TRIPASS XR تري باس

 

.

Woolf AD et al. Tricyclic antidepressant poisoning: an evidence-based consensus guideline for out-of-hospital

management. Clin Toxicol (Phila). 2007;45:203.

Jaeger RW et al. Radiopacity of drugs and plants in vivo limited usefulness. Vet Hum Toxicol. 1981;23(Suppl

1):2.

James JA. Acute iron poisoning: assessment of severity and prognosis. J Pediatr. 1970;77:117.

Perrone J et al. Special considerations in gastrointestinal decontamination. Emerg Med Clin North Am.

1994;12:285.

Tenebein M. Whole bowel irrigation in iron poisoning. J Pediatr. 1987;111:142.

Chyka PA et al. Serum iron concentrations and symptoms of acute iron poisoning in children. Pharmacotherapy.

1996;16:1053.

Lovejoy FH, Jr. Chelation therapy in iron poisoning. J Toxicol Clin Toxicol. 1982;19:871.

Engle JP et al. Acute iron intoxication: treatment controversies. Drug Intell Clin Pharm. 1987;21:153.

Helfer RE, Rodgerson DO. The effect of deferoxamine on the determination of serum iron and iron-binding

capacity. J Pediatr. 1966;68:804.

Ingelfinger JA et al. Reliability of the toxic screen in drug overdose. Clin Pharmacol Ther. 1981;29:570.

Rogers SC et al. Rapid urine drug screens: diphenhydramine and methadone cross-reactivity. Pediatr Emerg

Care. 2010;26:665.

Brahm NC et al. Commonly prescribed medications and potential false-positive urine drug screens. Am J Helath

Syst Pharm. 2010;67:1344.

Yealy DM et al. The safety of prehospital naloxone administration by paramedics. Ann Emerg Med.

1990;19:902.

Watson AJ et al. Acute Wernickes encephalopathy precipitated by glucose loading. Ir J Med Sci. 1981;150:301.

Zubaran C et al. Wernicke-Korsakoff syndrome. Postgrad Med J. 1997;73:27.

Handal KA et al. Naloxone. Ann Emerg Med. 1983;12:438.

Lora-Tamayo C et al. Cocaine-related deaths. J Chromatogr A. 1994;674:217.

Weinbroum A et al. Use of flumazenil in the treatment of drug overdose: a double-blind and open clinicalstudy in

110 patients. Crit Care Med. 1996;24:199.

Forsberg S et al. Coma and impaired consciousness in the emergency room: characteristics of poisoning versus

other causes. Emerg Med J. 2009;26:100.

Callaham M. Tricyclic antidepressant overdose. JACEP. 1979;8:413.

Ettinger NA, Albin RJ. A review of the respiratory effects of smoking cocaine. Am J Med. 1989;87:664.

Finkle BS, McCloskey KL. The forensic toxicology of cocaine (1971–1976). J Forensic Sci. 1978;23:173.

Kline JN, Hirasuna JD. Pulmonary edema after freebase 3 cocaine smoking—not due to an adulterant. Chest.

1990;97:1009.

Cucco RA et al. Nonfatal pulmonary edema after “freebase” cocaine smoking. Am Rev Respir Dis.

1987;136:179.

Duberstein JL, Kaufman DM. A clinical study of an epidemic of heroin intoxication and heroin-induced

pulmonary edema. Am J Med. 1971;51:704.

Warner-Smith M et al. Morbidity associated with non-fatal heroin overdose. Addiction. 2002;97:963.

Sporer KA, Dorn E. Heroin-related noncardiogenic pulmonary edema. Chest. 2001;120:1628.

Chan TC et al. Drug-induced hyperthermia. Crit Care Clin. 1997;13:785.

Albertson TE et al. A prolonged severe intoxication after ingestion of phenytoin and phenobarbital. West J Med.

1981;135:418.

Adams BK et al. Prolonged gastric emptying half-time an gastric hypomotility after drug overdose. Am J Emerg

Med. 2004;22:548.

Knopp R. Caustic ingestions. JACEP. 1979;8:329.

Dawson AH, Whyte IM. Therapeutic drug monitoring in drug overdose. Br J Clin Pharmacol. 1999;48:278.

