The term drug overdose (or simply overdose or OD) describes the ingestion Ingestion is the consumption of a substance by an organism. In animals, it normally is accomplished by taking in the substance through the mouth into the gastrointestinal tract, such as through eating or drinking. In single-celled organisms, ingestion can take place through taking the substance through the cell wall or application of a drug A drug, broadly speaking, is any substance that, when absorbed into the body of a living organism, alters normal bodily function. There is no single, precise definition, as there are different meanings in drug control law, government regulations, medicine, and colloquial usage or other substance in quantities that are excessive.[1] An overdose is widely considered harmful and dangerous as it can result in death Death is the termination of the biological functions that sustain a living organism. The word refers both to the particular processes of life's cessation as well as to the condition or state of a formerly-living body.
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Classification
The word "overdose" implies that there is a common safe dosage and usage for the drug; therefore, the term is commonly only applied to drugs, not poison In the context of biology, poisons are substances that can cause disturbances to organisms, usually by chemical reaction or other activity on the molecular scale, when a sufficient quantity is absorbed by an organism. Legally and in hazardous chemical labeling, poisons are especially toxic substances; less toxic substances are labeled ", though even certain poisons are harmless at a low enough dosage. Drug overdoses are sometimes caused intentionally to commit suicide Suicide is the act of a human being intentionally causing his or her own death. Suicide is often committed out of despair, or attributed to some underlying mental disorder which includes depression, bipolar disorder, schizophrenia, alcoholism and drug abuse. Financial difficulties, interpersonal relationships and other undesirable situations play or as self-harm Self-harm or deliberate self-harm (DSH) includes self-injury (SI) and self-poisoning and is defined as the intentional, direct injuring of body tissue without suicidal intent. These terms are used in the more recent literature in an attempt to reach a more neutral terminology. The older literature, especially that which predates the DSM-IV-TR,, but many drug overdoses are accidental and are usually the result of either irresponsible behavior or the misreading of product labels. Drug overdose often happens as a result of the use of multiple drugs with counter indications simultaneously (for instance, heroin Heroin, or diacetylmorphine , also known as diamorphine (BAN), is a semi-synthetic opioid drug synthesized from morphine, a derivative of the opium poppy. It is the 3,6-diacetyl ester of morphine (di (two)-acetyl-morphine). The white crystalline form is commonly the hydrochloride salt diacetylmorphine hydrochloride, though often adulterated thus/certain prescription pain medications and cocaine Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic. Specifically, it is a serotonin-norepinephrine-dopamine/amphetamines Amphetamine or amfetamine (INN) is a psychostimulant drug that is known to produce increased wakefulness and focus in association with decreased fatigue and appetite. Amphetamine is chemically related to methamphetamine and lisdexamfetamine, a class of potent drugs that act by increasing levels of dopamine and norepinephrine in the brain, inducing/alcohol In chemistry, an alcohol is any organic compound in which a hydroxyl functional group (-O .) Usage of illicit drugs that are of unexpected purity, in large quantities, or after a period of abstinence Abstinence is a voluntary restraint from indulging in bodily activities that are widely experienced as giving pleasure. Most frequently, the term refers to abstention from sexual intercourse, alcohol or food. The practice can arise from religious prohibitions or practical considerations can also induce overdose. Cocaine Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic. Specifically, it is a serotonin-norepinephrine-dopamine users that inject intravenously An injection is an infusion method of putting fluid into the body, usually with a hollow needle and a syringe which is pierced through the skin to a sufficient depth for the material to be forced into the body. An injection follows a parenteral route of administration; that is, administered other than through the digestive tract can overdose accidentally as the margin between an optimal flash and an overdose is small.[2]
