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OSNOVNE KARAKTERISTIKE TROVANJA BENZODIAZEPINIMA – ANALIZA HOSPITALNO LIJEČENIH BOLESNIKA /

BASIC CHARACTERISTICS OF BENZODIAZEPINE POISONING - ANALYSIS OF HOSPITAL TREATED PATIENTS

Authors

 

Miomir Šoškić1, Jasmina Jović-Stošić2, Tomislav Režić2, Nataša Perković-Vukčević2, Snežana Đorđević2

1Clinical Center of Montenegro, Ljubljanska bb, 81000 Podgorica, Montenegro;
2University of Defence - Medical Faculty of Military Medical Academy, Crnotravska 17, 11000 Belgrade, Serbia

 

UDK: 616.45-089-06(497.11)"2012/2016"


The paper was received / Rad primljen: 10.05.2020.

Accepted / Rad prihvaćen: 15.05.2020.

 


Correspondence to:


Miomir Šoškić,
Tel. +38269644229
e-mail: miomir.soskic@kccg.me

 

 

Sažetak

 

Benzodiazepini se prema Nacionalnom centru za kontrolu trovanja (NCKT) VMA, evidentiraju kao najčešći uzrok samotrovanja. Cilj istraživanja bio je analizirati aktuelnu upotrebu, zloupotrebu i toksičnost ingestiranih benzodiazepina kod pacijenata hospitalno liječenih na Klinici za urgentnu i kliničku toksikologiju NCKTVMA, tokom 2018. godine. Istraživanje je dizajnirano kao retrospektivna studija. Analizirani su pacijenti liječeni isključivo zbog akutne intoksikacije benzodiazepinima, bez koingestije drugih ljekova ili psihoaktivnih supstanci. U posmatranom periodu, hospitalno je zbog trovanja psihotropnim ljekovima liječeno 377 bolesnika, pri čemu je kod 185 (49%) jedan od uzročnika bio neki od benzodiazepina, a kod 89 (23,6 %) benzodiazepini su bili jedini ingestirani agens. Prosječna starost analizirane populacije iznosila je 47,89 ± 20,94 godina (15-90 godina). Rezultati sprovedene analize ukazuju da je više od polovine pacijenata zloupotrijebilo lijek bromazepam (54,72%). Odmah iza bromazepama, po učestalosti nalaze se alprazolam (13,21%), klonazepam (12,26%) i lorazepam (11,32%). Takođe, utvrđeno je da su pacijenti benzodiazepine koristili i u međusobnoj kombinaciji (16,85%). Osobe srednje životne dobi, ženskog pola, bile su sklonije zloupotrebi benzodiazepina. Specifični antidot flumazenil, primjenjivan je kod 17,98% pacijenata. Najčešća upotreba flumazenila, bila je u grupi pacijenata starijih od 65 godina. Prema Glazgov koma skali, kod 70 pacijenata je došlo do poremećaja stanja svijesti nivoa somnolencije, kod 9 nivoa sopora, kod 7 nivoa kome, dok je  normalno stanje svijesti registrovano kod 3 pacijenta. Letalni ishod, zabilježen je kod 1 pacijenta, starosti 89 godina. Praćenje aktuelnih trendova u upotrebi i zloupotrebi, može doprinijeti u racionalizaciji propisivanja benzodiazepina. Buduća istraživanja, sprovedena na većem uzorku, obuhvatiće pacijente, koji bi na prijemu imali potvrđeno prisustvo alkohola i drugih psihoaktivnih supstanci.

 

 

 

Ključne reči:

akutno trovanje, benzodiazepini, psihoaktivne supstance, Nacionalni centar za kontrolu trovanja.

 

 

Abstract

 

Benzodiazepines are reported as the most common cause of poisoning according to the National Poison Control Center of MMA. The aim of this study was to analyze the current use, abuse and toxicity of ingested benzodiazepines at the Clinic for Emergency and Clinical Toxicology at the National Center for the Control of Poisoning of the MMA, during 2018. Research designed as a retrospective study included patients treated exclusively for acute intoxication with benzodiazepines. During the observational period, 377 patients were admitted due to poisonings by psychotropic medications, including 185 cases (49%) of benzodiazepines ingestion, among which there were 89 patients (23.6%) overdosed by benzodiazepines as the only agent. The average age of the analyzed population was 47.89 ± 20.94 years (15-90 years). The results of the conducted analysis indicate that more than half of the patients abused the drug bromazepam, 54.72%. Immediately after bromazepam, the frequency of abuse is followed by alprazolam with 13.21%, clonazepam with 12.26% and lorazepam with 11.32%. Analysis of the available data, it has been found that in addition to benzodiazepines are the individual application and used in combination (16.85%). Females of middle age are more likely to abuse benzodiazepines. A specific antidote flumazenil was applied at 17.98% of the patients. The most common use of flumazenil, was in the group of patients older than 65 years. According to the Glasgow Coma Score, state of awareness level of somnolence, had 70 patients, the level of somnolence, 9 patients, the level of coma, 7 patients and the normal state of consciousness, 3 patients. The lethal outcome was observed in 1 patient, aged 89 years. Psychiatric consultation (evaluation) was performed for most patients. Monitoring of current trends in use and abuse can contribute to the rationalization of prescribing benzodiazepines. Future research, conducted on a larger sample will include patients who would have confirmed the presence of alcohol and other psychoactive substances.

 

 

Key words:

acute poisoning, benzodiazepines, psychoactive substances, National Poison Control Center.

 

 

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PDF Šoškić M. et al • MD-Medical Data 2020;12(2): 067-072

 

 

 

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