Ege Üniversitesi Tıp Fakültesi Acil Servis'ine başvuran ilaç ile zehirlenme olgularının retrospektif değerlendirilmesi
Küçük Resim Yok
Tarih
2013
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç Zehirlenmeler eski çağlardan günümüze toplumları yakından ilgilendiren kadar önemli sağlık sorunlarından biri olmuştur. İlaçlarla olan zehirlenmeler zehirlenme olgularının büyük bir kısmını kapsamaktadır. Bu yöntem yaygın intihar girişimi yöntemlerindendir. Bu çalışmada amacımız; Ege Üniversitesi Tıp Fakültesi Hastanesi Acil Servis'ine başvuran ilaç ile zehirlenme olgularının klinik ve demografik özelliklerini araştırmak, zehirlenmelere yönelik bir protokol oluşturmaktır. Gereç ve Yöntem Çalışmamızda Ege Üniversitesi Tıp Fakültesi Hastanesi Acil Servis'ine 01.01.2008-31.12.2012 tarihleri arasında oral ilaç ve madde alımıyla başvuran 18 yaş ve üzeri 1.332 olgunun kayıtları geriye dönük olarak tarandı. Bu tarihler arasında acil servise başvuran zehirlenme olgularına adli vaka defterinden ulaşıldı. Bunlardan oral ilaç ve madde alımı olan hastaların dosyaları incelendi. Dosya incelemesinde verileri eksik olan, kayıtları düzgün tutulmamış, acil serviste 30 dakikadan daha kısa süre kalan ve izinsiz terk eden 89 olgu çalışma dışı bırakıldı. Çalışmaya toplam 1243 hasta dahil edilerek analizler yapıldı. 18 yaş üstü tüm erişkinlerde Ege Üniversitesi Tıp Fakültesi Acil Servisi'ne başvuran ilaç ile zehirlenme hastalarının epidemiyolojik, demografik ve klinik özelliklerinin belirlenmesi amaçlandı. Olgular yaş, cinsiyet, yaş grubu, zehirlenmelerin olduğu ay, mevsim, yıl, hastaneye başvuru süresi, hastaneye başvuru zamanı, başvuru merkezinin ilk olup olmadığı, zehirlenmeye neden olan farmakolojik ajanlar, GKS'ları, vital bulguları (kan basıncı, nabız, solunum sayısı, ateş, kan oksijen saturasyonu yüzdesi (SO2)), beraberinde alkol xi alınıp alınmadığı, hastanede kalış süreleri, acil servis izlemi sonrası son durumları (taburculuk, hastaneye yatış, yoğun bakıma yatış, sevk), psikiyatrik hastalık öyküsünün olup olmadığı, uygulanan tedaviler (gastrik lavaj, aktif kömür, diyaliz, antidot) ve laboratuar sonuçları yönünden değerlendirildi. Hastaların bilinç değerlendirilmesinde Glaskow Koma Skalası (GKS) kullanıldı. GKS 13> olan hastalar bilinç değişikliği bakımından yüksek riskli kabul edildi. Hastaların hemodinamisi Kanada Triaj skorlamasına göre değerlendirildi, buna göre tansiyon, nabız, solunum sayısı, ateş ve saturasyon değerleri kaydedildi. Hastaların EKG'lerine bakılarak, ritm değerlendirmesi yapıldı, taşikardi (ventriküler, supraventriküler) ve bradikardisi olanlar, ST-T veya QT değişikliği olanlar belirlendi. Zehirlenmeye neden olan ilaçlar kendi içinde analjezikler, antidepresanlar, antipsikotikler, antihistaminikler, kardiyovasküler sisteme etkili ilaçlar, temizlik maddeleri, insektisit ve pestisitler ve diğer ilaçlar olarak gruplandırıldı. Çalışma sonucu sonuçları SPSS 20.0 for Windows programına kaydedilmiştir. Sayısal veriler ortalama (+/-) standart sapma (SD) olarak verildi. Frekans analizlerinde sayısal veriler yanında yüzde değerler de verildi. Kategorik verilerin karşılaştırılmasında 'var', 'yok' veya 'evet', 'hayır' şeklindeki analizlerde Pearson Chi-square (ki-kare) testi kullanıldı. Kategorik veriler n (sayı) ve yüzdelerle (%) ifade edilmiştir. Veriler % 95 güven düzeyinde incelenmiş olup, istatistiksel sonuçlar p<0,05 anlamlı, p>0,05 anlamsız kabul edilmiştir. Bulgular Ege Üniversitesi Tıp Fakültesi Hastanesi Acil Servis'ine 5 yıllık süre içinde ağızdan ilaç alımı ile zehirlenerek başvuran olgu sayısı 1.332 idi. Çalışmaya alınan olgu sayısı 1243 idi. Olguların 875'i (% 70,4) kadın, 368'i (% 29,6), kadın/erkek oranı 2.38/1 idi. Genel