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Corvalol poisoning: signs of what to do?
Last reviewed: 23.04.2024
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The drug Corvalol is used by many to relieve coronary spasms in vasospastic angina pectoris and normalize heartbeat and relieve pain in neurogenic cardiac arrhythmias. However, this is not a cardiological remedy, but a psycholeptic (sedative) and hypnotic, representing barbiturate in combination with other components (which is recorded in the ATX code - N05CВ02). And Corvalol poisoning according to ICD-10 is coded T42.7 - as poisoning with anticonvulsant, sedative and hypnotic drugs.
An overdose of barbiturate may be intentional or unintentional. Intentional overdose is closely related to the epidemiology of depression and the presence of comorbidities such as anxiety and other mood disorders. Unintentional overdose often occurs when patients ingest substances such as alcohol and benzodiazepines, which have an additive effect, leading to sedation and decreased breathing.
Causes of the corvalol poisoning
Doctors say that the main causes of Corvalol poisoning are its frequent use without a doctor's prescription (self-treatment), as well as unintentional or deliberate overdose (for example, alcoholics - to achieve a state of intoxication).
Any improper use of sedatives based on barbiturates can lead to an overdose. And one of the components of Corvalol is a depressant of the group of barbiturates - Phenobarbital, which inhibits many structures of the brain and central nervous system. Separately, it is used to relieve convulsions in epilepsy, chorea, and spastic paralysis.
This drug is listed in the United Nations Convention on Psychotropic Substances (IV) Convention, that is, it can only be purchased with a prescription. While the Corvalol is banned by the FDA.
As the statistics of sales of non-prescription drugs show, the fourth place - after analgesics, antibiotics and cough medicines - is occupied by sedatives, including the most affordable ones (which contain Phenobarbital). These are Corvalol, Barboval, Bellaspon, Valocordin, Valordin, Corvaldine, Corvalcaps, Corvaltab, etc.
Risk factors
With too frequent use and overdose, the risk factors for Corvalol poisoning are associated with cumulation of bromides in the body, the formation of dependence, old age (when the biotransformation of drugs by liver enzymes slows down).
Some may also take Corvalol if they have contraindications in the form of cirrhosis of the liver (including alcoholism), enzyme deficiency of the liver and / or kidneys, chronic obstructive bronchopulmonary diseases, arterial hypotension, organic pathologies of the cardiovascular and central nervous system.
Pathogenesis
The additive synergism of the effects of the components of Corvalol - Phenobarbital, ethyl bromide sovalerate (2-bromo-2-methylbutyrate or synthetic ethyl ester of alpha-bromizovalerianic acid), peppermint oil and ethanol (ethyl alcohol) causes the pathogenesis of poisoning.
The direct effect of these substances on gamma-aminobutyric acid (GABA) receptors, leading to inhibition of the functions of the trunk, the reticular areas of the cortex and the cortex of the brain, is enhanced, that is, the transmission of nerve impulses to the CNS and the reflex excitability of neurons is practically blocked. And this leads to inhibition and inhibition of the vasomotor and respiratory centers of the brain.
At the same time, ethyl bromide bromide and menthol mint essential oil potentiate the action of phenobarbital, which in principle cannot be combined with other sedatives to avoid a pathological effect on the respiratory and cardiovascular systems - with the threat of respiratory failure and contractions of the heart muscle.
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Symptoms of the corvalol poisoning
There are such types of Corvalol poisoning as acute and chronic, as well as three degrees of severity, depending on the amount of the drug taken.
With a mild degree of poisoning, its first signs are manifested by dizziness, general weakness and drowsiness, a decrease in the volume of urination; after a short period of time, the heartbeat increases, coordination of movements is disturbed, and they become spontaneous, frequent involuntary eye movements (nystagmus) are observed.
Symptoms of moderate toxic effects include psycholeptic impairment of consciousness with weakening of muscle tone and tendon reflexes, abnormal breathing, blue skin (cyanosis). In severe cases, the patient (who is unconscious) narrows the pupils (not responding to light), decreases pressure and body temperature, slows heart rate (indicating collapse and stupor), develops respiratory distress and pulmonary edema.
