PHARMACEUTICAL
OVERDOSE IN MALTA
Roberta Messina Fenech
Janet Mifsud
DEPT. of CLINICAL PHARMACOLOGY and THERAPEUTICS
AIM
The aim of this research was to investigate if the
extent of the problem of paracetamol overdosage
in Malta was similar to that observed in other
countries
1
METHODOLOGY
DRUG INGESTION
by PATIENT
Overdose
Death
1
Admission to
hospital
Forensic tests
By MNL
A&E
2
Blood
Investigations
3
Emergency
Laboratory
4
Taxicology
Laboratory
Admission
to
Ward
Discharge
Patient trail followed in complication of date
Figure 4.1
Patient trail followed in compilation of date
5 Letter (HIU)
RESULTS
40
220
210
195
190
181
180
175
170
No of admis s ion
200
No of admission
38
35
35
209
31
30
26
25
20
15
10
5
160
0
98
150
98
99
00
01
Year
Admissions to St Luke’s Hospital with a discharge
diagnosis of overdose of undetermined intent from
1998 to 2001
99
00
01
Year
Admissions to St Luke’s Hospital with a discharge
diagnosis of accidental overdose from 1998 to 2001
2
RESULTS
200
174
140
140
120
128
90
100
73
80
60
40
20
10
19
17
8
4
4
un
sp
e
-8
4
65
75
-7
4
4
-6
55
45
35
-4
-5
4
4
4
-3
-2
25
14
15
5-
0-
4
0
c.
No of admissions
180
160
Age (yrs)
Age distribution for admissions with a discharge diagnosis of
overdose irrespective of intent (accidental, deliberate or
undetermined) from 1995 to 2001
RESULTS
18
16
16
No of Deaths
14
12
12
12
11
10
8
8
8
7
6
4
2
0
95
96
97
98
99
00
01
Year
Graph 1 - Deaths due to poisoning from 1995 to 2001
Deaths due to poisoning from 1995 to 2001
3
RESULTS
25
20
No of deaths
20
18
14
15
11
10
5
4
5
1
1
0
0-10
10-19 20-29 30-39 40-49 50-59 60-69 70-79
Age (years)
Age distribution for deaths due to overdose from 1995 to 2001
RESULTS
alcohol (X45)
5.2%
4.1%
8.1%
narcotis &
psychodysleptics (X42,
X62, Y12)
4.1%
18.9%
anti-epileptic sedative
hypotic, anti-park.
Psychotropics (X41, X61,
Y11)
39.2%
20.3%
some gases & vapours
(X47, X67)
unspecified (X44)
anti-pyr. No-apioid antiRH (X60)
other (X43, X49, X68,
X69)
Substances responsible for deaths due to overdose in Malta from 1995 - 2001
4
CONCLUSION
It appears that, even though the number of
admissions due to paracetamol overdose in the
UK is 10 times that in Malta the number of
deaths due to paracetamol overdose in Malta is
higher than expected, with respect to deaths due
to paracetamol in the UK.
REFERENCES
Š
Emergency Laboratory, St. Luke's Hospital, Malta, 2002
Š
Gunnell D. Use of Paracetamol for suicide and non - fatal poisoning in the UK and France: are
restrictions on availability justified? Jepid Comm. Health 1997, 51:175-179.
Š
Hall AK. Changing epidemology and management of deliberate self - poisoning in Christ
Church, NZ. Med. J. 1994, 107:987 pp. 396-9
Š
Hawton K. Trends in deliberate self - poisoning and self - injury in Oxford 1976-90. BMJ 1992,
304 (6839) pp. 149-11.
Š
Hawton K. Paracetamol: Self - poisoning Characteristics, Prevention and Harm Reduction. Br.
J. Psychiatry 1996, 168:43-48.
Š
Health Information Unit, G'Mangia.
Š
Mr. Leone P. Hospitalisation for deliberate self - poisoning in Scotland from 1981 to 1993:
Trends in rates and types of drugs used. Br. J. Psychiatry 1996, 169:1 pp. 81-5.
Š
National Formulary Management Office, GPS, Malta.
Š
Paracetamol Information Centre
5