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Ann Emerg Med 2003 Jan;41(1):159-60
[Medline record in process]
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PMID: 12526134, UI: 22413932
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BMJ 2003 Jan 18;326(7381):157-60
Department of Paediatric Nephrology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, Guy's, King's, and St Thomas's School of Medicine, London SE1 9RT.
PMID: 12531853, UI: 22418984
BMJ 2003 Jan 18;326(7381):126
PMID: 12531838, UI: 22418969
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Med J Aust 2003 Jan 20;178(2):72-4
Professor of Health Outcomes, Department of Psychiatry, Dalhousie University, Abbie J Lane Memorial Building, 5909 Veterans Memorial Lane, Suite 9211, Halifax, NS B3H 2E2, Canada. stephen.kisely@cdha.nshealth.ca
OBJECTIVES: To assess the effect of two recalls of paracetamol products on rates of intentional and unintentional overdoses of paracetamol in all age groups, as well as any effect on poisoning by other agents. DESIGN: A before-and-after epidemiological study using data from the Western Australian Health Services Research Linked Database, which records all admissions to public and private hospitals throughout the State. MAIN OUTCOME MEASURES: Hospital admissions in Western Australia for poisonings with all agents, including paracetamol and other over-the-counter analgesics. RESULTS: There were 11 752 admissions for poisoning from 1996 to 2001. Paracetamol was the primary poisoning agent in 2266 (19.3%) admissions, aspirin in 120 (1%) and ibuprofen in 277 (2%). There was a significant decrease in the admission rate for paracetamol poisoning when sales were restricted in 2000 (rate ratio, 0.82; 95% CI, 0.68-0.99) compared with the same period in other years. There was no increase in poisoning with other agents at this time. However, admissions for paracetamol overdose also showed a large random variation that tended to obscure any effect. CONCLUSIONS: Our study highlights the need to control for random as well as seasonal fluctuations in admission rates, and for restrictions on paracetamol sales to last for several months across all retail outlets. Limiting access to paracetamol may reduce paracetamol poisonings without a coincident increase in the use of other agents
PMID: 12526726, UI: 22415560
Med J Aust 2003 Jan 20;178(2):61-3
NSW Poisons Information Centre, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia. Corrinebalit@aol.com
OBJECTIVE: To investigate the toxicity of bupropion hydrochloride in deliberate self-poisoning in adults and accidental ingestion by children. DESIGN AND SETTING: Prospective study of cases identified from calls to the New South Wales Poisons Information Centre (NSW PIC), with follow-up through hospital medical records. PARTICIPANTS: Patients with bupropion poisoning managed in hospital, about whom the NSW PIC was contacted for advice, from 1 November 2000 to 31 July 2001 (59 adults and 10 children). MAIN OUTCOME MEASURES: Clinical effects, adverse outcomes (including seizures and death) and treatment. RESULTS: 45 of the 59 adults were followed up (76%), 19 of whom had taken bupropion alone. Major clinical effects of bupropion included sinus tachycardia (83%), hypertension (56%), seizures (37%), gastrointestinal symptoms (37%) and agitation (32%). Seizures were dose-dependent, with those having seizures ingesting a significantly higher median dose (P = 0.02). All seizures were brief and self-limiting. 29 patients received decontamination therapy. 10 patients required pharmacological sedation, 10 were admitted to intensive care and six were intubated. None died. Eight of 10 accidental ingestions by children were followed up (80%); one child had symptoms (vomiting and hallucinations). CONCLUSIONS: Bupropion overdose caused significant clinical effects in adults, but few in children.
PMID: 12526723, UI: 22415557