Summary: Accidental or deliberate use of a medication or street drug in excess of normal dosage.
- Laurence A, Wight J, Forrest A. Fatal theophylline poisoning with rhabdomyolysis. Anaesthesia. 1992;47:82 pubmed
- Davis M, Vogel L. Local anesthetic safety in pediatric patients. N Y State Dent J. 1996;62:32-5 pubmed..Safe dosage levels, technique recommendations and early clinical signs of possible overdose are presented here. ..
- Chou R, Turner J, Devine E, Hansen R, Sullivan S, Blazina I, et al. The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med. 2015;162:276-86 pubmed publisher..Evidence is insufficient to determine the effectiveness of long-term opioid therapy for improving chronic pain and function. Evidence supports a dose-dependent risk for serious harms. Agency for Healthcare Research and Quality. ..
- Protti A, Fortunato F, Monti M, Vecchio S, Gatti S, Comi G, et al. Metformin overdose, but not lactic acidosis per se, inhibits oxygen consumption in pigs. Crit Care. 2012;16:R75 pubmed publisher..001). Metformin intoxication induces lactic acidosis, inhibits global oxygen consumption and causes mitochondrial dysfunction in liver and other tissues. Lactic acidosis per se does not decrease whole-body respiration. ..
- Wu P, Juurlink D. Clinical Review: Loperamide Toxicity. Ann Emerg Med. 2017;70:245-252 pubmed publisher..In patients who survive loperamide toxicity, consideration should be given to the treatment of an underlying opioid use disorder, if present. ..
- Khan M, Islam S, Kundi A. Parasuicide in Pakistan: experience at a university hospital. Acta Psychiatr Scand. 1996;93:264-7 pubmed..In Pakistani culture, marriage appears to be a significant source of stress for women. Reports based on official police records do not reflect the true picture of the problem in Pakistan. ..
- Mercado Crespo M, Sumner S, Spelke M, Sugerman D, Stanley C. Notes from the field: increase in fentanyl-related overdose deaths - Rhode Island, November 2013-March 2014. MMWR Morb Mortal Wkly Rep. 2014;63:531 pubmedDuring November 2013-March 2014, twice as many all-intent drug overdose deaths were reported in Rhode Island as were reported during the same period in previous years...
- Hamdi E, Amin Y, Mattar T. Clinical correlates of intent in attempted suicide. Acta Psychiatr Scand. 1991;83:406-11 pubmed..The SIS can distinguish between relatively homogeneous subgroups of suicide attempters for depth studies of aetiology and management. ..
- Stone D, Holland K, Bartholow B, E Logan J, LiKamWa McIntosh W, Trudeau A, et al. Deciphering Suicide and Other Manners of Death Associated with Drug Intoxication: A Centers for Disease Control and Prevention Consultation Meeting Summary. Am J Public Health. 2017;107:1233-1239 pubmed publisher..Continued collaboration and coordination of activities are needed among stakeholders to affect prevention efforts. ..
- Wendon J, Harrison P, Keays R, Williams R. Cerebral blood flow and metabolism in fulminant liver failure. Hepatology. 1994;19:1407-13 pubmed..Mannitol infusion should remain the main treatment of the cerebral complications of fulminant liver failure.(ABSTRACT TRUNCATED AT 250 WORDS) ..
- Pourmand A, Shay C, Redha W, Aalam A, Mazer Amirshahi M. Cholinergic symptoms and QTc prolongation following donepezil overdose. Am J Emerg Med. 2017;35:1386.e1-1386.e3 pubmed publisher..As no specific antidote is available for donepezil overdose, this case highlights the importance of supportive care with particular attention to the management of cardiac dysrhythmias in patients displaying signs of toxicity. ..
- Chen X, Yang Z. Successful treatment of propafenone-induced cardiac arrest by calcium gluconate. Am J Emerg Med. 2017;35:1209.e1-1209.e2 pubmed publisher..We recommend that for patients poisoned by propafenone, close monitoring for decreased blood calcium is important. ..
- Strang J, Powis B, Best D, Vingoe L, Griffiths P, Taylor C, et al. Preventing opiate overdose fatalities with take-home naloxone: pre-launch study of possible impact and acceptability. Addiction. 1999;94:199-204 pubmed..Such a new approach would be supported by most drug misusers. On the basis of these findings, we conclude that it is appropriate to proceed to a carefully constructed trial of naloxone distribution. ..
