Effects of Oxidative Stress in Acute Poisoning in Central India

Abstract

Background: Tissue inflammation, low food intake of micronutrients due to sleepiness, free radical burst from activated macrophages, and excessive medication cause oxidative stress in acute poisoning. If not neutralised by antioxidants, these free radicals may contribute to tissue inflammation. The word oxidative stress refers to a scenario in which free radical generation and antioxidant defence are out of balance. In humans, oxidative stress is caused by a reduction in bodily antioxidants when free radical generation exceeds endogenous antioxidant levels, resulting in significant cell damage/death.
 Free radicals may destroy all major macromolecules, including lipids, proteins, and nucleic acids, but lipids are the most vulnerable.
 Aim: To evaluate antioxidant status in acute amitriptyline poisoning (AP) cases undergoing routine standard treatment (RST) after supplementation with Vitamin C and alpha lipoic acid either alone or in combination, and compare it with that of normal healthy volunteers.
 Material and Method: A total of 150 people were enrolled in the study, and they were split into five groups. They came from the IMCU and the Toxicology Ward. The consent of the patients' attendants was sought. The patients were chosen at random. To classify the level or grade of coma in poisoned individuals, the Edinburgh scale was utilized. At the time of admission and discharge, the levels of plasma cholinesterase, SOD, catalase, Glut-peroxidase, Glutathione transferase, MDA, Total-Antioxidant, LDH, and CK were measured.
 Results: This study offers quantifiable recommendations for vitamin C and alpha lipoic acid intake to aid in rapid recovery and glutathione antioxidant status. On supplementation with vitamin C and alpha lipoic acid, we detected a significant decrease in catalase activity in all groups of acute Amitriptyline poisoning cases. For Gr. V (acute Amitriptyline poisoning cases), we found reduced glutathione activity on admission and higher values on discharge. In light of the preceding discussion, it is worth noting that the higher LDH and CPK in groups that may be attributable to pulmonary infarction rather than cardiac or skeletal muscle involvement could be due to pulmonary infarction.
 Conclusion: Supplementation with vitamin C and alpha lipoic acid improved antioxidant levels during therapy. We propose that the antioxidant level of acute amitriptyline poisoning cases be examined for more successful recovery, and that diets poor in antioxidants may cause recovery to be sluggish. Oral supplementation, in our opinion, will be more successful for chronic Amitriptyline poisoning patients for a longer period of time, while IV form of vitamin C and alpha lipoic acid will be more effective for acute Amitriptyline poisoning instances.
 Keywords: Amitriptyline, MDA, Total-Antioxidant, LDH, CK, SOD, AP, RST.