Toxicity Analysis: A Collection of Case Studies and Drug Management Strategies

Erwin  Samsul; Ika  Khotimah; Theodora Jane  Harludi; Gmelina Adelia Putri  Purba; Aji Arda Nur  Wahyuda; Mahatma Setya Sudarma; Nur Wulan Mas  Rajo; Saina Cintami Abdila Rahma; Willy  Ardhito

doi:10.70392/jpns.v2i1.0114

Authors

Erwin Samsul Fakultas Farmasi, Universitas Mulawarman Author
Ika Khotimah Fakultas Farmasi, Universitas Mulawarman Author
Theodora Jane Harludi Fakultas Farmasi, Universitas Mulawarman Author
Gmelina Adelia Putri Purba Fakultas Farmasi, Universitas Mulawarman Author
Aji Arda Nur Wahyuda Fakultas Farmasi, Universitas Mulawarman Author
Mahatma Setya Sudarma Fakultas Farmasi, Universitas Mulawarman Author
Nur Wulan Mas Rajo Fakultas Farmasi, Universitas Mulawarman Author
Saina Cintami Abdila Rahma Universitas Mulawarman Author
Willy Ardhito Fakultas Farmasi, Universitas Mulawarman Author

DOI:

https://doi.org/10.70392/jpns.v2i1.0114

Keywords:

napza, toxicology, addiction

Abstract

Narcotics, Psychotropics, and Addictive Substances (NAPZA), are any compound or drug that can alter the central nervous system and behavioural patterns, that can also cause an addiction. Narcotics and psychotropics in itself can be categorized into 3 categories of narcotics, and 4 categories of psychotropics, based on their use as a medication and the possibility of an addiction. Since NAPZA can alter the central nervous system, the possibility of their toxicity needs more attention. This study is done to review the handling and the mechanism of toxicity of NAPZA. We used the narrative review method to gather information from various sources, including 3 websites, 1 book, 7 national articles, and 22 international articles that were published in the time span of 2014 to 2024. From the 11 cases of NAPZA toxicity, 4 were caused by narcotics, 4 by psychotropics, and 3 by addictive substances, with most cases were of drug misuse by the productive population. The main handling of narcotics toxicity were to secure the breathing function, oxygen supplementation, and the use of Naloxone as an antidote. While psychotropics and addictive substances poisoning were handled with the use of benzodiazepines, hemodialysis, or to increase the rate of drug elimination in the plasma.

Author Biography

Saina Cintami Abdila Rahma, Universitas Mulawarman

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References

Pusat Analisis Kebijakan Obat dan Makanan. Kajian Analisis Data Kasus Keracunan Obat dan Makanan Tahun 2023, 2023. Available online: https://pusakom.pom.go.id/riset-kajian/detail/analisis-data-kasus-keracunan-obat-dan-makanan-tahun-2023 [Accessed 23 November 2024].

Alifia, U. Apa Itu Narkotika dan Napza?. PT. Bengawan Ilmu: Semarang, Indonesia, 2019.

Nasution, A.S., Azzahra, T.M., Sari, R.I., Abdurrahman. Fenomena penyalahgunaan narkoba di kalangan remaja berdasakan teori interksionisme simbolik di Kota Medan. Community Development Journal 2024, 5(1), 197-210.

Nurmaya, A. Penyalahgunaan NAPZA di kalangan remaja (Studi kasus pada 2 siswa di MAN 2 Kota Bima). Jurnal Psikologi Pendidikan & Konseling 2016, 2(1), 26-32.

Ningrum, S.W., Sutarni, S., Gofir, A. Penyalahgunaan narkotika, psikotropika, dan zat adiktif sebagai faktor resiko gangguan kognitif pada remaja jalanan. Berkala Neurosains 2016, 15(2), 85-95.

