ABSTRACT
The increasing prevalence of toxic substance-exposure in pets in South Korea endangers the health and safety of numerous companion animals, and has become a cause for concern. Notably, the annual incidence of forensic analysis in pets has increased by more than 150% in South Korea, mainly in populous regions such as Seoul, Incheon, and Gyeonggi. In response to this growing issue, veterinary forensic examinations were conducted on 549 dogs and cats from 2019 to 2022. This study revealed the presence of various toxic substances, including pesticides, insecticides, and drugs such as analgesics, anesthetics, antidepressants, and muscle relaxants, in pets. Among the 38 different toxins identified in pets, coumatetralyl, methomyl, terbufos, and buprofezin were the most frequently detected. In this study, toxic substances for pets were identified based on the “toxic agent list for humans,” developed by the National Forensic Services, because no list of toxic agents for animals currently exists and data regarding potentially toxic substances for dogs and cats is limited. This is one of the limitations of this study, and necessitates the establishment of a toxic agent list for animals. Continued monitoring and research is also recommended to reveal the incidence, causes, and solutions of toxicity in animals.
ABSTRACT
We reported a case of acute intoxication by tramadol and zolpidem, resulting in QT prolongation in a patient. A 38-year-old male patient presented to the emergency department (ED) because of poisoning from 3 g of tramadol and 50 mg of zolpidem 4 hours before. During supportive treatment, he developed QT prolongation without clinical manifestations. He was discharged 5 days after admission without any sequelae. We measured the blood and urine concentrations of tramadol and zolpidem at various time points, which revealed a blood tramadol concentration-dependent change in QT intervals and an increased blood tramadol concentration at 8 hours after the ED visit. Tramadol and zolpidem were metabolized by the same enzyme, cytochrome P450 3A4. Therefore, competitive inhibition may increase drug toxicity. In addition, the blood concentration of tramadol may increase and result in QT prolongation even after appropriate initial treatment.