Poisonings And Overdose Emergencies

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Poison

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any substance with a chemical action that can damage body structures or impair body function.

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opioids

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narcotic medicines that have actions similar to morphine

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substance abuse

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the misuse, usually knowingly, of any substance to produce a desired effect

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toxidrome: signs/symptoms of overdose of opiates/opioids

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hypoventilaton and respiratory arrest; constricted pupils; sedation and coma; hypotension; bradycardia

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mydriasis

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dilated pupils

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miosis

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constricted pupils

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toxidrome: signs/symptoms of overdose of sympathomimetics

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hypertension; tachycardia; dilated pupils; agitation; seizures; hyperthermia

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toxidrome: signs/symptoms of overdose of sedatives and hypnotics

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slurred speech; sedation and coma; hypoventilation and respiratory arrest; hypotension; bradycardia

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toxidrome: signs/symptoms of overdose of anticholinergics

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tachycardia; hyperthermia; hypertension; dilated pupils; dry skin and mucous membranes; sedation; agitation; seizures; coma; delirium; decreased bowel sounds

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toxidrome: signs/symptoms of overdose of cholinergics

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SLUDGE: excess - salivation; lacrimation; urination; defecation; GI irritation, Eye constriction and emesis; airway compromise; muscle fasciculations; nausea and vomiting

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4 routes for poison to enter body

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Ingestion; inhalation; injection; absorption

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% of poisons that are ingested

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80%

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most worrisome route of poisoning

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injection

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cause depression of the central nervous system resulting in respiratory and cardiovascular depression

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opiates, sedatives, barbituates

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2 emergency treatments for contact (absorbed) poisons

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avoid contaminating yourself or others; remove the irritating or corrosive substance from the patient as rapidly as possible

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contraindication for charcoal

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when patient has ingested an acid, alkali, or petroleum product; patients with decreased level of conciousness; patients who are unable to swallow

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dosage for charcoal

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adult 1g/kg (normally 25g - 50g)
pediatric 1g/kg (normally 12.5g - 25g)

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tolerance

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over time, with misuse of a substance, the need to increase the amount in order to achieve the same result

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addiction

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an overwhelming desire or need to continue using an agent, at whatever cost, with a tendency to increase the dosage

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sedative

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substance that decreases activity and excitement

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hypnotic

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substance that induces sleep

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most commonly abused drug in US

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(ETOH) ethyl alcohol

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emesis

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vomit

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hematemesis

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bloody vomit

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delirium tremens (DTs)

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alcohol withdrawal - characterized by restlessness, fever, sweating, disorientation, agitation, and seizures. Develop 1-7 days after a person stops drinking

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carbon monoxide's affinity for hemoglobin vs. oxygen

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200 times greater

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carboxyhemoglobin

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significant level of carbon monoxide in the blood

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sympathomimetics

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CNS stimulants that frequently cause hypertension, tachycardia, and dilated pupils; amphetamines and methamphetamines

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hallucinogens

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alter sensory perceptions

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anticholinergic

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block the parasympathetic nervous system, causing agitation, tachycardia, and dilated pupils

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cholinergic agents

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overstimulate normal body functions that are controlled by the parasympathetic nerves; used in chemical warfare: DUMBELS/SLUDGE (salivation, lacrimation, urination, defecation, GI irritation, eye constriction and emesis)

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ptomaine poisoning

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a class of chemicals found in rotting food

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toxin

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a poison or harmful substance produced by bacteria, animals, or plants

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salmonella bacterium

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organism that causes severe GI symptoms including nausea/vomiting, abdominal pain, and diarrhea

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most common cause of food poisoning

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staphylococcus

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staphylococcus

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a powerful toxin produced by bacteria in foods that have been prepared in advance an kept too long

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botulism

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most severe form of food poisoning; often fatal; results from eating improperly canned food

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antidote

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a substance that is used to neutralize or counteract a poison