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1 160424083110
1 160424083110
2. Inorganic:
i. Non-metallic: K, I, Cl, Br, CCl4
ii. Metallic: As, Cu, Pb, Hg, Zn
iii. Mechanical: Powdered glass, Diamond dust
3. Organic:
i. Vegetable: Abrus precatorious, Calotropins
ii. Animal: Snake & Insect venom, Cantharides
C. SYSTEMIC:
1. Cerebral:
i. CNS depressants: Alcohols, Opioids, Sedatives,
Hypnotics.
ii. CNS stimulants: Amphetamines, Caffeine,
Antidepressants
iii. Deliriants: Dhatura, Belladona, Cannabis, Cocaine
2. Spinal: Nux vomica, Gelsemium
3. Peripheral: Conium, Curare
4. Cardiovascular: Aconite, Quinine, Oleander, Aconite,
Tobacco
5. Asphyxiants: CO, CO2, H2S
D. MISCELLANEOUS:
- Food poisoning/botulism
1. Fulminating: is produced by a massive dose, death
occurs rapidly, sometime without preceding
symptoms.
2. Acute: caused by excessive single dose or several
smaller doses of poison taken over a short interval of
time.
i. Activated charcoal
ii. Demulcents- (forms coating)
eg. milk, barley-water, starch,
egg white, mineral oil
iii. Bulky food- for glass particles.
iv. Diluents- water
B. Chemical antidotes-
(Counteract the action of poison by forming harmless or
insoluble compounds or by oxidizing poison when brought
in contact with them)
eg. 1.Common salt for Ag NO3,
2.Egg albumin for HgCl3,
3.Dialysed iron for As,
4.CuSO4 for phosphorous,
5.1:5000 solution of Potassium permanganate,
6.Tannic acid 4% for nicotine, cocaine, aconite etc
7.Weak alkali for acids.
8.Weak vegetable acids for alkalis.
C. Universal Antidote: it is the combination of:
i. Activated charcoal (2 parts)- adsorbs poison.
ii. Magnesium oxide (1 part)- neutralizes acid
without gas formation.
iii. Tannic acid (1 part)- precipitates alkaloids &
many metals.
D. Physiological or Pharmacological antidotes:
1. B.A.L
2. E.D.T.A
3. Penicillamine
4. D.M.P.S
5. D.M.S.A
6. Desferrioxamine metal
1. B.A.L ( Dimercaprol )
Dose:
25-35mg/kg in 250-500ml 5% dextrose/NS i.v. over a
period of 1-2 hr twice daily for 5 days and may be
repeated after 2 – 3 days.
3. Penicillamine (Cuprimine)
Indications:
i. Severe poisoning.
ii. Progressive deterioration inspite of full supportive
care.
iii. High risk of serious morbidity or mortality.
iv. If normal route of excretion of toxins is impaired.
v. when the poison produces serious delayed toxic
effects.
vi. If the patient has CVS, respiratory or other d/s.
a. Increasing renal excretion:
Large amount of fluid, tea, lemonade orally,
Urinary alkalinisation for salicylates & phenobarbital.
b. Purging:
-30gm Sodium sulphate with large amounts of water
hastens poison elimination in stool.
c. Whole-bowel irrigation:
-with polyethylene glycol with electrolyte lavage
solution.
d. Diaphoretics:
- increases perspiration.
- 5mg of Pilocarpine nitrate s.c
6. Adequate follow-up:
-to treat complication if any.
-in suicidal cases, psychiatric treatment is needed.
http://www.dda.gov.np/uhn.php
1. Quantity of the poison.
11. Tolerance
In Living Subjects
1. History
2. Clinical Examination
3. Laboratory tests – e.g. blood, urine, stool, vomitus,
stomach wash contents.
In the Dead: