TOXICOLOGY- is the branch of pharmacology that encompasses the deleterious effects of chemicals on

biologic systems.

-study of the effect mechanisms & treatment of poisons

-science of poisons

Poisons-Corpus delecti (body of evidence)

- any agent that may cause serious damage/ disease/ injury/ death when applied or developed
inside the body
Definitions
1. Clinical Toxicology-Focuses on the effects of substances in patients caused by accidental
poisonings or intentional overdoses of medications, drugs of abuse, household products, or
various other chemicals
2. Intoxication-Toxicity associated with any chemical substance
3. Poisoning-A clinical toxicity secondary to accidental exposure
4. Overdose- An intentional exposure with the intent of causing self-injury or death
5. Toxicity- describes the degree to which a substance is poisonous or can cause injury depends on
a variety of factors: dose, duration and route of exposure, shape and structure of the chemical
itself, and individual human factors
6. Selective toxicity-means that a chemical will produce injury to one kind of living matter without
harming another form of life, even though the two may exist close together.
7. Sensitive Sub-Population- describes those persons who are more at risk from illness due to
exposure to hazardous substances than the average, healthy person. These persons usually
include the very young, the chronically ill, and the very old. It may also include pregnant women
and women of childbearing age. Depending on the type of contaminant, other factors(e.g., age,
weight, lifestyle, sex) could be used to describe the population.
8. Harmful or adverse effects- are those that are damaging to either the survival or normal
function of the individual
9. Hazard- likelihood that injury will occur in a given situation or setting
10. Risk- expected frequency of the occurrence of an undesirable effect arising from exposure to a
chemical or physical agent
11. Toxidromes- A group of signs, symptoms, and laboratory findings that suggest a specific
ingestion
12. Toxicokinetics vs. Toxicodynamics
▪Toxicokinetics- describes the fate of toxic compound in the body. The measurement of the time
course of absorption, distribution, biotransformation, and excretion of toxic compounds
(sometimes referred to as pharmacokinetics).
Toxicodynamics- describesthe determination and quantification of the sequence of events at the
cellular and molecular levels
Branches of Toxicology
a. Clinical Toxicology-observation of the signs & symptoms of poisoning
-focuses on the effects of substances in patients caused by accidental poisonings or intentional
overdoses of medications, drugs of abuse, household products, or various other chemicals
 b. Experimental Toxicology- observation of toxic effects after administration to a biological
system.
c. Environment Toxicology- deals with the identification or removal of the toxicants from the
environment.
d. Regulatory Toxicology- concern with the safety testing of products to provide information from
regulatory
- requirement & safety data sheet
e. Machanistic Toxicology- deals with the mechanism of action of the poisons
f. Descriptive Toxicology- concerned with tosicity testing, which provides necessary information
for safety evaluation & regulatory requirements
g. Forensic Toxicology-concerned with the medico-legal aspects of the harmful effects of
chemical on humans & animals 8
h. Chemical toxicology- is a scientific discipline involving the study of structure and mechanism
related to the toxic effects of chemical agents, and encompasses technology advances in
research related to chemical aspects of toxicology.
Effects of Poisons
1. Local- effects can be seen at the site of application
2. Remote-effects of poisons id distributed from point of entry
3. Systemic- the effects of poison are distributed from the point of entry
4. Combination- Local + Remote, Local + Systemic
Phosphorus (St.Elmo’s Fire)- characteristics: Luminus Vomitus, Garlic Odor
Cantharidin- irritating active from dried blister better or catharides (Cantharides Vesicatoria)

Factors Affect Poisoning:

A. Poison Related
1. Concentration- the higher the concentration, the greater the toxic effect.
2. Solubility- the higher the lipophilicity, the higher the toxication.
3. Route of Administration- intravenous: 100% F
B. Patient Related
a. Age
Pediatrics - is not yet fully developed which may cause the accumulation of drugs
even when given at normal doses.
Geriatrics- have slower metabolizing rates as compared to adults aged 20-40
b. Habits
Smoking Cigarettes- Enzyme induction
Acute Alcohol- Enzyme Inhibitor
c. Tolerance- receptors becomes “Desensitize”
-reduction physical response
-increase dose and frequency - causes an increase of toxic effect
Tachyphylaxis- rapid development of tolerance
d. Idiosyncrasy- genetically determined

Types of Poisoning
1. Acute- prompt & there is marked disturbances of function or death within a short period of time
2. Chronic- gradual & there is progressive deterioration of the functioning of tissues
-usually produced by taking small dose for a protracted period of time

3. Combined- Acute + Chronic

Evidences of Poisoning
1. Circumstantial- from the event & site of poisoning
2. Post Mortem- gathered after an autopsy is performed
3. Experimental Evidences- after observation of the signs/ symptoms after administering to a living
system
4. Chemical Evidence- is acquired by extracting body fluids from the patient & tested w/ specific
reagent or chemical
5. Symptomatic Evidence- comparison of the established signs/ symptoms w/ that of the patient

General Assessment of a Poison Patient:

i. . Initial Assessment- Evaluate vital signs & support vital functions
A- Airways
B- Breathing (ventilate, applied 100% O2)
C- Circulation
D- Disability: Neurologic Status
ii. Treatment of the depressed mental state
 Adult – 500mL of 3% dextrose
 Children – 1mL/ kg
 Administer Vit.B (Thiamine) – 100mL IV push
 Give Naloxone (0.4-2mg) to treat Opioid Poisoning
iii. Identify the patient & the poison
Basic Info: Substance, Time Ingested, Amount, Signs & Symptoms
iv. Decontamination
a. Inhalational Exposure- one of the most dangerous
Treatment: Rapid Removal from environment
b. Dermal Exposure
Treatment:
o Remove contaminated materials from patient
o wash with Slightly Cool Water
o wash with Baking Soda
c. Ocular Exposure- wash with Plain NSS irrigation for 15 minutes