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Suicidal Cardiovascular Drug Intoxication in Emergency Department

Year 2015, Volume: 2 Issue: 3, 329 - 333, 24.05.2015

Harun Ayhan Dogac Özüçelik Halil Doğan Mehmet Erdoğan Yavuz Yigit

https://doi.org/10.17681/hsp.41599

Abstract

Objectives: As elderly population in Turkey increases, patients using cardiovascular drugs increases. Access to these drugs for suicide attempt gets easier due to common use. Aim of the study is to evaluate the results of intoxication with cardiovascular drugs.

Methods: Data of 1399 patients admitted to two level 1 hospital emergency departments for drug intoxication were reviewed from July 2009 to March 2014 retrospectively. Cardiovascular drug intoxication was diagnosed in 81 patients.

Results: The average age of 1318 patients with other drug intoxication was 25.9± 10.8 years (72,9% female, 27,1% male); the average age of 81 patients (72,8% female, 27,2% male) with cardiovascular drug toxicity was 27,3± 13,6 years. All suicide attempts had a peak incidence between 18:00-02:00 o’clock. Seasonal distribution of all drug intoxications showed a peak incidence in fall. Ten different group cardiovascular drugs were taken. The most common cardiovascular drug (39.5%) was found ACEI group. Beta blocker intoxication was 37%. Most of the patients requiredsupportive treatment. Average length of staywas 16,6±10,6 h (range: 2–48 h). One patient died from cardiogenic shock due to beta blocker toxicity.

Conclusion: Our study shows an increase in suicidal ACE inhibitor and beta blocker intoxication in cardiovascular drugs. All drug intoxications are more common between 18:00 and 02:00 o’clock. Seasonal distribution of suicide attempts showed a peak incidence in fall. Especially in young intoxication patients, physicians should take detailed information about the use of cardiovascular drugs by family members to rule out possible cardiovascular drug intoxication.

