Dokuz Eylül Üniversitesi Tıp Fakültesi ilaç ve zehir danışma merkezine bildirilen analjezik ilaçlarla zehirlenmeler
Analgesic poisonings reported to the Dokuz Eylül University drug and poison information center
Yazar: NİL HOCAOĞLU
Danışman: PROF.DR. YEŞİM TUNÇOK
Dokuz Eylül Üniversitesi / Tıp Fakültesi / Farmakoloji Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2005
Konu: Eczacılık ve Farmakoloji = Pharmacy and Pharmacology

Özet:
IV. SUMMARY Analgesic Poisonings Reported to the Dokuz Eylul University Drug and Poison Information Center Nil Hocaoglu, Dokuz Eylul University School of Medicine Department of Pharmacology, Izmir,Turkey. Objective: To analyze poisonings concerning analgesics that were reported to Dokuz Eylul University Drug and Poison Information Center (DPIC), in Izmir between 1993 and 2004. We also evaluated analgesic poisonings reported to DPIC and admitted to Emergency Medicine of Dokuz Eylul University Hospital (EMDEU) in the second part of our study. Method: In this cross-sectional, descriptional study, age and sex of the patient, analgesic type, route and reason for the exposure, clinical effects, treatment attempts and outcome of the poisoned patients were recorded on standart data forms, then entered into a computerized database program. The severity of clinical manifestations were graded and assessed according to the EAPCCT/IPCS Poisoning Severity Score. Statistical analysis was performed by using the chi-squre test. Results: The DPIC recorded 55,962 poisoning calls, 48,654 (86.9%) of them related to medicines. Analgesics accounted 16.3 % (7,939 cases) of all medicine-related poisonings. Among them 446 poisoning cases were admitted to EMDEU. More than half of the analgesic poisoning calls and admitted cases involved adults (55.9%, 4,440) and females dominated both in adults and in children (70.3%, 5,578). Mean age of adults and children were 27.7±0.1 and 10.6±0.1 years, respectively. The most involved analgesics were paracetamol (47.9 %), propionic acid derivatives (16.1 %), salicylates (13.7%) and acetic acid derivatives (10.3 %). Combined agents accounted of more than one third of the poisonings (37.5 %). Most of the poisonings were intentional (75.1%), especially in 19-29 age group of adults (pO.OOl) and 13-18 age group of children (pO.0001). At the time of telephone inquiry, 84.4% of the patients had no symtoms of toxicity. Clinical effects were graded as (14.0%) mild, (1.0%) moderate or (0.5%) severe poisoning. Observation alone was recommended in 63.2% of all cases. Gastrointestinal decontamination methods were performed more frequently for admitted poisoning cases before hospital admission than reported poisoning cases (61 % and 21 % respectively). Five patients died (1.6%) from paracetamol and/or salicylate ingestion. Conclusion: Although poisonings concerning analgesic ingestion reported to our DPIC were common, most of them were asymptomatic or mild. DPICs have an important role for theproper management with short observation periods and referral of these analgesic ingestions without unnecessary gastrointestinal decontamination procedures. Keywords: analgesic poisonings, paracetamol, salicylate, Drug and Poison Information Center. 10

Abstract:
IV. SUMMARY Analgesic Poisonings Reported to the Dokuz Eylul University Drug and Poison Information Center Nil Hocaoglu, Dokuz Eylul University School of Medicine Department of Pharmacology, Izmir,Turkey. Objective: To analyze poisonings concerning analgesics that were reported to Dokuz Eylul University Drug and Poison Information Center (DPIC), in Izmir between 1993 and 2004. We also evaluated analgesic poisonings reported to DPIC and admitted to Emergency Medicine of Dokuz Eylul University Hospital (EMDEU) in the second part of our study. Method: In this cross-sectional, descriptional study, age and sex of the patient, analgesic type, route and reason for the exposure, clinical effects, treatment attempts and outcome of the poisoned patients were recorded on standart data forms, then entered into a computerized database program. The severity of clinical manifestations were graded and assessed according to the EAPCCT/IPCS Poisoning Severity Score. Statistical analysis was performed by using the chi-squre test. Results: The DPIC recorded 55,962 poisoning calls, 48,654 (86.9%) of them related to medicines. Analgesics accounted 16.3 % (7,939 cases) of all medicine-related poisonings. Among them 446 poisoning cases were admitted to EMDEU. More than half of the analgesic poisoning calls and admitted cases involved adults (55.9%, 4,440) and females dominated both in adults and in children (70.3%, 5,578). Mean age of adults and children were 27.7±0.1 and 10.6±0.1 years, respectively. The most involved analgesics were paracetamol (47.9 %), propionic acid derivatives (16.1 %), salicylates (13.7%) and acetic acid derivatives (10.3 %). Combined agents accounted of more than one third of the poisonings (37.5 %). Most of the poisonings were intentional (75.1%), especially in 19-29 age group of adults (pO.OOl) and 13-18 age group of children (pO.0001). At the time of telephone inquiry, 84.4% of the patients had no symtoms of toxicity. Clinical effects were graded as (14.0%) mild, (1.0%) moderate or (0.5%) severe poisoning. Observation alone was recommended in 63.2% of all cases. Gastrointestinal decontamination methods were performed more frequently for admitted poisoning cases before hospital admission than reported poisoning cases (61 % and 21 % respectively). Five patients died (1.6%) from paracetamol and/or salicylate ingestion. Conclusion: Although poisonings concerning analgesic ingestion reported to our DPIC were common, most of them were asymptomatic or mild. DPICs have an important role for theproper management with short observation periods and referral of these analgesic ingestions without unnecessary gastrointestinal decontamination procedures. Keywords: analgesic poisonings, paracetamol, salicylate, Drug and Poison Information Center. 10