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.

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

    2. High molecular weight:

      1. Hydrocarbons of petroleum distillate origin:

      2. Petroleum jelly and paraffin wax.

      3. Hydrocarbons of non-petroleum distillate origin:

      4. 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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