Puji, L.K.R., Kasumawati, F., Indah, F.P.S., Ratnaningtuas, T.O., Ilmi, A.F, Hasanah, N., Ismaya, N.W.A., Adha, M.Z., Bahri, S., Putri, W. G. The effect of drugs on mental health and reproductive health in adolescents. Jurnal Abdi Masyarakat 2022, 3(2),155-163

Finlayson, A.J.R., Macoubrie, J., Huff, C., Foster, D.E., Martin, P.R. Experiences with benzodiazepine use, tapering, and discontinuation: An internet survey. Ther Adv Psikofarmakol 2022, 12, 1-10.

Saragih, R., Saragi, P., Sianipar, A.W.H. Penegakan hukum dan perlindungan hukum terhadap peredaran dan penya-lahgunaan narkoba di kalangan remaja: Studi kasus di Indonesia. Honeste Vivere 2024, 34(2), 244-254.

United Nations Office on Drugs and Crime. Legal Framework for Drug Trafficking, 2024. Available online: https://www.unodc.org/unodc/es/drug-trafficking/legal-framework.html [Accessed 23 November 2024].

Alouazen, O., Bekraoui, A., Fadel, H., Belfkih, R., Rachidi, S.A. Cocaine-induced multifocal leukoencephalopathy: A case report and literature review. Radiology Case Reports 2024, 19, 6470-6473.

Bravo, R.R., Faria, A.C., Brito-da-Costa, A.M., Carmo, H., Mladěnka, P., Silva, D.D., Remião, F. Cocaine: An updated overview on chemistry, detection, biokinetics, and pharmacotoxicological aspects including abuse pattern. Toxins 2022, 14(4), 1-25.

Laverteu, S. M., Signorella, S., Baig, R., Emerson, A., Joyce, J., Zhang, R. Death after marijuana use in a 27-year-old male: A case report. Advances in Clinical Medical Research and Healthcare Delivery 2023, 3(2), 1-4.

Lee, J., Sharma, N., Kazi, F., Youssef, I., Myers, A., Marmur, J.D., Salifu, M.O., McFarlane S.I. Cannabis and myocardial infarction: Risk factors and pathogenetic insights. Scifed J Cardiol 2018, 1(1), 1-9.

Schep, L.J., Slaughter, R.J., Glue, P., Gee, P. The clinical toxicology of cannabis. The New Zealand Medical Journal 2020, 133(1523), 96-103.

Richard, J.R., Schandera, V., Elder, J.W. Treatment of acute cannabinoid overdose with naloxone infusion. Toxicology Communications 2017, 1(1), 29-33.

Jones, J.D., Nolan, M.L., Daver, R., Comer, S.D., Paone, D. Can naloxone be used to treat synthetic cannabinoid overdose?. Biol Psychiatry 2017, 81(7), 51-52.

Kim, S., Kang, K. Morphine over infusion of intrathecal drug administration system under magnetic resonance evaluation for the diagnosis of stroke: A case report. BMC Neurology 2021, 21(147), 1-3.

Ofoegbu, A., Ettiene, E.B. Pharmacogenomics and morphine. The Journal of Clinical Pharmacology 2021, 61(9), 1149-1155.

Lynn, R.R., Galinkin,J.L. Naloxone dosage for opioid reversal: current evidence and clinical implications. Therapeutic Advances in Drug Safety 2018, 9(1), 63-88.

Singhal, K.C., Garg, K.C., Rahman, S.Z. Who is pushing patients to death trap by improper use of codeine? Time now to reorient physicians or ban the use of codeine!. Journal of Pharmacovigilance and Drug Safety 2020, 17(1), 15-18.

Lubis, N.M.D., Ramadhania, Z.L. Artikel tinjauan: Efek samping penggunaan kodein pada pediatrik. Farmaka 2018, 16(2), 64-79.

Stephens, E. MedScape. [Online]. Opioid Toxicity 2024. Available online: https://emedicine.medscape.com/article/815784-overview [Accessed 28 November 2024].

Burish, M.J., Thoren, K.L., Madou, M., Toossi, S., Shah, M. (2014). Hallucinogens causing seizures? A case report of the synthetic amphetamine 2,5-dimethoxy-4-chloroamphetamine. The Neurohospitalist 2014, 5(1), 1-3.