Hoffman RJ, Nelson L. Rational use of toxicology testing in children. Curr Opin Pediatr. 2001;13:183.

Rayburn W et al. Drug overdose during pregnancy: an overview from a metropolitan poison control center.

Obstet Gynecol. 1984;64:611.

Perrone J, Hoffman RS. Toxic ingestions in pregnancy: abortifacient use in a case series of pregnant overdose

patients. Acad Emerg Med. 1997;4:206.

Crome P. Poisoning due to tricyclic antidepressant overdosage: clinical presentation and treatment. Med Toxicol.

1986;1:261.

Callaham M, Kassel D. Epidemiology of fatal tricyclic antidepressant ingestion: implications of management.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

Ann Emerg Med. 1985;14:1.

Dziukas L, Cameron P. Management of antidepressants in overdose. CNS Drugs. 1994;2:367.

Frommer DA et al. Tricyclic antidepressant overdose: a review. JAMA. 1987;257:521.

Guharoy SR. Adult respiratory distress syndrome associated with amitriptyline overdose. Vet Hum Toxicol.

1994;36:316.

Shannon M, Lovejoy FH, Jr. Pulmonary consequences of severe tricyclic antidepressant ingestion. J Toxicol Clin

Toxicol. 1987;25:443.

Sohn D, Byers J, 3rd. Cost effective drug screening in the laboratory. Clin Toxicol. 1981;18:459.

Garriott JC. Interpretive toxicology. Clin Lab Med. 1983;3:367.

Henry JA. Epidemiology and relative toxicity of antidepressant drugs in overdose. Drug Saf. 1997;16:374.

Phillips S et al. Fluoxetine versus tricyclic antidepressants: a prospective multicenter study of antidepressant drug

overdoses. The Antidepressant Study Group. J Emerg Med. 1997;15:439.

Singh N et al. Serial electrocardiographic changes as a predictor of cardiovascular toxicity in acute tricyclic

antidepressant overdose. Am J Ther. 2002;9:75.

Pentel P, Benowitz N. Efficacy and mechanism of action of sodium bicarbonate in the treatment of desipramine

toxicity in rats. J Pharmacol Exp Ther. 1984;230:12.

Shannon M, Liebelt EL. Targeted management strategies for cardiovascular toxicity from tricyclic

antidepressant overdose: the pivotal role for alkalinization and sodium loading. Pediatr Emerg Care.

1998;14:293.

Kingston ME. Hyperventilation in tricyclic antidepressant poisoning. Crit Care Med. 1979;7:550.

Wrenn K et al. Profound alkalemia during treatment of tricyclic antidepressant overdose: a potential hazard of

combined hyperventilation and intravenous bicarbonate. Am J Emerg Med. 1992;10:553.

Seger DL et al. Variability of recommendations for serum alkalinization in tricyclic antidepressant overdose: a

survey of U.S. poison center medical directors. J Toxicol Clin Toxicol. 2003;41:331.

Kozer E, Koren G. Management of paracetamol overdose: current controversies. Drug Saf. 2001;24:503.

Davis M et al. Paracetamol overdose in man: relationship between pattern of urinary metabolites and severity of

liver damage. Q J Med. 1976;45:181.

Corcoran GB et al. Evidence that acetaminophen and N-hydroxyacetaminophen form a common arylating

intermediate, N-acetyl-p-benzoquinoneimine. Mol Pharmacol. 1980;18:536.

Zed PJ, Krenzelok EP. Treatment of acetaminophen overdose. Am J Health Syst Pharm. 1999;56:1081.

Lester D, Beck AT. Attempted suicide and pregnancy. Am J Obstet Gynecol. 1988;158:1084.

Czeizel A, Lendvay A. Attempted suicide and pregnancy [letter]. Am J Obstet Gynecol. 1989;161:497.

Riggs BS et al. Acute acetaminophen overdose during pregnancy. Obstet Gynecol. 1989;74:247.

Rollins DE et al. Acetaminophen: potentially toxic metabolite formed by human fetal and adult liver microsomes

and isolated fetal liver cells. Science. 1979;205:1414.

