Chapter 22 toxicology

which kind of poisoning is more common?

chronic poisoning is more common than acute poisoning

poison

any substance whose chemical action can damage body structures or impair body function

toxin

poisonous substance produced by bacteria, animals, or plants

substance abuse

misuse of any substance to produce desired effects

overdose

toxic dose of drug

what are the routes of poison into the body?

inhalation, absorption, ingestion, injection

inhaled poison

move into fresh air asap, may need O2

absorbed poison

skin, mucous membrane damage, chemical burns, rashes, systemic effects

treatment of absorbed poisons

remove substance and contaminated clothing asap, flush and wash skin:

dry powder: brush off, flood 15-20 min w/ water, wash with soap & H2O

liquid: flood 15-20 min

ingested poisons

most common, may include burns around mouth, GI pain, vomiting, seizures, etc

injected poisons

IV drug abuse, envenomation, can’t be removed in field, monitor airway & provide O2

activated charcoal

binds to specific toxins which are then carried out of the body

tolerance

over time, person may need increasing amounts of a substance to achieve same result

alcohol

can damage liver, whether through chronic use or occasional heavy use (binge), powerful CNS depressant

affects of alcohol as CNS depressant?

decreases activity & excitement, induces sleep, dulls sense of awareness, slows reflexes, reduces reaction time

delirium tremens (DT)

alcohol withdrawal symptom that causes confusion, shaking, hallucinations, agitation

opioid

narcotic med used to relieve pain, CNS depressants

opiate

subset of opioids, natural nonsynthetic opioids

signs and symptoms of opioid overdose

pinpoint pupils, hypoventilation, decreased LOC, nausea, vomiting

sedative-hypnotic drugs

barbiturates, benzodiazepines, CNS depressants

treatment: patent airway, assist ventilation, provide prompt transport

hydrogen sulfide

highly toxic, colorless, flammable gas, distinct rotten egg odor, affects all organs with most impact on lungs & CNS

sympathomimetics

CNS stimulants that mimic effects of the sympathetic nervous system

stimulant

agent that produces an excited state

frequently causes hypertension, tachycardia, dilated pupils

synthetic cathinones

bath salts, similar to MDMA, produce euphoria, increased mental clarity

marijuana

THC chemical in marijuana plant that produces its high, produces euphoria, relaxation, drowsiness

high doses: may cause hallucinations, anxiety, or paranoia

hallucinogens

alter a person’s sensory perceptions, cause visual hallucinations, generally separate the user from reality

anticholinergic agents

meds that block parasympathetic nerves

include atropine, benadryl

cholinergic agents

overstimulate the normal body functions that are controlled by parasympathetic nerves

SLUDGEM for cholinergic agents

Salivation, sweating

Lacrimation

Urination

Defecation, drooling, diarrhea

Gastric upset and cramps

Emesis

Muscle twitching/miosis

what must be done first before transporting patient exposed to poison

decontamination

aspirin poisoning

potentially lethal, nausea, vomiting, hyperventilation, ringing in ears

acetaminophen overdose also common

food poisoning

contaminated food, organism itself may cause disease or organism may produce toxins that cause disease

salmonellosis

caused by salmonella bacterium

severe GI symptoms

botulism

can result from eating improperly canned food, blurred vision, weakness, difficulty speaking & breathing

plant poisoning

many plants poisonous if ingested, assess airway and vitals, notify poison center