Accidental overdoses can eventuate out of a number of different causes including overprescription, failing to recognise a drug's active ingredient, or unwitting ingestion by children[3] A common unintentional overdose in young children involves multi-vitamins containing iron. Iron Iron is the most common element in the earth as a whole, and the fourth most common in the Earth's crust. It is produced as a result of stellar fusion in high-mass stars, and it is the heaviest stable element produced by stellar fusion because the fusion of iron is the last nuclear fusion reaction that is exothermic. Iron is the most widely used is a component of the hemoglobin Hemoglobin is the iron-containing oxygen-transport metalloprotein in the red blood cells of vertebrates and the tissues of some invertebrates. Hemoglobin in the blood is what transports oxygen from the lungs or gills to the rest of the body (i.e. the tissues) where it releases the oxygen for cell use molecule A molecule is defined as an electrically neutral group of at least two atoms in a definite arrangement held together by very strong chemical bonds. Molecules are distinguished from polyatomic ions in this strict sense. In organic chemistry and biochemistry, the term molecule is used less strictly and also is applied to charged organic molecules in blood Blood is a specialized bodily fluid that delivers necessary substances to the body's cells – such as nutrients and oxygen – and transports waste products away from those same cells, used to transport oxygen Oxygen (pronounced /ˈɒksɨdʒɨn/, OK-si-jin, from the Greek roots ὀξύς (acid, literally "sharp", from the taste of acids) and -γενής (-genēs) (producer, literally begetter), is the element with atomic number 8 and represented by the symbol O. It is a member of the chalcogen group on the periodic table, and is a highly to living cells. When taken in small amounts, iron allows the body to replenish hemoglobin, but in large amounts it causes severe pH In chemistry, pH is a measure of the acidity or basicity of a solution. It approximates but is not equal to p[H], the negative logarithm of the molar concentration of dissolved hydronium ions (H3O+); a low pH indicates a high concentration of hydronium ions, while a high pH indicates a low concentration. Crudely, this negative of the logarithm imbalances in the body. If this overdose is not treated with chelation therapy Chelation therapy is the administration of chelating agents to remove heavy metals from the body. For the most common forms of heavy metal intoxication—those involving lead, arsenic or mercury—the standard of care in the United States dictates the use of dimercaptosuccinic acid .[citation needed] Other chelating agents, such as 2,3-dimercapto-1, it can lead to death or permanent coma In medicine, a coma is a profound state of unconsciousness. A person in a coma cannot be awakened, fails to respond normally to pain, light or sound, does not have sleep-wake cycles, and does not take voluntary actions. A person in a state of coma can be described as comatose.
Signs and symptoms
Main article: Toxidrome In medicine, a toxidrome is a syndrome caused by a dangerous level of toxins in the body. It is often the consequence of a drug overdose. Common symptoms include dizziness, disorientation, nausea, vomiting, and oscillopsia. A toxidrome may indicate a medical emergency requiring treatment at a poison control center. Aside from poisoning, a systemicSigns and symptoms of an overdose varies depending on the drug or toxin exposure. The symptoms can often be divided into differing toxidromes In medicine, a toxidrome is a syndrome caused by a dangerous level of toxins in the body. It is often the consequence of a drug overdose. Common symptoms include dizziness, disorientation, nausea, vomiting, and oscillopsia. A toxidrome may indicate a medical emergency requiring treatment at a poison control center. Aside from poisoning, a systemic. This can help one determine what class of drug or toxin is causing the difficulties.
A summary of the toxidromes:[4]
| toxidrome | BP | HR | RR | Temp | Pupils | bowel sounds | diaphoresis |
| anticholinergic | ~ | up | ~ | up | up | down | down |
| cholinergic | ~ | ~ | unchanged | unchanged | unchanged | up | up |
| opioid | down | down | down | down | down | down | down |
| sympathomimetic | up | up | up | up | up | up | up |
| sedative-hypnotic | down | down | down | down | ~ | down | down |
Causes
The drugs A psychoactive drug, psychopharmaceutical or psychotropic is a chemical substance that crosses the blood-brain barrier and acts primarily upon the central nervous system where it alters brain function, resulting in changes in perception, mood, consciousness, cognition, and behavior. These drugs may be used recreationally, to purposefully alter one' or toxins A toxin is a poisonous substance produced by living cells or organisms (although humans are technically living organisms, man-made substances created by artificial processes usually are not considered toxins by this definition). It was the organic chemist Ludwig Brieger (1849–1919) who first used the term 'toxin' which are most frequently involved in overdose and death (grouped by ICD-10 The International Statistical Classification of Diseases and Related Health Problems 10th Revision is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization. (WHO). The code set allows more than 14,400 different codes):
- Among Opioid overdose Symptoms and signs are often those of an opiate toxidrome. These include: decreased level of consciousness and pinpoint pupil except with meperidine where one sees dilated pupils (F11)
- Heroin Heroin, or diacetylmorphine , also known as diamorphine (BAN), is a semi-synthetic opioid drug synthesized from morphine, a derivative of the opium poppy. It is the 3,6-diacetyl ester of morphine (di (two)-acetyl-morphine). The white crystalline form is commonly the hydrochloride salt diacetylmorphine hydrochloride, though often adulterated thus (T40.1)