- . Vital signs: overdoses of prescription opioid pain relievers---United States, 1999--2008. MMWR Morb Mortal Wkly Rep. 2011;60:1487-92 pubmed..OPR were involved in 14,800 deaths (73.8%) of the 20,044 prescription drug overdose deaths. Death rates varied fivefold by state...
- Chacko J, Greenstein J, Ardolic B, Berwald N. Effect of an emergency department opioid prescription policy on prescribing patterns. Am J Emerg Med. 2017;35:1327-1329 pubmed publisher..The opioid clinical policy had a clear effect in decreasing the number of patients prescribed opioids. Such policies may be the key to reducing the epidemic and saving lives from unintentional opioid overdoses. ..
- Jongbloed K, Pearce M, Pooyak S, Zamar D, Thomas V, Demerais L, et al. The Cedar Project: mortality among young Indigenous people who use drugs in British Columbia. CMAJ. 2017;189:E1352-E1359 pubmed publisher..These deaths likely reflect complex intersections of historical and present-day injustices, substance use and barriers to care. ..
- Webster L. Risk Factors for Opioid-Use Disorder and Overdose. Anesth Analg. 2017;125:1741-1748 pubmed publisher..Clinical tools and an evolving evidence base are available to assist clinicians with identifying patients whose risk factors put them at risk for adverse outcomes with opioids. ..
- . Vital signs: overdoses of prescription opioid pain relievers and other drugs among women--United States, 1999-2010. MMWR Morb Mortal Wkly Rep. 2013;62:537-42 pubmed..In 2010, a total of 15,323 deaths among women were attributed to drug overdose, a rate of 9.8 per 100,000 population...
- Rana M, Bonasera L, Bordelon G. Pharmacologic Considerations of Anesthetic Agents in Geriatric Patients. Anesthesiol Clin. 2017;35:259-271 pubmed publisher..This variability requires a unique approach to anesthetic delivery and drug dosing on an individual basis to avoid complications such as postoperative cognitive dysfunction and delirium. ..
- Sun E, Dixit A, Humphreys K, Darnall B, Baker L, Mackey S. Association between concurrent use of prescription opioids and benzodiazepines and overdose: retrospective analysis. BMJ. 2017;356:j760 pubmed publisher..b>Conclusions From 2001 to 2013, concurrent benzodiazepine/opioid use sharply increased in a large sample of privately insured patients in the US and significantly contributed to the overall population risk of opioid overdose. ..
- Nolan S, Buxton J, Dobrer S, Dong H, Hayashi K, Milloy M, et al. Awareness, Possession, and Use of Take-Home Naloxone Among Illicit Drug Users, Vancouver, British Columbia, 2014-2015. Public Health Rep. 2017;132:563-569 pubmed publisher..53; P < .001), and at least daily heroin injection (aOR = 1.69; 95% CI, 1.09-2.62; P < .02). Efforts to improve knowledge of and participation in the THN program may contribute to reduced opioid overdose mortality in Vancouver. ..
- Lam R, Tang M, Leung S, Chong Y, Tsui M, Mak T. Supraventricular tachycardia and acute confusion following ingestion of e-cigarette fluid containing AB-FUBINACA and ADB-FUBINACA: a case report with quantitative analysis of serum drug concentrations. Clin Toxicol (Phila). 2017;55:662-667 pubmed publisher..In the context of acute poisoning, the presence of unexplained tachyarrhythmias, confusion, and a negative recreational drug screen should prompt clinicians to consider synthetic cannabinoid toxicity as a differential diagnosis. ..
- McCabe D, Lu J. The association of hemodialysis and survival in intubated salicylate-poisoned patients. Am J Emerg Med. 2017;35:899-903 pubmed publisher..Survival was decreased in these patients if hemodialysis was not performed. Mortality increases with the measured serum salicylate level. Timely hemodialysis for intubated salicylate overdose patients decreases mortality. ..
- O CONNOR A, Cluroe A, Couch R, Galler L, Lawrence J, Synek B. Death from hyponatraemia-induced cerebral oedema associated with MDMA ("Ecstasy") use. N Z Med J. 1999;112:255-6 pubmed
- Miro O, Galicia M, Dargan P, Dines A, Giraudon I, Heyerdahl F, et al. Intoxication by gamma hydroxybutyrate and related analogues: Clinical characteristics and comparison between pure intoxication and that combined with other substances of abuse. Toxicol Lett. 2017;277:84-91 pubmed publisher..The clinical features are more severe when GHB is consumed in combination with other substances of abuse. ..
