Akutna trovanja lekovima

Data collected from poison control centers indicate on millions of poisoning due to drug overdoses and acute drug poisonings represent one of the major causes of deaths. Groups of drugs that most commonly cause acute poisoning include sedatives/hypnotics/antipsychotics (benzodiazepines above all), paracetamol and different combinations with paracetamol, drugs used in the treatment of cardiovascular diseases, opioids, antiepileptics, antihistamines, etc. The trend of drug poisoning is increasing in the world and in our country as well where the most common poisoning are those caused by psychoactive drugs, especially by benzodiazepines. This paper gives a brief overview of the toxicity of antidepressants and antianxiety drugsbenzodiazepines, antipsychotics, antiepileptic-carbamazepine, drugs used in treatment of cardiovascular diseases, antihistaminics, methotrexate, and paracetamol which is a rather significant cause of poisoning despite the fact it is OTC drug.Podaci centara za kontrolu trovanja ukazuju na milionske slučajeve trovanja usled predoziranja lekovima, a akutna trovanja lekovima predstavljaju i jedan od značajnih uzročnika smrtnih ishoda. Grupe lekova koje najčešće dovode do akutnih trovanja su: sedativi/hipnotici/antipsihotici pre svih benzodiazepini, zatim paracetamol i različite kombinacije sa paracetamolom, lekovi koji se koriste u terapiji kardiovaskularnih bolesti, opioidi, antiepileptici, antihistaminici itd. Trend trovanja lekovima raste kako u svetu, tako i u našoj zemlji, gde su najzastupljenija trovanja psihoaktivnim lekovima, posebno benzodiazepinima. U radu je dat kratak prikaz toksičnosti benzodiazepina, antidepresiva, antipsihotika, lekova koji se koriste u terapiji kardiovaskularnih oboljenja, karbamazepina kao predstavnika antiepileptika, kao i nekih drugih lekova koji mogu biti uzročnici trovanja

Osnovni principi izučavanja toksikologije smeša

The vast majority of toxicity studies and risk assessments deals with single chemicals. In reality, however, humans are exposed simultaneously to a large number of chemicals, indicating that exposure assessment and safety evaluation should focus on mixtures rather than on single chemicals. This review on the toxicology of chemical mixtures covers widely varying issues, ranging from the basic concepts and terminology of joint action and interaction of chemicals to different designs for studying the toxicity of mixtures. Literature data indicate that exposure to mixtures which contain low levels of chemicals, levels lower than their no observed adverse effect levels (NOAELs), can exert toxic effects whether their components have similar modes of action or not. Different approaches and examples of studies on priority real-life mixtures, strategy and guidelines for mixture risk assessment as well as challenges ahead are also presented.Većina toksikoloških studija i evaluacija rizika odnose se na pojedinačne hemikalije. Međutim, u realnom okruženju izloženi smo istovremeno velikom broju hemikalija, što ukazuje da bi pri proceni izloženosti i rizika trebalo posmatrati smeše, a ne samo pojedinačne hemikalije. Ovaj pregledni rad o toksikologiji hemijskih smeša pokriva više stavki, od osnovnih koncepata i terminologije zajedničkog dejstva i interakcija hemikalija do različitih modela za ispitivanje toksičnosti smeša. Literaturni podaci ukazuju na činjenicu da izloženost smešama koje sadrže niske nivoe hemikalija, nivoe koji su niži od njihovih doza bez štetnog efekta (No observed adverse effect level - NOAEL) vrednosti, može rezultirati toksičnim odgovorom bez obzira da li komponente smeše imaju ili ne sličan način dejstva. Dati su i različiti pristupi i primeri koncepata i modela procene toksičnosti prioritetnih smeša iz realnog života, strategija i smernice, kao i dalji izazovi

