THOSE DEPENDANT ON THE DRUGS DO NOT SIT AT AUDITORIUM’S DESK

The authors‘ of the article assumption that the majority of traffic accidents are caused by drivers – drug and psychotropic substances abusers – is based on the findings of the European Union DRUID Project. Drug addiction is spreading rapidly in Lithuania. The statistical data of the Drug Control Department under the Government of the Republic of Lithuania prove that the majority of drug abusers are young people of 20–39 years of age. Young people whose efforts and time should be directed towards education and studies. The authors focus attention on the increasing delinquency among drug abusers and the lethal outcome of the drug overdosage. However, it is not a specific national feature. This phenomenon is widely spread from both time and geographical perspective. The established in vitro methods of detection at major extent facilitate the struggle against drug abuse and distribution. In many European cities this method is already being applied when detecting islands of cocaine abusers by the chemical analysis of communal sewage, thus quantitatively identifying the concentration of benzoilekgonin - the stable cocaine metabolite. The article provides a description of the SYNCHRON CX test for identification of cocaine in urine produced by „Beckman Coulter“. Key words: drugs, the metabolite of cocaine, urban wastewater treatment.

Drug Overdosage and Other Poisoning in Hong Kong - The Prince of Wales Hospital (Shatin) Experience

From 1988 to 1991, 732 patients (91.1% Chinese) were admitted to four general medical wards at the Prince of Wales Hospital in Hong Kong with acute poisoning. The patients were predominantly female (68.9%) and relatively young (86.3% below the age of 40). Further analysis of 655 patients indicates that the vast majority of patients (96%) were admitted after self-poisoning with drugs or chemicals while 4% of cases were due to accidental poisoning. The main agents used by the former group included hypnotics/sedatives (33.1 %), household products (15.7%), and analgesics (13.7%). There were nine deaths (1.4%). When compared to other Western countries, two important variations in the pattern of acute poisoning were seen. A substantial proportion of drugs ingested by our patients were not precisely identified. 'Dettol', a household product, was commonly used for self-poisoning in Hong Kong. Territory-wide studies of longer duration are needed to provide the physicians in Hong Kong with much needed information on the incidence and the pattern of acute poisoning.

Ipecac-Induced Emesis and Reduction of Plasma Concentrations of Drugs Following Accidental Overdose in Children

Syrup of ipecac is widely used following accidental drug overdosage in children. Proof of its efficacy, however, in reducing the risk of poisoning is limited. We prospectively studied the effect of early v late induction of emesis by ipecac in 50 children younger than 5 years of age with accidental acetaminophen poisoning. The mean estimated ingested dose was 165 mg/kg, and all patients vomited within 15 to 255 (mean 78) minutes postingestion. Although the predicted four-hour plasma acetaminophen concentration was 97 ± 4 µg/mL (mean ± SEM, calculated on the basis of the estimated ingested dose), the measured four-hour plasma acetaminophen concentration was 34 ± 5 µg/mL (P < .01). To assess the efficacy of early v late ipecac-induced emesis, we used the ratio of measured to predicted four-hour acetaminophen plasma concentration. The ratio of the measured to predicted four-hour level increased as the delay in time to vomiting increased (r = .60, P < .001). Ipecac syrup was administered more promptly when available in the home than when obtained from a pharmacy or a medical facility (26 ± 8 v 83 ± 13 minutes postingestion, respectively; P < .001) and vomiting occurred earlier (49 ± 9 v 103 ± 12 minutes postingestion; P < .01). Although the mean estimated doses ingested were greater in patients who received ipecac syrup at home, their four-hour plasma acetaminophen concentrations were lower. These data suggest that prompt administration of ipecac syrup results in a greater reduction in plasma acetaminophen concentrations in potentially toxic overdosages in children. Further availability of ipecac syrup at home facilitates its prompt use.