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Oral Lidokain Alımına Bağlı Suisid Girişimi: Olgu Sunumu

Year 2012, Volume: 3 Issue: 2, 3 - 3, 01.04.2012

Abstract

Lidokain, lokal anestezik ve antiaritmik olarak, topikal ve parenteral
yolla kullanılabilen, ülkemizde de yaygın kullanımı olan bir
ajandır. Literatürde kaza ile ya da suicid amacıyla parenteral kullanımına
ilişkin bildirimler yanında az sayıda fakat ölümle sonuçlanmış
oral maruziyetler de bildirilmiştir. Kırk iki yaşında erkek hasta
20 adet jetokain ampulun (Lidokain HCL + Epinefrin) içeriğini oral
olarak aldığı ifade edilerek yakınları tarafından acil servisimize
getirildi. Geldiğinde genel durumu iyi, şuuru açık olan hasta ile
kooperasyon yeterince kurulamıyordu. Fizik muayenesinde vital
bulguları stabildi ve belirgin patolojik bulguya rastlanmadı. Yakınlarından
daha önce psikiyatrik problemleri olduğu ve benzeri
girişimlerde bulunduğu öğrenildi. Hasta ileri tetkik ve izlem için
acil gözlem ünitesine yatırıldı. İzleminde hemodinamik açıdan
problem gelişmeyen, laboratuar tetkiklerinde anlamlı bulguya
rastlanmayan hasta, 24 saat gözlendikten sonra psikiyatri kliniği
ile konsülte edilip önerilerle taburcu edildi. Lidokainin oral alımda
biyoyararlanımı oldukça düşük olmasına rağmen, özellikle yüksek
dozlarda maruziyet durumunda ölümcül olma potansiyeli olduğu
akılda tutulmalıdır. Hastalara oral ilaç intoksikasyonlarında
uygulanan rutin protokol uygulanmalı ve yeterli süre gözlem altında
tutulmalıdırlar.

References

  • Tepe T, Antiaritmikler. Satar S, İkizceli İ. Goldfrank’ın Toksikolojik aciller el kitabı (Türkçe Çeviri) Adana: Nobel Kitabevi 2008; 537-43.
  • Shimizu K, Shiono H, Matsubara K, Awaya, T, Takahashi T, Saito O, et al. The tissue distribution of lidocaine in acute death due to overdosing. Legal Med 2000; 2: 101-5. [CrossRef]
  • Clements EA, Kuhn BR. Pharmacology Of Antidysrhythmic And Vasoactive Medications. Tintinalli JE, Kelen GD, Stapczynski JS. Emergency Medicine. 6th edition. New York:Mc Graw Hill 2004; 202-4.
  • Dawling S, Flanagan RJ, Widdop B. Fatal lignocaine poisoning: report of two cases and review of the literature, Human Toxicol 1989; 8: 389-92. [CrossRef]
  • Centini F, Fiore C, Riezzo I, Rossi G, Fineschi V. Fineschi. Suicide due to oral ingestion of lidocaine: a case report and reviewof the literature. Forensic Science Internationale 2007; 171: 57-2. [CrossRef]
  • Borkowski T, Dluzniewska A. A fatal case involving lidocaine. Bull. Int. Assoc. Forensic Toxicol 1976; 12: 17-8.
  • Dawling S, Flanagan RJ, Widdop B. Fatal lignocaine poisoning: report of two cases and review of the literature. Human Toxicol 1989; 8: 389-92. [CrossRef]
  • Nisse P, Lhermitte M, Dherbecourt V, Fourier C, Leclerc F, Houdret N, et al. Fatal intoxication after accidental viscous lidocaine ingestion by a young children. Acta Clin. Belg 2002; 1: 51-3.
  • Benowitz NL, Meister W. Clinical pharmacokinetics of lignocaine. Clin. Pharmacokinet 1978; 3: 177-201. [CrossRef]

Affiliated Oral Uptake of Lidocaine Suicidal Initiative: A Case Report

Year 2012, Volume: 3 Issue: 2, 3 - 3, 01.04.2012

Abstract

Lidocaine is an agent commonly used in our country as a local anesthetic
and antiarrhythmic, and is administered by both topical
and parenteral routes. A few reports on the accidental or suicidal
use of parenteral to oral exposures which resulted in death. have
also been reported in the literature, A forty-two year old male patient
admitted to the emergency department was reported by the
relatives to have taken the contents of a 20 jetokain bulb (lidocaine
hydrochloride + epinephrine) orally. When the general condition
was good, he was conscious, alert and sufficiently cooperative
There were no significant pathological findings in the physical examination
and vital signs were stable. Relatives reported previous
psychiatric problems and that there had been similar attempts.
The patient was admitted to the emergency observation unit for
further evaluation and follow-up. Hemodynamic follow-up did not
develop a problem, and no significant finding in the laboratory tests
of patient was observed 24 hours after the consultation and he was
discharged from the psychiatric clinic. The intake of oral bioavailability
of lidocaine is quite low, although it should be kept in mind
that it is potentially fatal, especially in the case of exposure to high
doses. Patients who undergo a routine protocol of oral drug intoxication
should be kept under observation for an adequate period.

