Downloaded 218 times
![ The methylxanthines theobromine and
caffeine can be found in a variety of
substances (e.g., chocolate, cocoaand
coffee beans, over-the-countersleep
prevention aids, asthma medications
[theophylline, aminophylline]).](https://image.slidesharecdn.com/poisoningtoxicology-140427003447-phpapp01/85/Poisoning-toxicology-77-320.jpg)
Uploaded byBimel Kottarathil
Poisoning (toxicology)
A poison is any substance that causes harm if it gets into the body in large enough doses. The amount of a substance that enters the body is called the dose. Poisons can enter the body through ingestion, inhalation, skin contact, or injection. Common poisons include drugs, household chemicals, pesticides, carbon monoxide, and snake venom. Symptoms and treatment depend on the specific poison, but often involve supporting vital functions and detoxification through methods like activated charcoal or dialysis.
More Related Content
Similar to Poisoning (toxicology)
More from Bimel Kottarathil
Poisoning (toxicology)
- 1.
- 2. A poison isany substance that causes harm if it gets into the body. . Almost any chemical can be a poison if there is enough in the body.
- 3. The amount ofa chemical substance that gets into the body at one time is called the dose.
- 4. Depends uponavailability and culture Uk –paracetamol is a problem Srilanka –pesticides South india –copper sulphate
- 5. Acute exposure Chronic exposure
- 6. Through mouthby swallowing Through lungs by breathing Contact Through skin Injection through skin
- 7. Most commonroute Children are commonly involved Can be accidental or deliberate Eg. Pesticide poisoning
- 8. Gas, vapour,dust Fine spray or droplet Poison enters to lungs and then spread across the whole body Eg. carbon monoxide
- 9. chemical issprayed or splashed onto the skin if they wear clothes soaked with chemical. E.g. pesticide
- 10. Poisons canbe injected through the skin from a syringe or a pressure gun During tattooing The bite or sting of a poisonous animal, insect, fish or snake.
- 11. DRUGS ,OTHERCHEMICALS Ethylene glycol Methanol Amphetamine Anticonvulsants Corrosives Anti diabetic drugs Antimalarials Batteries Benzodiazepines
- 12. Calcium channelblockers Insecticide Carbon monoxide Cocaine Cyanide Digoxin House hold products Nail polish Heavy metal poisoning Organophosphorous poisoning
- 13. Antidepressants Acetaminophen NSAID Antipsychotics Methyl xanthine Theophylline Snakes
- 14. Ethylene glycolis a sweet-tasting substance that is a common constituent of antifreeze.
- 15. The clinicalcourse of ethylene glycol intoxication can be divided into three phases The first phase The first phase occurs less than 1 h after ingestion and is characterized by mental status depression, similar to that of alcohol intoxication ,coma ,seizurs, and respiratory depression
- 16. Second phase Cardiopulmonary toxicity Acidosis ,heart failure and pulmonary oedema Final stage Flank pain Acute tubular necrosis Hypocalcaemia Renal toxicity due to calcium oxalate
- 17. Air waysupport Circulatory support Correction of metabolic abnormalities Control of seizures Bicarbonate to correct acidosis Fomepizole is the new antidote by FDA Haemodialysis
- 18. Industrial alcohol Toxic alcohol Used in antifreeze,paint,thinner rubbing alcohol
- 19. Oxidised toformaldehyde then to formate Formate produces toxic effect and acidosis
- 20. Cns depression Head ache Lethargy Convulsions Delirium Coma Ocular symptoms Photophobia Central scotoma (loss of central vision ) Visual field defects Fixed pupils
- 21. Difficuilty inlight adaptation Optic disc oedema Optic atrophy Other symptoms Nausea ,vomiting ,diaphoresis ,abdominal pain (due to pancreatitis)
- 22. airway protec-tion circulatory support correction of metabolic abnorm-alities control of seizures. ethanol and fomepizole for specific treatment Hemodialysis