yaş ortalaması 27+/- 10,54 idi. Yaş ortalaması; kadınlarda 26+/- 9,80, erkeklerde 29+/- 11,57 olarak saptandı. En sık zehirlenmenin olduğu yaş grubunun 789 (% 63,5) olgu ile 18-30 yaş arasında görüldüğü saptandı. Bunu sırasıyla 337 (% 27,1) olgu ile 31-45 yaş aralığı ve 116 (% 9,3) olgu ile 46 yaş ve üzeri yaş grubu izledi. xii İlaç içme nedeniyle başvuran olguların yıllara göre dağılımına bakılmıştır. En fazla zehirlenme olgusunun 2012 yılında görüldüğü görüldü. Zehirlenme olgularının sayısında yıllara göre artış saptandı. İlaç içme olgularının yıllara göre insidansı değerlendirilmiştir. 2008 yılındaki insidans % 0,27, 2009 yılındaki insidans % 0,42, 2010 yılındaki insidans % 0,36, 2011 yılındaki insidans % 0,38, 2012 yılındaki insidans % 0,34 olarak saptandı. 2008 yılından sonra zehirlenme vakalarının insidansında artış olduğu görülmüş, sonraki yıllarda ise insidansın yaklaşık olarak benzer olduğu saptanmıştır. Zehirlenme olgularının sayısında yıllara göre artış olduğu saptandı. Olguların aylara göre dağılımı incelendiğinde; Mart, Temmuz ve Nisan aylarında zehirlenme olgularının sayısında bir artış olduğu saptandı (Sırasıyla % 10,1, % 9,9, % 9). Olguların yıllar içerisinde Ocak, Şubat, Nisan, Mayıs, Eylül ve Ekim aylarının zehirlenme insidanslarında artış olduğu saptandı. Yıllara göre en yüksek üç ayın zehirlenme insidansı değerlendirilmiştir. 2008 yılında temmuz ve mart aylarında zehirlenme insidansı (sırasıyla % 0,47 ve % 0,40) en yüksek iken, 2009 yılında en yüksek insidans sırasıyla ekim ve eylül aylarında bulunmuştur (sırasıyla % 0,79 ve % 0,61). 2010 yılında en yüksek insidans (% 0,75) nisan ayında iken, ikinci sırada ağustos (% 0,52), üçüncü sırada şubat ayı (% 0,44) gelmektedir. 2011 yılında ocak ayı insidansı (% 0,58) en yüksektir. İkinci sırada şubat ve mart ayları (%0,52) gelmektedir. 2012 yılında en yüksek zehirlenme insidansı sırasıyla temmuz ve şubat aylarındadır (sırasıyla % 0,45 ve % 0,37). İlaç içme olgularının zehirlenme fark edildikten sonra hastanemize başvuru süreleri 0-1 saat, 1-6 saat, 6 saat üzeri olarak gruplandırıldığında; olguların % 44,2'sinin ilk 1 saat içinde, % 47,7'sinin 1-6 saat içinde, % 8'inin 6 saat sonrasında başvurduğu saptandı. İlaç içme nedeniyle acil servisimize başvuran olguların 1134'ünün (%91,2) kasıtlı nedenle, 109'unun (% 8,8) kaza nedeniyle zehirlendiği saptandı. İntihar amacıyla başvuran olguların 801'ini (% 70,6) kadın, 333'ünü (% 29,4) erkek olgular, kaza nedeniyle zehirlenen olguların 74'ünü (% 67,9) kadın, 35'ini (% 32,1) erkek olgular oluşturuyordu. Her iki grupta da olan zehirlenmelerde kadın olguların sayısı erkek olguların sayısından fazla idi. İlaç alımıyla olan zehirlenmelerde; intihar amacıyla zehirlenen 1133 olgunun 719'unun (% 63,5) 18-30 yaş grubunda olduğu, 310 olgunun (% 27,4) 30-45 yaş grubunda xiii olduğu, 104 (% 9,2) olgunun 46 yaş ve üzerinde olduğu saptandı. Kaza sonucu zehirlenen 109 olgunun 70'inin (% 64,2) 18-30 yaş grubunda olduğu 27 (% 27,8) olgunun 30-45 yaş grubunda olduğu, 12 (% 11) olgunun da 46 yaş ve üzerinde olduğu görüldü. Her iki grupta da zehirlenme olgularının 18-30 yaş grupta en fazla olduğu saptandı. Zehirlenmeye neden olan ilaçların türüne göre olguların dağılımı incelendiğinde; en sık alınan ilaçların 676 olgu (% 54,4) ile analjezikler, ikinci sırada alınan ilaçların 630 olgu (%50,7) ile psikotrop ilaç alımları olduğu görüldü. Analjezikler içinde en sık alınan grubun 342 olgu (% 27,5) ile parasetamol grubu analjeziklerin, 255 olgu (% 20,5) ile nonsteroid antiinflamatuar grubu analjezikler olduğu görüldü. Psikotrop ilaç alımları içinde en sık alınan ilaç grubunu 205 olgu (%16,5) ile SSGAİ grubu ilaçlar, ikinci sırada164 olgu (%13,2) ile trisiklik antidepresan (TSA) grubu ilaçlar oluşturuyordu. İlaç zehirlenmesi nedeniyle başvuran 345 (% 27,9) olguda vital bulgu anormalliği saptandı. 