Criminal clozapine intoxications

• Published in: Anesteziologiia i reanimatologiia no. 4; p. 61
• Main Authors: Sliundin, D G, Livanov, A S, Anuchin, V V, Bobrinskaia, I G, Gutova, E V
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 01-07-2007
• Subjects: Adult; Antidotes - administration & dosage; Antidotes - therapeutic use; Carbamates - administration & dosage; Carbamates - therapeutic use; Clozapine - blood; Clozapine - pharmacokinetics; Clozapine - poisoning; Crime; Female; Galantamine - administration & dosage; Galantamine - therapeutic use; Humans; Male; Middle Aged; Poisoning - diagnosis; Poisoning - drug therapy; Poisoning - physiopathology; Pyridines - administration & dosage; Pyridines - therapeutic use; Pyridostigmine Bromide - administration & dosage; Pyridostigmine Bromide - analogs & derivatives; Pyridostigmine Bromide - therapeutic use
• ISSN: 0201-7563

The paper deals with the topical problem--study criminal clozapine intoxications that have recently ranked first in the total structure of criminal intoxications, by ousting poisoning by clofelin. Thus, in 2004 to 2006, the number of victims taken to the Prof. A. A. Ostroumov Moscow City Hospital No. 33 increased by 1.9 times, by amounting to 1120 cases in 2006. At the same time, its correct prehospital diagnosis was made only in 1.76% of the victims. Abundant clinical material (2720 cases) has been analyzed, by using the currently performed studies. The specific features of the development and clinical manifestations of these intoxications, including those concurrent with alcoholic intoxication, are described in detail. The characteristic manifestations of impaired consciousness, hypersalivation, and myosis in the absence of generally, respiratory failure and hemodynamic disorders, as well as altered clinical and biochemical blood parameters are shown. At the same time there were elevated ammonia levels within the first hours after intoxication, which, in the authors' opinion, may suggest the development of hepatic dysfunction. Emphasis is laid on the fact that the leading component in the complex of medical measures is the administration of central anticholinesterase agents (aminostigmine and galantamine hydrobromide) that may be used as an antidote and for the differential diagnosis of these intoxications.