Keywords

cardiovascular drugs poisoning intoxication suicide epidemiology

References

  • Roy A. Psychiatricemergencies. Sadock BJ, Sadock VA (eds): ComprehensiveTextbook of Psychiatry, 7.ed, Baltimore, Lippincott Williams &Wilkins, 2000, 2031-40.
  • Statistical Indicators 1923-2011.Turkish Statistical Institute. Turkish Statistical Institute, Printing Division, Ankara December 2012, p: 45.
  • Köppel C, Oberdisse U, Heinemeyer G. Clinicalcourse and outcome in class IC antiarrhythmicoverdose. J ToxicolClinToxicol. 1990;28(4):433-44.
  • DeGraff ACJ. DigitalisIntoxication. Circulation 1954 Jan;9(1):115-26.
  • Satar S, Seydaoglu G, Akpinar A, Sebe A, Karakoc E, Gumusay U, Yilmaz M, Gokel Y. Trends in acuteadultpoisoning in a ten-yearperiod in Turkey: factorsaffectingthehazardousoutcome.BratislLekListy. 2009;110(7):404-11.
  • -
  • Kalkan S, Hocaoglu N, Oransay K, Unverir P, Tuncok Y. Cardiovascularmedicationexposures and poisonings in Izmir, Turkey: A 14-year experience. Hum ExpToxicol 2011May;30(5):347-53.
  • Hanssens Y, Deleu D, Taqi A. Etiologic and
  • DemographicCharacteristics of Poisoning: A ProspectiveHospital-BasedStudy in Oman. J ToxicolClinToxicol 2001;39(4):371-80.
  • -
  • Litovitz TL, Klein-Schwartz W, Caravati EM, YounissJ, Crouch B, Lee S. 1998 Annualreport of theAmericanassociation of poisoncontrolcenterstoxicexposuresurveillancesystem. Am J EmergMed 1999;17(5):435-87.
  • Shafii M, Steltz-Lenarsky J, Derrick AM, Beckner C, Whittinghill JR. Comorbidity of mentaldisorders in the post-mortemdiagnosis of completedsuicide in children and adolescents. J AffectDisord 1988 Nov-Dec;15(3):227-33.
  • Çayköylü A, Coşkun İ, Kırkpınar İ, Özer H. Özkıyım girişiminde bulunanlarda sosyodemografik özellikler ve tanı dağılımı. Kriz Dergisi 1997;5:37-42.
  • Repetto MR. Epidemiology of poisoningduetopharmaceuticalproducts, Poison Control Centre, Sevile,Spain. EuropeanJournal of Epidemiology 1997 Apr;13(3): 353–6.
  • Vucinić S, Vucinić Z, Segrt Z, Joksović D, Jovanović D, Todorović V. Acutepoisoningwithcardiovascularagents. VojnosanitPregl. 2003 Nov-Dec;60(6):691-6.
  • Ozkose Z, Ayoglu F. Etiological and demographicalcharacteristics of acuteadultpoisoning in Ankara, Turkey. Hum ExpToxicol 1999 Oct;18(10):614–8.
  • Gnyp L, Lewandowska-Stanek H, SawiniecJ.Analysis of cases of acutepoisoningwithcardiovasculardrugs. PrzeglLek. 2003;60(4):286-8.
  • Aydın ŞA, Köksal Ö, Fedakâr R, Emircan Ş, Durmuş O.1996-2004 Yılları Arasındaki Erişkin Zehirlenme Olguları. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2006;32(1):25-7.
  • Pach J, Polewka A, Zieba A, Kroch S, ChrostekMaj J, Mikołaszek-Boba M, Datka W, Rachel W. A trialforthecomplex risk assessment of repeatedsuicidepredictors in patientsaftersuicidalpoisoningattempts, hospitalized in theDepartment of ClinicalToxicology CM UJ in Krakow. II. Clinicalpredictors. PrzeglLek; 2001;58(4):330-4
  • Hatzitolios AI, Sion ML, Eleftheriadis NP, Toulis E, Efstratiadis G, Vartzopoulos D, Ziakas AG. Parasuicidalpoisoningtreated in a Greekmedicalward: epidemiology and clinicalexperience. Hum ExpToxicol 2001Dec; 20(12):611-7.
  • Love JN, Litovitz TL, Howell JM, Clancy C. Characterization of fatal beta blockeringestion: a review of theAmericanAssociation of Poison Control Centersdata form 1985 to1995. ClinicalToxicology, 1997;35(4):353-9.
  • Viertel A, Weidmann E, Brodt HR. Cases of acutepoisoningadmittedto a medicalintensivecareunit. DtschMedWochenschr 2001Oct 19;126(42): 1159-63.
  • Juárez-Aragón G, Castañón-González JA, Pérez-Morales AJ, Montoya Cabrera MA. Clinical and epidemiologicalcharacteristics of severe poisoning in a adultpopulationadmittedto an intensivecareunit. GacMedMex 1999;135(6):669-75.
  • Joubert PH. Poisoningadmission of Black South Africans. J ToxicolClinToxicol 1990; 28(1): 85-94.
  • Chodorowski Z, Anand JS, Waldman W. Suicidalpoisoningwithantihypertensivedrugs. PrzeglLek 2003;60(4):233-5

Acil Tıp Kliniğinde İntiharlı Kardiyovasküler İlaç İntoksikasyonları

Year 2015, Volume: 2 Issue: 3, 329 - 333, 24.05.2015

Harun Ayhan Dogac Özüçelik Halil Doğan Mehmet Erdoğan Yavuz Yigit

https://doi.org/10.17681/hsp.41599

Abstract

Amaç: Türkiye’de son yıllarda artan yaşlı popülasyonala birlikte kardiyovasküler ilaç kullanımında da kontrolsüz bir artış olmuştur. Bu çalışmanın amacı diğer suicidal ilaçlar arasında kardiyovasküler ilaçlar ile olan intoksikasyonları değerlendirmektir. Gereç ve Yöntem: Araştırmada iki devlet hastanesinin acil tıp kliniklerinde Temmuz 2009 – Haziran 2010 ve Mart 2013-Mart 2014 tarihleri arasında ilaç intoksikasyonu nedeniyle takip edilen 1399 hasta geriye dönük olarak incelenmiştir. Bunların içerisinde kardiyovasküler ilaç intoksikasyonu nedeniyle takip edilmiş olan 81 hasta araştırmaya alınmıştır. Bulgular: Kalp dışı ilaç intoksikasyonu nedeniyle takip edilen 1318 hastanın yaş ortalaması 25,9±10,8 (%80,3 kadın ve %19,7 erkek), kardiyovasküler ilaç intoksikasyonuyla takip edilen 81 hastanın yaş ortalaması 27,3 ± 13,6 (%27,2 erkek, %72,8 kadın) olarak bulunmuştur. Hastalar tarafından 10 farklı gruptan kardiyovasküler ilaç alınmıştır. Kardiyovasküler ilaçlar içerisinde en fazla ACE inhibitörü grubu (%39,5), sonra beta bloker (%37,0) ilaçlar alınmıştır. Kardiyovasküler ilaçlarla intoksikasyonlar en sık (%70,3) genç sağlıklı insanlarda (10-30 yaş) görülmüştür. Hastaların çoğu destek tedavisi ile taburcu olmuştur. Hastaların hastanede kalış süresi ortalama 16,6 ± 10.6 saattir (2-48 saat). Bir hasta beta bloker kullanımına bağlı kardiyojenik şok sonucu ölmüştür. Sonuç: Bu araştırma ACE inhibitörleri ile intoksikasyonlarda bir artış olduğunu göstermiştir. Son zamanlarda kardiyovasküler ilaçların kolay bulunması nedeniyle, özellikle genç intoksikasyon hastalarında aile de ilaç kullanım öyküsü daha detaylı sorgulanmalıdır. Kardiyovasküler ilaçların satışındaki kontrolün ve kısıtlamanın arttırılması bu ilaçlarla olan suicidal girişimleri azaltabilir

