The document reports on 9 cases of drug overdoses and poisonings seen in young males and one female. Cases include zinc phosphide and warfarin rodenticide poisonings, alprazolam and apnea, locaine and methadone with alcohol, clonazepam and alprazolam with opium use, heroin inhalation with dyspnea, alcohol use with abdominal fullness, olanzapine, lorazepam and citalopram overuse, and cannabis inhalation.

1. 1. Young – M- RODENTICIDES poisoning – zinc phosphide.
2. Young – M- RODENTICIDES poisoning – Warfarin type-
3. 31 yrs- M – Alprazolam , Apnea –
4. 23 yrs- M – loc , methadone , Alcohol
5. Young- F – clonazepam – Alprazolam – opium
6. 40 yrs- M- dyspnea and whizzing fallowing Heroin inhalation
7. 23 yrs - M – Abdominal fullness , Alcohol use last day
8. Young – M – drug overuse : Olanzapine, lorazepam, citalopram
9. Young – M – Cannabis inhalation -

2. general approach
• reversal of the underlying disease
• the aim is to maintain the arterial pH above 7.1 until the primary
process causing the metabolic acidosis can be reversed.
• give 1 to 2 meq/kg sodium bicarbonate as an intravenous bolus. We
repeat this dose after 30 to 60 minutes if the pH is still less than 7.1.

3. Adverse effects
● Increased arterial and tissue capillary PCO2
● Acceleration of lactate generation
● Reduced ionized calcium
● Hypernatremia
● Extracellular fluid (ECF) volume expansion

4. Metabolic Acidosis