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Chapter 37: Domestic Poisons

37.1: Domestic/Household Poisons

Hydrocarbons

Aliphatic Hydrocarbons

  • These are petroleum distillates which are common constituents of several industrial and household products and are involved in accidental poisoning, especially among children.

    1. Low molecular weight:

      1. Gaseous Forms — Methane, ethane, propane, and butane.

      2. Liquid Forms —  Petroleum distillates, are break-down products remaining after processing crude oil.

        1. Kerosene, diesel oil, gasoline, and furniture polishes.

    2. High molecular weight:

      1. Hydrocarbons of petroleum distillate origin:

        1. Petroleum jelly and paraffin wax.

      2. Hydrocarbons of non-petroleum distillate origin:

        1. Turpentine and carbon tetrachloride.

Sign and Symptoms

Acute Poisoning

  • A characteristic odor specific to hydrocarbon ingested is appreciated in the vicinity of the patient.

  • Peculiar odor is usually evident in breath and vomitus. Cyanosis can occur due to pulmonary complications such as bronchopneumonia.

  • Depression resulting in vertigo, giddiness, drowsiness, headache, tremors, convulsions, etc. Toluene sniffing may present with a drunken appearance. Pupils are usually constricted initially but later on dilated when coma supervenes.

  • Ingestion of the poison results in pain, burning pain in throat, nausea, vomiting, colicky abdomen, diarrhea, etc.

  • Cardiomyopathy, arrhythmias, etc.

  • In fatal cases:

    • Drowsiness merges into coma and death due to respiratory failure.

    • There may be intense excitement, hallucinations and convulsions, cyanosis, unconsciousness, profound coma, and death.

Chronic Poisoning

  • Chronic eczematoid dermatitis, with redness, itching, and inflammation. Cutaneous exposure to gasoline and other hydrocarbons can cause second-degree burns.

  • Dizziness, weakness, weight loss, anemia, nervousness, pain in limbs, peripheral numbness, paraesthesias’s, etc.

Treatment

  • Wash the contaminated skin with a copious amount of water and soap.

  • Give liquid paraffin orally — dose 250 ml. It dissolves kerosene and reduces its absorption.

  • Activated charcoal in large doses is recommended, though petroleum distillers are not adsorbed.

  • Saline purgatives may also be useful.

  • Avoid gastric lavage for the fear of aspiration.

  • Avoid intravenous fluid overload, as it may precipitate pulmonary edema.

  • Rest of the treatment includes symptomatic measures.

  • Chronic case of poisoning — isolate and prevent further absorption of poison.

Aromatic Hydrocarbons

  • Most of the aromatic hydrocarbons are widely used in industry. Some of the examples are benzene, toluene, xylene, styrene, etc.

  • Most of the aromatic hydrocarbons have characteristic odors and they are absorbed through inhalation, ingestion and direct skin contact.

  • Both benzene and toluene are highly toxic, while xylene is relatively nontoxic.

Common Domestic Poisons

  • Babies and Children

    • Baby powder — Boric acid

    • Crayons (chalk) —- Colored by copper, arsenic, lead components

    • Crayon (wax) — Paranitroaniline, azo dyes

    • Fireworks — Arsenic, antimony, lead, thiocyanate, phosphorus

    • Toys (paints) — Lead, chromium, copper, etc.

  • Cosmetics

    • Cuticle remover — Potassium hydroxide, trisodium phosphate

    • Depilatories — Barium sulfide

    • Nailpolish removers — Acetone, ethylacetate

    • Sun tan lotions — Denatured alcohol, methyl salicylate

  • Kitchen

    • Baking powder — Tartaric acid (mild irritant)

    • Baking soda — Sodium bicarbonate (causes alkalosis in doses over 5 gm/kg)

    • Dishwashing compounds (machine) — Sodium polyphosphates, sodium carbonate

    • Domestic fuel — Kerosene

    • Domestic gas — LPG (accumulated gas explodes with air when flame/spark is provided)

