• 대한임상독성학회지
• /
• 제5권2호
• /
• pp.106-111
• /
• 2007

Purpose: Inadequate hospital stocking and unavailability of essential antidotes is a worldwide problem. The purpose of this study was to determine the adequacy of antidote stocks in Korean hospitals based on a modified version of US antidote stocking guidelines. Methods: Both written and telephone surveys to collect information on hospital demographics and antidote stocking were given to the emergency departments or hospital pharmacies of 117 hospitals with emergency medical centers. The twenty antidotes included in the survey were taken from year 2000 US antidote stocking guidelines, except for activated charcoal and black widow spider antivenin. Antidote stocks were compared by hospital size, geographic location, and type of emergency medical center. Results: Complete responses were received from all hospitals. A mean of $12.4{\pm}2.9$ antidotes were adequately stocked per hospital. All hospitals stocked atropine, $CaCl_2$ naloxone, and sodium bicarbonate. However, digoxin Fab fragment (16%), cyanide kits (15%), EDTA (10%), BAL (9%), and fomepizole (1%) were not uniformly stocked. Large and teaching hospitals were significantly more likely to stock greater numbers of antidotes. Conclusions: Korean hospitals as a group do not have adequate antidote stocks. Korean stocking guidelines and an antidote management system are recommended in order to correct these deficiencies.

• 한국임상약학회지
• /
• 제23권1호
• /
• pp.57-64
• /
• 2013

Purpose: Drug can be hazardous for people if misused although they are useful for their indication. In urgent incidences such as overdose, proper treatment for intoxication can save patients' lives. In emergent case regarding drug overdose, pharmacists should know how to provide correct information including antidote to other healthcare providers. However, in Korea, there is neither regular class nor education material regarding detoxification. Therefore, the object of our study is to investigate the perception of pharmacists about it. Method: We surveyed hospital pharmacists by means of self-reporting questionnaire in order to investigate the pharmacists' perception of detoxification treatments from May $12^{th}$ 2012 to August $10^{th}$ 2012. The questionnaire comprised of demographic information, interest in detoxification treatment (inquiry from patients and education about antidote), knowledge of antidote, effective drug search route and perception of the need for education and stocking materials about antidotes). Results: It included total 281 hospital pharmacists from 30 hospitals in S. Korea. Of them, only 16.7% have been questioned about drug overdose from patient or representative and 35% have learned about antidotes in case of drug overdose through education program of Korean association of hospital pharmacist or university. About 98% thought that education and stocking materials about frequently overdosed drug and antidotes are helpful for patients in emergent case. Also, the percentage of correct answer of each questions about antidotes were higher in educated group ($p{\leq}0.001$). The more work years are, the percentage of correct answer of each questions are higher ($p{\leq}0.001$). Conclusion: In conclusion, it will be helpful for reducing damage by drug overdose that pharmacists take regular education about antidote for all pharmacist and pharmacy student. In addition, preparing and keeping booklet for Korean Style-antidote in pharmacy is needed currently for protecting public health.

• 대한임상독성학회지
• /
• 제5권1호
• /
• pp.57-60
• /
• 2007

Cyanide has been well known from antiquity. Cyanide poisoning causes histotoxic hypoxia--inhibition of mitochondrial cytochrome oxidase with disruption of the ability of cells to use oxygen. The mortality rate is 95% within 30 minutes. Acute cyanide poisoning is mostly the result of attempted suicide, and because of the high doses typically employed it usually is lethal within minutes. Also acute cyanide poisoning leads to a very poor prognosis because medical personnel can't detect cyanide intoxication and so many hospital haven't antidote. We report two cases of cyanide poisoning which responded well to treatment with the Taylor cyanide antidote package.

• 한국임상약학회지
• /
• 제22권4호
• /
• pp.304-315
• /
• 2012

Today, suicide by self-poisoning of prescribed or non-prescribed drugs on purpose has been increasing and is a major cause of mortality. It is very important to treat promptly and properly for saving the lives from those suicides. There is neither an organization such as poison control center nor measurement in S. Korea, though. The object of this study was to evaluate information of frequently used substances for suicide attempt in S. Korea. Our results also can provide healthcare provider including pharmacists and doctors, etc and contribute to increasing health and welfare for Korean. From June $1^{st}$ 2006 to April $30^{th}$ 2012, we retrospectively studied patients visiting emergency room due to suicide attempt. We collected information of underlying disease, history of past medical condition and suicide attempt, ingredient and getting route of ingesting substances, emergency treatment, and outcome by reviewing electronic medical record. We also evaluated actual treatment of self-poisoning and made guide information about antidote medication for S. Korean healthcare provider. Among total 242 cases of suicidal attempts, cases ingesting substances including prescription, non-prescription drugs and agricultural chemicals were 86.4%. The most frequently used drugs for suicide attempt were sedatives-hypnotics (53.6%), followed by analgesics (16.7%) and antidepressants (12.4%). Analgesics including acetaminophen and aspirin were most in teenagers but sedatives-hypnotics including benzodiazepines, non-benzodiazepine (zolpidem) and antihistamine were most in other ages including elderly people. Most frequently used antidote was activated charcoal (62.7%) and specific antidotes for some substances (acetaminophen, aspirin, agricultural chemicals) were also treated properly, accompanying with medication for supportive care. In conclusion, the most used substances for suicide attempt were sedatives-hypnotics and treatments for self-poisoning in emergency room were appropriate based on existing references. Therefore, information of frequently used substances and antidote reflecting these results will be useful for South Korean healthcare provider.

