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Background The Department of Pharmacy of the University Hospital of Ferrara (AOUFE) activated a project called ‘Monitoring and use of the Reference Centre for antidote stocks’. The project followed the correct allocation of available antidotes to the Reference Centre of the Emilia Romagna Region (ERR). Purpose Epidemiological analysis to identify different types of intoxication and check that they have been treated successfully. Materials and methods All 17 Hospitals of the ERR were asked to provide information about episodes of intoxication recorded from 1/1/2005 to 31/12/2009 as well as the antidote treatments administered. Required data were: year, type of intoxication and toxic substance, patient demographic data, type of antidote used and treatment period. Results 16 hospitals took part in the analysis. 8151 intoxications were recorded and they are grouped as follows: 1704 intoxications in 2005 (21% of the 5-year total); 1523 in 2006 (19%); 1593 in 2007 (20%); 1560 in 2008 (19%); 1771 in 2009 (21%). Categorisation by toxic substance showed the following: 31% caused by drugs; 17% caused by ethanol; 4% by opioids; 3% by carbon monoxide; 3% by food; 1% by sodium hypochlorite and derivatives; 36% by non-classifiable intoxications; 5% by various intoxications. The authors only evaluated complete intoxication data (1223 cases) and The authors had calculated in 80% of these cases the following antidotes were used: 19% (232/1223) activated charcoal associated with gastric lavage; 11% (132/1223) activated charcoal; 9% (109/1223) activated charcoal associated with MgSO 4 ; 12% (144/1223) flumazenil; 6% (76/1223) hyperbaric oxygen; 12% (151/1223) naloxone; 7% (80/1223) metadoxine; 4% (53/1223) benzodiazepines. Conclusions Drug and ethanol poisonings were the most frequent; non-specific treatments were the most frequently performed, followed by the use of specific antidotes such as flumazenil and naloxone. Epidemiological analysis shows that the frequency of intoxications in ERR is 3.82 per 10000 inhabitants/year.

Background The Department of Pharmacy of the University Hospital of Ferrara (AOUFE) has been appointed Regional Centre of Reference for the supply of some antidotes by the Region Emilia Romagna (RER). In order to assess their availability, a qualitative-quantitative assessment of antidotes available in regional hospitals was carried out. Purpose The authors looked particularly at antidotes supposed to be used within 30 min, (type A antidotes) which should be available in all hospitals. Materials and methods All 17 regional hospitals were asked for information about the kind and the quantity of antidotes stocked. The number of potential poisoning victims treatable with the quantity in stock was calculated based on the maximum dosage. Results All 17 regional hospitals provided the required information with the following results. Of the 27 type A antidotes The authors investigated, the stock for the maximum treatment of one patient was the following: 2 antidotes (activated charcoal, ipecacuanha) were available in 16 hospitals; 4 antidotes (atropine sulphate, calcium gluconate, physiostigmine and protamine sulphate) were available in 15 hospitals, and methylene blue was available in 14 hospitals. Eleven type A antidotes (pyridoxine, hydroxocobalamin, sodium bicarbonate, dantrolene, calcium folinate, polyethylene glycol 4000, MgSo 4 , diazepam, Fuller9s earth, digoxin-specific antibodies, polyethylene glycol 4000, fomepizole) were available in fewer than 10 hospitals. Glucagon was not present in any hospital to treat a patient. Conclusions Quantities of some antidotes available in regional hospitals were not sufficient to treat a single patient. This was the case for fomepizole, digoxin-specific antibodies and Fuller9s earth among type A antidotes, and for Prussian blue, dimercaprol and pralidoxime among type B antidotes. Therefore, the need to provide many regional hospitals with higher stocks of antidotes is recognised.