Chapel Hill, NC 27516, USA. 5 Department of Epidemiology, University of North Carolina, 135 Dauer Dr., Chapel Hill, NC 27599, USA. 6 Center for Prisoner Health and Human Rights, The Miriam Hospital, 8 Third St., 2nd floor, Providence, RI [ncbi.nlm.nih.gov]
Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2016. Available at http://wonder.cdc.gov Centers for Disease Control and Prevention. [web.archive.org]
CDC’s WONDER (Wide-ranging Online Data for Epidemiologic Research) an easy-to-use, menu-driven system that makes the information resources of the Centers for Disease Control and Prevention (CDC) available to public health professionals and the public [cdc.gov]
Pathophysiology
Neurology (126) Internal Medicine (88) Physiology and Pathophysiology (76) Paediatrics, Neonatology (76) Pathology and Forensic Medicine (72) Genetics (62) Oncology, Radiation Therapy (39) Haematology (37) Medical Chemistry and Biochemistry (34) Neurosurgery [portal.mefanet.cz]
"The relationship of depression and diabetes: pathophysiological and treatment implications". Psychoneuroendocrinology. 36 (9): 1276–86. doi:10.1016/j.psyneuen.2011.03.005. PMID 21474250. ^ Li M, Fitzgerald P, Rodin G (April 2012). [en.wikipedia.org]
Pathophysiology Antidepressants Antidepressants work by different mechanisms, but ultimately most attempt to correct an imbalance of the dopaminergic, noradrenergic, and serotonergic systems. [clinicaladvisor.com]
Several consensus groups have developed excellent guidelines for the management of asthma that are available on the World Wide Web: http://www.nhlbi.nih.gov/about/naepp http://www.ginasthma.com Pathophysiology The pathophysiology of asthma consists of [doi.org]
Prevention
Tertiary prevention includes treating opioid use disorders and providing naloxone to prevent overdose death. [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]