Epidemiologic profile of benzodiazepine poisoning seen at the Uruguayan Toxicology Assistance and Information Center, from 2010 through 2011
Keywords:
BENZODIAZEPINES, POISONINGAbstract
Introduction: the use of benzodiazepine has constantly increased since the 1960s. High exposure to this drug is evident in the large number of benzodiazepine poisoning cases, which represent between 27% and 40% of drug poisoning in international series, as well as in other factors.
Objective: to describe the epidemiological profile of benzodiazepine poisoning in our country.
Method: all consultations for poisoning involving benzodiazepine that was registered in the database of the Toxicology Assistance and Information Center from 2010 through 2011 were analysed.
Results: the total number of toxic agents involved in poisoning consultations was 31,228, 18,530 of which corresponded to drugs. Benzodiazepines accounted for 22.80% (7,123) of toxic agents and 36.3% (6,769) of drugs. Twenty one thousand 452 consultations for presumed intoxication which were associated to benzodiazepines as a toxic agent involved in 6,186 (28.20%) were registered. Benzodiazepine poisoning prevailes in adults (4,578, 74.10%) and women (4,600, 74.30%). Intentional intake of benzodiazepines was the most frequent poisoning event (89.54%). Clonazepam, diazepam and alprazolam were the benzodiazepines involved more often. All acute cases (68, 1.09%) corresponded to combined poisoning, five of which resulted in death.
Conclusions: national poisoning casuistic for benzodiazepine matches those reported in international series and still evidences the major role played by benzodiazepines in acute drug poisoning. Data reveal a large number of intoxications involving this therapeutic drug that includes a high percentage of children and a low number of acute cases, what suggests we should focus on consumption and use and type of use as determining factors of the high exposure to thess psychiatric drugs in our population.
References
(2) Neutel CI. The epidemiology of long-term benzodiazepine use. Int Rev Psychiatry 2005; 17(3):189-97.
(3) Catenaccio V, Sosa V, Danza A, López M, Speranza N, Tamosiunas G. Promoviendo una prescripción racional de las benzodiazepinas. Bol Farmacol 2011; 2(4). Disponible en: http://www.boletinfarmacologia.hc.edu.uy/index.php?option=com_content&task=view&id=89&Itemid=60http://www.boletinfarmacologia.hc.edu.uy/index.php?option=com_content&task=view&id=89&Itemid=60. Consulta: 29 enero 2015.
(4) Nogué S, Munné P, Bertrán A y Millá J. Intoxicación aguda por benzodiazepinas. Emergencias 1989; 1(6):47-9.
(5) Lee DC, Ferguan KL. Sedatives-hypnotics. En: Nelson LS, Lewin NA, Howland mA, Hoffman RS, Goldfrank LR, Flomenbaum NE, eds. Golfrank`s toxicologic emergencies. 9 ed. New York: McGraw Hill Education, 2010:1060-71.
(6) Buykx P, Loxley W, Dietze P, Ritter A. Medications used in overdose and how they are acquired - an investigation of cases attending an inner Melbourne emergency department. Aust N Z J Public Health 2010; 34(4):401-4.
(7) Riquelme Rodríguez A, Burillo Putze G, Jiménez Sosa A, Hardisson de la Torre A. Epidemiología global de la intoxicación aguda en un área de salud. Aten Primaria 2001; 28(7):506-7.
(8) Guevara Serrano J, Torres Bondía F, Ortega García P, Fernández Villalba E, López Briz E, Carmona Ibáñez G. Estudio de las autoagresiones medicamentosas atendidas en urgencias de un hospital general durante un período de seis años. Farm Hosp 2000; 24(4):248-52.
(9) Torres N, Moscoloni N, Guerrero LM, Piola JC. Análisis de correspondencias múltiples y clasificación de coordenadas factoriales para caracterizar autointoxicaciones intencionales atendidas en SERTOX, Rosario, Argentina entre los años 2000 y 2009. Retel 2003; 41:12-38. Disponible en: http://www.sertox.com.ar/img/item_full/41002c.pdf. Consulta: 29 enero 2015.
(10) Persson HE, Sjöberg GK, Haines JA, Pronczuk de Garbino J. Poisoning severity score: grading of acute poisoning. J Toxicol Clin Toxicol 1998; 36(3):205-13.
(11) González Fernández D, Alonso-Fernández M. Intoxicaciones agudas en un Servicio de Urgencias: estudio descriptivo en el área Sanitaria III de Asturias. Rev Toxicol 2009; 26:122-7.
(12) Bronstein AC, Spyker DA, Cantilena LR Jr, Rumack BH, Dart RC. 2011 Annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 29th Annual Report. Clin Toxicol (Phila) 2012; 50(10):911-1164.
(13) Uruguay. Ministerio de Salud Pública. División de Epidemiología. Informe sobre las intoxicaciones agudas 2005-2009. Montevideo: MSP, 2010. Disponible en: http://www2.msp.gub.uy/ucepidemiologia_6195_1.html. Consulta: 29 enero 2015.
(14) Agencia Española de Medicamentos y Productos Sanitarios. Ficha técnica: diazepam. Disponible en: http://www.aemps.gob.es/cima/pdfs/es/ft/40959/FT_40959.pdf. Consulta: junio 2014.
(15) Orueta Sánchez R, Santos Rodríguez C, González Hidalgo E, Fagundo Becerra EM, Alejandre Lázaro G, Carmona de la Morena J, et al. Medicalización de la vida. Rev Clín Med Fam 2011; 4(2):150-61.
(16) Uruguay. Universidad de la República. Facultad de Medicina. Hospital de Clínicas. Departamento de Toxicología. Centro de Información Toxicológica. Informe Anual Años 2000-2001. Montevideo: CIAT, 2001.
(17) Mato M, Toledo M, Olmos I, Frontini M, Nan M, Parpal F, et al. Estudio de consumo de benzodiacepinas en la Policlínica Psiquiátrica del Hospital Vilardebó. Rev Psiquiatr Urug 2012; 76(1):25-34.
(18) García G, Vignolo J, Contera M, Murillo N. Consumo de psicofármacos en el Centro de Salud Sayago: Montevideo, 1998. Rev Méd Urug 2002; 18(2):154-60.
(19) Uruguay. Junta Nacional de Drogas. Quinta Encuesta Nacional en Hogares sobre Consumo de Drogas: informe de investigación mayo 2012. Montevideo: JND, 2012. Disponible en: http://www.infodrogas.gub.uy/images/stories/pdf/v_ enc_hogares_2011.pdf. Consulta: 29 enero 2015.