- Kordrostami R, Akhgari M, Ameri M, Ghadipasha M, Aghakhani K. Forensic toxicology analysis of self-poisoning suicidal deaths in Tehran, Iran; trends between 2011-2015. Daru. 2017;25:15 pubmed publisher..It seems that free access to suicide means such as drugs and poisons should be restricted by national and health authorities. Not applicable. ..
- Carvalho N, Tassi C, Dobraschinski F, Amaral G, Zemolin A, Golombieski R, et al. Reversal of bioenergetics dysfunction by diphenyl diselenide is critical to protection against the acetaminophen-induced acute liver failure. Life Sci. 2017;180:42-50 pubmed publisher..In summary, the treatment with (PhSe)2 maintained mitochondrial function, promoted genes related to mitochondrial dynamic and demonstrating to play critical role in the modulation of cellular protective responses during ALF. ..
- . Laboratory analyses for poisoned patients: joint position paper. Ann Clin Biochem. 2002;39:328-39 pubmed..spib.axl.co.uk), will enable the poisoned patient to receive appropriate, 'best practice' investigations according to their clinical needs and will avoid the use of unnecessary investigations. ..
- Wojciechowski V, Călina D, Tsarouhas K, Pivnik A, Sergievich A, Kodintsev V, et al. A guide to acquired vitamin K coagulophathy diagnosis and treatment: the Russian perspective. Daru. 2017;25:10 pubmed publisher..With early diagnosis and prescription of appropriate therapy, prognosis is favorable. Reasons for vitamin K antagonists-dependent coagulopathy cases. ..
- Taney J, Anastasio H, Paternostro A, Berghella V, Roman A. Placental Abruption With Delayed Fetal Compromise in Maternal Acetaminophen Toxicity. Obstet Gynecol. 2017;130:159-162 pubmed publisher..Maternal acetaminophen overdose can be associated with delayed fetal compromise, suggesting the importance of continued fetal surveillance several days after ingestion. ..
- Parr M, Low H, Botterill P. Hyponatraemia and death after "ecstasy" ingestion. Med J Aust. 1997;166:136-7 pubmed..Advice to those using ecstasy at dance parties should be modified to suggest moderate fluid intake only and to emphasise the need to seek prompt medical attention for non-resolving symptoms. ..
- Gomes T, Juurlink D, Antoniou T, Mamdani M, Paterson J, van den Brink W. Gabapentin, opioids, and the risk of opioid-related death: A population-based nested case-control study. PLoS Med. 2017;14:e1002396 pubmed publisher..The objective of this study was to investigate whether co-prescription of opioids and gabapentin is associated with an increased risk of accidental opioid-related mortality...
- . CDC grand rounds: prescription drug overdoses - a U.S. epidemic. MMWR Morb Mortal Wkly Rep. 2012;61:10-3 pubmedIn 2007, approximately 27,000 unintentional drug overdose deaths occurred in the United States, one death every 19 minutes. Prescription drug abuse is the fastest growing drug problem in the United States...
- Tomassoni A, Hawk K, Jubanyik K, Nogee D, Durant T, Lynch K, et al. Multiple Fentanyl Overdoses - New Haven, Connecticut, June 23, 2016. MMWR Morb Mortal Wkly Rep. 2017;66:107-111 pubmed publisher..Effective communication and timely, coordinated, collaborative actions of community partners reduced the harm caused by this event and prevented potential subsequent episodes. ..
- Mckay C. Acetaminophen: hidden complexities of a simple overdose. MLO Med Lab Obs. 2011;43:12-4, 16; quiz 18-9 pubmed
- Briassoulis G, Kalabalikis P, Tamiolaki M, Hatzis T. Lamotrigine childhood overdose. Pediatr Neurol. 1998;19:239-42 pubmed..Interestingly in this child, lamotrigine overdose presented exclusively with treatment-emergent neurologic abnormalities, sparing all other systems. ..
- Johnson J, Williams K, Banner W. Adolescent with prolonged toxidrome. Clin Toxicol (Phila). 2017;55:364-365 pubmed publisher..Though bezoar formation is a rare clinical scenario, it is one that toxicologists must consider in patients with clinical courses that persist far beyond expected based on known toxicokinetic principles. ..
- Rudd R, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths - United States, 2010-2015. MMWR Morb Mortal Wkly Rep. 2016;65:1445-1452 pubmed publisherThe U.S. opioid epidemic is continuing, and drug overdose deaths nearly tripled during 1999-2014. Among 47,055 drug overdose deaths that occurred in 2014 in the United States, 28,647 (60.9%) involved an opioid (1)...
