MANAGEMENT OF

POISONED PATIENT
PREPARED BY:
Dr. HAMMAD AHMED
Pharm.D, M.Phil. (Pharmacology), PhD (Fellow), R.ph
Assistant Professor
ZIAUDDIN UNIVERSITY
MANAGEMENT OF POISONED PATIENT:
Introduction:
• Poisoning occurs when any substance interfere with the body functions after it
swallowed, inhaled, injected or absorbed by any mean.
• The term toxicokinetics denotes the absorption, distribution, excretion, and
metabolism of toxins, toxic doses of therapeutic agents, and their metabolites. The
term toxicodynamics is used to denote the injurious effects of these substances on
vital function.
• Toxicodynamics describes the mechanism or mode of action of toxicants, how they
can cause tissue damage, and under what conditions in terms of tissue
concentrations and time of tissue exposure/dose do adverse effects on tissue
structure and function occur.
TYPES OF POISOINING

There are four basic types of poisoning includes:

• Deliberate

• Accidental

• Enviromental

• Industrial exposure
MANAGEMENT OF POISONED PATIENT
Initial management of poison patient involve:

1. Stabilizing and resuscitation (ABCDs)

2. History & Physical Examination

3. Laboratory & Imaging Procedures

4. Toxicology Screening Tests

5. Decontamination

6. Specific Antidotes
1. Stabilizing and resuscitation (ABCDs)
• Stabilizing the patient is more important first than knowing the type of poison
(Remember ABCDs)
• A= Airway
• B= Breathing
• C= Circulation
• D= Dextrose/Defibrillator
2. History & Physical Examination
A. HISTORY
Oral statements about the amount and even the type of drug ingested.
B. PHYSICAL EXAMINATION
A brief examination should be performed, emphasizing those areas most likely to give clues to the
toxicological diagnosis.
These include
• Vital signs,
• Eyes
• Mouth
• Skin
• Abdomen and
3. Laboratory & Imaging Procedures
• Arterial blood gases

• Electrolytes

• Renal function test

• Serum osmolality

• Electrocardiogram

• Imaging findings
4. Toxicology Screening Tests

• Toxicity screening tests may be helpful in confirming a suspected

intoxication or for ruling out intoxication as a cause of apparent brain death,
they should not delay needed treatment.
5. Decontamination
Decontamination involves removing toxins from the skin or gastrointestinal
tract.
A. SKIN: Wash contaminated skin with soap and water.

B. GASTROINTESTINAL TRACT

I. Emesis

II. Gastric lavage

III. Activated charcoal

IV. Cathartics
6. Specific Antidotes
7. Methods of Enhancing Elimination of Toxins:
A. DIALYSIS PROCEDURES

I. Peritoneal dialysis

II. Hemodialysis

B. FORCED DIURESIS AND URINARY PH MANIPULATION