Mehmet ÜSTÜNDAĞ, Cahfer GÜLOĞLU, Murat ORAK, Yusuf Ali ALTUNCI, Halil DOĞAN, Yusuf TAMAM

Acil serviste olanzapin zehirlenmelerinin klinik özellikleri: Üç yıllık tecrübemiz

Amaç: Dünyada yaygın olarak kullanılmaya başlanmasından beri olanzapin zehirlenmesinin klinik özellikleri acil servis için önemli olmaya başlamıştır. Çalışmamızda olanzapin zehirlenmesi olan hastaları geriye dönük olarak araştırmayı amaçladık. Yöntem: Şubat 2004-Nisan 2007 tarihleri arasında acil servisimize olanzapin zehirlenmesi nedeniyle başvuran hastaların kayıtları arşivimizden geriye dönük olarak tarandı. Zehirlenmenin ciddiyetini belirle-mede Avrupa PSS skoru (The Poisoning Severity Score of the European Association of Poison Centers and Clini-cal Toxicologists: EAPCCT) kullanıldı. Bulgular: Çalışmamız olanzapin zehirlenmesi olan 15 hastayı içermekte-dir. Kadın/erkek oranı ikidir. Ortalama yaş 27.33±9.27 yıl (aralık: 17-48) ve hastaneye başvuru ile zehirlenme arasında geçen süre ortalama 3.96±2.38 saat (aralık: 1.5-10) idi. Alınan olanzapin miktarı 50-600 mg arasında değişmekteydi. Tek başına olanzapin alan dokuz hastanın dördünde (%44.4) PSS puanı düşük, dördünde (%44.4) orta ve birinde (11.2) yüksek bulundu. PSS puanı düşük olan grupta ortalama alınan olanzapin dozu 50-75 mg arasında değişirken, PSS puanı orta olan grupta alınan en düşük doz 140 mg idi. Sonuçta 13 hasta şifa ile taburcu edildi ve iki hasta öldü. Sonuç: Çalışmamızdaki bulgular göstermiştir ki, akut olanzapin zehirlenmesi görece iyi tolere edilmesine karşın, özellikle diğer ilaçlarla birlikte ve yüksek doz alımlarında yaşamı tehdit edebil-mektedir. Doz ile klinik özellikler ve prognoz arasında ilişki vardır.

The clinical features of olanzapine overdose in emergency department: A three years experience

Objective: Since using of olanzapine becomes widespread in the world, clinical features of olanzapine intoxica-tion become important for emergency departments. In our study, we evaluated the patients with Olanzapine intox-ication retrospectively. Methods: Olanzapine overdose patients who were admitted to an emergency department between February 2004 and April 2007 were included in the study. The Poisoning Severity Score of the European Association of Poison Centers and Clinical Toxicologists was used to assess intoxication severity. Results: In our study we include fifteen olanzapine overdose patients. Female and male ratio was two (10/5). The average age was 27.33±9.27 years (range: 17-48 years). The ingested olanzapine doses ranged from 50 to 600 mg whereas the mean of admission time was 3.96±2.38 (range: 1.5-10) hours after ingestion. For a subgroup of patients ingesting olanzapine alone, The Poisoning Severity Score was "minor" in four (44.4%), "moderate" in four (44.4%), and severe in one (11.2%) patients. While minor intoxication symptoms occurred in a broad range of ingested doses (50-75 mg), moderate intoxications were observed at a minimal ingested reported dose of 140 mg. Finally 13 patients were discharged after full recovery and two patients died. Conclusion: Our findings showed that olanzapine overdose is relatively well tolerated especially when it is not accompanied by any co-ingestant. How-ever, it can be life threaten when it is high doses are ingested or in association with other ingestants. There is correlation between dose and clinical features or prognosis.

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