Drug overdose

The term drug overdose (or simply overdose or OD) describes the ingestion or application of a drug or other substance in quantities greater than are recommended or generally practiced. An overdose is widely considered harmful and dangerous as it can result in death.

Signs and symptoms

Signs and symptoms of an overdose varies depending on the drug or toxin exposure. The symptoms can often be divided into differing toxidromes. This can help one determine what class of drug or toxin is causing the difficulties.

Diagnosis

Diagnosis of an overdosed patient is generally straightforward if the drug is known. However, it can be very difficult if the patients cannot (or refuse to) state what drug they have overdosed on. At times, certain symptoms and signs exhibited by the patient, or blood tests, can reveal the drug in question. Even without knowing the drug, most patients can be treated with general supportive measures.

In some instances, antidotes may be administered if there is sufficient indication that the patient has overdosed on a particular type of medication.

Treatment

A bottle of activated charcoal withsorbitol. A commonly used agent fordecontamination of the gastrointestinal tract in overdoses.

Initial measures

Stabilization of the ABC's are the initial treatment of an overdose. This involves establishing a stable airway, breathing rate and circulatory system as an essential first step. Ventilation is considered when there is a low respiratory rate or when blood gases show the person to be hypoxic. The next necessary step is to treat for shock. Investigations should be carried out in labs to help identify the drug(s) at hand such as glucose, urea and electrolytes, paracetamol levels and salicylate levels. Monitoring of the patient should continue before and throughout the treatment process, with particular attention to temperature, pulse, respiratory rate, blood pressure, urine output, electrocardiography (ECG) and O₂saturation.^[2]

Specific treatment

Specific antidotes are available for certain causative agents. The overdose agent is usually determined either via history or laboratory toxicology.

Poison control centers and Medical toxicologists are available in many areas to provide guidance in overdoses to both physicians and the general public.

Prevention

• Refrain from mixing depressant drugs like alcohol, barbiturates, benzodiazepines, and opiates together.
• Start with small amounts, in order to estimate the potency of a drug.
• Be careful when taking a drug after a period of abstinence, as your tolerance may be drastically lowered.
• If you have a pharmaceutical chemical, make sure it is not expired. Toxicity can increase drastically.