Time filter

Source Type

Charleston, WV, United States

Spiller H.A.,Kentucky Regional Poison Center | Scaglione J.M.,Cincinnati Drug and Poison Information Center | Aleguas A.,Northern Ohio Poison Center | Foster H.,Arkansas Poison and Drug Information Center | And 5 more authors.
Annals of Pharmacotherapy | Year: 2010

BACKGROUND: There is limited information on the effect of scheduling a drug as a controlled substance with comparable data from both a pre-scheduling and post-scheduling time period. OBJECTIVE: To investigate the temporal changes on poisoning cases involving tramadol in 4 states: 2 states where it has been scheduled and 2 where it is not scheduled. METHODS: Databases were searched for all cases involving tramadol reported from 2003 through 2009 at 6 regional poison centers that served Arkansas, Kentucky, Ohio, and West Virginia. To allow for comparison based on population, state population estimates were obtained from the US Census Bureau. RESULTS: Over the 7-year study period, the number of tramadol cases increased from 401 per year to 1009 cases per year. The mean annual increase in tramadol cases for all 4 states ranged from 8.8% to 14.1%. Post-scheduling in Arkansas and Kentucky, there was a mean decrease in cases of 4% and 31%, respectively. During this same period, the comparison states of West Virginia and Ohio showed a continued increase of 14% and 23%, respectively. The mean annual increase in tramadol cases per 100,000 population for all 4 states ranged from 16% to 31%. Post-scheduling of tramadol, there was an annual decrease in tramadol human exposures of 5% to 31% in Arkansas and Kentucky, respectively. During this same period, West Virginia and Ohio showed a continued annual increase of 14%. CONCLUSIONS: The decrease in the number of cases of tramadol exposure following its addition to the schedule of controlled substances in Kentucky and Arkansas suggests that adding a drug to the schedule of controlled substances may result in a decrease in poisoning exposures related to that drug. Source

Hardison Jr. L.S.,University of Virginia | Wright E.,Charleston Area Medical Center | Pizon A.F.,University of Pittsburgh | Pizon A.F.,West Virginia Poison Center
Journal of Medical Toxicology | Year: 2014

Introduction: Phosgene is a rare exposure with strong clinical implications. We report a phosgene exposure that resulted in the patient's death. Case Report: A 58 year-old man arrived to the emergency department 1 hour after exposure to phosgene with complaints of a sore throat. Initial vital signs were blood pressure 175/118 mmHg, heart rate 98/min, respirations 12/min, and oxygen saturation of 93% on room air. Physical exam revealed few scattered rhonchi, without signs of distress. Initial arterial blood gases (ABG's) revealed pH 7.42, pCO2 43 mmHg, pO2 68 mmHg, HCO3 27 meq/L, and oxygen saturation of 93% on room air. Initial chest x-ray 2 hours after the exposure demonstrated clear lung fields. Approximately 2.5 hours after the exposure, he began complaining of dyspnea, restlessness and his oxygen saturation dropped below 90%. He received nebulized albuterol, 1 gram intravenous methylprednisolone, and 100 % oxygen via face mask. Minimal improvement was noted and he was intubated. The post intubation chest x-ray, 3.5 hours after the exposure, revealed diffuse alveolar infiltrates. Acetylcysteine, terbutaline, and IV steroids were administered without improvement. The patient died 30 hours after exposure. Discussion: There are many misunderstandings concerning phosgene due to its rare presentation. Traditional treatment modalities are often unproven in human trials and were unsuccessful in this case. Conclusion: This case highlights the significant toxicity that results from phosgene exposure and the challenges of the limited treatment modalities. There is concern for the use of this agent in chemical terrorism. © 2013 American College of Medical Toxicology. Source

Jones P.R.,Pacific Institute for Research and Evaluation | Sheppard M.A.,Pacific Institute for Research and Evaluation | Snowden C.B.,Pacific Institute for Research and Evaluation | Miller T.R.,Pacific Institute for Research and Evaluation | And 4 more authors.
American Journal of Health Education | Year: 2010

Background: Unintentional poisoning is an important public health issue that exacts a heavy toll on our nation's seniors. However, relatively few empirical studies have examined the efficacy of poison prevention education programs on this cohort. Purpose: This study assessed the impact of a poison education program on the knowledge, perceptions, intentions, and behaviors of seniors in Missouri and West Virginia. Methods: One-hundred and twenty-seven seniors completed pre- and post-test surveys, which were designed to assess the program's efficacy. Participants were re-interviewed after four weeks to determine whether they had implemented the behaviors described in the program. Results: The results revealed that the program improved the knowledge of participants and impacted both their behavioral intentions and actual behaviors. Discussion: When taken together, these data indicate that brief educational interventions may be an effective tool in reducing the incidence of unintentional poisonings among seniors. Translation to Health Education Practice: More generally, these methods and findings suggest that single sessions of theory-driven health education can be effective for interventions among seniors. Source

Discover hidden collaborations