McElhatton PR et al. Paracetamol poisoning in pregnancy: an analysis of the outcomes of cases referred to the

Teratology Information Service of the National Poisons Information Service. Hum Exp Toxicol. 1990;9:147.

Prescott LF et al. Plasma-paracetamol half-life and hepatic necrosis in patients with paracetamol overdosage.

Lancet. 1971;1:519.

Rumack BH, Matthew H. Acetaminophen poisoning and toxicity. Pediatrics. 1975;55:871.

Anker AL, Smilkstein MJ. Acetaminophen: concepts and controversies. Emerg Med Clinic North Am.

1994;12:335.

Acetaminophen (N-Acetyl-P-Aminophenol, APAP). Drug Facts and Comparisons. Facts and Comparisons

[database online]. St Louis, MO: Wolters Kluwer Health; April 2004. Accessed September 12, 2015.

Rumack BH et al. Acetaminophen overdose: 662 cases with evaluation of oral acetylcysteine treatment. Arch

Intern Med. 1981;141(3, Spec No):380.

Linden CH, Rumack BH. Acetaminophen overdose. Emerg Med Clinic North Am. 1984;2:103.

Prescott L. Oral or intravenous N-acetylcysteine for acetaminophen poisoning? Ann Emerg Med. 2005;45:409.

Prescott LF. Treatment of severe acetaminophen poisoning with intravenous acetylcysteine. Arch Intern Med.

1981;141(3, Spec No):386.

Acetadote (acetylcysteine) injection labeling [product information]. Nashville, TN: Cumberland Pharmaceuticals;

2006.

Smilkstein MJ et al. Acetaminophen overdose: a 48-hour intravenous N-acetylcysteine treatment protocol. Ann

Emerg Med. 1991;20:1058.

Bailey B, McGuigan MA. Management of anaphylactoid reactions to intravenous N-acetylcysteine. Ann Emerg

.

.

.

.

.

.

.

.

.

.

179.

180.

.

.

.

.

Med. 1998;31:710.

Kerr F et al. The Australasian Clinical Toxicology Investigators Collaboration randomized trial of different

loading infusion rates of N-acetylcysteine. Ann Emerg Med. 2005;45:402.

Buckley NA et al. Oral or intravenous N-acetylcysteine: which is the treatment of choice for acetaminophen

(paracetamol) poisoning? J Toxicol Clin Toxicol. 1999;37:759.

Woo OF et al. Shorter duration of oral N-acetylcysteine therapy for acute acetaminophen overdose. Ann Emerg

Med. 2000;35:363.

Yip L, Dart RC. A 20-hour treatment for acute acetaminophen overdose. N EnglJ Med. 2003;348:2471.

Clarke S, Herren K. Towards evidence based emergency medicine: best BETs from the Manchester Royal

Infirmary. Oral or intravenous antidote for paracetamol overdose. Emerg Med J. 2002;19:247.

Perry HE, Shannon MW. Efficacy of oral versus intravenous N-acetylcysteine in acetaminophen overdose:

results of an open-label clinical trial. J Pedatr. 1998;132:149.

Yarema MC et al. Comparison of the 20-hour intravenous and 72-hour oral acetylcysteine protocols for the

treatment of acute acetaminophen poisoning. Ann Emerg Med. 2009;54:606.

Smilkstein MJ et al. Efficacy of oral N-acetylcysteine in the treatment of acetaminophen overdose: analysis of

the national multicenter study (1976–1985). N EnglJ Med. 1988;319:1557.

Doyon S, Klein-Schwartz W. Hepatotoxicity despite early administration of intravenous N-acetylcysteine for

acute acetaminophen overdose. Acad Emerg Med. 2009;16:34.

Bernal W et al. Use and outcome of liver transplantation in acetaminophen-induced acute liver failure.

Hepatology. 1998;27:1050.

Mitchell I et al. Earlier identification of patients at risk from acetaminophen-induced acute liver failure. Crit Care

Med. 1998;26:279.

Gow PJ et al. Paracetamol overdose in a liver transplantation centre: an 8-year experience. J Gastroenterol

Hepatol. 1999;14:817.

Harrison PM et al. Serial prothrombin time as prognostic indicator in paracetamol induced fulminant hepatic

failure. BMJ. 1990;301:964.

