Acute Intoxications Involving Synthetic Psychoactive Substances

• Main Authors: Sergey A. Vasil'ev, Viktor V. Shilov, Pavel A. Barabanov, Valentin G. Sentsov, Boris B. Yatsinyuk
• Format: Article
• Language: Russian
• Published: Russian Academy of Medical Sciences 2018-03-01
• Series: Obŝaâ Reanimatologiâ
• Subjects: acute poisoning; synthetic narcotics; methadone; cannabinoids; therapy; naloxone; cytoflavin
• Online Access: https://www.reanimatology.com/rmt/article/view/1635
• ISSN: 1813-9779; 2411-7110

The purpose of this study was to evaluate the effectiveness of a succinic acid derivate, a substrate metabolic agent cytoflavin in patients with acute poisoning with synthetic psychoactive drugs.Materials and methods. A retrospective evaluation of effectiveness of a combined intensive care treatment protocol for 622 patients with acute narcotic poisoning (methadone and synthetic cannabinoids) was carried out. All patients were divided into two groups. The main group (112 patients, median age 38.2±12.0 years) included patients who, in addition to the basic treatment, received cytoflavin by intravenous drop infusion, 20–40 ml diluted in 400–500 ml of 10% glucose, for 5 days. Patients of the reference group (510 subjects, median age 37.6±14.1 years) received treatment according to the «classical scheme». In addition to conventional examination, all patients underwent duplex scanning of cerebral vessels, examination of changes in the cerebral blood circulation and electroencephalogram findings. The severity of somatic disorders was assessed using criteria of the Glasgow coma scale. The severity of the asthenic syndrome was assessed according to the MFI-20 scale.Results. Compared to patients who received a standard therapy, patients of the main group had a significantly more rapid recovery from coma (by 1.5-fold: 23.5±3.1 days, versus 15.1±3.0 days, respectively, P0.05); the duration of psychotic disorders was shorter (by 1.8-fold: 15.5±4.2 hours vs 8.3±2.5 hours., respectively, P0.05), and the intensity of asthenic syndrome (by 2.8-fold: 64.1±3.3 rel. units vs 23.0±4,9 rel. units, respectively, P0.05) was also lower.Conclusion. Inclusion of cytoflavin in a protocol of a complex treatment of patients with synthetic drugs poisoning increased the effectiveness of the therapy. Data demonstrate that inclusion of the drug can be recommended for treatment of acute synthetic narcotic poisoning.