Acute Drug Poisoning at Critical Care Departments in Japan.

Abstract

During 1996, 1188 patients with acute drug poisoning were admitted to 59 critical care departments in Japan. The patients were predominantly female (68.4%) and relatively young (69.2%, under the age of 40). Further analysis of the 1188 patients indicated that the majority (77.9%) were admitted as a result of deliberate self-poisoning, while 15.1 % of the cases were admitted due to accidental poisoning (unknown cause 7%). A total of 2517 drugs was taken by these patients. The most common group of drugs involved were benzodiazepines (32.1 %), followed by neuroleptics (12.2%), antidepressants (10.2%), analgesics (9.1%), antihistamines (7.3%) and barbiturates (6.2%).An important difference observed in the pattern of acute drug poisoning, when compared with that in other countries, was the preferential use of bromvalerylurea by young individuals for deliberate self-poisoning. This drug has not been used in any other country recently.There were twelve cases of fatal drug poisoning in the 59 critical care departments during 1996, including nine women. Four patients had taken barbiturates and six patients had taken a combination of benzodiazepines. In order to treat patients with acute drug poisoning, it is important to provide physicians with essential information on the incidence, mechanism of poisoning, and metabolism of the drug involved. In the case of rare drug poisoning, however, as it would take consideiable time for any one critical care department alone to amass enough admissions for generating a reliable information databese regarding management and prognosis, we therefore believe that a national approach is required to address the issue of management of patients with acute drug poisoning.