Keywords

Kardiovasküler ilaçlar zehirlenme ilaçlı intihar epidemiyoloji

References

  • Roy A. Psychiatricemergencies. Sadock BJ, Sadock VA (eds): ComprehensiveTextbook of Psychiatry, 7.ed, Baltimore, Lippincott Williams &Wilkins, 2000, 2031-40.
  • Statistical Indicators 1923-2011.Turkish Statistical Institute. Turkish Statistical Institute, Printing Division, Ankara December 2012, p: 45.
  • Köppel C, Oberdisse U, Heinemeyer G. Clinicalcourse and outcome in class IC antiarrhythmicoverdose. J ToxicolClinToxicol. 1990;28(4):433-44.
  • DeGraff ACJ. DigitalisIntoxication. Circulation 1954 Jan;9(1):115-26.
  • Satar S, Seydaoglu G, Akpinar A, Sebe A, Karakoc E, Gumusay U, Yilmaz M, Gokel Y. Trends in acuteadultpoisoning in a ten-yearperiod in Turkey: factorsaffectingthehazardousoutcome.BratislLekListy. 2009;110(7):404-11.
  • -
  • Kalkan S, Hocaoglu N, Oransay K, Unverir P, Tuncok Y. Cardiovascularmedicationexposures and poisonings in Izmir, Turkey: A 14-year experience. Hum ExpToxicol 2011May;30(5):347-53.
  • Hanssens Y, Deleu D, Taqi A. Etiologic and
  • DemographicCharacteristics of Poisoning: A ProspectiveHospital-BasedStudy in Oman. J ToxicolClinToxicol 2001;39(4):371-80.
  • -
  • Litovitz TL, Klein-Schwartz W, Caravati EM, YounissJ, Crouch B, Lee S. 1998 Annualreport of theAmericanassociation of poisoncontrolcenterstoxicexposuresurveillancesystem. Am J EmergMed 1999;17(5):435-87.
  • Shafii M, Steltz-Lenarsky J, Derrick AM, Beckner C, Whittinghill JR. Comorbidity of mentaldisorders in the post-mortemdiagnosis of completedsuicide in children and adolescents. J AffectDisord 1988 Nov-Dec;15(3):227-33.
  • Çayköylü A, Coşkun İ, Kırkpınar İ, Özer H. Özkıyım girişiminde bulunanlarda sosyodemografik özellikler ve tanı dağılımı. Kriz Dergisi 1997;5:37-42.
  • Repetto MR. Epidemiology of poisoningduetopharmaceuticalproducts, Poison Control Centre, Sevile,Spain. EuropeanJournal of Epidemiology 1997 Apr;13(3): 353–6.
  • Vucinić S, Vucinić Z, Segrt Z, Joksović D, Jovanović D, Todorović V. Acutepoisoningwithcardiovascularagents. VojnosanitPregl. 2003 Nov-Dec;60(6):691-6.
  • Ozkose Z, Ayoglu F. Etiological and demographicalcharacteristics of acuteadultpoisoning in Ankara, Turkey. Hum ExpToxicol 1999 Oct;18(10):614–8.
  • Gnyp L, Lewandowska-Stanek H, SawiniecJ.Analysis of cases of acutepoisoningwithcardiovasculardrugs. PrzeglLek. 2003;60(4):286-8.
  • Aydın ŞA, Köksal Ö, Fedakâr R, Emircan Ş, Durmuş O.1996-2004 Yılları Arasındaki Erişkin Zehirlenme Olguları. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2006;32(1):25-7.
  • Pach J, Polewka A, Zieba A, Kroch S, ChrostekMaj J, Mikołaszek-Boba M, Datka W, Rachel W. A trialforthecomplex risk assessment of repeatedsuicidepredictors in patientsaftersuicidalpoisoningattempts, hospitalized in theDepartment of ClinicalToxicology CM UJ in Krakow. II. Clinicalpredictors. PrzeglLek; 2001;58(4):330-4
  • Hatzitolios AI, Sion ML, Eleftheriadis NP, Toulis E, Efstratiadis G, Vartzopoulos D, Ziakas AG. Parasuicidalpoisoningtreated in a Greekmedicalward: epidemiology and clinicalexperience. Hum ExpToxicol 2001Dec; 20(12):611-7.
  • Love JN, Litovitz TL, Howell JM, Clancy C. Characterization of fatal beta blockeringestion: a review of theAmericanAssociation of Poison Control Centersdata form 1985 to1995. ClinicalToxicology, 1997;35(4):353-9.
  • Viertel A, Weidmann E, Brodt HR. Cases of acutepoisoningadmittedto a medicalintensivecareunit. DtschMedWochenschr 2001Oct 19;126(42): 1159-63.
  • Juárez-Aragón G, Castañón-González JA, Pérez-Morales AJ, Montoya Cabrera MA. Clinical and epidemiologicalcharacteristics of severe poisoning in a adultpopulationadmittedto an intensivecareunit. GacMedMex 1999;135(6):669-75.
  • Joubert PH. Poisoningadmission of Black South Africans. J ToxicolClinToxicol 1990; 28(1): 85-94.
  • Chodorowski Z, Anand JS, Waldman W. Suicidalpoisoningwithantihypertensivedrugs. PrzeglLek 2003;60(4):233-5
There are 25 citations in total.

