Numerous drugs are known to cause seizures with therapeutic use or overdose. However, the relative frequency of such complications has rarely been studied, and little is known about the relationship of drug-induced seizures to eventual medical outcome. This study was performed to determine the causes and consequences of seizure associated with poisoning and drug intoxication. We analyzed about 786 cases of drug intoxication visited to Chung-Ang Gil hospital during recent 4 years from Jan. 1993 to Dec. 1996. The results were summarized as follows: 1. The total number of cases of drug intoxication was 786 and the most common drug of intoxication was antihistamines(291 cases, 36.3%); insecticides(113 cases, 14.7%); caustics(90 cases, 11.8%); herbicides(47 cases, 6.1%); NSAID(38 cases, 4.9%); rodenticides(36 cases, 4.6%); acetaminophens(34 cases, 4.4%); anticonvulsants(18 cses, 2.3%); neuroleptics(13 cases, 1.6%); hydrocarbons(9 cases, 1.2%); sympathomimetics(8 cases, 1.0%). 2. The leading causes of seizures were antihistamines(12 cases, 42.8%); insecticides(7 cases, 25.0%); sympathomimetics(3cases, 10.7%); neuroleptics(2 cases, 7.2%); others(4 cases, 14.3%). 3. Seizures associated with antihistamines were generally brief(11 cases, 92.0%) and uncomplicated(3 cases, 25.0%). 4. Seizures incidence by drug intoxication was relatively high in sympathomimetics(3 cases, 35.7%); and neuroleptics(2 cases, 15.4%). 5. Poisoning associated with seizure had relatively high risk compared with non seizure poisoning for medical complication.
Drug Overdose* ; Histamine Antagonists ; Incidence ; Poisoning* ; Seizures*

Drug intoxication in children and adolescents is not uncommon in Korea. But the tendency of intoxication is changing with some factors, such as national surveillance system, Naderism and increasing concern among physicians. But the death rate of intoxication among adolescents is increasing in spite of decreasing total death rate of intoxication among children and adolescents. Therefore the physician must be concerned about the basic management of intoxication and figure out the common toxic substance among children and adolescents.
Adolescent* ; Child* ; Drug Overdose ; Humans ; Korea ; Mortality ; Poisoning*

In recent years, with the sustained increase of the incidence of diabetes in humans and the wider use of exogenous insulin, the cases of inappropriate use and overdose of insulin is growing, even the cases of suicide and homicide using insulin. Through searching the literature at home and abroad about the mechanism, clinical and case report of poisoning and death caused by insulin intoxication, this paper reviews the mechanism, clinical manifestations, pathological changes, and forensic examination.
Death ; Drug Overdose/diagnosis* ; Homicide ; Humans ; Insulin/poisoning* ; Suicide

The number of death from insulin overdose, including accidental poisoning, suicide and homicide, is increasing these years. The forensic diagnosis of death from insulin overdose is a tough task. Glucose is the main energy source of the brain. Therefore, hypoglycemic brain damage is considered to be the main reason of death from insulin overdose. Recently, research of hypoglycemic brain damage caused by insulin overdose is gradually being paid attention in the field of forensic medicine. This paper summarizes the neuropathologic changes, pathophysiologic process and potential neural molecular markers of hypoglycemic brain damage caused by insulin overdose in terms of forensic neuropathology, providing reference for the research and practice in forensic medicine related fields.
Brain ; Drug Overdose ; Humans ; Hypoglycemic Agents ; Insulin ; Neuropathology

Many people end their lives by committing suicide every year. Most of these people inflict their own death using a method that is considered least painful such as hanging, gun shots, and drug overdose. Some choose to use their surroundings and jump off high buildings. We here present two cases of extremely rare suicide methods compared to the typically observed self-inflicted deaths. In the first case, a woman amputated her foot above the ankle with a kitchen knife, and in the second case, a man used an abrasive saw to cut his neck. Both victims had a psychiatric problem consistent with schizophrenia. Examination of these extraordinary death cases warrants a thorough scene investigation and an autopsy to determine past and present psychiatric illnesses and drug prescriptions.
Ankle ; Autopsy ; Drug Overdose ; Drug Prescriptions ; Female ; Foot ; Humans ; Methods ; Neck ; Schizophrenia ; Suicide

Patient-controlled analgesia (PCA) provides excellent pain control and high stability, thereby minimizing the incidence of adverse effects. However, one of our patients experienced respiratory depression and hypotension within 30 minutes of initiation of PCA therapy. We discovered that machine malfunction caused continuous activation of the PCA button, resulting in a drug overdose. The PCA machine was sent to the manufacturer, who found an electrical short in the PCA button. All PCA units of the same make and model were immediately removed from hospitals and replaced with redesigned units without defects in the PCA button. We have used the improved machines without any problems. The purpose of this report is to raise awareness of this type of malfunction in PCA units in order to help prevent adverse events in the future.
Analgesia, Patient-Controlled ; Drug Overdose ; Humans ; Hypotension ; Incidence ; Passive Cutaneous Anaphylaxis ; Respiratory Insufficiency