130 (% 10,5) olguda hipertansiyon, 45 (% 3,6) olguda hipotansiyon, 246 (%20) olguda taşikardi, 16 (% 1,3) olguda bradikardi, 1 (% 0,1) takipne vardı. 2 (% 0,3) olguda ateş yüksekliği vardı, 9 (% 0,9) olguda oksijen saturasyon değeri 90'ın altında idi. Olguların acil serviste gözlem ve tedavi sonucunda; 974 (% 78,5) olgunun taburcu edilmiş, 178 (% 14,3) olgunun dış merkeze sevk edilmiş, 33 (% 2,7) olgunun yoğun bakıma yatırılmış, 56 (% 4,5) olgunun servise yatırılmış olduğu saptandı. Sonuç Akut zehirlenmeler acil servisler için önemli bir medikal sorundur. İlaç alımı yaygın intihar girişimi yöntemlerinden biridir. Özkıyım sonucu oluşan zehirlenmeler genç erişkinlerde özellikle kadınlarda daha yaygındır. Ülkemizde kadınların eğitim ve sosyoekonomik gelişimlerinin daha fazla sağlanmasıyla depresyona girme oranları azalabilir. En sık kullanılan ilaçlar sırasıyla analjezikler ve antidepresanlardır. Bu ilaçların kolaylıkla eczaneden temin edilebilmesi özellikle intihar girişimlerinde kullanım oranını arttırmaktadır. İlaç satışına bazı sınırlamalar getirilmesi de çözüm olarak sunulabilir. Anahtar Sözcükler: İlaç alımı, Acil servis, Zehirlenme
Introduction and Objectives Since old ages, poisionings have always been one of the most important health issues concerning the societies. Drug poisionings contain most of the poisoning cases and the method of using drugs for suicide is one of the most common suicide methods. Our objective in this study is to study the clinical and demographical properties of the cases with drug poisonings admitted to the Emergency Department of Medical School of Ege University so that making a protocol to be used for the poisonings. Materials and Methods We scanned the files of the 1,332 cases retrospectively who are 18 years and older and admitted to the Emergency Service of the Medical School of Ege University with oral intake of medicine or substance between the dates of 01.01.2008 and 31.12.2012. We were able to reach the poisoning cases admitted to the emergency service between those dates with the help of the legal case reports. Only the files of the patients with oral intake of medicine or substance were examined and 89 cases were excluded as either their records are not are not proper or they left the service in less than 30 minutes. In that way, we included 1243 patients to our study and made analysis of them with the purpose of determining epidemiological, demographical and clinical properties of the drug poisioning cases who are 18 years and older and admitted to the Emergency Service of the Medical School of Ege University. The cases were evaluated in terms of age, gender, age group, the month the poisoning happened, season, year, the duration before the admission to the hospital, the time when they were admitted to the hospital, if this is the first place they were admitted or not, the pharmalogical agents caused the poisoning, their GCSs (Glasgow Coma Scale), vital signs (blood pressure, pulse, respiratory rate, temperature, blood oxygen saturation xv percentage (SO2)), if they took alcohol with the drug, the duration they stayed in the hospital, their last situation after the emergency service care (discharge, hospital stay, intensive care stay, referral), psychiatric disease history, the treatments applied (gastric lavage, active coal, dialysis, antidotes) and the laboratory results. We used the Glasgow Coma Scale to evaluate the consciousness of the patients. GCS 13> patients were accepted as high risky for a change in consciousness. The hemodynamy of patients