https://ogma.newcastle.edu.au/vital/access/ /manager/Index ${session.getAttribute("locale")} 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:11541 Wed 11 Apr 2018 13:32:58 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:14379 Wed 11 Apr 2018 13:28:54 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:11302 Wed 11 Apr 2018 12:24:49 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:14492 c of 440 ms or 500 ms. Plotting the QT-HR pair for patients on drugs suspected or known to cause QT prolongation allows assessment of the QT interval based on normal population QT variability. This risk assessment then allows the safer commencement of drugs therapeutically or management of drug induced effects in overdose.]]> Wed 11 Apr 2018 10:07:08 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:51419 120 mg) admitted to two tertiary toxicology units between March 2007 and May 2021. Demographic information, details of ingestion (dose, co-ingestants), clinical effects, investigations (ECG parameters including QT interval), complications (coma [GCS < 9], serotonin toxicity, seizures and cardiovascular effects), length of stay [LOS] and intensive care unit [ICU] admission were extracted from a clinical database. Results: There were 241 duloxetine overdoses (>120 mg), median age 37 years (interquartile range [IQR]: 25–48 years) and there were 156 females (65%). The median dose was 735 mg (IQR: 405–1200 mg). In 177 patients, other medications were co-ingested, most commonly alcohol, paracetamol, quetiapine, diazepam, ibuprofen, pregabalin and oxycodone. These patients were more likely to be admitted to ICU (12 [7%] vs. none; p = 0.040), develop coma (16 [9%] vs. none; p = 0.008) and hypotension [systolic BP < 90 mmHg] (15 [8%] vs. one; p = 0.076). Sixty four patients ingested duloxetine alone with a median dose of 840 mg (180–4200 mg). The median LOS, in the duloxetine only group, was 13 h (IQR:8.3–18 h), which was significantly shorter than those taking coingestants, 19 h (IQR:12–31 h; p = 0.004). None of these patients were intubated. Six patients developed moderate serotonin toxicity, without complications and one had a single seizure. Tachycardia occurred in 31 patients (48%) and mild hypertension (systolic BP > 140 mmHg) in 29 (45%). One patient had persistent sympathomimetic toxicity, and one had hypotension after droperidol. Two patients of 63 with an ECG recorded had an abnormal QT: one QT 500 ms, HR 46 bpm, which resolved over 3.5 h and a second with tachycardia (QT 360 ms, HR 119 bpm). None of the 64 patients had an arrhythmia. Conclusion: Duloxetine overdose most commonly caused sympathomimetic effects and serotonin toxicity, consistent with its pharmacology, and did not result in coma, arrhythmias or intensive care admission, when taken alone in overdose.]]> Thu 30 May 2024 09:52:57 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:186 500 ms and in seven of these causality was established based on a pre- or post-ECG with a QTc < 500 ms. Only 10% of the moclobemide cases had a heart rate (HR) > 100 beats per minute, making overcorrection of HR by Bazett's formula an unlikely cause of the findings. No cardiac arrythmias were observed other than one case of first-degree heart block. Conclusions Moclobemide prolongs the QT and QTc intervals in overdose and a 12-lead ECG should be done on all moclobemide deliberate self-poisonings. Continuous cardiac monitoring for what is otherwise a relatively benign overdose would appear to be an inappropriate use of resources but can be considered in patients with a QTc > 500 ms or with known risks for QT prolongation.]]> Thu 25 Jul 2013 09:09:31 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:242 Thu 25 Jul 2013 09:09:27 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:14457 120 mg) identified from admissions to a toxicology unit between January 1987 and August 2013. Demographic information, details of ingestion, clinical effects, ECG parameters (HR, QT and QRS), and length of stay were extracted from a clinical database. Results: From 267 mirtazapine overdoses, there were 89 single-agent mirtazapine ingestions and 178 cases where mirtazapine was taken with at least one other drug. The median age of the 89 single-agent mirtazapine ingestions was 36 years [interquartile range (IQR): 26 – 49 years; Range: 15 – 81 years]; 45 were female (51%). The median ingested dose was 420 mg (IQR: 270 – 750 mg; Range: 150 – 1350 mg) and 41 patients (46%) had a Glasgow coma score (GCS) < 15, but the minimum GCS was 10. There were no seizures, serotonin toxicity or delirium. Tachycardia occurred in 29 patients (33%) and hypertension in 32 patients (36%). The median QRS was 80 ms (Range: 80 – 120 ms) and there were no cases with QT prolongation. There were no arrhythmias and no deaths. The median length of stay was 14 h (IQR: 8.8 – 18.2 h; Range:2.2 – 75 h). No single-agent mirtazapine patient was admitted to intensive care. The 178 patients taking co-ingestants had more severe toxicity depending on the co-ingested drug. Conclusion: Mirtazapine appears to be relatively benign in overdose, associated with tachycardia, mild hypertension and mild CNS depression not requiring intervention.]]> Sat 24 Mar 2018 08:19:18 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:10754 Sat 24 Mar 2018 08:08:21 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:21162 Sat 24 Mar 2018 07:58:06 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:29544 Sat 24 Mar 2018 07:33:10 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:44730 Mon 24 Oct 2022 08:28:51 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:30853 Mon 23 Sep 2019 11:26:20 AEST ]]>