RESUMO
Objetivos: Analizar las características de las intoxicaciones en niños atendidos en el Hospital Nacional de Niños. Diseño: Estudio retrospectivo. Materiales y Métodos: Se analizaron todos los "Registros de la Consulta Toxicológica", del Centro Nacional de Control de Intoxicaciones (Centro), durante el período comprendido entre 1990-1996. Se seleccionó el código "013" que identifica a las consultas de pacientes atendidos en este hospital y el código 0 que corresponde a intoxicaciones. Se estudiaron las variables de mes, hora, día de la semana, causa, sexo, ruta de exposición, edad, estancia hospitalaria, agentes, signos y síntomas, mortalidad, uso de antídotos y severidad de la intoxicación. Resultados: Se atendieron 4025 niños intoxicados. La distribución mensual es similar en el transcurso del año así como la frecuencia por días de la semana. A mediodía es el pico máximo de atención de pacientes. El 49.6 por ciento de los productos ingeridos fueron líquidos. La proporción del sexo masculino sobre el femenino fue de 1.36. La edad más susceptible fue 1-2 años. El 76 por ciento de los pacientes tuvieron una estancia hospitalaria menor de 24 horas. Un 32.3 por ciento de los pacientes cursaron asintomáticos. La mortalidad fue de 0.25 por ciento. El uso de antídotos farmacológicos fue requerido en un 8.3 por ciento de los pacientes. Un 21.3 por ciento no necesitó ninguna intervención terapeútica. El 58 por ciento de los agentes fueron clasificadas de una severidad moderada. Conclusiones: La morbilidad en pediatría por intoxicaciones es alta. El patrón de este tipo de accidentes es similar al que se reporta en otros países del mundo. Palabras claves: intoxicaciones, tóxico, ingestión, lorazepan, niños, mortalidad, epidemiológia, hospitalización, antídotos, accidente
Assuntos
Humanos , Pré-Escolar , Criança , Adolescente , Lactente , Acidentes Domésticos , Lorazepam/efeitos adversos , Paraquat/efeitos adversos , Intoxicação/diagnóstico , Intoxicação/etiologia , Substâncias Tóxicas , Toxicologia , Costa RicaRESUMO
Effect of diphenhydramine was investigated on withdrawal signs in lorazepam dependent rats. Physical dependence was produced by giving lorazepam admixed with the food in the following dose schedule: 10 x 4, 20 x 4, 40 x 4, 80 x 4 and 120 x 7 (mg/kg, daily x days). The parameters observed during the periods of administration of lorazepam and after its withdrawal were spontaneous locomotor activity (SLA), body temperature, reaction time to pain, foot shock aggression (FSA) and audiogenic seizures. Diphenhydramine was administered orally in the dose schedules of once daily (10, 20 and 40 mg/kg) and twice daily (5, 10 and 20 mg/kg) in separate groups during the withdrawal period. The withdrawal signs observed in control group (without diphenhydramine) were hyperkinesia, hyperthermia, hyperaggression and audiogenic seizures. Hyperkinesia and hyperthermia were blocked in all the groups of diphenhydramine-treated rats. FSA was inhibited only by diphenhydramine (10 and 20 mg/kg) given twice daily. Audiogenic seizures were completely blocked by once daily (20 and 40 mg/kg) as well as twice daily (20 mg/kg) doses of diphenhydramine. It may be concluded that diphenhydramine exerts a protective effects on benzodiazepine withdrawal syndrome.
Assuntos
Estimulação Acústica , Administração Oral , Agressão/efeitos dos fármacos , Animais , Ansiolíticos/efeitos adversos , Temperatura Corporal/efeitos dos fármacos , Difenidramina/administração & dosagem , Feminino , Hipnóticos e Sedativos/administração & dosagem , Lorazepam/efeitos adversos , Masculino , Atividade Motora/efeitos dos fármacos , Ratos , Ratos Wistar , Convulsões/etiologia , Síndrome de Abstinência a Substâncias/tratamento farmacológicoRESUMO
Effects of calcium channel blockers were investigated on withdrawal signs in lorazepam dependent rats. Physical dependence was produced by giving lorazepam admixed with the food in the following dose schedule: 10 x 4, 20 x 4, 40 x 4, 80 x 4 and 120 x 7 (mg/kg daily x days). Parameters such as body weight, food intake, spontaneous locomotor activity (SLA), body temperature, reaction time to pain, foot shock-aggression (FSA) and audiogenic seizures were observed during the period of administration of lorazepam and after its withdrawal. Calcium channel blockers viz. verapamil, nifedipine and nimodipine in different doses were administered orally twice daily in separate groups during the withdrawal period. The withdrawal signs observed in control group (without calcium channel blockers) were hyperkinesia, hyperthermia, hyper-aggression and audiogenic seizures. The administration of verapamil (5-20 mg/kg), nifedipine (1.75-7 mg/kg) and nimodipine (5-20 mg/kg) during the withdrawal period of lorazepam showed dose dependent significant blockade of all the withdrawal signs. Audiogenic seizures were completely blocked by 20 mg/kg dose of verapamil and nimodipine while nifedipine was partially effective. It may be concluded that calcium channel blockers exert protective effects on benzodiazepine withdrawal syndrome.
Assuntos
Estimulação Acústica , Agressão/efeitos dos fármacos , Animais , Temperatura Corporal/efeitos dos fármacos , Bloqueadores dos Canais de Cálcio/farmacologia , Feminino , Lorazepam/efeitos adversos , Masculino , Atividade Motora/efeitos dos fármacos , Ratos , Ratos Wistar , Convulsões/induzido quimicamente , Síndrome de Abstinência a Substâncias/tratamento farmacológicoRESUMO
Neste artigo, o segundo de uma série de três, prosseguimos na revisäo da segurança e tolerância dos benzodiazepínicos, analisando seu potencial de induzir déficit cognitivo global - agudo, sob a forma de delirium e crônico, na demência - e seletivo - ao interferirem no funcionamento normal da memória