This short letter briefly reviews the significance of opioid OVERDOSE as well as the existing approaches to combat the epidemic. It also signifies the importance of naloxone, its commercially available dosage forms, and the unmet need for developing safe and effective naloxone dosage forms that can easily be administered in emergency settings.

Background: N-Acetylcysteine (NAC) is a cost-effective antioxidant and very useful treatment for several diseases. Methods: Here we report a rare case of iatrogenic NAC OVERDOSE following the mistake in calculation of the loading dose. Results: The patient was 14 years old girl referred to a local hospital due to history of intentional ingesting about 7grams acetaminophen. The physician prescribed her 6 grams NAC as a loading dose but 42grams NAC were infused by mistake. After infusion, the patient showed signs of anaphylactic shock and then transferred to Imam Reza toxicology-unite with weakness, lethargy, extreme fatigue, nausea, and dizziness. NAC overdosing, in a short period of time, led to coagulopathy, reduced platelet count, acute renal failure and metabolic acidosis. After 24 h, the patient died. The Medical forensic examination showed minor lung hemorrhage and presence of little amount of Aluminum phosphide in tissues they did not find no vital organ hemorrhage. It is unclear related to NAC OVERDOSE, phosphine intoxication or synergic effects. Conclusion: Massive transfusion of NAC was associated with impairment of coagulation factors, intracranial hypertension, renal failure and metabolic acidosis. Thus, NAC administration should be with caution. The medical history of patients committed suicide are not always accurate and complete evaluation are recommended.

Objectives: The present study was carried out to investigate the relationship between different lunar phases and the occurrence of OVERDOSE attempted suicide. Method: The study was carried out for a period of three lunar years (Shaban 1416 to Shaban 1419) with patients admitted to the Intoxication Emergency Clinic at Imam Reza Hospital in Mashad. In this research,13422 cases of suicide attempts, which were recorded in the hospital files were studied. Admission dates which were originally recorded according to solar calendar, were later converted to lunar calender for the purpose of this study. Then, on the basis of lunar phases and the shape of the moon as observed from the earth, the days of lunar months were divided into four periods: the crescent-to-half moon period, the half moon-to-full moon period, the full moon to half-moon period, and the half moon-to-crescent period. The data collected for each period were analyzed through chi2. Findings: The result demonstrated that the highest numbers of OVERDOSE suicide attempts were made during the full moon period and the days around it. The frequency of attempts shows a significant difference in the above periods (P<0.05).

Dear Editor: Lamotrigine is used for the treatment of seizure and bipolar depression (1). Lamotrigine prevents the opening of voltage-gated sodium channels and weakens the excitatory neurotransmitters’ release. Lamotrigine OVERDOSE can delay inter-ventricular conduction. It can culminate in the prolongation of QRS, QTc (QT corrected), and R waves (2). Data regarding lamotrigine OVERDOSE is scarce. Here, we describe a case with lamotrigine OVERDOSE, who developed Accelerated Idioventricular Rhythm (AIVR). AIVR is characterized by three or more sequential monophasic beats. AIVR has a gradual onset and a slow end (1, 2). This condition has been reported with some drugs (halothane, desfl urane, cocaine, propofol), electrolyte disturbances (hypokalemia and hyperkalemia), and cardiomyopathies, as well as after the resuscitation period (3)...