Latest Articles and News - Jul 11, 2025

High-Dose Insulin Euglycemic Therapy in Concomitant Beta-Blocker and Calcium Channel Blocker Overdose.

Beta-blockers and calcium channel blockers are among the most commonly used drugs in the adult population, and the National Poison Data System annual reports note 11 075 beta-blocker overdoses and 6256 calcium-channel blocker overdoses in 2022. Poisoning with these medications presents clinically with profound bradycardia, depression of myocyte contractility, and vasodilation resulting in hemodynamic instability often refractory to initial vasopressor treatment. Herein we present a case of concomitant beta-blocker and calcium-channel blocker overdose with hypotension refractory to vasopressors successfully managed with high-dose insulin euglycemic therapy. Close monitoring is required to prevent adverse effects from therapy, which are predictable: hypokalemia and hypoglycemia often result from the use of up to hundreds of units of insulin per hour, as was done in this case. Frequent monitoring is required to safely utilize high-dose insulin euglycemic therapy, which has a good safety profile when appropriate monitoring is utilized.

https://pubmed.ncbi.nlm.nih.gov/40642834/

Epidemiology of Poisoning Cases at Lumbini Medical College, Nepal: A 5-Year Retrospective Study.

Poisoning is a major global public health problem, disproportionately burdensome in low-resource healthcare settings. The objective of this study was to gain epidemiological insights into poisoning cases at Lumbini Medical College and Teaching Hospital over a period of 5 years. A retrospective cross-sectional analysis was performed of hospital records and 402 poisoning cases admitted to Lumbini Medical College between January 2019 and May 2024 were analyzed descriptively using SPSS V.27.0. The study meticulously documented a wide range of data, such as patient demographics, types of poisons, contexts for poisoning, clinical presentation, and medical outcomes. Of 402 cases, females predominated (61.2%, n = 246), with a median age of 26.5 years (IQR: 18.2-39.2). Pesticides, particularly organophosphates, were the leading agent (57.7%, n = 232), with self-harm as the primary reason (70.9%, n = 285), often linked to family conflict. Poisoning peaked in the evening, notably among females aged 25-44 years (42.3%, n = 170). Mortality was low (0.2%, n = 1), with 68.7% of patients receiving some form of psychiatric consultation. Poisoning primarily involved young, married females using organophosphorus pesticides for self-harm, often due to family conflict and mental health issues, with most receiving psychiatric consultation.

https://pubmed.ncbi.nlm.nih.gov/40642566/

Changing trends in drug overdose mortality in Spain, 2001-2022.

To measure the evolution of drug overdose mortality in Spain between 2001 and 2022. A repeated cross-sectional observational study using nationwide mortality data from Spain, 2001-2022, among individuals aged 15-64 years. The outcome was overdose deaths [International Classification of Diseases, 10th revision (ICD-10) codes: X40-X44, X60-X64, X85, Y10-Y14]. Annual age-standardized mortality rates (ASMRs) per million person-years were estimated. Joinpoint regression assessed changes in trends using annual percentage change (APC) and average APC (AAPC). Overdose deaths were grouped by the underlying drug categories involved: nonopioid analgesics, antipyretics and antirheumatics (X40/X60/Y10); antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs (X41/X61/Y11); narcotics and psychodysleptics (X42/X62/Y12); other drugs acting on the autonomic nervous system (X43/X63/Y13); other and unspecified drugs, medicaments and biological substances (X44/X64/Y14); and drugs, medicaments and biological substances in the context of assault (X85). Intentionality (based on ICD-10 code characters) within the underlying drug categories was assessed. All analyses were stratified by sex. In Spain, 15 862 overdose deaths occurred during 2001-2022. ASMR increased by 49.0% over the period, from 24.7 [95% confidence interval (95% CI) = 23.0, 26.5] to 36.8 (95% CI = 34.7, 39.0) deaths per million person-years. APC showed a statistically significant change in trends in 2010, shifting from a -3.3% (95% CI = -7.3 to -1.7) decline to an increase of 3.4% (95% CI = -0.3 to 6.5). In 2018, a more abrupt change was observed, with the APC further increasing to 13.8% (95% CI = 9.3, 22.5). Females showed an earlier trend change (2006) with an AAPC 1.7 times higher (3.4%; 95% CI = 2.4, 4.7) than males (2.0%; 95% CI = 1.2, 2.7). Leading drug categories were other and unspecified drugs, medicaments and biological substances, followed by narcotics and psychodysleptics. In males, trends followed the overall pattern; in females, the antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs category predominated, mostly due to intentional overdoses. Between 2001 and 2022, drug overdose deaths in Spain increased substantially, beginning in 2010 and further accelerated in 2018, though population rates remain low. The most prevalent underlying ICD-10 drug categories were other and unspecified drugs, medicaments and biological substances-likely reflecting polydrug use-and narcotics and psychodysleptics. The observed rise in deaths involving antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs, particularly intentional overdoses among females, highlights the need for sex-based interventions.

https://pubmed.ncbi.nlm.nih.gov/40640085/

Drug intoxication: a silent obstacle to organ donation.

https://pubmed.ncbi.nlm.nih.gov/40639923/