- 23. commonly knownas ecstasy drug or party drug, has been abused world-wide. Amphetamines are CNS and cardiovascular stimulants
- 24. Euphoria, extrovertbehavior, lack of desire to eat or sleep, tremor, dilated pupils, tachycardia and hypertension Severe intoxication Agitation, paranoid delusions, hallucinations and violent behavior. Convulsions, rhabdomyolysis, hyperthermia and cardiac arrhythmias Intracerebral and subarachnoid Hemorrhage(rare)
- 25. Base linesupport Agitation is controlled by diazepam 10-20 mg i.v. chlorpromazine 50-100 mg i.m. injection
- 26. Carbamazepine. Phenytoin. Sodium valproate. Gabapentin. Lamotrigine Topiramaie
- 27. Drowsiness, respiratorydepression,loss of consciousness, moclonic jerks, seizurs Lethargy, ataxia, slurred speech, nystagmus Posturing, agitation ,hallucinations
- 28. charcoal 50-100g oral Hemodialysis
- 29. Corrosive agents: Acids: hydrochloric acid, sulfuric acid, hydrofluoric acid Alkali: sodium hydroxide, potassium hydroxide, ammonia, sodium hypochlorite Other: zinc chloride, mercuric chloride,, phenols, potassium permanganate, button batteries
- 30. Do notput NGT Acid exposure is life threatening Maintain ABC Specific antidots given to nutralise acid or alkali Sodium bi carbonate in acid poisoning Soda ,lemon juice ammonia in alkali poisoning
- 31.
- 32. drowsiness, coma,twitching, convulsion depressed limb reflexes,apnea, pulmonary oedema, tachycardia and hypoglycemia
- 33. Ensure plasmaglucose concentration Intra venous glucose Glucogon is also used Maintatanance with continuous glucose infusion with kcl
- 34.
- 35. Hypotension acuteheart failure, pulmonary oedema and cardiac arrest. Agitation and acute psychosis, convulsions and coma Brady arrhythmias and tachyarrhythmia's are common and ECG conduction abnormalities are similar to those seen in quinine poisoning (QT prolongation) tinnitus, deafness, vertigo, nausea, headache and diarrhea
- 36. Common suicidalagents Rarely produce severe poisoning Mostly in elderly with respiratory disease
- 37. drowsiness, ataxia, dysarthria nystagmus. Coma respiratory depression
- 38. Respiratory depressionis managed by Airway support Flumanezenil 0.5-1.0 mg iv is the drug of choice
- 39. act byblocking voltage-gated calcium channels, Overdose of these drugs, particularly with verapamil and diltiazem, are serious with heart block and hypotension causing a significant fatality rate.
- 40. Hypotension Myocardialdepression Conduction block Sinus bradycardia Heart block Pulmonary oedema Nausea Vomiting Seizures Lactic acidosis
- 41. Activated charcoal Intravenous hypotension with intravenous crystalloid Iv glucagon Dopamine to treat hypotension
- 42. Carbonate insecticidesinhibit acetyl cholinesterase this effect is comparatively short-lived,and milder similar to Organophosphorous poisoning Atropine is the drug of choice
- 43. The commonestsource of carbon monoxide is an improperly maintained and poor, ventilated heating system. The affinity of hemoglobin for carbon monoxide is some 240 times greater than that for oxygen. Carbon monoxide combines with hemoglobin to form carboxyhaemoglobin
- 44. Symptoms ofmild to moderate exposure to carbon monox-ide may be mistaken for a viral illness In headache and mild exertional dyspnoea Higher concentrations of COHB are associated with coma, convulsions and cardio respiratory arrest
- 45. High flowoxygen Et intubation and mechanical ventillation
- 46. Assess airwayand breathing Intubations Primary intervention Oxygen administration Intubation Subsequent assessment History,determine, LOC ,asses complaints Vital signs , look for rales or wheezes
- 47. Cocaine hydrochloride('street' cocaine, 'coke') is a water-soluble powder or granule that can be taken orally, intrave-nously or intranasally.