- Codeine Codeine or 3-methylmorphine (a natural isomer of methylated morphine, the other being the semi-synthetic 6-methylmorphine) is an opiate used for its analgesic, antitussive, and antidiarrheal properties (T40.2)
- Morphine Morphine (pronounced /ˈmɔrfiːn/) (MS Contin, MSIR, Avinza, Kadian, Oramorph, Roxanol, Kapanol) is a potent opiate analgesic medication and is considered to be the prototypical opioid (T40.2)
- Methadone Methadone is a synthetic opioid, used medically as an analgesic, antitussive and a maintenance anti-addictive for use in patients on opioids. It was developed in Germany in 1937. Although chemically unlike morphine or heroin, methadone also acts on the opioid receptors and thus produces many of the same effects. Methadone is also used in managing (T40.3)
- Fentanyl Fentanyl is a synthetic strong agonist at the mu and kappa opiate receptors. Fentanyl is a potent narcotic analgesic with a rapid onset and short duration of action. Historically it has been used to treat chronic breakthrough pain and is commonly used pre-procedures
- Hydromorphone Hydromorphone, a more common synonym for dihydromorphinone and dimorphone, commonly a hydrochloride is a potent centrally-acting analgesic drug of the opioid class. It is a derivative of morphine, to be specific, a hydrogenated ketone thereof and, therefore, a semi-synthetic drug. It is, in medical terms, an opioid analgesic and, in legal terms, a
- Propoxyphene Dextropropoxyphene, manufactured by Eli Lilly and Company, is an analgesic in the opioid category. It is used to treat mild pain and is additionally an anti-tussive and local anesthetic
- Among sedative A sedative is a substance that induces sedation by reducing irritability or excitement-hypnotics Hypnotic drugs are a class of psychoactives whose primary function is to induce sleep and to be used in the treatment of insomnia and in surgical anesthesia. When used in anesthesia to produce and maintain unconsciousness "sleep" is metaphorical and there are no regular sleep stages or cyclical natural states; patients rarely recover (F13)
- Among Barbiturate overdose Barbiturates are drugs that act as central nervous system depressants, and, by virtue of this, they produce a wide spectrum of effects, from mild sedation to total anesthesia. They are also effective as anxiolytics, hypnotics and as anticonvulsants. They have addiction potential, both physical and psychological. Barbiturates have now largely been (T42.3)
- Amobarbital Amobarbital is a drug that is a barbiturate derivative. It has sedative-hypnotic and analgesic properties. It is a white crystalline powder with no odor and a slightly bitter taste. It was first synthesized in Germany in 1923. If amobarbital is taken for extended periods of time, physical and psychological dependence can develop
- Pentobarbital Pentobarbital is a short-acting barbiturate that was first synthesized in 1928. Pentobarbital is available as both a free acid and a sodium salt, the former of which is only slightly soluble in water and ethanol. One trade name for this drug is Nembutal, coined by Dr. John S. Lundy, who started using it in 1930, from the structural formula of the
- Secobarbital Secobarbital Sodium is a barbiturate derivative drug that was first synthesized in 1928. It possesses anaesthetic, anticonvulsant, sedative and hypnotic properties. In the United Kingdom, it was known as Quinalbarbitone
- Among Benzodiazepine overdose Benzodiazepine overdose describes the ingestion of one of the drugs in the benzodiazepine class in quantities greater than are recommended or generally practiced. Death as a result of benzodiazepines is uncommon but does occasionally happen. Deaths after hospital admission are considered to be low. However, combinations of high doses of (T42.4)
- Diazepam Diazepam , first marketed as Valium (/ˈvæliəm/) by Hoffmann-La Roche, is a benzodiazepine derivative drug. It is commonly used for treating anxiety, insomnia, seizures including status epilepticus, muscle spasms, restless legs syndrome, alcohol withdrawal, benzodiazepine withdrawal and Ménière's disease. It may also be used before certain
- Flunitrazepam Flunitrazepam is marketed as a strong hypnotic and powerful sedative, anticonvulsant, anxiolytic, amnestic, and skeletal muscle relaxant drug. A short-intermediate acting benzodiazepine derivative, flunitrazepam is prescribed for the treatment of severe insomnia, marketed by Roche most commonly under the trade name Rohypnol. It is also marketed in
- Nitrazepam Nitrazepam is a type of benzodiazepine drug and is marketed in English-speaking countries under the following brand names: Alodorm, Arem, Insoma, Mogadon, Nitrados, Nitrazadon, Ormodon, Paxadorm, Remnos and Somnite. It is a hypnotic drug used in the treatment of insomnia which has sedative and motor impairing properties, as well as anxiolytic,
- Temazepam Temazepam is an intermediate-acting 3-hydroxy benzodiazepine. It is generally prescribed for the short-term treatment of sleeplessness in patients who have difficulty maintaining sleep. In addition, temazepam has anxiolytic (anti-anxiety), anticonvulsant, and skeletal muscle relaxant properties