were evaluated with the Canadian Triage Scoring and according to that blood pressure, pulse, respiratory rate, temperature and saturation values were recorded. Looking at the ECGs, a rythm evaluation was made and the ones with tachycardia ( ventricular, supraventricular) and bradycardia and ST-T or QT changes were defined. The drugs causing the poisoning were grouped as analgesics, antidepressants, antipsychotics, antihistaminics, cardiovascular system drugs, cleaners and detergents, insectisides and pesticides and others. The results of the study were recorded by using SPSS 20.0 for Windows. Numerical values were given as mean(+/-) standard deviation (SD). Both the numerical values and the percentage values were given in frequency analysis. To compare the categorical values in analysis with "present", "absent" or "yes", "no" values, we used Pearson Chi-square test. Categorical values were defined as n (number) and percentages (%). The data were investigated in confidence of 95 % and the statistical results with p<0,05 were accepted as significant while the p>0,05 were accepted as insignificant. Results In the five year records of Medical School of Ege University Emergency Department, 1.332 cases of oral poisoning have been reported. In our study, there were 1243 cases. 875 cases (% 70,4) were female, 368 cases (% 29,6) were male and female/male ratio was 2.38/1. Average age was 27+/- 10,54. Female average age was calculated as 26+/- 9,80, male average age was calculated as 29+/- 11,5. We have found that the age group which has the most of the poisoning cases was the age range 18-30 with 789 cases (% 63,5). The following group was the age range 31-45 xvi with 337 cases (% 27,1) and the last group was the age range 46 and older with 116 cases (% 9,3) The distribution in years of the cases which admitted to the emergency room with drug poisoning were scanned. The year which had the ultimate number of poisonings is 2012. The increase in poisoning cases in years was also noted. The incident of drug abuse cases was evaluated. Incidence in 2008 was % 0,27, in 2009 was % 0,42, in 2010 was % 0,36, in 2011 was % 0,38, in 2012 was % 0,34. We found that after the year of 2008, incidence of poisoning cases was increased and the following years have similar incidance scores. We have found the poisoning cases are increased in years. When the distribution of cases to months is evaluated, it is found that on March, July and April, the incidance of the poisoning cases reached a top number. (In order on above % 10,1, % 9,9, % 9). The three months with utmost incidences were evaluated. In 2008, top incidances were on July and March (% 0,47 and % 0,40 in order), in 2009 they were on October and December (% 0,79 and % 0,61 in order), in 2010 the utmost incidance was on April (% 0,75), followed by August (% 0,52), then by February (% 0,44). In 2011 the greatest incidance was on January (% 0,58) followed by February and March (% 0,52). In 2012, the top poisoning case incidances were on (in decreasing order) July (% 0,45) and February (% 0,37). The admission delays of the cases of drug abuse after detection are classified as 0-1 hour, 1-6 hour(s), and 6 hours and later. It is found that % 44,2 of the cases were admitted in 1 hour, % 47,7 of the cases were admitted in 1 to 6 hours, and % 8 of the cases were admitted in 6 hours of later. 