- 48. Initial euphoria, agitation,tachycardia, hypertension, sweating, hallucinations, convulsions ,metabolic acidosis, hyperthermia, rhabdomyolysis, ventricular arrhythmias. Dissection of the aorta, Myocarditis, myocardial infarction, dilated cardiomyopathy, subarachnoid Hemorrhage, and cerebral Hemorrhage
- 49. Diazepam 10mg iv to control agitation Active cooling Phentolamine 2-5 mg iv for hypertension
- 50. Primary assessmentand interventions Subsequent assessment General interventions
- 51. Cyanide reversiblyinhibits cytochrome oxidase a3 so that cellular respiration ceases. Cyanide and its derivatives are used widely in industry
- 52. Chest tightness Dyspnoea Coma Convulsion Metabolic acidosis
- 53. Support ABC Dicobalt edetate Sodium thiosulphate hydroxocobalamin
- 54. Toxicity occurringduring chronic administration is common, though acute poisoning is infrequent
- 55. nausea, vomiting,dizziness, anorexia and drowsiness. Rarely, confusion, visual disturbances and hallucinations SVT with or without heart block VPC hyperkalemia
- 56. Atropine Digoxin –fab–specific antibody to neutralise Digoxin
- 57. bleach, cosmetics,toiletries, detergents, disinfectants and petroleum distillate Management Symptomatic
- 58. Arsenic Mercury Cadmium Iron Aluminium Lead
- 59. Arsenic isthe most common cause of acute heavy metal poisoning in adults
- 60. Symptoms ofacute exposure are cough, sore throat, and shortness of breath; metallic taste in the mouth, abdominal pain, nausea, vomiting and diarrhea; headaches, weakness, visual disturbances, tachycardia, and hypertension.
- 61. It isused in nickel-cadmium batteries chronic exposure could include alopecia, anemia, arthritis, learning disorders, migraines, growth impairment, emphysema, osteoporosis, loss of taste and smell, poor appetite, and cardiovascular disease
- 62. most ofthe toxic effects of iron occurs because iron is absorbed rapidly in the gastrointestinal tractMost overdoses appear to be the result of children mistaking red- coated ferrous sulfate tablets or adult multivitamin preparations for candy
- 63. Although aluminumis not a heavy metal Symptoms of aluminum toxicity include memory loss, learning difficulty, loss of coordination, disorientation, mental confusion, colic, heartburn, flatulence, and headaches
- 64. Lead accountsfor most of the cases of pediatric heavy metal poisoning. It is a very soft metal and was used in pipes, drains, and soldering materials for many years. Target organs are the bones, brain, blood, kidneys, and thyroid gland exposure to lead occurs occupationally
- 65. abdominal pain-vomiting,constipation and encephalopathy (seizures, delir-ium, and coma) may develop in more severe cases.
- 66. chelation therapy sodium calcium acetate 75 mg/kg/day has been the chelating agent of choice
- 67. Organophosphorous insecticidesare used widely throughout the world and are a common cause of poisoning, causing thousands of deaths, in the developing world
- 68. anxiety, restlessness,tired-ness, headache, and muscarinic features such as nausea, vomiting, abdominal colic, diarrhoea, tenesmus, sweating, hypersalivation and chest tightness. intermediate syndrome
- 69. Support ABC Gastric lavage Activated charcol Atropine 2 mg i.v. Should be given to reduce pulmonary oedema
- 70. Tricyclic antidepressants(TCAS) are potentially lethal in overdose. TCA agents act on multiple receptor sites. Their principal antidepressant action is mediated by serotonin and noradrenalin re-uptake inhibition.