PURPOSE: This study was designed to determine the factors hindering psychiatric intervention for suicide attempters in the emergency room (ER). METHODS: Participants were 299 patients aged 18 years or older admitted to the ER for suicidal drug overdose between July 2012 and June 2014. Patients were divided into two groups according to whether they had received psychiatric treatment in the ER. Medical histories and follow-up treatments were determined by examining patients' medical records and through phone surveys, and were then compared using χ2-test and Fisher's exact test. In addition, the rate of satisfaction of the treatment group and the reasons for their dissatisfaction were also determined. RESULTS: The treatment and non-treatment groups comprised 135 (45%) and 164 patients (55%), respectively. Factors influencing participation in psychiatric intervention were previous history of suicide attempts (p=0.004), history of psychiatric disorder (p<0.001), time of day (p=0.039), and day of the week (p=0.040) of arrival in the ER. Whether or not the patient received follow-up psychiatric treatment was not significantly relevant (p=0.300). Of the 82 patients who participated in the treatment satisfaction survey, 50.2% reported being unsatisfied, mainly because of unfriendly medical personnel (36.6%), discomfort regarding other people's perceptions (24.4%), and cursory care (14.6%). CONCLUSION: To raise the participation rate of psychiatric consult, cooperation with psychiatry at night and on weekends is required, and incorporation of patients without previous history of suicidal attempt or other psychiatric disorder is important. Resolution of complaints toward psychiatric consult in suicide attempt survivors is also required.
Drug Overdose ; Emergencies* ; Emergency Service, Hospital* ; Follow-Up Studies ; Humans ; Medical Records ; Poisoning ; Suicide ; Survivors

PURPOSE: This study was designed to determine the factors hindering psychiatric intervention for suicide attempters in the emergency room (ER). METHODS: Participants were 299 patients aged 18 years or older admitted to the ER for suicidal drug overdose between July 2012 and June 2014. Patients were divided into two groups according to whether they had received psychiatric treatment in the ER. Medical histories and follow-up treatments were determined by examining patients' medical records and through phone surveys, and were then compared using χ2-test and Fisher's exact test. In addition, the rate of satisfaction of the treatment group and the reasons for their dissatisfaction were also determined. RESULTS: The treatment and non-treatment groups comprised 135 (45%) and 164 patients (55%), respectively. Factors influencing participation in psychiatric intervention were previous history of suicide attempts (p=0.004), history of psychiatric disorder (p<0.001), time of day (p=0.039), and day of the week (p=0.040) of arrival in the ER. Whether or not the patient received follow-up psychiatric treatment was not significantly relevant (p=0.300). Of the 82 patients who participated in the treatment satisfaction survey, 50.2% reported being unsatisfied, mainly because of unfriendly medical personnel (36.6%), discomfort regarding other people's perceptions (24.4%), and cursory care (14.6%). CONCLUSION: To raise the participation rate of psychiatric consult, cooperation with psychiatry at night and on weekends is required, and incorporation of patients without previous history of suicidal attempt or other psychiatric disorder is important. Resolution of complaints toward psychiatric consult in suicide attempt survivors is also required.
Drug Overdose ; Emergencies* ; Emergency Service, Hospital* ; Follow-Up Studies ; Humans ; Medical Records ; Poisoning ; Suicide ; Survivors

PURPOSE: Intentional and accidental drug intoxication is commonly seen in the emergency department. When treating intoxicated patients, the amount of the ingested drug is crucial albeit often difficult. We investigated the tablet counts when asked to hold tablets in their fists and hands (semi-quantitative terms). METHODS: The widths and lengths of the participants'hands were measured. Then, the subjects were asked to hold 5-mm round, 10-mm round, 10-mm oval, and 15-mm elliptical tablets using their hands and fists and to estimate the number of tablets they were holding. Differences between the estimated and actual numbers of tablets were examined. RESULTS: A total of 47 members of the public and 33 healthcare professionals were included in our study. In analyses of differences between the actual and estimated amounts of tablets held in the participants'hands and fists, the actual amount was higher than the estimated amount for all tablet types and in both groups. When participants held the tablets in the same manner (handful or fistful), the differences between the actual and estimated amounts were greater for 5- than 15-mm-sized tablets (p<0.05) CONCLUSION: Treatment of patients presenting with drug overdoses to the emergency department should be based on the assumption that the actual amount of drugs ingested is likely greater than the amount stated by the patient.
Delivery of Health Care* ; Drug Overdose ; Emergency Service, Hospital ; Hand ; Humans ; Tablets

Adult ; Aged ; Carthamus tinctorius ; Drug Overdose ; Drugs, Chinese Herbal ; adverse effects ; Female ; Humans ; Middle Aged