Social factors may affect the available sources of toxic substances and causes of poisoning; and these factors may change over time. Additionally, understanding the characteristics of patients with acute toxic poisoning is important for treating such patients. Therefore, this study investigated the characteristics of patients with toxic poisoning. Patients visiting one of 3 hospitals in 2003 and 2011 were included in this study. Data on all patients who were admitted to the emergency departments with acute toxic poisoning were retrospectively obtained from medical records. Total 939 patients were analyzed. The average age of patients was 40.0 +/- 20 yr, and 335 (36.9%) patients were men. Among the elements that did not change over time were the facts that suicide was the most common cause, that alcohol consumption was involved in roughly 1 of 4 cases, and that there were more women than men. Furthermore, acetaminophen and doxylamine remained the most common poisoning agents. In conclusion, the average patient age and psychotic drug poisoning has increased over time, and the use of lavage treatment has decreased.
Acetaminophen/poisoning ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking ; Child ; Child, Preschool ; Doxylamine/poisoning ; Emergency Service, Hospital/*statistics & numerical data ; Female ; Hospitals, University ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Poisoning/*epidemiology ; Retrospective Studies ; Sex Factors ; Suicide, Attempted ; Young Adult

PURPOSE: There have been few studies of the direct effect of a drug overdose on the gastrointestinal (GI) mucosa. This study evaluated the frequency of GI mucosal injury and the necessity for esophagogastroduodenoscopy (EGD) in patients with non-caustic drug ingestion (DI). METHODS: Patients who presented to the emergency department with non-caustic DI from January 2001 to December 2003 were enrolled in this study. EGD was performed on the patients after acute toxicologic management. Those who did not consent to EGD were excluded. The EGD findings were analyzed according to the non-caustic drug that had been ingested. RESULTS: Among the 37 patients, 24 (65%) had significant endoscopic lesions. Endoscopic findings were gastric erosion (n=17), ulcers (n=5), esophageal erosion (n=1), and a gastric hemorrhage (n=1). Pesticides, rodenticides, salicylates, and high dose doxylamine (>5 g) were associated with drug-induced gastropathy. CONCLUSION: This study suggests that GI mucosal injury has been underestimated in DI patients and that a treatment for gastromucosal protection should be performed when the non-caustic ingested drug is a pesticides, a rodenticides, a salicylates or high-dose doxylamine.
Doxylamine ; Drug Overdose ; Eating* ; Emergency Service, Hospital ; Endoscopy, Digestive System ; Hemorrhage ; Humans ; Mucous Membrane ; Pesticides ; Poisoning ; Rodenticides ; Salicylates ; Ulcer

PURPOSE: The separation of prescription and dispensation of drugs starting from July 2000 has led to a reduced exposure to drugs for the general population. Therefore, we hypothesize that the policy of separation the prescribing and the dispensing of drugs has decreased the actual incidence of drug intoxication from drug abuse. METHODS: Patients with acute intentional drug intoxication who were admitted to emergency centers in Seoul were retrospectively studied. The study period was subdivided into three: before, during, and after the launch of the policy of separation of prescription and dispensation, corresponding to the periods January to June, 2000; January to June 2001; and January to June 2002, respectively. RESULTS: Acute drug intoxication was associated with 0.2% of all prescriptions during the studied period. There was no significant difference in the types of intoxicating drugs whereas the most commonly abused drug was Doxylamine succinate. Prescribed medications accounted for 37.0%, 29.2%, and 32.3% of the acute drug intoxication cases in 2000, 2001, and 2002, respectively. There was no significant difference in the treatment outcomes between the three study groups although three patients died of paraquat intoxications in 2001. CONCLUSION: The launch of the policy of separation of prescription and dispension of drugs did not significantly reduce the rate of acute drug intoxication from drug abuse which questions the effectiveness of the policy in decreasing drug abuse. We suggest reassessment of sedatives, in particular, those prescribed medications, in order to decrease the incidence of acute intoxications.
Doxylamine ; Emergencies* ; Humans ; Hypnotics and Sedatives ; Incidence ; Paraquat ; Poisoning* ; Prescriptions* ; Retrospective Studies ; Seoul ; Substance-Related Disorders ; Succinic Acid

Doxylamine succinate is common over-the-counter sleep medication that is frequently involved in accidental poisonings and suicide attempts. Doxylamine overdose is generally directed at the anticholinergic effect including autonomic,and central nervous system effect and direct cardiac toxicity. Rarely, rhabdomyolysis has been reported with doxylamine overdose. We experienced two cases of rhabdomyolysis with overdose of doxylamine in 17-year-old and 31-year-old male. They were diagnosed with high levels of creatine phosphokinase in serum, myoglobin in serum and urine, and increased radionuclide uptake of muscles in (99m)Tc-MDP bone scan. Patients recovered without any complications with hydration and diuresis. Clinicians should be aware of the possibility of rhabdomyolysis in patients with doxylamine overdose.
Acute Kidney Injury ; Adolescent ; Adult ; Central Nervous System ; Creatine Kinase ; Diuresis ; Doxylamine* ; Humans ; Male ; Muscles ; Myoglobin ; Poisoning ; Rhabdomyolysis* ; Succinic Acid ; Suicide