Nagashima Kazuki, Sumida Megumi, Imanaka Shoichi, Kuwabara Tatsuro, Kaneko Ichiro, Miyake Yasufumi, Yasuno Nobuhiro, Itagaki Fumio, Watanabe Machiko
Laboratory of Clinical Pharmaceutics, Faculty of Pharma-Science, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
Department of Pharmacy, Teikyo University Hospital, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan.
J Pharm Health Care Sci. 2021 Oct 1;7(1):34. doi: 10.1186/s40780-021-00217-8.
Drug overdose accounts for most of the admissions to the emergency department. Prescription drugs, most of which are psychotropic medications, are often misused for drug overdose. The purpose of this study was to investigate the association between overdose in patients transported with disorders of consciousness and psychotropic medications administered prior to transport, so as to enable quick differentiation of drug overdose patients from patients with disorders of consciousness.
We evaluated 222 patients transported to the Advanced Critical Care Center of Teikyo University Hospital due to disorders of consciousness. The patients were categorized into two groups: overdose group (n = 128) and control group with other disorders of consciousness (n = 94). Logistic regression models were used to assess the association between disorders of consciousness due to drug overdose and psychotropic drugs prescribed before emergency transportation based on sex and age.
According to multivariate logistic regression analysis, only female sex (odds ratio [OR] 4.54, 95% confidence interval [CI] 2.43-8.05, P < 0.0001) was associated with overall overdose. Results from the univariate logistic regression analysis showed that in the group of patients aged 40-50 years, female sex (OR 4.36, 95% CI; 1.54-12.4, P = 0.006) and the use of psychotropic drugs (OR 5.05, 95% CI; 1.75-14.6, P = 0.003), benzodiazepines (OR 4.64, 95% CI; 1.61-13.4, P < 0.05), antidepressants (OR 11.4, 95% CI; 2.35-55.8, P = 0.003), and anticonvulsants (OR 4.46, 95% CI; 1.11-17.9, P = 0.035) were associated with overdose. According to multivariate logistic regression analysis, female sex (OR 4.44, 95% CI; 1.37-14.3, P = 0.013) and antidepressants (OR 7.95, 95% CI; 1.21-52.1, P = 0.031) were associated with overdose patients aged 40-50 years.
As a reference in distinguishing overdose in women in their 40s and 50s who present with impaired consciousness, attention may need to be paid to the type of psychotropic drug used, especially antidepressants.
药物过量是急诊科大多数入院病例的原因。处方药（其中大部分是精神药物）经常被滥用导致药物过量。本研究的目的是调查意识障碍患者转运前使用的精神药物与药物过量之间的关联，以便能够快速区分药物过量患者和意识障碍患者。
我们评估了222例因意识障碍被转运至帝京大学医院高级重症监护中心的患者。患者分为两组：过量组（n = 128）和其他意识障碍对照组（n = 94）。采用逻辑回归模型，根据性别和年龄评估急诊转运前开具的精神药物与药物过量导致的意识障碍之间的关联。
根据多变量逻辑回归分析，仅女性（优势比[OR] 4.54，95%置信区间[CI] 2.43 - 8.05，P < 0.0001）与总体过量有关。单变量逻辑回归分析结果显示，在40 - 50岁的患者组中，女性（OR 4.36，95% CI；1.54 - 12.4，P = 0.006）、使用精神药物（OR 5.05，95% CI；1.75 - 14.6，P = 0.003）、苯二氮䓬类药物（OR 4.64，95% CI；1.61 - 13.4，P < 0.05）、抗抑郁药（OR 11.4，95% CI；2.35 - 55.8，P = 0.003）和抗惊厥药（OR 4.46，95% CI；1.11 - 17.9，P = 0.035）与过量有关。根据多变量逻辑回归分析，女性（OR 4.44，95% CI；1.37 - 14.3，P = 0.013）和抗抑郁药（OR 7.95，95% CI；1.21 - 52.1，P = 0.031）与40 - 50岁的过量患者有关。
作为区分40多岁和50多岁意识受损女性过量情况的参考，可能需要关注使用的精神药物类型，尤其是抗抑郁药。