1134 cases (% 91,2) which were admitted our emergency service for drug abuse were deliberately poisoned and 109 cases (% 8,8) were accidentaly poisoned.801 female (% 70,6) and 333 male (% 29,4) cases were poisoned with suicidal motives; 74 female (% 67,9) and 35 male (% 32,1) cases were poisoned accidentally. In both groups there were more females than males. Among the drug poisoning cases with suicidal motives, it was found that the 719 cases (% 63,5) of 1133 were in age range 18-30, 310 (% 27,4) were in age range 30-45, 104 (% 9,2) were 46 and older. Among the 109 accidental poisoning cases 70 cases (% 64,2) were in age range 18-30, 27 cases (% 27,8) were in age range 30-45, 12 cases (% 11) were 46 and older. In both groups, 18-35 age range were more. xvii The disribution of abused drugs regarding their classes are evaluated. The most common drug class used in poisoning cases is analgesics with 676 cases (% 54,4), the second common class is psychotropic drugs with 630 cases (% 50,7). In analgesic molecule groups, most common was paracetamol group with 342 cases (% 27,5), followed by nonsteroid antiinflammatory group with 255 cases (%20,5). Among the psychotropic drugs, the most common group used in poisoning cases was selective serotonin reuptake inhibitors with 205 cases (% 16,5), followed by tricyclic antidepressants with 164 cases (% 13,2). Among all cases admitted to the emergency room with drug poisoning, 345 (% 27,9) showed anomalies in vital findings. 130 cases (% 10,5) had hypertension, 45 cases (% 3,6) had hypotension, 246 cases (% 20) had tachycardia, 16 (% 1,3) cases had bradycardia, 1 (% 0,1) cases had tachypnea. 2 case (% 0,3) had high fever and 9 case (% 0,9) had his/her blood oxygen saturation was under 90. After the treatment and surveillance of these cases in the emergency room,974 cases (% 78,5) were discharged, 178 (% 14,3) cases were sent to another medical facility, 33 cases (% 2,7) were taken into intensive care, 56 cases (% 4,5) were hospitalized. Conclusion Acute poisonings are an important medical problem for emergency services. Abusing drugs is a commonly used suicidal attempt method. Poisonings as a result of selfdamage are common in young adults especially in women. By developing the levels of education and socioeconomy of women in our country, the depression rate may decrease. The most used drugs are respectively analgesics and anti-depressants. Especially the ease of reaching these drugs in pharmacies makes their usage rate in suicidal attempts much more. So, as a solution to that, we may bring some restrictions to drug selling. Key Words: Drug Intake, Emergency Medicine, Poisonings
Introduction and Objectives Since old ages, poisionings have always been one of the most important health issues concerning the societies. Drug poisionings contain most of the poisoning cases and the method of using drugs for suicide is one of the most common suicide methods. Our objective in this study is to study the clinical and demographical properties of the cases with drug poisonings admitted to the Emergency Department of Medical School of Ege University so that making a protocol to be used for the poisonings. Materials and Methods We scanned the files of the 1,332 cases retrospectively who are 18 years and older and admitted to the Emergency Service of the Medical School of Ege University with oral intake of medicine or substance between the dates of 01.01.2008 and 31.12.2012. We were able to reach the poisoning cases admitted to the emergency service between those dates with the help of the legal case reports. Only the files of the patients with oral intake of medicine or substance were examined and 89 cases were excluded as either their records are not are not proper or they left the service in less than 30 minutes. In that way, we included 1243 patients to our study and made analysis of them with the purpose of determining epidemiological, demographical and clinical properties of the drug poisioning cases who are 18 years