[Hyponatremia in toxicological practice].

Hyponatremia, defined as a serum sodium <135 mmol/l, is the most common clinical disorder of water and electrolyte balance. Hyponatremia occurs in approximately 15-20% of hospitalized patients and up to 20% of patients in critical condition. It can lead to a wide range of clinical symptoms, from mild to even life-threatening, and is associated with increased mortality and longer duration of hospitalization in patients affected by many different syndromes. The diagnosis and treatment of hyponatremia in patients' is still a major problem. Hyponatremia is a disorder observed commonly in toxicological practice. It most often occurs in people who abuse alcohol, narcotics - mainly ecstasy, drugs, as well as the so-called water intoxication in athletes and the people who are mentally ill. In view of the complex pathomechanisms and a variety of symptoms observed in poisoned patients, hyponatremia should be considered as one of the reasons and the exponent of the general condition of the patient.

[Morphine (obtained from poppy seeds) and dextrometorfan poisoning­ a case report].

Morphine is one of the many, and pharmacologically most important, opium poppy alkaloid (Papaver somniferum). A poppy plant consists of a lot of alkaloids. Most of them are morphine, codeine, narcotine, papaverine, thebaine, narceine and narcotoline. Most of the alkaloid is in the poppy milk - opium..It is a dried and properly processed juice with precut immature poppy-heads. It induces euphoria, somnolence, has an analgesic effect. In the study was presented a 24-yearold patient who was admitted to the Department of Toxicology and Cardiology because of suspicion of poisoning with unknown drugs. In retrospect, it turned out that he was poisoned brew with 5 kg of poppy and dextromethorphan. In the past, he drank alcohol heavily, used legal highs, amphetamine, methamphetamine, opiates, diazepam, cannabinoids. At the time of admission to the department, his general condition was severe, he was unconscious, with periodic breathing disorders, pinpoint pupils. In the laboratory: opiates>2000 ng/ml, other toxicological tests were negative. On the subsequent days of his stay he remained in a generally very severe condition; he was unconscious. Some electrolyte disorders were observed, as well as characteristics of developing rhabdomyolysis. With the applied intensive medical therapy, a gradual improvement of his general condition was achieved. Due to quadriplegia on the 30th day of the hospitalization, the patient was transferred to the Department of Neurology for further treatment.