    • Fire extinguishing fluids — Carbon tetrachloride, methyl bromide

    • Matches — Antimony, phosphorus sesquisulfide, potassium chlorate

  • Rat poisons

    • Rat paste — Phosphorus, zinc/aluminum phosphide

    • Rodine (brown bran paste) — Barium carbonate, thallium acetate

    • Warfarin — Yellow phosphorus, it is a 4-hydroxy coumarin

  • Sanitary

    • Deodorants — Formaldehyde, naphthalene

    • Drain cleaners — Sodium hydroxid

    • Lysol — Phenol

  • Miscellaneous

    • Anti-rust products — Ammonium sulfide, naptha, oxalic acid

    • Cleaning solvents (inflammable) — Petroleum hydrocarbons

    • Cleaning solvents (noninflammable) — Carbon tetrachloride, trichloroethylene

    • Dentifrices, mouthwashes — Hydrogen peroxide

    • Furniture polish — Ordinary denatured spirit, resins, sodium hypochlorite (5%), oxalic acid

    • Insecticide (spray) — Organochloro, organophosphorus and carbamate insecticides

    • Lavatory cleaners — Mineral acids

    • Marking ink — Aniline

    • Mothballs — Naphthalene

    • Paint removers — Sodium hydroxide, acetone

    • Shoe polish — Aniline, nitrobenzene

    • Straw hat cleaner — Oxalic acid

Medical Household Poisons

  • Antiseptics — lodine, benzoin, phenol

  • Cough remedies — Codeine

  • Headache remedies — Asprin, phenacetin, analgin

  • Pep tablets — Benzedrine

  • Sleeping preparations — Barbiturates

  • Throat tablets — Potassium chlorate

  • Tonic syrup — Easton’s syrup (strychnine)

  • Others — Antidepressants, tranquilizers, antibiotics, analgesics, etc.

Garden Poisons

  • Fungicides — Lead arsenate, copper compounds, organic mercurials, lime, sulfur

  • Insecticides pesticides — Nicotine, tar oils, organochloro and  organophosphorus compound carbamates, cyanides, etc.

  • Weed killers — Sodium chlorate, arsenious oxide (herbicides) and arsenites, dinitrocresol, paraquat



MA

Chapter 37: Domestic Poisons

37.1: Domestic/Household Poisons

Hydrocarbons

Aliphatic Hydrocarbons

  • These are petroleum distillates which are common constituents of several industrial and household products and are involved in accidental poisoning, especially among children.

    1. Low molecular weight:

      1. Gaseous Forms — Methane, ethane, propane, and butane.

      2. Liquid Forms —  Petroleum distillates, are break-down products remaining after processing crude oil.

        1. Kerosene, diesel oil, gasoline, and furniture polishes.

    2. High molecular weight:

      1. Hydrocarbons of petroleum distillate origin:

        1. Petroleum jelly and paraffin wax.

      2. Hydrocarbons of non-petroleum distillate origin:

        1. Turpentine and carbon tetrachloride.

Sign and Symptoms

Acute Poisoning

  • A characteristic odor specific to hydrocarbon ingested is appreciated in the vicinity of the patient.

  • Peculiar odor is usually evident in breath and vomitus. Cyanosis can occur due to pulmonary complications such as bronchopneumonia.

  • Depression resulting in vertigo, giddiness, drowsiness, headache, tremors, convulsions, etc. Toluene sniffing may present with a drunken appearance. Pupils are usually constricted initially but later on dilated when coma supervenes.

  • Ingestion of the poison results in pain, burning pain in throat, nausea, vomiting, colicky abdomen, diarrhea, etc.

  • Cardiomyopathy, arrhythmias, etc.

  • In fatal cases:

    • Drowsiness merges into coma and death due to respiratory failure.

    • There may be intense excitement, hallucinations and convulsions, cyanosis, unconsciousness, profound coma, and death.

Chronic Poisoning

  • Chronic eczematoid dermatitis, with redness, itching, and inflammation. Cutaneous exposure to gasoline and other hydrocarbons can cause second-degree burns.

  • Dizziness, weakness, weight loss, anemia, nervousness, pain in limbs, peripheral numbness, paraesthesias’s, etc.

Treatment

  • Wash the contaminated skin with a copious amount of water and soap.