and older and admitted to the Emergency Service of the Medical School of Ege University. The cases were evaluated in terms of age, gender, age group, the month the poisoning happened, season, year, the duration before the admission to the hospital, the time when they were admitted to the hospital, if this is the first place they were admitted or not, the pharmalogical agents caused the poisoning, their GCSs (Glasgow Coma Scale), vital signs (blood pressure, pulse, respiratory rate, temperature, blood oxygen saturation xv percentage (SO2)), if they took alcohol with the drug, the duration they stayed in the hospital, their last situation after the emergency service care (discharge, hospital stay, intensive care stay, referral), psychiatric disease history, the treatments applied (gastric lavage, active coal, dialysis, antidotes) and the laboratory results. We used the Glasgow Coma Scale to evaluate the consciousness of the patients. GCS 13> patients were accepted as high risky for a change in consciousness. The hemodynamy of patients were evaluated with the Canadian Triage Scoring and according to that blood pressure, pulse, respiratory rate, temperature and saturation values were recorded. Looking at the ECGs, a rythm evaluation was made and the ones with tachycardia ( ventricular, supraventricular) and bradycardia and ST-T or QT changes were defined. The drugs causing the poisoning were grouped as analgesics, antidepressants, antipsychotics, antihistaminics, cardiovascular system drugs, cleaners and detergents, insectisides and pesticides and others. The results of the study were recorded by using SPSS 20.0 for Windows. Numerical values were given as mean(+/-) standard deviation (SD). Both the numerical values and the percentage values were given in frequency analysis. To compare the categorical values in analysis with "present", "absent" or "yes", "no" values, we used Pearson Chi-square test. Categorical values were defined as n (number) and percentages (%). The data were investigated in confidence of 95 % and the statistical results with p<0,05 were accepted as significant while the p>0,05 were accepted as insignificant. Results In the five year records of Medical School of Ege University Emergency Department, 1.332 cases of oral poisoning have been reported. In our study, there were 1243 cases. 875 cases (% 70,4) were female, 368 cases (% 29,6) were male and female/male ratio was 2.38/1. Average age was 27+/- 10,54. Female average age was calculated as 26+/- 9,80, male average age was calculated as 29+/- 11,5. We have found that the age group which has the most of the poisoning cases was the age range 18-30 with 789 cases (% 63,5). The following group was the age range 31-45 xvi with 337 cases (% 27,1) and the last group was the age range 46 and older with 116 cases (% 9,3) The distribution in years of the cases which admitted to the emergency room with drug poisoning were scanned. The year which had the ultimate number of poisonings is 2012. The increase in poisoning cases in years was also noted. The incident of drug abuse cases was evaluated. Incidence in 2008 was % 0,27, in 2009 was % 0,42, in 2010 was % 0,36, in 2011 was % 0,38, in 2012 was % 0,34. We found that after the year of 2008, incidence of poisoning cases was increased and the following years have similar incidance scores. We have found the poisoning cases are increased in years. When the distribution of cases to months is evaluated, it is found that on March, July and April, the incidance of the poisoning cases reached a top number. (In order on above % 10,1, % 9,9, % 9). The three months with utmost incidences were evaluated. In 2008, top incidances were on July