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Clinical pharmacy and clinical trials (including case series)
An epidemiological analysis of poisonings in the italian region of emilia Romagna from 2005 to 2009
  1. S.B. Bianchi Stefano,
  2. B.E. Bianchini Erica,
  3. S.P. Scanavacca Paola,
  4. M.A. Marra Anna,
  5. C.R. Carletti Rossella,
  6. O.D. Osti Daria,
  7. Z.R. Zoppellari Roberto
  1. 1University Hospital, Department of Pharmacy, Ferrara, Italy
  2. 2University Hospital, Department of Anaesthesia and Intensive Care, Ferrara, Italy

Abstract

Background The Department of Pharmacy of the University Hospital of Ferrara (AOUFE) activated a project called ‘Monitoring and use of the Reference Centre for antidote stocks’. The project followed the correct allocation of available antidotes to the Reference Centre of the Emilia Romagna Region (ERR).

Purpose Epidemiological analysis to identify different types of intoxication and check that they have been treated successfully.

Materials and methods All 17 Hospitals of the ERR were asked to provide information about episodes of intoxication recorded from 1/1/2005 to 31/12/2009 as well as the antidote treatments administered. Required data were: year, type of intoxication and toxic substance, patient demographic data, type of antidote used and treatment period.

Results 16 hospitals took part in the analysis. 8151 intoxications were recorded and they are grouped as follows: 1704 intoxications in 2005 (21% of the 5-year total); 1523 in 2006 (19%); 1593 in 2007 (20%); 1560 in 2008 (19%); 1771 in 2009 (21%). Categorisation by toxic substance showed the following: 31% caused by drugs; 17% caused by ethanol; 4% by opioids; 3% by carbon monoxide; 3% by food; 1% by sodium hypochlorite and derivatives; 36% by non-classifiable intoxications; 5% by various intoxications. The authors only evaluated complete intoxication data (1223 cases) and The authors had calculated in 80% of these cases the following antidotes were used: 19% (232/1223) activated charcoal associated with gastric lavage; 11% (132/1223) activated charcoal; 9% (109/1223) activated charcoal associated with MgSO4; 12% (144/1223) flumazenil; 6% (76/1223) hyperbaric oxygen; 12% (151/1223) naloxone; 7% (80/1223) metadoxine; 4% (53/1223) benzodiazepines.

Conclusions Drug and ethanol poisonings were the most frequent; non-specific treatments were the most frequently performed, followed by the use of specific antidotes such as flumazenil and naloxone. Epidemiological analysis shows that the frequency of intoxications in ERR is 3.82 per 10000 inhabitants/year.

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