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Type: Outros documentos
Title: Antidote availability in emergency departments in the municipality of Campinas, Sao Paulo state, Brazil
Author: Fernandes, Luciane C. R.
Prado, Camila C.
Branco, Maira M.
Fernandes, Carla B.
De Capitani, Eduardo M.
Hyslop, Stephen
Bucaretchi, Fabio
Abstract: The lack of adequate and prompt availability of antidotes is a worldwide problem, with potentially disastrous consequences. We evaluated the availability of antidotes used in the treatment of poisonings in public and private emergency departments in the municipality of Campinas, S ã o Paulo state, Brazil. Methods: A structured questionnaire was sent to the pharmacy directors of public and private emergency departments in the municipality of Campinas. The availability, amount in stock, place of storage, and access time in the emergency room (immediately or within the fi rst hour) were investigated for 31 antidotes in 33 pharmaceutical preparations. A stock was defi ned as at least one full antidote treatment per service per 70 kg adult. The selection of antidotes was based on stock recommendations contained in published international guidelines. 1,2 Antivenoms were not included in the analysis. Results: Questionnaires were completed by 14 of 17 emergency departments (7 public and 7 private) operating at the time, including the public ambulance transport service. No emergency department stocked all of the 31 selected antidotes, and none of them had digoxin antibodies, physostigmine, fomepizole, hydroxocobalamin or pralidoxime. Eight units had an adequate stock of N-acetylcysteine, but in inappropriate presentations for use as antidotes (injectable solution 3 mg/mL for IV use; 100 mg, 200 mg or 600 mg sachets for use orally or by nasogastric tube). Only seven antidotes (atropine, sodium bicarbonate 8.4%, diazepam, phytomenadione, fl umazenil, glucose 50% and calcium gluconate 10%) were stocked in all evaluated units, followed by 13/14 units where there was a stock of activated charcoal and naloxone. Only the referral public department for the treatment of poisonings had a stock profi le close to that outlined above, with 25 antidotes and 27 pharmaceutical forms, but without digoxin antibodies, physostigmine, fomepizole, hydroxocobalamin, glucagon and pralidoxime. (Before the 2014 FIFA World Cup in Brazil, the referral public service received an additional stock of hydroxocobalamin and pralidoxime). Conclusion: The stock of antidotes in emergency departments in the municipality of Campinas is inadequate and poorly scaled, potentially jeopardizing the treatment of poisoned patients
Subject: Toxicologia
Country: Estados Unidos
Editor: Taylor & Francis
Citation: Antidote Availability In Emergency Departments In The Municipality Of Campinas, Sao Paulo State, Brazil. Informa Healthcare, v. 53, p. 259-259 MAY-2015.
Rights: fechado
Identifier DOI: 10.1186/s12974-017-0869-7
Date Issue: 2017
Appears in Collections:FCM - Artigos e Outros Documentos

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