- Nair A, Paul F, Protopapas M. Management of near fatal mixed tricyclic antidepressant and selective serotonin reuptake inhibitor overdose with Intralipid®20% emulsion. Anaesth Intensive Care. 2013;41:264-5 pubmed
- Wang G, Hoppe J, Brou L, Heard K. Medication organizers (pill minders) increase the risk for unintentional pediatric ingestions. Clin Toxicol (Phila). 2017;55:897-901 pubmed publisher..Further research is needed to evaluate the specific role of medication organizers, and subsequently, improve prevention strategies. ..
- Wong A, Sivilotti M, Graudins A. Accuracy of the paracetamol-aminotransferase multiplication product to predict hepatotoxicity in modified-release paracetamol overdose. Clin Toxicol (Phila). 2017;55:346-351 pubmed publisher..When below 1500?mg/L?×?IU/L the likelihood of developing hepatotoxicity was very low. Persistently high serial multiplication product calculations were associated with the greatest risk of hepatotoxicity. ..
- Finlay J, Wyatt K, North C. Recovery from Cyclophosphamide Overdose in a Dog. J Am Anim Hosp Assoc. 2017;53:230-235 pubmed publisher..The dog made a complete recovery with no long-term complications at the time of writing. To the author's knowledge, this is the highest inadvertently administered dose of cyclophosphamide to result in complete recovery. ..
- Strike C, Miskovic M. Zoning out methadone and rising opioid-related deaths in Ontario: Reforms and municipal government actions. Can J Public Health. 2017;108:e205-e207 pubmed publisher..Changes that exacerbate these factors may lead to increased use of bylaws to curtail access at a time when efforts are underway to reduce alarming rates of opioid-related overdose. ..
- Coffin P, Behar E, Rowe C, Santos G, Coffa D, Bald M, et al. Nonrandomized Intervention Study of Naloxone Coprescription for Primary Care Patients Receiving Long-Term Opioid Therapy for Pain. Ann Intern Med. 2016;165:245-52 pubmed publisher..Providing naloxone in primary care settings may have ancillary benefits, such as reducing opioid-related adverse events. National Institutes of Health. ..
- Coffin P, Santos G, Matheson T, Behar E, Rowe C, Rubin T, et al. Behavioral intervention to reduce opioid overdose among high-risk persons with opioid use disorder: A pilot randomized controlled trial. PLoS ONE. 2017;12:e0183354 pubmed publisher..We pilot tested a behavioral intervention to reduce the occurrence of opioid overdose among opioid dependent persons at high-risk for subsequent overdose...
- Wheeler E, Jones T, Gilbert M, Davidson P. Opioid Overdose Prevention Programs Providing Naloxone to Laypersons - United States, 2014. MMWR Morb Mortal Wkly Rep. 2015;64:631-5 pubmedb>Drug overdose deaths in the United States have more than doubled since 1999. During 2013, 43,982 drug overdose deaths (unintentional, intentional [suicide or homicide], or undetermined intent) were reported...
- Agulnik A, Kelly D, Bruccoleri R, Yuskaitis C, Ebrahimi Fakhari D, Sahin M, et al. Combination Clearance Therapy and Barbiturate Coma for Severe Carbamazepine Overdose. Pediatrics. 2017;139: pubmed publisher..Future studies are required to validate this aggressive approach. The occurrence of mitochondrial dysfunction must be confirmed in patients with carbamazepine toxicity and the need to treat it validated. ..
- Robinson W, Kazbour C, Nassau T, Fisher K, Sheu S, Rivera A, et al. Brief Report: Nonfatal Overdose Events Among Persons Who Inject Drugs: Findings From Seven National HIV Behavioral Surveillance Cities 2009 & 2012. J Acquir Immune Defic Syndr. 2017;75 Suppl 3:S341-S345 pubmed publisher..Adapting systems such as NHBS may be useful in responding to and monitoring emergent public health problems such as the overdose epidemic. ..
- Chetty M, Kenworthy J, Langham S, Walker A, Dunlop W. A systematic review of health economic models of opioid agonist therapies in maintenance treatment of non-prescription opioid dependence. Addict Sci Clin Pract. 2017;12:6 pubmed publisher..This could more adequately support decision-making and policy development for treatment of non-prescription opioid dependence. ..
- ..Multilevel approaches to address the problem are needed. ..
