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急诊科急性中毒患者的多药使用模式。

Patterns of Polydrug Use in Patients Presenting at the Emergency Department with Acute Intoxication.

作者信息

Manjón-Prado Helena, Serrano Santos Enrique, Osuna Eduardo

机构信息

Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence "Campus Mare Nostrum", Faculty of Medicine, University of Murcia, 30120 Murcia, Spain.

Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Ctra. Madrid-Cartagena, s/n, 30120 Murcia, Spain.

出版信息

Toxics. 2025 May 7;13(5):380. doi: 10.3390/toxics13050380.

Abstract

Studies analyzing the prevalence of associated substance use are limited. Currently, the World Health Organization (WHO) defines polydrug use as the concurrent (simultaneous use) or sequential (use of one drug followed by another) abuse of more than one drug or type of drug, with dependence on at least one. Associated drug consumption can exacerbate the adverse effects and complicate the clinical management of patients. This study aimed to investigate the prevalence of polydrug use, excluding tobacco, in patients presenting with acute intoxication in the Emergency Department (ED) of the Clinical University Hospital Virgen de la Arrixaca (Murcia, Spain) in the year 2023. To this end, a retrospective analysis of 2562 patients was conducted, examining demographic variables, substance use patterns, reasons for presenting to the ED, and the substances consumed by each patient. The study reveals an average patient age of 41 ± 0.5 (SD = 11.96) composed of predominantly male patients (74.4%). A high prevalence of benzodiazepines and cocaine use, often in combination, was observed. The main reasons for attendance included symptoms such as palpitations, dyspnea, vomiting, diarrhea, behavioral disturbances, and self-harm. Only 25.5% of patients admitted to consuming all substances detected in their analyses. Polydrug use is frequent in our environment, which can lead to added complexity in diagnosis and treatment. Consumption patterns show a profile strongly related to the age of the subject. Among the youngest subjects, tetrahydrocannabinol (THC) and benzodiazepines predominate, whilst among older subjects, alcohol and benzodiazepines, and sometimes cocaine, predominate. This study highlights the need to design specific intervention and prevention strategies to address patterns of substance abuse, the importance of family and community support, and the need to tackle challenges in identifying and treating cases of polysubstance abuse. Moreover, cooperation between the healthcare system and law enforcement is also important to obtain up-to-date knowledge of new drugs and their consumption patterns in an emergency context.

摘要

分析相关物质使用流行情况的研究有限。目前,世界卫生组织(WHO)将多药使用定义为同时(并发使用)或相继(先使用一种药物,随后使用另一种药物)滥用一种以上药物或药物类型,且对至少一种药物产生依赖。相关药物消费会加剧不良反应,并使患者的临床管理复杂化。本研究旨在调查2023年在西班牙穆尔西亚市阿利克斯卡圣母大学临床医院急诊科就诊的急性中毒患者中,不包括烟草在内的多药使用流行情况。为此,对2562名患者进行了回顾性分析,研究人口统计学变量、物质使用模式、前往急诊科就诊的原因以及每位患者所消费的物质。研究显示,患者平均年龄为41±0.5(标准差=11.96),主要为男性患者(74.4%)。观察到苯二氮卓类药物和可卡因的使用 prevalence 很高,且常常同时使用。就诊的主要原因包括心悸、呼吸困难、呕吐、腹泻、行为障碍和自残等症状。只有25.5%的患者承认在分析中检测到的所有物质都有使用。在我们的环境中,多药使用很常见,这会导致诊断和治疗更加复杂。消费模式显示出与个体年龄密切相关的特征。在最年轻的人群中,四氢大麻酚(THC)和苯二氮卓类药物占主导,而在年龄较大的人群中,酒精和苯二氮卓类药物,有时还有可卡因,占主导。本研究强调需要设计特定的干预和预防策略来应对物质滥用模式,家庭和社区支持的重要性,以及应对识别和治疗多物质滥用病例方面的挑战的必要性。此外,医疗系统与执法部门之间的合作对于在紧急情况下获取有关新药及其消费模式的最新知识也很重要。

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