• 대한임상독성학회지
• /
• 제11권1호
• /
• pp.9-18
• /
• 2013

Purpose: Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea. Methods: An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week. Results: From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8). Conclusion: Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.

• 대한임상독성학회지
• /
• 제16권2호
• /
• pp.131-140
• /
• 2018

Purpose: The National Emergency Medical Center has been running a project for the storage and delivery of antidotes for acute poisoning patients of the Department of Health and Welfare, Korea. This study analyzed the results of this project over the past two years. Methods: The requests received by the National Emergency Medical Center and the data on the delivery process were analyzed. Results: This study analyzed a total of 121 patients with acute poisoning, who were requested to receive an antidote reserved at 20 key hospitals in 2015-2017, and whose age was $52.3{\pm}23.5\;years$; old; 54 were women. Intentional poisoning were 58.7%, and the home was the most common place of exposure (66.9%). The toxic substances were chemicals (32.2%), pesticides (27.3%), medicines (24.8%), and snake venom (4.1%). The patient's poison severity score was $2.4{\pm}0.7$ (median 3) indicating moderate-to-severe toxicity. Antidote administration was the cases treated in key hospitals 67.8% (82/121), in which transferred patients accounted for 57.3% (47/82). After receiving an antidote request from a hospital other than the key hospitals, the median was 75.5 minutes (range 10 to 242 minutes) until the antidote reached the patient, and an average of 81.5 minutes was required. The results of emergency care were intensive care unit (70.3%), general wards (13.2%), death (10.7%), and discharge from emergency department (5.0%). Conclusion: This study showed that the characteristics of acute poisoning patients treated with an antidote were different from previous reports of poisoned patients in the emergency department, and basic data on the time required for delivery from key hospitals was different.

• 대한한의학회지
• /
• 제21권4호
• /
• pp.276-285
• /
• 2000

Paraquat is a very potent herbicide which causes fatal toxicity when ingested, and there is no specific antidote against it. Human ingestion induces acute renal failure, hepatic dysfunction and progressive respiratory failure with high mortality rate. Clinical investigation and medical treatment were done on two cases of acute renal failure caused by paraquat poisoning admitted to the Department of Internal Medicine, Wonkwang University Oriental Chonju Medical Hospital. We report two cases of patients who survived after acute paraquat intoxication, by means of oriental medicine such as Gamdutang, a typical antidote of toxins, chinese ink as an absorbent and burned powder of Rhei Radix et Rhizoma for laxative and so on, western medicine such as gastric lavage, diuretics and fluid therapy. We suggest more experiments and studies related to such treatment for paraquat poisoning be conducted.

• Environmental Analysis Health and Toxicology
• /
• 제11권3_4호
• /
• pp.11-16
• /
• 1996

Paraquat is a useful nonselective herbicide widely used throught the world. However accidental or intentional ingestion of the herbicide cause fatal pulmonary injuring. But there is not suitable antidote of paraquat intoxication and therapeutic agents now be used are not effective. So, in this study we intended to evaluate the inhibitory effects of acetylmannan from Dioscorea batalas on paraquat toxicity. 100mg/kg acetylmannan from wild or cultured Dioscorea bataras was administered orally to male SD rats for 3 days and the administration time interval was 24hours. After one hour of final administration, 50mg/kg paraquat was administered intraperitonially. After 24 hours, the biochemical parameters of blood and tissues were examined. In paraquat treated groups, sGPT, BUN, creatinine, ALP levels were increased by 2 to 4 times of normal values. However in acetylmannan from wild Dioscorea batatas treated groups, sGPT, BUN, creatinine, ALP levels in blood and lung tissue were significantly decreased to normal levels. In acetylmannan from cultured Dioscorea batatas treated groups, BUN, creatinine were significantly decreased to normal values, but not in sGPT, ALP levels. Therefore, we concluded that acetylmannan from wild Dioscorea batatas can be used as an. antidote of paraquat toxicity.

• Environmental Analysis Health and Toxicology
• /
• 제13권3_4호
• /
• pp.117-123
• /
• 1998

Paraquat is a useful nonselective herbicide widely used throughout the world. However, accidental or intentional ingestion of the paraquat cause fetal pulmonary injuring. But there is not suitable antidote of paraquat intoxication and therapeutic agents now be used are not effective. So, in this study we intended to evaluate the inhibitory effects of DDB(dimethyl-4,4'dimethoxy-5,6,5',6'-dimethylene dioxyphenyl-2,2'-dicarboxylate) on paraquat toxicity. DDB (100mg/kg) was administered orally to SD rats lhr after paraquat(50mg/kg) injection. After 24 hours, the biochemical parameters of blood and tissues were examined. In paraquat treated groups sGPT, sGOT, BUN, creatinine, MDA and alkaline phosphatase levels in blood and MDA, glucose-6-phosphatase activity in tissues were elevated by 2 to 5 times of normal values. However in schizandrin treated groups, sGPT, sGOT, MDA and alkaline phosphatase activity in blood and MDA and glucose-6-phosphatase activity were significantly decreased to notmal levels but not in biochemical parameters of nephrotoxicity, BUN and creatinine levels. Therefore, we concluded that schizandrin can be used as an antidote of pulmono, hepatotoxicity of paraquat.

• 고려인삼학회:학술대회논문집
• /
• 고려인삼학회 2007년도 춘계 학술대회
• /
• pp.26-26
• /
• 2007