Drug-related episode

The Drug Abuse Warning Network, which collects information on drug-related episodes from the nation s emergency rooms, showed that methamphetamine-relat-ed visits to emergency rooms more than tripled between 1991 and 1994, rising from 4,900 to more than 17,000. That number stayed the same until the late 1990s, and actually decreased somewhat (to 13,500) by 2000. 

In 2000, patients aged 18 to 25 and 26 to 34 had the highest rates of ED drug-related episodes, followed by patients aged 12 to 17. Patients 35 years and over accounted for the lowest rate of episodes. 

Data for Australia refer to closed drug related treatment episodes over the July 2003-June 2004 period. Source UNODC, Annual Reports Questionnaire (ARQ) data... 

In 2000, heroin was second only to cocaine in the number of drug-related emergency room episodes reported to a national registry run by the Drug Abuse Warning Network. Heroin, listed as a principal agent in respiratory and cardiac emergencies, went from 33,884 episodes nationwide in 1990 to 94,804 in 2000—an increase of nearly 180%. 

It is difficult to obtain marijuana-specific data from DAWN information, since up to four different substances can be recorded for each ED episode. And because a drug-related visit to an ED can have multiple drug mentions, not every reported substance may be, by itself, the cause of the medical emergency. Until DAWN data can provide more marijuana-specific information, many feel that policymakers cannot draw definitive conclusions about the consequences of marijuana use from these reports. DAWN researchers acknowledge this limitation of their data. DAWN, like NHSDA, is directed by the Substance Abuse and Mental Health Services Administration. 

From 1999 to 2000, total drug-related ED episodes increased 20 percent for adolescents. Out of 63,448 mentions of drugs, marijuana was mentioned 15,683 times. 

In 2000, the majority (56 percent) of all drug-related ED episodes involved more than one drug. 

Liposomal amphotericin and ABLC have been compared in an open randomized study in 75 adults with leukemia and 82 episodes of suspected or documented mycosis (48). The median durations of treatment and dosages were 15 days at 4 mg/kg/day for liposomal amphotericin and 10 days at 3 mg/kg/day for ABLC. Acute but not dose-limiting infusion-related adverse events occurred in 36 versus 70%. Bilirubin increased to over 1.5 times baseline in 59 versus 38%. There was no difference in the effects of either agent on renal function and drug-related withdrawals. The overall response rate to therapy in documented fungal infections (29 and 30% respectively) was not different between the two drugs. 

Drug-related epidemics have occurred, mercifully relatively infrequently. However, with each unfortunate episode, there is inevitably a variety of regulatory and clinical fallout. Indeed, the illnesses associated with ingestion of glycol-tainted linctus led to the Food, Drugs and Cosmetics ( ) Act in the USA, and the disastrous association of phocomelia with thalidomide propelled reforms of drug regulations worldwide. Other famous examples include, of course, practolol-induced ocu-lomucocutaneous syndrome, and, more recently, fenfluramine-induced myocardial fibrosis, and isotretinoin-associated birth defects. 

In the U.K., Dr. Karch served as a consultant to the Crown and helped prepare the cases against serial murderer Dr. Harold Shipman, who was subsequently convicted of murdering 248 of his patients. He has testified on drug abuse-related matters in courts around the world. He has a special interest in cases of alleged euthanasia, and in episodes where mothers are accused of murdering their children by the transference of drugs, either in utero or by breast feeding. 

Antibodies have and likely will find additional use in transplantation-related medicine. In general, cell-mediated immunological mechanisms are responsible for mediating rejection of transplanted organs. In many instances, transplant patients must be maintained on immunosuppressive drugs (e.g. some steroids and, often, the fungal metabolite cyclosporine). However, complications may arise if a rejection episode is encountered that proves unresponsive to standard immunosuppressive therapy. Orthoclone OKT-3 was the first monoclonal antibody-based product to find application in this regard. 

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