and March (% 0,47 and % 0,40 in order), in 2009 they were on October and December (% 0,79 and % 0,61 in order), in 2010 the utmost incidance was on April (% 0,75), followed by August (% 0,52), then by February (% 0,44). In 2011 the greatest incidance was on January (% 0,58) followed by February and March (% 0,52). In 2012, the top poisoning case incidances were on (in decreasing order) July (% 0,45) and February (% 0,37). The admission delays of the cases of drug abuse after detection are classified as 0-1 hour, 1-6 hour(s), and 6 hours and later. It is found that % 44,2 of the cases were admitted in 1 hour, % 47,7 of the cases were admitted in 1 to 6 hours, and % 8 of the cases were admitted in 6 hours of later. 1134 cases (% 91,2) which were admitted our emergency service for drug abuse were deliberately poisoned and 109 cases (% 8,8) were accidentaly poisoned.801 female (% 70,6) and 333 male (% 29,4) cases were poisoned with suicidal motives; 74 female (% 67,9) and 35 male (% 32,1) cases were poisoned accidentally. In both groups there were more females than males. Among the drug poisoning cases with suicidal motives, it was found that the 719 cases (% 63,5) of 1133 were in age range 18-30, 310 (% 27,4) were in age range 30-45, 104 (% 9,2) were 46 and older. Among the 109 accidental poisoning cases 70 cases (% 64,2) were in age range 18-30, 27 cases (% 27,8) were in age range 30-45, 12 cases (% 11) were 46 and older. In both groups, 18-35 age range were more. xvii The disribution of abused drugs regarding their classes are evaluated. The most common drug class used in poisoning cases is analgesics with 676 cases (% 54,4), the second common class is psychotropic drugs with 630 cases (% 50,7). In analgesic molecule groups, most common was paracetamol group with 342 cases (% 27,5), followed by nonsteroid antiinflammatory group with 255 cases (%20,5). Among the psychotropic drugs, the most common group used in poisoning cases was selective serotonin reuptake inhibitors with 205 cases (% 16,5), followed by tricyclic antidepressants with 164 cases (% 13,2). Among all cases admitted to the emergency room with drug poisoning, 345 (% 27,9) showed anomalies in vital findings. 130 cases (% 10,5) had hypertension, 45 cases (% 3,6) had hypotension, 246 cases (% 20) had tachycardia, 16 (% 1,3) cases had bradycardia, 1 (% 0,1) cases had tachypnea. 2 case (% 0,3) had high fever and 9 case (% 0,9) had his/her blood oxygen saturation was under 90. After the treatment and surveillance of these cases in the emergency room,974 cases (% 78,5) were discharged, 178 (% 14,3) cases were sent to another medical facility, 33 cases (% 2,7) were taken into intensive care, 56 cases (% 4,5) were hospitalized. Conclusion Acute poisonings are an important medical problem for emergency services. Abusing drugs is a commonly used suicidal attempt method. Poisonings as a result of selfdamage are common in young adults especially in women. By developing the levels of education and socioeconomy of women in our country, the depression rate may decrease. The most used drugs are respectively analgesics and anti-depressants. Especially the ease of reaching these drugs in pharmacies makes their usage rate in suicidal attempts much more. So, as a solution to that, we may bring some restrictions to drug selling. Key Words: Drug Intake, Emergency Medicine, Poisonings
Açıklama
Anahtar Kelimeler
İlk ve Acil Yardım, Emergency and First Aid, Acil servis, Emergency service, Analjezikler, Analgesics, Anti aritmik ilaçlar, Anti arrhythmia agents, Nöroleptik ilaçlar, ; Psikotrop ilaçlar, Psychotropic drugs, Zehirlenmeler, Poisonings, İlaç kullanımı, Drug utilization, İlaçlar, Drugs