Neželjeni efekti i toksičnost analgetika

Even though among the most widely used analgoantipiretics with confirmed pharmacological effects, acetylsalicylic acid, paracetamol and ibuprofen may be the cause of poisonings and even death. Acetylsalicylic acid and paracetamol are most commonly used drugs that are dispensed without a prescription. However, poison control centers are warning of the risk associated with the use of these COX inhibitors. It is well known that acetylsalicylic acid causes prolonged inhibition of blood coagulation, metabolic acidosis and other toxic effects while the toxic effects of paracetamol are mainly manifested on liver. Ibuprofen poisoning is much rarer, especially those leading to death. Ibuprofen overdose can cause mainly gastrointestinal disturbances, and can also lead to renal damage.U ovom radu obrađeni su acetilsalicilna kiselina, paracetamol i ibuprofen, s obzirom da su među najšire korišćenim analgoantipireticima koji i pored neosporno potvrđenog farmakološkog dejstva mogu biti uzročnici trovanja, pa i smrti. Acetilsalicilna kiselina i paracetamol su najčešće korišćeni lekovi koji se izdaju bez recepta, a izveštaji centara za kontrolu trovanja opominju na rizik koji nose ovi COX inhibitori. Poznato je da acetilsalicilna kiselina dovodi do produžene inhibicije koagulacije krvi, metaboličke acidoze i drugih toksičnih efekata, a da se toksičnost paracetamola prvenstveno ispoljava na jetri. Trovanja ibuprofenom su znatno ređa, posebno sa smrtnim ishodom. Pri predoziranju ibuprofenom dominiraju gastrointestinalne smetnje, a može doći i do renalnog oštećenja

O psihoaktivnim kontrolisanim supstancama - situacija u svetu

Although the psychoactive substances are strictly controlled in most of the countries in the world, their abuse is still very present, as confirmed by the data from the year of 2009 when over 200 million drug addicts were registered. The most commonly used psychoactive controlled substance in the world is cannabis, followed by amphetamine-type stimulants (methamphetamine, amphetamine and ecstasy), opioids (opium, heroin and opioids used in medical purposes), and cocaine. A similar situation is in Europe: most frequently abused substance is cannabis, followed by cocaine and ecstasy and recent epidemiological study conducted in Serbia points to the widespread use of psychoactive substances among young population. Increasingly problem in many countries is the abuse of prescription drugs, particularly painkillers, sedatives and tranquilizers. Prevention of psychoactive substance abuse should be an essential part of the each country strategy in its efforts to protect human health, particularly health of children and young people.Iako se psihoaktivne supstance nalaze pod strogom kontrolom u većini zemalja sveta, njihova zloupotreba je i dalje izuzetno prisutna, što potvrđuju i podaci da je u 2009. godini registrovano preko 200 miliona zavisnika. Najčešće korišćena psihoaktivna kontrolisana supstanca u svetu je kanabis, a slede ga stimulansi tipa amfetamina (metamfetamin, amfetamin i ekstazi), zatim opijati (opijum, heroin i opijati koji se koriste i u medicinske svrhe) i kokain. Slična je situacija i u zemljama Evrope: najčešće zloupotrebljavana supstanca je kanabis, a potom slede kokain i ekstazi, a poslednje epidemiološko istraživanje sprovedeno u Srbiji ukazuje na rasprostranjenost upotrebe psihoaktivnih supstanci među mladima u našoj zemlji. Sve prisutniji problem u velikom broju zemalja sveta predstavlja i zloupotreba lekova, pre svega analgetika, sedativa i trankilizera. Prevencija zloupotrebe psihoaktivnih supstanci predstavlja neophodan deo strategije svake države u njenim nastojanjima da zaštiti zdravlje ljudi, posebno dece i mladih

Role of parental monitoring in the prevention of peer violence on the internet

Numerous studies show that the prevalence of bullying on the Internet is increasing. Preventing exposure and manifestation of this form of bullying is a particular challenge for parents. Their protective role is diminished, as children are more information-technology literate and have devices that allow unlimited internet access. Supervision of a child’s activities on the Internet is a specific type of parental monitoring. Most parents use restrictive strategies, in the form of time and content limitations, which have weak effects. There is a need to educate parents about effective strategies to monitor child’s activities on the Internet that can contribute to preventing and reducing bullyBrojna istraživanja pokazuju da je prevalencija vršnjačkog nasilja na inter- netu u porastu. Prevencija izloženosti i ispoljavanja ovog oblika vršnjačkog nasilja predstavlja poseban izazov za roditelje. Njihova protektivna uloga je umanjena, jer su deca informaciono-tehnološki pismenija i poseduju uređaje koji omogućavaju neograničen pristup internetu. Nadzor nad aktivnostima dete- ta na internetu predstavlja specifičnu vrstu roditeljskog nadzora. Većina roditelja koristi restriktivne strategije, u vidu ograničavanja vremena i sadržaja, koje imaju slabe efekte. Postoji potreba za edukacijom roditelja o efektivnim strategijama nadziranja aktivnosti deteta na internetu koje mogu doprineti prevenciji i redukovanju vršnjačkog nasilja