Sedative poisoning
Introduction
Introduction Poisoning of sedative hypopnotic drugs is a series of central nervous system hyperinhibition disorders caused by overdose of sedative hypnotics. Sedative hypnotic poisoning manifested as lethargy, emotional instability, inattention, memory loss, ataxia, ambiguous pronunciation, gait instability, nystagmus, ataxia, and significant respiratory depression.
Cause
Cause
Take an excessive amount of sedative hypnotics. The sedative-hypnotic drug is a central nervous system inhibitory drug with sedative and hypnotic effects. The excessive dose can be anesthetized throughout the body, including the cerebral center. Sedative hypnotic poisoning manifested as lethargy, emotional instability, inattention, memory loss, ataxia, ambiguous pronunciation, gait instability, nystagmus, ataxia, and significant respiratory depression.
Benzodiazepines
1) Long-acting classes (half-life > 30 hours) represent drugs: chlordiazepoxide, diazepam, and flurazepam.
2) Medium-effect class (half-life 6-30 hours) represents drugs: alprazolam, oxazepam, and temazepam.
3) Long-acting class representative drug: triazolam.
Barbiturate
1) Long-acting class representative drugs: barbital and phenobarbital.
2) Representative drugs for intermediate-effects: pentobarbital, barbiturate, and bupropion.
3) Long-acting class representative drugs: Scobarbital and thiopental.
Non-barbital non-benzodiazepines (medium effect - short-acting)
Representative drugs: chloral hydrate, glumectamide (hypnotic energy), methaqualone (hypnotic), methyl propyl amide (Mian Ertong)
Phenothiazines (antipsychotics)
1) Aliphatic representative drug: chlorpromazine
2) Piperidine representative drug: thioridazine (methylthiodazine)
3) Piperazines represent drugs: perphenazine, fluphenazine, trifluoperazine
Examine
an examination
Related inspection
Urine concentration dilution test blood analyzer check
The early detection, early diagnosis and early treatment of acute poisoning of sedative sleeping pills are extremely important for prognosis. A preliminary diagnosis can be made based on the patient's medication history, symptoms, and signs. However, it is difficult to determine which drug is poisoned by physical examination alone. Especially for deliberate suicides, some sedative sleeping pills are often not the only poisoning agents, for example, they may also take a lot of alcohol. In the case of this central inhibitor mixed poisoning, the final diagnosis relies on the identification of chemicals in body fluids (blood, urine, gastric juice, etc.).
(1) Determination of drug concentration in blood, urine and gastric juice
It has reference significance for diagnosis. The determination of serum benzodiazepine concentration does not help the diagnosis, because the active metabolite half-life and individual drug discharge rate are different.
(2) Blood biochemical examination
Glucose, urea nitrogen, creatinine, electrolytes, etc.
(3) Arterial blood gas analysis
Diagnosis
Differential diagnosis
1. Identification of acute poisoning and other coma diseases
Ask about the history of hypertension, epilepsy, diabetes, liver disease, kidney disease, and the history of exposure to toxic substances such as carbon monoxide and alcoholic organic solvents, check for foreign head, fever, meningeal irritation, hemiplegia, purpura, etc. The laboratory test, comprehensive consideration, can make a differential diagnosis. 2, chronic poisoning and depressive disease differentiation chronic poisoning in patients with mild mania is prone to fatigue, accompanied by tremors, gait instability and so on.
3, withdrawal syndrome and neuropsychiatric differentiation
Primary epilepsy has a history of seizures, schizophrenia, tremors caused by alcoholism, the former has a history, the latter has a long history of alcohol or alcohol withdrawal.
The early detection, early diagnosis and early treatment of acute poisoning of sedative sleeping pills are extremely important for prognosis. A preliminary diagnosis can be made based on the patient's medication history, symptoms, and signs. However, it is difficult to determine which drug is poisoned by physical examination alone. Especially for deliberate suicides, some sedative sleeping pills are often not the only poisoning agents, for example, they may also take a lot of alcohol. In the case of this central inhibitor mixed poisoning, the final diagnosis relies on the identification of chemicals in body fluids (blood, urine, gastric juice, etc.).
1. Acute poisoning has a history of taking a large number of sedative and hypnotic drugs, causing disturbance of consciousness and respiratory depression and blood pressure, and detecting sedative and hypnotic drugs in gastric juice, blood and urine.
2, chronic poisoning long-term abuse of a large number of hypnotics, mild ataxia and mental symptoms.
3, withdrawal syndrome has a long history of abuse of hypnotic drugs, sudden withdrawal or rapid reduction, anxiety, insomnia or seizures and paralysis.
