Modern approaches of the diagnostics and intensive care of combined methadone poisonings in the specialised toxicological centre

May 16, 2018
968
Specialities :
Resume

In recent years, the number of methadone poisonings in Kiev increased significantly. Poisonings are characterize by severe course, high mortality rate, complications in clinical diagnosis and treatment. Aim — to study the features of methadone poisoning, deaths to minimize lethality and disability. Materials and methods. Cases of acute methadone poisoning (n=1000), acts of forensic research (n=35), statistical reports of the Kiev Toxicological Center (2005–2017), toxicological, biochemical, functional research methods, retrospective analysis and «MS Excel» tools. Results. The acute methadone poisonings are the most dangerous form of drugs poisoning, which confirmed by a 2.5-fold increase in their number over the past 5 years and a special course of poisoning characterized by various complications and high mortality rates (up to 8.3%). The main factors that formed the level of lethality were the lethal dose of the poison, the presence of concomitant diseases, prolonged narcotic illness and various complications. The program of intensive therapy in methadone poisoning differed from the standard treatment regimen of the opioid coma and aimed at rapid detoxification using the membrane therapy (hemodialysis, ultrafiltration). Conclusions. Today, methadone poisonings are the socially significant problem, which requires careful study and urgent measures to minimize the negative effects on human health.

O.V. Ivashchenko, V.V. Andryushchenko, A.G. Bogomol, M.M. Kalish, N.V. Kurdil

Key words: toxicology, drugs, methadone.

Published: 15.05.2018

References:

  • Ivashchenko O.V., Nedashkivskyi S.M. (2009) Osoblyvosti kliniky, diahnostyky y likuvannia pry otruienni metadonom. Med. neotl. sost., 5(24) (http://www.mif-ua.com/archive/article/11160).
  • Kuchma A.B., Struk V.F., Padalka V.M. (2016) Analiz navantazhennia na viddilennia intensyvnoi terapii ta hospitalnyi etap nevidkladnoi dopomohy za rakhunok patsiientiv z hostrym otruienniam metadonom. Med. neotl. sost., 4(75) (http://www.mif-ua.com/archive/article/43204).
  • Nedashkivskyi S.M. (2015) Hostra nyrkova nedostatnist pry tiazhkykh otruienniakh metadonom. Med. neotl. sost., 1(64) (http://www.mif-ua.com/archive/article/40225).
  • Alinejad S., Ghaemi K., Abdollahi M., Mehrpour O. (2016) Nephrotoxicity of methadone: a systematic review. Springer plus, 5(1): 2087.
  • Cao X., Wu Z., Li L. et al.; National Methadone Maintenance Treatment Program Working Group (2013) Mortality among methadone maintenance clients in China: a six-year cohort study. PLoS One, 8(12): e82476.
  • Centers for Disease Control and Prevention (CDC) (2012) Vital signs: risk for overdose from methadone used for pain relief — United States, 1999–2010. MMWR Morb. Mortal. Wkly Rep., 61(26): 493–497.
  • Flanagan R.J., Rooney C. (2002) Recording acute poisoning deaths. Forensic. Sci. Int., 128(1–2): 3–19.
  • Livanov G., Loladze A., Batotsyrenov B. et al. (2017) Acute Poisoning with Methadone (Dolphin) (Review). Gen. Reanimatol., 13(3): 48–63.
  • Madden M.E., Shapiro S.L. (2011) The methadone epidemic: methadone-related deaths on the rise in Vermont. Am. J. Forensic. Med. Pathol., 32(2): 131–135.
  • Mijatović V., Samojlik I., Ajduković N. et al. (2014) Methadone-related deaths — epidemiological, pathohistological, and toxicological traits in 10-year retrospective study in Vojvodina, Serbia. J. Forensic. Sci., 59(5): 1280–1285.
  • Rando J., Szari S., Kumar G., Lingadevaru H. (2016) Methadone overdose causing acute cerebrellitis and multi-organ damage. Am. J. Emerg. Med., 34(2): 343.
  • Taheri F., Yaraghi A., Sabzghabaee A.M. et al. (2013) Methadone toxicity in a poisoning referral center. Res. Pharm. Pract., 2(3): 130–134.