Details

Primary Language English
Journal Section RESEARCH ARTICLE
Authors

Harun Ayhan

Dogac Özüçelik

Halil Doğan

Mehmet Erdoğan

Yavuz Yigit This is me

Publication Date May 24, 2015
Published in Issue Year 2015 Volume: 2 Issue: 3

Cite

APA Ayhan, H., Özüçelik, D., Doğan, H., Erdoğan, M., et al. (2015). Suicidal Cardiovascular Drug Intoxication in Emergency Department. Sağlık Bilimleri Ve Meslekleri Dergisi, 2(3), 329-333. https://doi.org/10.17681/hsp.41599
AMA Ayhan H, Özüçelik D, Doğan H, Erdoğan M, Yigit Y. Suicidal Cardiovascular Drug Intoxication in Emergency Department. HSP. October 2015;2(3):329-333. doi:10.17681/hsp.41599
Chicago Ayhan, Harun, Dogac Özüçelik, Halil Doğan, Mehmet Erdoğan, and Yavuz Yigit. “Suicidal Cardiovascular Drug Intoxication in Emergency Department”. Sağlık Bilimleri Ve Meslekleri Dergisi 2, no. 3 (October 2015): 329-33. https://doi.org/10.17681/hsp.41599.
EndNote Ayhan H, Özüçelik D, Doğan H, Erdoğan M, Yigit Y (October 1, 2015) Suicidal Cardiovascular Drug Intoxication in Emergency Department. Sağlık Bilimleri ve Meslekleri Dergisi 2 3 329–333.
IEEE H. Ayhan, D. Özüçelik, H. Doğan, M. Erdoğan, and Y. Yigit, “Suicidal Cardiovascular Drug Intoxication in Emergency Department”, HSP, vol. 2, no. 3, pp. 329–333, 2015, doi: 10.17681/hsp.41599.
ISNAD Ayhan, Harun et al. “Suicidal Cardiovascular Drug Intoxication in Emergency Department”. Sağlık Bilimleri ve Meslekleri Dergisi 2/3 (October 2015), 329-333. https://doi.org/10.17681/hsp.41599.
JAMA Ayhan H, Özüçelik D, Doğan H, Erdoğan M, Yigit Y. Suicidal Cardiovascular Drug Intoxication in Emergency Department. HSP. 2015;2:329–333.
MLA Ayhan, Harun et al. “Suicidal Cardiovascular Drug Intoxication in Emergency Department”. Sağlık Bilimleri Ve Meslekleri Dergisi, vol. 2, no. 3, 2015, pp. 329-33, doi:10.17681/hsp.41599.
Vancouver Ayhan H, Özüçelik D, Doğan H, Erdoğan M, Yigit Y. Suicidal Cardiovascular Drug Intoxication in Emergency Department. HSP. 2015;2(3):329-33.
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