References

  • Tepe T, Antiaritmikler. Satar S, İkizceli İ. Goldfrank’ın Toksikolojik aciller el kitabı (Türkçe Çeviri) Adana: Nobel Kitabevi 2008; 537-43.
  • Shimizu K, Shiono H, Matsubara K, Awaya, T, Takahashi T, Saito O, et al. The tissue distribution of lidocaine in acute death due to overdosing. Legal Med 2000; 2: 101-5. [CrossRef]
  • Clements EA, Kuhn BR. Pharmacology Of Antidysrhythmic And Vasoactive Medications. Tintinalli JE, Kelen GD, Stapczynski JS. Emergency Medicine. 6th edition. New York:Mc Graw Hill 2004; 202-4.
  • Dawling S, Flanagan RJ, Widdop B. Fatal lignocaine poisoning: report of two cases and review of the literature, Human Toxicol 1989; 8: 389-92. [CrossRef]
  • Centini F, Fiore C, Riezzo I, Rossi G, Fineschi V. Fineschi. Suicide due to oral ingestion of lidocaine: a case report and reviewof the literature. Forensic Science Internationale 2007; 171: 57-2. [CrossRef]
  • Borkowski T, Dluzniewska A. A fatal case involving lidocaine. Bull. Int. Assoc. Forensic Toxicol 1976; 12: 17-8.
  • Dawling S, Flanagan RJ, Widdop B. Fatal lignocaine poisoning: report of two cases and review of the literature. Human Toxicol 1989; 8: 389-92. [CrossRef]
  • Nisse P, Lhermitte M, Dherbecourt V, Fourier C, Leclerc F, Houdret N, et al. Fatal intoxication after accidental viscous lidocaine ingestion by a young children. Acta Clin. Belg 2002; 1: 51-3.
  • Benowitz NL, Meister W. Clinical pharmacokinetics of lignocaine. Clin. Pharmacokinet 1978; 3: 177-201. [CrossRef]
There are 9 citations in total.

Details

Other ID JA57JK47CA
Journal Section Case Report
Authors

Sedat Koçak This is me

Birsen Ertekin

Hasan Kara This is me

Ayşegül Bayır This is me

Publication Date April 1, 2012
Submission Date April 1, 2012
Published in Issue Year 2012 Volume: 3 Issue: 2

Cite

APA Koçak, S., Ertekin, B., Kara, H., Bayır, A. (2012). Affiliated Oral Uptake of Lidocaine Suicidal Initiative: A Case Report. Journal of Emergency Medicine Case Reports, 3(2), 3-3.
AMA Koçak S, Ertekin B, Kara H, Bayır A. Affiliated Oral Uptake of Lidocaine Suicidal Initiative: A Case Report. Journal of Emergency Medicine Case Reports. April 2012;3(2):3-3.
Chicago Koçak, Sedat, Birsen Ertekin, Hasan Kara, and Ayşegül Bayır. “Affiliated Oral Uptake of Lidocaine Suicidal Initiative: A Case Report”. Journal of Emergency Medicine Case Reports 3, no. 2 (April 2012): 3-3.
EndNote Koçak S, Ertekin B, Kara H, Bayır A (April 1, 2012) Affiliated Oral Uptake of Lidocaine Suicidal Initiative: A Case Report. Journal of Emergency Medicine Case Reports 3 2 3–3.
IEEE S. Koçak, B. Ertekin, H. Kara, and A. Bayır, “Affiliated Oral Uptake of Lidocaine Suicidal Initiative: A Case Report”, Journal of Emergency Medicine Case Reports, vol. 3, no. 2, pp. 3–3, 2012.
ISNAD Koçak, Sedat et al. “Affiliated Oral Uptake of Lidocaine Suicidal Initiative: A Case Report”. Journal of Emergency Medicine Case Reports 3/2 (April 2012), 3-3.
JAMA Koçak S, Ertekin B, Kara H, Bayır A. Affiliated Oral Uptake of Lidocaine Suicidal Initiative: A Case Report. Journal of Emergency Medicine Case Reports. 2012;3:3–3.
MLA Koçak, Sedat et al. “Affiliated Oral Uptake of Lidocaine Suicidal Initiative: A Case Report”. Journal of Emergency Medicine Case Reports, vol. 3, no. 2, 2012, pp. 3-3.
Vancouver Koçak S, Ertekin B, Kara H, Bayır A. Affiliated Oral Uptake of Lidocaine Suicidal Initiative: A Case Report. Journal of Emergency Medicine Case Reports. 2012;3(2):3-.