NON-COMPLIANCE TO SAFETY RULES REGARDING MEDICATION PRESCRIPTION, LEADS TO TWO ADULTS' DEATH DUETO COLCHICINE INTOXICATION
Keywords:
good manipulation pratices, colchicine, pharmaceutical chemistryAbstract
We present data from two cases seen at an emergency facility, occurring within a one-week period with two members of the same family, who died of septicemia and acute hemorrhagic enteritis. The investigation, conducted by the sanitary and epidemiological surveillance department, concluded that these deaths were due to accidenta/ intoxication with colchicines. The drug was prepared in a compounding pharmacy, and there were breaches of safety norms /eading to the ingestion of doses 7 00 times higher than the recommended dosage. The present report intends to a/ert physicians who provide emergency care as to the need to include, during the anamnesis of patients, specific questions to them or to their companion regarding the use of compounded drugs, given that the use of medication prepared in compounding pharmacies is increasing and accidents, as the one reported, may become more frequent and may occur with other drugs as well.
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References
Roberts li LJ, Morrow JD. Analgésicos: antipiréticos, agentes antiinflamatórios e fármacos utilizados no tratamento da gota. ln: Goodman & Gilman, editores. As bases farmacológicas da terapêutica. 10.ed. Rio de Janeiro: Guanabara; 2003. Cap.27, p.517-50.
Putterman C, Chetrit-Ben E, Caraco Y, Levy M. Colchicine intoxication: ccclinical pharmacology, risk factors, features, and management. Semin Arthritis Rheum. 1991; 21(3):143-55
Deveaux M, Hubert N, Demarly C. Colchicine poisoning: case report of two suicides. Forensic Sei lnt. 2004; 143(2-3):219-22.
Borras-Biasco J, Enriquez R, Sirvent AE, Amoras F, Navarro-Ruiz A, Reyes A. Acute renal failure associated with an accidental overdose of colchicine. lnt J Clin Pharmacol Ther. 2005; 43(10):480-4
Maxwell MJ, Muthu P, Pritty PE. Accidental colchicine overdose. A case report and literature review. Emerg Med J. 2002; 19(3):265-7
Guven AG, Bahat E, Akman S, Artan R, Erol M. Late diagnosis of severe colchicine intoxication. Pediatrics. 2002; 109(5) 971-3.
Dehon B, Chagon JL, Vinner E, Pommery J, Mathieu D, Lhermitte M. Colchicine poisoning: report of a fatal case with body fluid and post-mortem tissue análises by high-performance liquid chromatography. Biomed Chromatogr. 1999; 13(3):235-8.
Sánchez MLA, Ferrero BO, Franco-Vicario R, Villa FM. lntoxicación aguda por colchicina. An Med Interna. 2000; 17(2):109-10.
Jones-Weakley B, Gerber JE, Biggs G. Colchicine poisoning: case report of two homicides. Am J Forensics Med Pathol. 2001; 22(2):203-6.
O. Cuartero AR. lntoxicación grave por colchicina. An Med Interna. 1999; 16(1):53-4.
Bénichou C. A farmacovigilância é indispensável. ln: Bénichou C. Guia prático de farmacovigilância. 2.ed. São Paulo: Andrei; 1999. p.13-6.
Taglião CA. Analgésicos e antireumáticos. ln: Oga S, editor. Fundamentos de toxicologia. 2.ed. São Paulo: Atheneu; 2003. Cap. 4.14, p.381-95.
Rang HP, Dale MM, Ritter JM. Agentes antiinfla matórios e imunossupressores. ln: Rang HP. Farma cologia. 4.ed. Rio de Janeiro: Guanabara Koogan; 2001. Cap.13, p.189-204.
Brasil. Ministério da Saúde. Resolução RDC nº33 (primeira parte). Brasília: Agência Nacional de Vigi lância Sanitária, 19/04/2000.