Signs of chronic toxic effects of the drug in cases of its long-term use are manifested by increased irritability; drowsiness and impaired sleep and wake cycles; general weakness and dizziness; problems with balance and coordination of movements; impaired consciousness and speech. There may be convulsions, heart and intestinal cramps, hallucinations.
Due to the effect of boron-containing ethyl ether of alpha-bromoisovaleric acid, depression, motor and neuropsychiatric disorders (with decreased memory and impaired speech), as well as skin rashes, irritation of the mucous membranes of the nasal cavity, upper respiratory tract and eye conjunctiva can be observed. This state of medicine is called bromism.
Complications and consequences
Corvalol poisoning causes such complications and consequences
Such as instability of myocardial contractions, reduced blood supply to the brain with the development of its hypoxia and ischemia, impaired general metabolism, cardiovascular system, lungs and kidneys.
The most severe consequences include collapse, coma, respiratory arrest and heart failure, resulting in death.
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Diagnostics of the corvalol poisoning
Methods of clinical diagnosis, including the necessary analyzes and hardware examinations (electrocardiography, electroencephalography, etc.), are discussed in detail in the publications:
Differential diagnosis
In cases of Corvalol poisoning, the stages of impaired consciousness are taken into account , and differential diagnosis should exclude all conditions with similar symptoms, including mental illness and neurological disorders, and also take into account the possibility of an anticholinergic syndrome or acute alcoholic (narcotic) intoxication.
The differential diagnosis should include intoxication with other substances with a sedative effect, such as benzodiazepines, anticonvulsants (carbamazepine), alcohols (ethanol, ethylene glycol, methanol), opioids, carbon monoxide, sleep aids and gamma-hydroxybutyric acid (GHB - known as date drug rape), including hypoglycemia and myxedema coma. Hypothermia should be excluded.
Who to contact?
Treatment of the corvalol poisoning
First, about what to do at home with Corvalol poisoning, because urgent care is needed - before the arrival of the medical team.
With a mild degree of poisoning, when a person is conscious, you need to flush the stomach, that is, drink water (two or three glasses) and induce vomiting. Then you should take five tablets of crushed activated carbon (or other sorbent).
If a person is unconscious, you need to check the pulse and breathing, and in their absence start to perform cardiopulmonary resuscitation - artificial respiration and heart massage.
Further, the provision of emergency care is carried out by physicians.
The main treatment for Corvalol poisoning is symptomatic intensive care for poisoning, which is aimed at:
- the removal of components of Corvalol from the body, the stomach is released by washing through a tube, the intestine - saline laxatives, kidneys - forcing diuresis using diuretics (Mannitol, Trisamine, Lasix, etc.);
- to neutralize blood-bound Phenobarbital, (intravenously, glucose solution in combination with ascorbic acid and insulin is administered);
- to maintain and restore the functions of the respiratory system and the heart (if necessary, using artificial ventilation of the lungs);
- to combat toxic shock and metabolic disorders, in particular, an increase in the acidity of urine and blood, for which sodium bicarbonate (4% solution) is administered and hemodialysis is performed.
Monitoring of vital signs of the body is required.
For treatment, such medications are used for intravenous infusions as Bemegrid (other trade names are Glutamizol, Megibal, Malizol, Etimid) - analeptic that stimulates breathing and blood circulation in case of sedative-hypnotic poisoning (0.5% solution); Dobutamine cardiotonic (Dobutrex, Inotrex), restoring the cerebral circulation Piracetam (20% solution).
In the infusion detoxification therapy , the antihypoxic drug Reamberin (meglumine sodium succinate + sodium chloride + magnesium chloride + potassium chloride) is used. Can be treated with phenobarbitone poisoning with repeated oral administration of activated carbon.
Prevention
Compliance with the recommended dosage of Corvalol and safety measures for its use (in particular, the refusal of long-term use of drops) is the basis for the prevention of poisoning with this tool.
You should also remember about the incompatibility of Corvalol with other sedatives and alcoholic beverages.
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Forecast
In acute intoxication, the prognosis depends on the severity of the condition and adequate medical care.