佐匹克隆致命中毒--值得关注吗?

IF 4 2区 医学 Q1 PHARMACOLOGY & PHARMACY Drug Safety Pub Date : 2024-07-01 Epub Date: 2024-03-27 DOI:10.1007/s40264-024-01424-6
Lova Tralla, Sara Gustavsson, Carl Söderberg, Anna K Jönsson, Fredrik C Kugelberg
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引用次数: 0

摘要

导言:佐匹克隆是一种用于治疗失眠症的管制药物,已成为法医尸检案例中常见的毒理学发现。本研究调查了瑞典致命中毒事件中使用佐匹克隆的作用和程度:方法:选取了 2012-2020 年间股骨血液中佐匹克隆检测呈阳性的所有法医尸检病例。在这些病例中,根据法医病理学家出具的死因证明,确定了因中毒致死的病例。佐匹克隆是死因之一的中毒事件也被纳入研究范围。研究还利用瑞典处方药登记册来检查研究对象是否服用了佐匹克隆:结果:在研究期间,共有7320起致命中毒事件接受了法医尸检,其中573起是由佐匹克隆引起的。在佐匹克隆致死病例中,87%(n = 494)有佐匹克隆处方,8%(n = 43)为单一中毒。大多数死亡病例(62%,n = 354)是自杀,而在瑞典所有中毒自杀病例中,约17%(n = 354)涉及佐匹克隆。在使用佐匹克隆的自杀案例中,女性的比例明显偏高(p < 0.01),占死亡案例的56%(n = 291)。佐匹克隆中毒者的中位年龄为55岁,而所有致命中毒者的中位年龄为44岁:这项研究表明,佐匹克隆的毒性既可与其他物质混合使用,也可单独使用而致人死亡。大多数在佐匹克隆致死中毒中死亡的人都是被处方了佐匹克隆,这可能表明,更严格地限制处方率可以防止今后发生中毒死亡事件,尤其是在护理自杀风险较高的病人时。
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Fatal Intoxications with Zopiclone-A Cause for Concern?

Introduction: Zopiclone, a controlled substance prescribed for insomnia, has become a common toxicological finding in forensic autopsy cases. This study investigated the role and extent of zopiclone use in fatal intoxications in Sweden.

Methods: All forensic autopsy cases positive for zopiclone in femoral blood during 2012-2020 were selected. Among these cases, fatalities caused by intoxication according to the cause of death certificates issued by the forensic pathologist were identified. Intoxications where zopiclone contributed to the cause of death were included in the study. The Swedish Prescribed Drug Register was utilized to examine whether the included cases were prescribed zopiclone or not.

Results: In total 7320 fatal intoxications underwent a forensic autopsy during the study period, 573 of them were caused by zopiclone. Among the zopiclone fatalities, 87% (n = 494) had a prescription for zopiclone, and 8% (n = 43) were monointoxications. Most fatalities, 62% (n = 354) were suicides, and zopiclone was involved in about 17% (n = 354) of all intoxication suicides in Sweden. Women were significantly (p < 0.01) overrepresented in suicides with zopiclone, comprising 56% (n = 291) of fatalities. The median age was 55 years among zopiclone intoxications compared with 44 years amongst all fatal intoxications.

Conclusion: This study demonstrates that the toxicity of zopiclone can be lethal both in combination with other substances and on its own. Most individuals dying in fatal zopiclone intoxications were prescribed zopiclone, which potentially indicates that a more restrictive prescribing rate could prevent future intoxication deaths, especially when caring for patients with an increased suicide risk.

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来源期刊
Drug Safety
Drug Safety 医学-毒理学
CiteScore
7.60
自引率
7.10%
发文量
112
审稿时长
6-12 weeks
期刊介绍: Drug Safety is the official journal of the International Society of Pharmacovigilance. The journal includes: Overviews of contentious or emerging issues. Comprehensive narrative reviews that provide an authoritative source of information on epidemiology, clinical features, prevention and management of adverse effects of individual drugs and drug classes. In-depth benefit-risk assessment of adverse effect and efficacy data for a drug in a defined therapeutic area. Systematic reviews (with or without meta-analyses) that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. Original research articles reporting the results of well-designed studies in disciplines such as pharmacoepidemiology, pharmacovigilance, pharmacology and toxicology, and pharmacogenomics. Editorials and commentaries on topical issues. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Drug Safety Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.
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