Clinical and institutional aspects of antidote therapy in Russia.
The problem of antidote application for treatment of acute poisoning is related to epidemiology and characterization of poisoning cases, and possibilities for supplying antidotes to health care institutions. To investigate the situation in Russia we have analyzed reports by poisoning treatment centers for 1997-1999, comparison of medical aid standards for poisoning treatment in Russia with WHO recommendations. Acute poisoning pattern varies in different regions. Particularly, poisoning pattern in large cities in European Russia and the Urals is dominated by pharmaceuticals (up to 63.1%). Pesticide and insecticide poisoning cases do not exceed 1 to 2%, metal compounds and methemoglobin forming poisons (below 1% in each group). Antidotes are used in Russia in line with the recommendations adopted in international toxicological practice. The most actual are antagonists of opiates and benzodiazepines, physostigmine, atropine, pyridoxine, antagonists of beta-adrenergic blockers, activated charcoal. Such antidotes as DMPS (Unithiol), N-acetylcysteine, methylene blue, amyl nitrite (or sodium nitrite), complex formers of EDTA group are also included in the list of specific agents. The main problem is that some important antidotes are currently not produced in Russia. The Ministry of Health of the Russian Federation is taking efforts to launch production of some previously known and also newly developed important antidotes.
Ostapenko
Y N
YN
Toxicology Information and Advisory Center, Ministry of Health of the Russian Federation, 3 block 7, Sukharevskaya ploshad, 129090 Moscow, Russia. rtiac@mednet.ru
Luzhnikov
E A
EA
Nechiporenko
S P
SP
Petrov
A N
AN
D000437:Alcoholism / Q000453:epidemiology; D000931:Antidotes / Q000145:classification / Q000600:supply & distribution* / Q000627:therapeutic use*; D000997:Antivenins / Q000627:therapeutic use; D002606:Charcoal / Q000627:therapeutic use; D004363:Drug Utilization / Q000706:statistics & numerical data*; D006801:Humans; D011041:Poisoning / Q000145:classification / Q000188:drug therapy* / Q000453:epidemiology; D015995:Prevalence; D012426:Russia / Q000453:epidemiology; D012909:Snake Bites / Q000188:drug therapy
D000931:Antidotes; D000997:Antivenins; D002606:Charcoal