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Poisoning

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POISONING

• Poisoning implies harmful effects of a chemical on a biological


system.
• It may result from large doses of drug because “it is the dose
which distinguish a drug from a poison

• POISON poison is a substance which endangers life by


severely affecting one or more vital function ; industrial
chemicals , insecticides are involved in poisoning
Drug automatism ( Barbiturate poisoning)
Automatism, in toxicology. refers to a tendency to take a drug over and over
again, forgetting each time that one has already taken the dose. This can lead
to a cumulative overdose. A particular example is barbiturates which were
once commonly used as hypnotic (sleep inducing) drugs.

Chronic symptoms Acute symptoms


Slurred speech Confusion
Ataxia Talkativeness
Hypotonia Emotional instability
Nystagmus Ataxia
Difficulty in accommodation Respiratory depression
Impaired superficial & deep reflexes Hypotension

Treatment:-
Gastric lavage
Endotracheal intubation
Forced diuressis
Alkalinization
Use of analeptic like Bemigride and nikethamide
OPIODS POISONING
Opioids Acute morphine poisoning
• It may be accidental , suicidal or seen
These are the substance obtained
in drug abuser
from the crude extract of Papaver
• In the nontolerant adult ,50 mg of
somniferum (poppy plant) morphine i.m produces serious
toxicity

• Manifestations
• stupor or coma
• Flaccidity
• cyanosis
• Pin-point pupil
• sedation
• Slowed or absent breath
• Fall in BP & shock, convulsion
• Pulmonary edema
• Death (due to respiratory failure)
Treatment
• Consists of respiratory support (positive pressure respiration also opposes
pulmonary edema formation) & maintenance of BP (i.v fluids ,
vasoconstrictor)
• Gastric lavage should be done with KMNO4 to unabsorbed drug .

• SPECIFIC ANTIDOTE
• Naloxone 0.4 -0.8 mg i.v repeated every 2-3 min till respiration picks up,
is the specific antagonist of choice because it acts rapidly , does not have any
agonistic action
Naloxone should be repeated every 1-4 hrs (due to short duration of action)
Organophosphate poisoning
• Anticholinesterases are easily • MANIFESTATION
available & extensively used as • Irritation of eye
agricultural & household
• Lacrimation
insecticides; accidental as well as
suicidal & homicida poisoning is • Salivation
common • Sweating
• Copious tracheo-bronchial secretion
• Miosis
• Blurring of vision , bronchospasm
• Breathlessness
• Urination
• Death due to respiratory failure
Treatment
1. Termination of further exposure to the poison ---fresh air ,
wash the skin and mucous membranes with soap & water ,
gastric lavage according to need
2. Maintain patent airway , positive pressure respiration if it is
failing.
3. Supportive measure---maintain BP, hydration , control of
convulsion with judicious use of diazepam.
4. Specific antidote
Atropine (choice antidote )
2mg repeated every 10 min till dryness of mouth upto 200 mg in
a day

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