Kociancic T, Reed MD. Acetaminophen intoxication and length of treatment: how long is long enough.

Pharmacotherapy. 2003;23:1052.

Wright RO et al. Effect of metoclopramide dose on preventing emesis after oral administration of Nacetylcysteine for acetaminophen overdose. J Toxicol Clin Toxicol. 1999;37:35.

Reed MD, Marx CM. Ondansetron for treating nausea and vomiting in the poisoned patient. Ann Pharmacother.

1994;28:331.

p. 82

End-of-life care consists of palliative and hospice care. It is ideally

introduced early in the disease progression to provide support to patients

of all ages with a serious chronic or life-threatening illness. Medicare

patients who enter a hospice program agree to relinquish their regular

Medicare benefits as they relate to the terminal illness and accept the

palliative rather than curative approach that will be provided by hospice.

The hospice provides all care related to the hospice diagnosis under a

managed-care model at a fixed reimbursement.

Case 6-1 (Question 1)

In 2008, the Hospice Conditions of Participation were updated to include

a review of the medication profile as part of the initial assessment of

new patients. The medication regimens of hospice patients should be

continually reviewed and updated, with unnecessary, ineffective, or

duplicative medications discontinued.

Case 6-1 (Question 2)

Patients near end of life can experience a number of distressing

symptoms. These should be anticipated and treated in a timely manner

that is acceptable to the patients and their families.

Case 6-1 (Question 3), Table

6-3

Well-trained pharmacists can improve medication management for

hospice patients, while helping the hospice manage their drug costs.

Case 6-1 (Question 2)

Many barriers exist regarding pain management and the use of opioids. Case 6-1 (Question 4)

Effective pain management uses a variety of approaches. Case 6-2 (Question 1)

Pain and symptom management may at times require an aggressive

approach.

Case 6-3 (Questions 1–3)

HOSPICE AND PALLIATIVE CARE

Terminology

Hospice care and palliative care are similar, but distinct, terms sharing the common

belief that the relief of suffering is a long-standing, central, and fully legitimate aim

of medicine. End-of-life care refers to both hospice care and palliative care. The

basic principle of end-of-life care is to optimize the quality of life for the patient and

family in the last weeks and months of life, as well as to provide support for the

family beyond the end of life into bereavement.

Palliative care, which includes hospice care, is ideally introduced early in the

disease progression to provide support to patients of all ages with a serious chronic

or life-threatening illness. It can be provided concurrently with other treatments to

cure or reduce disease or it can be provided independently. The word palliation,

derived from the Latin word pallium (a cloak), has been defined as “treatment to

reduce the violence of a disease.” The World Health Organization and the National

Consensus Project define palliative care as an approach that improves the quality of

life of patients and their families who are facing a life-threatening illness, by

preventing and relieving suffering through early identification and impeccable

assessment and treatment of pain and other physical, psychosocial, and spiritual

problems.

1–4 Palliative care

Affirms life and regards dying as a normal process;

Provides relief from pain and other distressing symptoms;

Intends neither to hasten nor postpone death;

Integrates the psychological and spiritual aspects of patient care;

Offers a support system to help patients live as actively as possible until death;

Uses a multidisciplinary team approach to address the needs of the patient and his

or her family during the patient’s illness; and

Provides bereavement counseling when indicated.

3

Hospice and palliative medicine became a recognized subspecialty of internal

medicine in 2006, awarded by the American Board of Medical Specialties.

5 The

Joint Commission offers an Advanced Certification Program for Palliative Care to

recognize hospitals that provide high-quality palliative care services.

6

p. 83

p. 84

Hospice, originally a place or way station for people making a pilgrimage, is

considered both a philosophy of care and a place to deliver care. Hospice care

focuses on the palliation of pain and other symptoms when active treatment to cure a

terminal illness ends. Hospice care can be delivered in a building designated as a

hospice, in the patient’s home, or in a facility where the patient resides. As a

programmatic model for delivering palliative care, hospice care provides an

interdisciplinary team approach to the individualized symptom management (e.g.,

pain), as well as psychosocial, emotional, spiritual, and bereavement support for the

patient and his or her family and caregivers during the last months of life.