Volume 3 Chapter 8

Study of the detection, chemistry, pharmacology and antidotes of toxic substances.

Any chemical (drug, poison or other) that causes adverse effects on an organism that is exposed to it.

• 4 million poisonings occur annually
• Ten percent of all ER visits
• 70% of accidental poisonings under 6 y/o

• Ingestion
• Inhalation
• Absorption
• Injection

Entry of a substance through GI tract

Entry of substance through respiratory tract

Entry of substance through skin or mucous membranes

Phosphorous-containing organic chemicals

Entry of substance through break in skin

Process of minimizing toxicity by reducing amount of toxin absorbed

• Reduce intake
• Reduce absorption
• Enhance elimination

Removing and ingested poison by repeatedely filling and emptying the stomach with water or saline via a gastric tube

A powder, usually premixed with water, that will absorb (bind) some poisons and help prevent them from being absorbed into the body

Administration of polyetylene glycol continuously at 1-2 L/hr through a nasogastric tube until the effluent is clear or objects are recovered

A substance that will neutralize a specific toxin or counteract its effect

A toxic syndrome, a group of typical signs and symptoms associated with exposure to a particular toxin

Endogenous Sources: Within the body, normal levels

Exogenous Sources: Outside sources, cars, heaters, etc.

Methylene chloride: Industrial solvent, breaks into CO

• Limits O2 transport
• Inbits O2 tranfer
• Causes tissue inflammation
• Causes reduces cardiac function
• Increases activation of nitric oxide
• Causes vasodilation
• Induces free-radical formation

<15-20% Mild- H/A, n/v, dizzness, blurred vision

21-40% Moderate- Confusion, syncope, CP, dyspnea, tacycardia, tachypnea, weakness

41-59% Severe- dysrhythmias, hypotension, cardiac ischemia, palpitations, respiratory arrest, pulmonary edema, seizures, coma, cardiac arrest

>60% Fatal

A system capable of providing measurements of oxygen saturation (SpO2), carboxyhemoglobin (SpCO), methemoglobin (SpMET), and pulse.

A substance that liberates hydrogen ions (H+) when in solution

Substance that liberates hydroxyl ions (OH-) when in a solution, strong base.

Maximum tolerated dose divided by minimum curative dose of a drug, range between curative and toxic dosages, also called therapeutic window.

Soluble poisonous substance secreted during growth of bacterium

Exotoxin that produces GI symptoms and diseases such as poisoning

Use of pharmacological substance for purposes other that medically defined reasons

Compulsive, overwhelming dependence on a drug. May be physiological or psyhcological or both.

Need to progressively increase dose of a drug to reproduce initial effect

When the patient's body reacts severely when deprived of the substance

Poisoning from pharmacological substance in excess of usual prescribed dose or that the body can tolerate

Disorder found in habitual and excessive users of alcoholic beverages after cessation for 48-72 hours. Visual, tactile, auditory disturbances. Death in severe cases.