- Triazolam Triazolam is a benzodiazepine derivative drug. It possesses pharmacological properties similar to that of other benzodiazepines, but it is generally only used as a sedative to treat insomnia. In addition to the hypnotic properties triazolam possesses, amnesic, anxiolytic, sedative, anticonvulsant and muscle relaxant properties are also present
- Uncategorized sedative-hypnotics (T42.6)
- Ethchlorvynol Ethchlorvynol is a sedative and hypnotic drug. It has been used to treat insomnia, but has been largely superseded and is only offered where an intolerance or allergy to other drugs exists (Placidyl)
- GHB GHB has been used in a medical setting as a general anesthetic, to treat conditions such as insomnia, clinical depression, narcolepsy, and alcoholism, and to improve athletic performance. It is also used as an intoxicant or as a date rape drug. GHB is naturally produced in the human body's cells and is structurally related to the ketone body beta-
- Glutethimide (Doriden)
- Methaqualone
- Ketamine (T41.2)
- Among Barbiturate overdose Barbiturates are drugs that act as central nervous system depressants, and, by virtue of this, they produce a wide spectrum of effects, from mild sedation to total anesthesia. They are also effective as anxiolytics, hypnotics and as anticonvulsants. They have addiction potential, both physical and psychological. Barbiturates have now largely been (T42.3)
- Among Stimulants (F14-F15)
- Cocaine overdose (T40.5)
- Amphetamine overdose (T43.6)
- Methamphetamine (T43.6)
- Among Poly drug use (F19)
- Drug "cocktails" (Speedballs)
- Medications/pharmaceuticals
- Aspirin poisoning (T39.0)
- Paracetamol toxicity (T39.1)
- Tricyclic antidepressant overdose (T43.0)
Diagnosis
Determination of the substance which was taken is often easy as usually the person knows what they took. However, if they will not or cannot due to an altered level of consciousness provide this information a search of the home or questioning of friends and family may be helpful.
Examination for toxidromes, drug testing, or laboratory test may be helpful. Naloxone the antidote for narcotics may be administered and if they improve it indicates this is probably part of the overdose.
Negative drug-drug interactions have sometimes been misdiagnosed as an acute drug overdose, occasionally leading to the assumption of suicide. [5]
Prevention
The distribution of naloxone to injection drug users decreases the risk of death from overdose.[6]
Avoid the mixing depressant drugs like alcohol, barbiturates, benzodiazepines, and opiates. [7]
Management
Stabilization of the ABCs are the initial treatment of an overdose. This involves establishing a stable airway, breathing rate and circulatory system as an essential first step. Ventilation is considered when there is a low respiratory rate or when blood gases show the person to be hypoxic. The next necessary step is to treat for shock. Investigations should be carried out in labs to help identify the drug(s) at hand such as glucose, urea and electrolytes, paracetamol levels and salicylate levels. Monitoring of the patient should continue before and throughout the treatment process, with particular attention to temperature, pulse, respiratory rate, blood pressure, urine output, electrocardiography (ECG) and O2 saturation.[8]
Antidotes
Main article: AntidotesSpecific antidotes are available for certain causative agents. The overdose agent is usually determined either via history or laboratory toxicology.
Poison control centers and Medical toxicologists are available in many areas to provide guidance in overdoses to both physicians and the general public.
Epidemiology
The National Center for Health Statistics report that 19,250 people died of accidental poisoning in the U.S. in the year 2004 (8 deaths per 100,000 population).[9]
In 2008 testimony before a Senate subcommittee, Medical Epidemiologist Dr. Leonard J. Paulozzi[10] of the Centers for Disease Control and Prevention stated that in 2005 (the most recent year for which data was available) more than 22,000 American lives were lost due to overdoses, and the number is growing rapidly. Dr. Paulozzi also testified that all available evidence suggests that unintentional overdose deaths are related to the increasing use of prescription drugs, especially opioid painkillers. [11]
See also
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Sat, 31 Jul 2010 20:34:47 GMT+00:00
Voice of America An overdose of radiation during the 1970s for treatment of cancer had made it impossible for him to walk unaided. He remembers his relief a few years later, ...
SunnyChanel
ue, 10 Aug 2010 23:10:18 GM
Fantasia Barrino was rushed to the hospital last night from an apparent . overdose. . Were the Rumors of Her Homewrecking To Blame.
Q. Save the concern, it's not for why you think... It's for a school report on depression. Any details you know about suicides by overdose is also appreciated.
Asked by Bri. - Thu Aug 13 19:06:40 2009 - - 3 Answers - 0 Comments
A. it differs dear according to the type of med. but if u want a help in your report u can choose any medicine u want and then read the banflet to see the dose good luck dear :)
Answered by honey sweet - Thu Aug 13 19:18:49 2009