Hemphill, K., Tierney, S., Tirschwell, D., Davis, A.P. A review of methamphetamine use and stroke in the young. Frontiers in Neurology 2024, 15, 1-12.

Wodarz, N., Scheidler, A.K., Christ, M., Fleischmann, H., Looser, W., Schoett, K., Vilsmeier, F., Bothe, L., Schaefer, C., Mayfrank, E.G. Evidence-based guidelines for the pharmacological management of acute methamphetamine-related disorders and toxicity. Pharmacopsychiatry 2016, 50(3), 87-95.

Sibanda, N.J., Kornhaber, R., Hunt, G.E., Morley, K., Cleary, M. Prevalence and risk factors of emergency department pre-setations with methamphetamine intoxication or dependence: A systematic review and meta-analysis. Issues in Mental Health Nursing 2019, 40(7), 567–578.

Patel, A., Parate, T., Bhure, N., Charde, S. Effect of haemodialysis in phenobarbital toxicity: A case report. International Journal of Science and Research 2023, 12(12), 791-792.

Kaur, N., Kaur, M., Sohal, H.S., Han, H., Bhowmik, P.K. A review on barbituric acid and its derivatives: Synthesis, reac-tions, and bio-applications. Organics 2024, 5(3), 298-345.

Dobisova, A., Vavrinec, P., Yaghi, D.V., Gebhardtove, A., Henning, R.H., Yaghi, A. Case report: Enhanced diazepam elimination with the molecular adsorbents recirculating system (MARS) in severe autointoxication: A survival case report. Frontiers in Medicine 2021, 8, 1-4.

Sah, S.K., Joshi, D., Pathak, S., Regmi, S., Regmi, B.M., Manandhar, P.N., Pandeya, S., Marasini, N. Effect of ethanol and pH on the in vitro adsorption of diazepam onto activated charcoal from simulated gastric fluid and simulated intestinal fluid. Indian Journal of Pharmaceutical Sciences 2016, 78(5), 624-630.

Ito, M., Ando, T., Yamamoto, K., Ishido, A. Caffeine intoxication as a result of excessive consumption of bottled coffee products: A case report. Journal of Rural Medicine 2023, 18(3), 200–204.

Wilson, C. The clinical toxicology of caffeine: A review and case study. Toxicology Reports 2018, 5, 1140-1152.

Beauchamp, G.A., Johnson, A.R., Crouch, B.I., Valento, M., Horowitz, B.Z., Hendrickson, R.G. A retrospective study of clinical effects of powdered caffeine exposures reported to three US poison control centers. J. Med. Toxicol. 2016, 12, 295–300.

Becam, J., Martin, E., Pouradier, G., Doudka, N., Solas, C., Guilhaumou, R., Fabresse, N. Transdermal nicotine poisoning: A rare case report of occupational exposure. Toxicans 2023, 11(5), 1-6.

Pozuelos, G.L., Vargas, M.R.S., Ramirez, E., Bandaru, D., Sha, J., Wohlschlegel, J., Talbot, P. Nicotine affects multiple bi-ological processes in EpiDerm™ organotypic tissues and keratinocyte monolayers. Atmosphere 2022, 13(5), 1-19.

Saputera, M.D., Saputera, J.D. Kecubung intoxication: A case report on a 16-year-old male at Kuningan District. Jurnal Penyakit Dalam Indonesia 2022, 9(4), 226-230.

Kienitz, R, Kay, L., Beuchat, I., Gelhard, S., Brauchitsch, S.V., Mann, C., Lucaciu, A., Schäfer, J.H., Siebenbrodt, K., Zöllner, J.P., Bast, S.S., Rosenow, F., Strzelczyk, A., Willems, L.M. 2022. Benzodiazepines in the management of seizures and status epilepticus: A review of routes of delivery, pharmacokinetics, efficacy, and tolerability. CNS Drugs 2022, 36, 951–975.