- 71. Anticholinergic effects Agitation, delirium Dilated pupils Dry, warm, flushed skin Tachycardia Urinary retention Neurotoxicity Sedation Seizures Coma
- 72. Cardiotoxicity Tachycardia Hypotension Broad complex arrhythmias Bradycardia (late) Ecg changes Prolonged pr, qrs and qt interval
- 73. Within afew hours of acetaminophen overdose, typical symptoms include nausea and vomiting. Tenderness and pain in the upper right abdomen may be present. Very large doses can result in lactic acidosis (a drop in pH of the blood) and coma
- 74. NSAID useis associated with significant adverse effects such as gastrointestinal bleeding, peptic ulcer disease, high blood pressure, edema (i.e., swelling), and kidney disease
- 75. combine withgastro protective agents H2 receptor antagonist Ppi inhibiters Nutritional Support Antioxidents
- 76. Dopamine receptors Serotonin receptors Muscarinicreceptors Alpha adrenargic receptors Histamine receptors
- 77. The methylxanthinestheobromine and caffeine can be found in a variety of substances (e.g., chocolate, cocoaand coffee beans, over-the-countersleep prevention aids, asthma medications [theophylline, aminophylline]).
- 78. vomiting, diarrhea,polyuria, polydipsia, hyperactivity, ataxia, tachycardia,tachypnea, hypertension, weakness,cardiac arrhythmias, tremors, seizures,coma, and death
- 79. Emesis Activatedcharcol Supportive management
- 80. Theophylline hasbeen widely prescribed for the management of patients with chronic obstructive lung disease and asthma. Despite declining use over recent years,
- 81. Agitation, hyperventilation,headache, convulsions Arrhythmiasnausea & vomiting (may be intractable), thirst, diarrhoea
- 82. Asymptomatic Charcoal1g/kg Observe 4 hours. If no symptoms, discharge if not slow release medication .If ingestion of slow release preparation, admit for observation and serial drug levels
- 83. Symptomatic Charcoal1g/kg initially unless altered conscious state (protect airway first) then 0.5g/kg 4 hourly, and whole bowel irrigation with colonic lavage solution 30ml/kg/hr.Cardiac monitoringI.V. fluid resuscitation & maintenance of adequate hydration is vital if depressed conscious state, arrhythmias or intractable vomiting may need intubation
- 84. Features Likely poisons Constrictedpupils(miosis) Opioids, organophosphorus insecticides, nerve agents dilated pupils (mydriasis) Tricyclic antidepressants, amfetamines, cocaine, antimuscarinic drugs Divergent strabismus Tricyclic antidepressants Nystagmus Carbamazepine, phenytoin Loss of vision Methanol, quinine Papilledema Carbon monoxide, methanol Convulsions Tricyclic antidepressants, theophylline, opioids, mefenamic acid, isoniazid, amfetamines
- 85. Features Likely poisons Dystonicreactions Metoclopramide, phenothiazines Delirium and hallucinations Amfetamines, antimuscarinic drugs, cannabis, recovery from tricyclic antidepressant poisoning Hypertonia and hyper reflexia Tricyclic anti depressants Tinitus and deafness Salicilates Hyperthermia Salicilates ecstasy drugs
- 86. . POISONABSORPTION Gut decontamination Gastric lavage.. Induce vomiting Single-dose activated charcoal Cathartics Whole bowel irrigation
- 87. Muiti-dose activatedcharcoal (mdac) Urine alkainization. Hemodialysis
- 88. Poison Antidote Aluminum (aluminum)Desferrioxamine (deferoxamine) Arsenic Dmsa,(dimercaptosuccinic acid) Benzodiazepines Flumazenil Beta -adrenoceptor blocking drugs Atropine, glucagon Calcium channel blockers Atropine Carbamate insecticides Atropine carbon monoxide Oxygen Copper D-penicillamine, dmps1
- 89. Poison Antidote Opioids Naloxone Organophosphorusinsecticides atropine, hi-6, obidoxime,pralidoxime paracetamol (n-acetylcysteine) Thallium Berlin (prussian) blue Warfarin and other anticoagulants Phytomenadione (vitamin k)
- 90.