  • Give liquid paraffin orally — dose 250 ml. It dissolves kerosene and reduces its absorption.

  • Activated charcoal in large doses is recommended, though petroleum distillers are not adsorbed.

  • Saline purgatives may also be useful.

  • Avoid gastric lavage for the fear of aspiration.

  • Avoid intravenous fluid overload, as it may precipitate pulmonary edema.

  • Rest of the treatment includes symptomatic measures.

  • Chronic case of poisoning — isolate and prevent further absorption of poison.

Aromatic Hydrocarbons

  • Most of the aromatic hydrocarbons are widely used in industry. Some of the examples are benzene, toluene, xylene, styrene, etc.

  • Most of the aromatic hydrocarbons have characteristic odors and they are absorbed through inhalation, ingestion and direct skin contact.

  • Both benzene and toluene are highly toxic, while xylene is relatively nontoxic.

Common Domestic Poisons

  • Babies and Children

    • Baby powder — Boric acid

    • Crayons (chalk) —- Colored by copper, arsenic, lead components

    • Crayon (wax) — Paranitroaniline, azo dyes

    • Fireworks — Arsenic, antimony, lead, thiocyanate, phosphorus

    • Toys (paints) — Lead, chromium, copper, etc.

  • Cosmetics

    • Cuticle remover — Potassium hydroxide, trisodium phosphate

    • Depilatories — Barium sulfide

    • Nailpolish removers — Acetone, ethylacetate

    • Sun tan lotions — Denatured alcohol, methyl salicylate

  • Kitchen

    • Baking powder — Tartaric acid (mild irritant)

    • Baking soda — Sodium bicarbonate (causes alkalosis in doses over 5 gm/kg)

    • Dishwashing compounds (machine) — Sodium polyphosphates, sodium carbonate

    • Domestic fuel — Kerosene

    • Domestic gas — LPG (accumulated gas explodes with air when flame/spark is provided)

    • Fire extinguishing fluids — Carbon tetrachloride, methyl bromide

    • Matches — Antimony, phosphorus sesquisulfide, potassium chlorate

  • Rat poisons

    • Rat paste — Phosphorus, zinc/aluminum phosphide

    • Rodine (brown bran paste) — Barium carbonate, thallium acetate

    • Warfarin — Yellow phosphorus, it is a 4-hydroxy coumarin

  • Sanitary

    • Deodorants — Formaldehyde, naphthalene

    • Drain cleaners — Sodium hydroxid

    • Lysol — Phenol

  • Miscellaneous

    • Anti-rust products — Ammonium sulfide, naptha, oxalic acid

    • Cleaning solvents (inflammable) — Petroleum hydrocarbons

    • Cleaning solvents (noninflammable) — Carbon tetrachloride, trichloroethylene

    • Dentifrices, mouthwashes — Hydrogen peroxide

    • Furniture polish — Ordinary denatured spirit, resins, sodium hypochlorite (5%), oxalic acid

    • Insecticide (spray) — Organochloro, organophosphorus and carbamate insecticides

    • Lavatory cleaners — Mineral acids

    • Marking ink — Aniline

    • Mothballs — Naphthalene

    • Paint removers — Sodium hydroxide, acetone

    • Shoe polish — Aniline, nitrobenzene

    • Straw hat cleaner — Oxalic acid

Medical Household Poisons

  • Antiseptics — lodine, benzoin, phenol

  • Cough remedies — Codeine

  • Headache remedies — Asprin, phenacetin, analgin

  • Pep tablets — Benzedrine

  • Sleeping preparations — Barbiturates

  • Throat tablets — Potassium chlorate

  • Tonic syrup — Easton’s syrup (strychnine)

  • Others — Antidepressants, tranquilizers, antibiotics, analgesics, etc.

Garden Poisons

  • Fungicides — Lead arsenate, copper compounds, organic mercurials, lime, sulfur

  • Insecticides pesticides — Nicotine, tar oils, organochloro and  organophosphorus compound carbamates, cyanides, etc.

  • Weed killers — Sodium chlorate, arsenious oxide (herbicides) and arsenites, dinitrocresol, paraquat



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