[CLINICAL CASE OF ACUTE SEVERE COMBINED POISONING WITH NARCOTIC SUBSTANCES OF DEPENDENT AND PSYCHOSTIMULATING...

A case of acute severe concomitant poisoning with narcotic substances of depreciating and psychostimulating action (1,4 - butanediol, 1-phenyl-2- (1-pyrrolidinyl) -1-pentanone, methadone) complicated by the development of severe hypoxic-ischemic changes in the supratentorial white matter of the large brain is presented. edema and swelling of the brain, nosocomial focal left-sided lower lobe pneumonia in a 25-year-old patient. Psychoactive substances were used for hedonic purposes. Acute poisoning occurred after taking 100 ml of 1,4-butanediol together with phenyl-2- (1-pyrrolidinyl) -1-pentanone and 2 g of methadone, clinically manifested in the form of convulsive syndrome, depression of consciousness to the level of coma 3, edema and swelling brain, acute respiratory failure, mixed decompensated respiratory and metabolic lactic acidosis (pH 7.193; partial pressure of carbon dioxide 62.3 mm Hg, lactate 7.4 mmol / l) and complications in the form of nosocomial focal left-sided lower lobe pneumonia. Intensive therapy was of a complex nature, including infusion-detoxification therapy, correction of acid-base state disorders, hypoxic disorders, by using the substrate antihypoxant "Cytoflavin" in a daily dosage of 60 ml, for 15 days, against the background of basic infusion therapy and vasopressor support ... The clinical picture of acute poisoning, the features of its course, the data of radiological diagnostics and the effectiveness of pathogenetic approaches to intensive therapy are presented.