Center Antipoison Et Of Toxicovigilance Cap Tv

Sainte-Foy-de-Peyrolières, France

Center Antipoison Et Of Toxicovigilance Cap Tv

Sainte-Foy-de-Peyrolières, France
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Glaizal M.,Comite de Coordination de ToxicoVigilance | Glaizal M.,Center Antipoison Et Of Toxicovigilance Cap Tv | Gazin V.,Comite de Coordination de ToxicoVigilance | Aymard I.,Center Antipoison Et Of Toxicovigilance Cap Tv | And 8 more authors.
Clinical Toxicology | Year: 2012

Context. Methadone is used in France since March 1995, only for opioid maintenance treatment, in a syrup form. For the launching of a capsule form in April 2008, French health authorities requested a prospective survey of all cases involving exposure to methadone in either of the two available pharmaceutical forms. Objective. The aim was to document, in different circumstances and compare the safety of the new capsule form to the syrup. This report presents the findings of one arm of the study, devoted to methadone-related suicide attempts. Materials and method. From April 15, 2008 to April 15, 2010, all self-injurious methadone poisonings notified to or managed by the French Toxicovigilance Centers network were included. Analysis mainly focused on patients' age and gender, estimated quantity ingested, eventual concomitantly taken substances, distribution of symptoms, and site of treatment. Results. 135 methadone-related suicide attempts were recorded. Analysis showed identical epidemiologic and clinical patient characteristics for the two pharmaceutical forms. Ten deaths occurred. The only discrepancy was a higher incidence of suicide attempts in the capsule group. However, as the number of capsule-treated patients increased during the second year, this difference remained significant but tended to decrease. Discussion. Combining these results with Pharmacovigilance and Addictovigilance arms, health authorities estimated that the benefit/risk balance of this new pharmaceutical form remains positive. They revised their position on requirements for prescribing and dispensing of the capsule form, and made them slightly easier. Following this, this "suicide" arm of Toxicovigilance survey was suspended, whereas the second one, concerning accidental pediatric methadone-related poisonings, has been extended until April 2014. Conclusion. In France, suicide attempts were more likely to occur with the capsule formulation. The clinical severity of intoxication was similar between the capsule and liquid forms. © 2012 Informa Healthcare USA, Inc.


Glaizal M.,Center Antipoison Et Of Toxicovigilance Cap Tv | Schmitt C.,Center Antipoison Et Of Toxicovigilance Cap Tv | Tichadou L.,Center Antipoison Et Of Toxicovigilance Cap Tv | Hayek-Lanthois M.,Center Antipoison Et Of Toxicovigilance Cap Tv | De Haro L.,Center Antipoison Et Of Toxicovigilance Cap Tv
Toxicologie Analytique et Clinique | Year: 2014

Aims After 11 years coding in the same data base, to make a descriptive analysis of 24 hours/24 7 days/7 calls managed by the poison center of Marseille (CAPM), to help complete the rare French epidemiological data in clinical toxicology. Methods Retrospective study of all cases treated by the CAPM from 01/01/2002 to 31/12/2012, all encoded in SICAP, the French poison centers' common software. The analysis focused on the description and the evolution of enquirers, type of request and, if applicable, patients' demographics, circumstances of exposure, and classes of implicated products. Results Two hundred and seventy-three thousand four hundred and nine files were collected (61% from public, 34% from health professionals), including 256,875 cases of exposure for 269,001 people (median age: 13 years old - 40% under 4 -; 53% women). Eighty-three percent were accidentally exposed, 12% in a suicidal situation. The most commonly found agents are pharmaceutical drugs (concerning 33% of accidentally exposed subjects, 80% of deliberately ones), followed by chemicals and household products. Three hundred and thirty-six fatal cases were collected (56% male, median age: 49 years), of which 67% in voluntary poisoning context. Concerning time trends, there is a decline in professionals' requests vs. public ones, an increase in accidental exposures part, and a lower part of exposure to drugs, primarily anxiolytics, hypnotics and antidepressants; at the opposite, paracetamol poisonings are steadily rising. Conclusion This report highlights the richness and potential of data from poison centers to explain, treat and prevent poisonings. However, this efficient tool remains very fragile and requires a rapid and significant support. © 2014 Société Française de Toxicologie Analytique. Published by Elsevier Masson SAS. Allrights reserved.


Glaizal M.,Center Antipoison Et Of Toxicovigilance Cap Tv | Lucciardi J.,Service de Chirurgie Thoracique et Viscerale | Tichadou L.,Center Antipoison Et Of Toxicovigilance Cap Tv | Spadari M.,Marseille University Hospital Center | And 3 more authors.
Therapie | Year: 2011

High dosage buprenorphine (HDB) is a sublingual maintenance treatment of opioid dependence which have proved its substantial Public Health results, but it is also known to be frequently abused and diverted, in particular for intravenous injection, with deleterious consequences. Intra-arterial use is more rarely reported with this substance, just like its complications, mainly ischemic, potentially necrotic, phenomena. We report here such a case, with a 30 years-old man suffering from severe ischemia of the thumb, the forefinger and the middle finger few hours after direct injection of a suspension of buprenorphine crushed tablets in right radial arteria. A treatment combining surgery (video-thoracoscopic thoracic sympathectomy) and medicines (heparin, iloprost and piribedil mesilate), permitted a semi-complete digital rehabilitation (only forefinger pulp necrosis persisted and requiried a distal amputation), and the patient was discharged after 2 weeks. © 2011 Société Française de Pharmacologie et de Thérapeutique.

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