- Peterson A, Gladden R, Delcher C, Spies E, Garcia Williams A, Wang Y, et al. Increases in Fentanyl-Related Overdose Deaths - Florida and Ohio, 2013-2015. MMWR Morb Mortal Wkly Rep. 2016;65:844-9 pubmed publisher..In Ohio, circumstances associated with fentanyl deaths included a current diagnosed mental health disorder(§) and recent release from an institution such as a jail, rehabilitation facility, or hospital. ..
- Abouchedid R, Hudson S, Thurtle N, Yamamoto T, Ho J, Bailey G, et al. Analytical confirmation of synthetic cannabinoids in a cohort of 179 presentations with acute recreational drug toxicity to an Emergency Department in London, UK in the first half of 2015. Clin Toxicol (Phila). 2017;55:338-345 pubmed publisher..This suggests that presentations to the ED with acute synthetic cannabinoid receptor agonist toxicity may be more common than reported. ..
- Senadheera C, Marecek J, Hewage C, Wijayasiri W. A hospital-based study on trends in deliberate self-harm in children and adolescents. Ceylon Med J. 2010;55:67-8 pubmed
- Jones C, Logan J, Gladden R, Bohm M. Vital Signs: Demographic and Substance Use Trends Among Heroin Users - United States, 2002-2013. MMWR Morb Mortal Wkly Rep. 2015;64:719-25 pubmed
- Orkin A, Zhan C, Buick J, Drennan I, Klaiman M, Leece P, et al. Out-of-hospital cardiac arrest survival in drug-related versus cardiac causes in Ontario: A retrospective cohort study. PLoS ONE. 2017;12:e0176441 pubmed publisherb>Drug overdose causes approximately 183,000 deaths worldwide annually and 50,000 deaths in Canada and the United States combined...
- Gwira Baumblatt J, Wiedeman C, Dunn J, Schaffner W, Paulozzi L, Jones T. High-risk use by patients prescribed opioids for pain and its role in overdose deaths. JAMA Intern Med. 2014;174:796-801 pubmedFrom January 1, 2003, through December 31, 2010, drug overdose deaths in Tennessee increased from 422 to 1059 per year. More of these deaths involved prescription opioids than heroin and cocaine combined...
- . Vital signs: risk for overdose from methadone used for pain relief - United States, 1999-2010. MMWR Morb Mortal Wkly Rep. 2012;61:493-7 pubmed..For chronic noncancer pain, methadone should not be considered a drug of first choice by prescribers or insurers. ..
- Daly E, Dufault K, Swenson D, Lakevicius P, METCALF E, Chan B. Use of Emergency Department Data to Monitor and Respond to an Increase in Opioid Overdoses in New Hampshire, 2011-2015. Public Health Rep. 2017;132:73S-79S pubmed publisher..Data from New Hampshire's ED syndromic surveillance system provided timely situational awareness to public health partners to support the overall response to the opioid epidemic. ..
- Moore J, Rodriguez R. Toxicity of fluoxetine in overdose. Am J Psychiatry. 1990;147:1089 pubmed
- Mowry J, Spyker D, Cantilena L, McMillan N, Ford M. 2013 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 31st Annual Report. Clin Toxicol (Phila). 2014;52:1032-283 pubmed publisher..NPDS is a model system for the nation and global public health. ..
- Chenoweth J, Colby D, Sutter M, Radke J, Ford J, Nilas Young J, et al. Massive diltiazem and metoprolol overdose rescued with extracorporeal life support. Am J Emerg Med. 2017;35:1581.e3-1581.e5 pubmed publisher..This case highlights the potential utility of extracorporeal life support in cases of severe toxicity due to multiple cardioactive medications. ..
- Livingston M, Barnett T, Delcher C, Wagenaar A. Recreational Cannabis Legalization and Opioid-Related Deaths in Colorado, 2000-2015. Am J Public Health. 2017;107:1827-1829 pubmed publisher..To examine the association between Colorado's legalization of recreational cannabis use and opioid-related deaths...
- Mack K, Jones C, Ballesteros M. Illicit Drug Use, Illicit Drug Use Disorders, and Drug Overdose Deaths in Metropolitan and Nonmetropolitan Areas - United States. MMWR Surveill Summ. 2017;66:1-12 pubmed publisher..Understanding differences in illicit drug use, illicit drug use disorders, and overall drug overdose deaths in metropolitan and nonmetropolitan areas is important for informing public health programs, ..