Severe beta-blocker overdose in a 65-year-old female

Introduction: Population of people over 65 years old is one of the groups of the greatest risk of suicide attempt. In this age range the highest suicide rate that results in death is observed. Metabolism alterations and co-morbidities development with age may play major role in increasing suicide rate. Accidental and intentional drug over-ingestions are more common for people with numerous prescriptions and comorbid conditions. Overdose in such patients can pose great threat to patients life. Aim of the study: The purpose of this study is to depict course of β-adrenolitics and benzodiazpines poisoning on the base of case report. Materials and methods: The analysis of the patient's medical history and the review of available literature in the PubMed and Google Scholar databases. Results: The 65-year-old female, was brought by emergency medical services to the Toxicology Clinic due severe drug poisoning. Upon admission patient was unconscious, intubated, on ventilator, in overall severe condition. She presented symptoms of circulatory insufficiency. History revealed overdose of β-adrenolitics and benzodiazepines. The application of proper pharmacological treatment and heart pacing resulted in gradual improvement of patients condition. After one-week stay she was discharged home in good condition. Conclusions: Course of β-adrenolitics poisoning with addition of benzodiazepines poses great threat, especially when one suffers from numerous comorbidities. Therefore, due to wider availability of drugs and rising number of suicide attempts, as well as events of medication errors, it is crucial to be aware of elder people problems and prevent such situations

Self medication in the age of connectivity and its risks - the case report

Introduction: Public healthcare systems throughout the world are strained by demographic changes, soaring costs and insufficient resources. This can negatively affect access to health services, which forces patients to seek other treatment options. Websites and online forums have become one of the most common sources of health advice, with online medicine trade burgeoning as well. However, while the internet provides vast knowledge database, using unverified advice or product can have dangerous consequences. We present a patient with acute amphetamine poisoning, caused by ingestion of substance marketed online as weight loss drug. Aim of study: to discuss potential risks and problems of using online advice and products in self medication Results: Our patient, the 36 year old female, was admitted to Department of Toxicology and Cardiology with symptoms suggestive of poisoning of some kind. She admitted to using a weight- loss medication throughout the last month, in increasing dosages. The drug was bought from online trading platform. She lost 8 kilograms of body weight through this period. Subsequently, she noticed some disturbing symptoms, including dystonia movements of limbs, paresthesia in right half of the body and blurred vision. Episodes of tachycardia were reported as well. On admission, the patient was weakened and mildly depressed. She reported not eating anything for the last 2 days. Toxicological examination revealed the presence of psychoactive substances in the urine- amphetamine at 7800 ng/ml and LSD at 1,08ng/ml. Our patient was consulted by psychiatrist and psychologist. Fluid therapy was applied, along with Relanium, low molecular weight heparin, Dexaven and Polprazol. Due to elevated blood pressure, a 24-hour blood pressure measurement was performed. Next, hypotensive therapy was administered. The patient’s condition improved and she was discharged from the hospital after 4 days, with scheduled control in ambulatory setting and recommendation of beginning the psychotherapy. Conclusions: Online health advice and products can be dangerous if used inappropriately. A focus on education and provision of freely available, high quality medical information can make it safe and useful complement to healthcare systems throughout the world. Appropriate systems controlling online medicine distribution should also be instituted, with patients’ safety and wellbeing as prime goals

The case series of baclofen intoxication

Baclofen, a gamma-amino butyric acid type B (GABAb) inhibitor, is commonly used in management of spasticity and other medical conditions, such as alcohol dependency. However, given its mechanism of action, increasing usage of baclofen raises concerns about possibility of intoxication. The authors present herein three cases of baclofen intoxication of patients in various age and general condition

New psychoactive substances abuse and its clinical consequences - the case report

Introduction: The meteoric rise of new psychoactive substances' use has been a public health problem for at least few years. Their presence was noticed by EU authorities around 2005. First cases of NPS poisoning in Poland appeared shortly thereafter, in 2008. Due to great variety of used substances and lack of information about them, precise diagnosis and targeted treatment remain a significant problem. Hereby, we present a patient with multi-drug poisoning related to NPS abuse and discuss new psychoactive substances that are often found in such cases. Aim of study: To discuss most common new psychoactive substances and their health effects on the basis of the case report Results: A 28-year old patient was admitted to the Department of Toxicology and Cardiology with symptoms suggesting acute intoxication with psychoactive substances. The patient had a history of drug abuse. A few pouches containing unidentified psychoactive substances were found near the patient. On admission, his condition was serious- he was unconscious and required mechanical ventilation. Tachycardia and aspiration pneumonia were present as well.The applied therapy focused on restoring acid- base homeostasis, electrolyte balance and mitigating toxic influence of detected drugs, with preventive antibiotic administration used as well. His general and psychological condition improved with treatment, and he was discharged from the department after ten days, with continuation of the therapy in ambulatory setting. Conclusions: An increasing amount of patients present cases of polysubstance abuse, whose treatment may prove especially difficult. Such cases require extensive therapy to prevent debilitating complications. A focus on drug regulation and patient education could diminish the number of such cases in the future

Cyanide poisoning from an alternative medicine treatment with apricot kernels in a 80-year-old female.

Introduction: Amygdaline, one of the most common cyanogenic glycosides, is present in the seeds and fruit pits of Prunus species. The excessive administration of this glycoside might lead to cyanide poisoning. Aim: The aim of the study is to depict the risk associated with apricot kernels ingestion on the base of the case report. Methods: The analysis of the patient’s medical history and the review of available literature. Results: 80- year- old female with the medical history of papillary thyroid cancer was admitted to the toxicology department due to accidental cyanide poisoning. The patient consumed extract consisted of milled apricot kernels, then suffered from dyspnea, vertigo and vomiting. After that, she lost consciousness. Lactic acidosis, highly specific for cyanide intoxication, was diagnosed during hospitalization. The patient was treated with fluid and steroid therapy, sodium bicarbonate and supplemental oxygen. On the 3rd day of stay, the patient was discharged with recommendation of control in toxicological clinic. Conclusions: Initial symptoms of cyanide poisoning are not specific, therefore it is worth taking this poisoning into account in differential diagnosis, especially in oncological patients or in children

Lead poisoning linked to occupational exposure - case reports

Introduction: Lead is one of the oldest widely used industrial metals. Throughout the ages, its significant toxicity caused poisoning of exposed people. Even today occupational exposure remains a significant hazard. Aim: The aim of the study is to depict the risk associated with lead exposure on the base of the case report. Methods: Patient’s medical history analysis and the review of available literature. Results: Two patients with history of occupational lead exposure were admitted to hospital. Their symptoms suggested chronic lead poisoning. Blood lead level was excessive in both cases. The patients were treated with antioxidants and advised to reduce their exposure to lead, with continuing ambulatory therapy. Conclusions: All known effects of Pb are extremely harmful to humans. Lead poisoning still appears to be a problem in some jobs and environments, particularly in cases of chronic low level exposure. Proper monitoring of workplace conditions and regular medical checkups for those at risk should be practiced to avoid cases of chronic poisoning in the future

Multiple complications of the induction phase chemotherapy for childhood acute lymphoblastic leukemia

Chemotherapy for childhood acute lymphoblastic leukemia (ALL) despite of high efficiency often leads to many different complications, what bring consequences like therapy failure, death, breaks in chemotherapy, elongate hospitalization. We reported case old 6-year-old girl treated with ALL, who experienced many, severe complications of chemotherapy during the induction phase of treatment