Benzodiazepine poisoning in elderly
Background/Aim. Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzo...
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| Format: | Article |
| Language: | English |
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2016-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2016/0042-84501500025P.pdf |
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| author | Perković-Vukčević Nataša Vuković-Ercegović Gordana Šegrt Zoran Đorđević Snežana Jović-Stošić Jasmina |
| author_facet | Perković-Vukčević Nataša Vuković-Ercegović Gordana Šegrt Zoran Đorđević Snežana Jović-Stošić Jasmina |
| author_sort | Perković-Vukčević Nataša |
| collection | DOAJ |
| description | Background/Aim. Benzodiazepines are among the most frequently ingested drugs
in self-poisonings. Elderly may be at greater risk compared with younger
individuals due to impaired metabolism and increased sensitivity to
benzodiazepines. The aim of this study was to assess toxicity of
benzodiazepines in elderly attempted suicide. Methods. A retrospective study
of consecutive presentations to hospital after self-poisoning with
benzodiazepines was done. Collected data consisted of patient's
characteristics (age, gender), benzodiazepine ingested with its blood
concentrations at admission, clinical findings including vital signs and
Glasgow coma score, routine blood chemistry, complications of poisoning,
details of management, length of hospital stay and outcome. According the
age, patients are classified as young (15-40-year old), middle aged
(41-65-year old) and elderly (older than 65). Results. During a 2-year
observational period 387 patients were admitted because of pure
benzodiazepine poisoning. The most frequently ingested drug was bromazepam,
the second was diazepam. The incidence of coma was significantly higher, and
the length of hospital stay significantly longer in elderly. Respiratory
failure and aspiration pneumonia occurred more frequently in old age. Also,
flumazenil was more frequently required in the group of elderly patients.
Conclusion. Massive benzodiazepines overdose in elderly may be associated
with a significant morbidity, including deep coma with aspiration pneumonia,
respiratory failure, and even death. Flumazenil is indicated more often to
reduce CNS depression and prevent complications of prolonged unconsciousness,
but supportive treatment and proper airway management of comatose patients is
the mainstay of the treatment of acute benzodiazepine poisoning. |
| format | Article |
| id | doaj-art-033b6e4c23e14a0ca0e0e5933ceda86c |
| institution | OA Journals |
| issn | 0042-8450 2406-0720 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-033b6e4c23e14a0ca0e0e5933ceda86c2025-08-20T02:02:57ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202016-01-0173323423810.2298/VSP141208025P0042-84501500025PBenzodiazepine poisoning in elderlyPerković-Vukčević Nataša0Vuković-Ercegović Gordana1Šegrt Zoran2Đorđević Snežana3Jović-Stošić Jasmina4Military Medical Academy, National Poison Control Centre, Belgrade + University of Defence, Faculty of Medicine, BelgradeMilitary Medical Academy, National Poison Control Centre, BelgradeUniversity of Defence, Faculty of Medicine, BelgradeMilitary Medical Academy, National Poison Control Centre, Belgrade + University of Defence, Faculty of Medicine, BelgradeMilitary Medical Academy, National Poison Control Centre, Belgrade + University of Defence, Faculty of Medicine, BelgradeBackground/Aim. Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. Methods. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collected data consisted of patient's characteristics (age, gender), benzodiazepine ingested with its blood concentrations at admission, clinical findings including vital signs and Glasgow coma score, routine blood chemistry, complications of poisoning, details of management, length of hospital stay and outcome. According the age, patients are classified as young (15-40-year old), middle aged (41-65-year old) and elderly (older than 65). Results. During a 2-year observational period 387 patients were admitted because of pure benzodiazepine poisoning. The most frequently ingested drug was bromazepam, the second was diazepam. The incidence of coma was significantly higher, and the length of hospital stay significantly longer in elderly. Respiratory failure and aspiration pneumonia occurred more frequently in old age. Also, flumazenil was more frequently required in the group of elderly patients. Conclusion. Massive benzodiazepines overdose in elderly may be associated with a significant morbidity, including deep coma with aspiration pneumonia, respiratory failure, and even death. Flumazenil is indicated more often to reduce CNS depression and prevent complications of prolonged unconsciousness, but supportive treatment and proper airway management of comatose patients is the mainstay of the treatment of acute benzodiazepine poisoning.http://www.doiserbia.nb.rs/img/doi/0042-8450/2016/0042-84501500025P.pdfpoisoningbenzodiazepinesoverdoseflumazenilaged |
| spellingShingle | Perković-Vukčević Nataša Vuković-Ercegović Gordana Šegrt Zoran Đorđević Snežana Jović-Stošić Jasmina Benzodiazepine poisoning in elderly Vojnosanitetski Pregled poisoning benzodiazepines overdose flumazenil aged |
| title | Benzodiazepine poisoning in elderly |
| title_full | Benzodiazepine poisoning in elderly |
| title_fullStr | Benzodiazepine poisoning in elderly |
| title_full_unstemmed | Benzodiazepine poisoning in elderly |
| title_short | Benzodiazepine poisoning in elderly |
| title_sort | benzodiazepine poisoning in elderly |
| topic | poisoning benzodiazepines overdose flumazenil aged |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2016/0042-84501500025P.pdf |
| work_keys_str_mv | AT perkovicvukcevicnatasa benzodiazepinepoisoninginelderly AT vukovicercegovicgordana benzodiazepinepoisoninginelderly AT segrtzoran benzodiazepinepoisoninginelderly AT đorđevicsnezana benzodiazepinepoisoninginelderly AT jovicstosicjasmina benzodiazepinepoisoninginelderly |