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Journal Article 2014; 35(Suppl 2): 180-185 PubMed PMID: 25638384 Citation  Keywords:  Acetaminophen:administration & dosage, Adolescent, Adult, Aged, Aged, 80 and over, Analgesics, Non-Narcotic:administration & dosage, Child, Child, Preschool, Czech Republic:epidemiology, Drug Overdose:epidemiology, Drug-Related Side Effects and Adverse Re.   

OBJECTIVES: Paracetamol overdose belongs to frequent calls to Toxicological Information Centre (TIC) in the Czech Republic and to the National Toxicological Information Centre (NTIC) in Slovakia. The aim of the study was to evaluate outcomes and side effects of paracetamol overdose in both countries.

METHODS: Data concerning paracetamol poisoning extracted from TIC and NTIC databases 2000-2013 and discharge reports were analysed. Numbers and outcomes in patients presenting within 24 hours of a single paracetamol overdose were compared in relation to 3 paracetamol concentration bands (≤ 100 mg/l, 100-149 mg/l, and 150 mg/l).

RESULTS: 5397 inquiries concerning paracetamol were recorded in TIS and NTIC. Data from 196 discharge reports with plasma level were studied. Median age of the patients was 18 (0.2-86) years. Eight/196 (4.1%) patients developed side effects after N-acetylcysteine (NAC) administration. 120 cases fulfilled time criteria of the study and were divided into 3 groups, where 55.7%, 73.1% and 96.9% patients have been treated with NAC. Among these 120 patients, favourable outcome was seen in 100%, 100%, and 92.8%, respectively. One death due to suicidal attempt with plasma level 407 mg/l presenting at 20 hours has been recorded among 120 patients. No patient without NAC treatment died due to acute overdose and plasma concentration ≤ 150 mg/I at 4 hours.

CONCLUSIONS: These data support the opinion that NAC should not be used in patients with < 149 mg/l levels in absence of higher risk factors because of very low risk of hepatotoxicity on one side, and side effects on the other side.

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Journal Article 2013; 34(Suppl 2): 25-30 PubMed PMID: 24362089 Citation  Keywords:  Adolescent, Adult, Central Nervous System Agents:poisoning, Czech Republic:epidemiology, Databases, Factual, Drug Overdose:epidemiology, Drug-Related Side Effects and Adverse Reactions:diagnosis, Female, Humans, Information Centers:statistics & numerical .   

OBJECTIVES: To analyze the number and trends in calls to the Toxicological Information Center (TIC) concerning pharmaceutical poisoning retrospectively during the past 15 years and to compare selected characteristics of the poisonings.

DESIGN: Inquiries arising from drug poisonings in the years 1997-2012 were extracted and evaluated from the Czech database recording the consultations of TIC specialists. In addition, their cause, severity and dose evaluation (data electronically collected after 2005) were compared in the years 2005-2012 using standard statistical methods.

RESULTS: During 15 years total 152,649 calls due to all types of potentially toxic agents were recorded in the TIC database. Central nervous system (CNS) affecting drugs represented 39.8% of calls due to all pharmaceutical poisonings. The proportion of adults was 72.2% and women comprised 64.4% of all patients. Whereas the number of calls caused by poisoning with tricyclic antidepressants (TCAs) and barbiturates decreased (by 366.7% and 340%, respectively), the calls due to selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines overdose increased (by 1347.4% and 359.8%). The dose of CNS affecting drugs in 2005-2012 was considered lethal in 14.6% of the inquiries due to barbiturates and 8.6% due to TCAs, but only in 1.6% calls due to SSRIs and 0.5% of benzodiazepines. The highest percentage of medications errors was found during the treatment with barbiturates (16.4%).

CONCLUSIONS: The current drugs prescription with improved safety profiles brings the beneficial effect of lowering the severity of poisonings and better prognosis of intoxications as observed in the TIC statistics....

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Journal Article 2008; 29(5): 631-634 PubMed PMID: 18987605 Citation  Keywords:  Adult, Anti-Infective Agents, Local:adverse effects, Anticonvulsants:adverse effects, Biological Availability, Boric Acids:adverse effects, Breast Feeding:adverse effects, Czech Republic, Drug Information Services:statistics & numerical data, Drug-Related.   

OBJECTIVES: The benefits of breastfeeding are generally accepted. Risk of drug usage for baby due to lactation is well assessed minimally in certain cases. However, information given about drugs are often insufficient, frustrating, and not recommending lactation. In Czech Teratology Information Service (CZTIS) counselling we use these information.

RESULTS: We have given advice in 58 cases inquiring the CZTIS about the risk of drug exposure during lactation. The most frequent queries were on chronic disease treatment following the drug exposure during pregnancy. Remaining cases were associated with acute infections. Mothers suffered from idiopathic bowel disease and psychiatric patients want to be informed before delivery about possibility to breastfeed their babies. Treatment of epilepsy, another frequent disease, is associated with better level of knowledge of both, neurologists and patients. Breastfeeding is recommended according to management in care of epileptic women.

CONCLUSION: In our counselling we consider the factors which are involved in drug transfer in the milk and mechanisms and steps of transfer as well. We follow the classification of drugs during lactation by their effect on infants: absolutely contraindicated, temporary cessation of breastfeeding, drugs of special concern and drugs compatible with breastfeeding....

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Journal Article 2008; 29(5): 609-613 PubMed PMID: 18987585 Citation  Keywords:  Animals, Antioxidants:pharmacology, Drug-Related Side Effects and Adverse Reactions, Herbicides:toxicity, Humans, Melatonin:pharmacology, Metals:toxicity, Neurotoxins:toxicity, Oxidative Stress:drug effects, Prescription Drugs:toxicity, Reactive Nitrogen .   

: The purpose of this brief review is to introduce the reader to the vast amount of published literature related to the free radical scavenging and antioxidative activity of melatonin. However, this review summarizes only a few of the many conditions in which melatonin has been found to be protective against oxidative/nitrosative damage. Melatonin ameliorates the extensive free radical-mediated damage that ensues following exposure to a wide variety of environmental insults. Concisely reviewed in this report are the protective effects of melatonin against toxic prescription drugs, neural toxins, herbicides and metals. The findings have clear implications for the utility of melatonin in toxicology....

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