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Comprehensive Guide to Poison Management: Treatment, Procedures, and Antidotes

Learn about the management of poisoning, including causes, symptoms, treatment fundamentals, drug interventions, poison removal procedures, specific antidotes, and heavy metal poisoning therapy. Get insights on poison control centers and stay informed on effectively handling poison emergencies.

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Comprehensive Guide to Poison Management: Treatment, Procedures, and Antidotes

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  1. Chapter 108 Management of Poisoning

  2. Poisoning • Over 2 million cases reported in the U.S. annually • 23,618 deaths in 2005 from accidental poisonings • 5833 deaths in 2005 from intentional poisonings • Most cases caused by drugs • 75% of suicides caused by drugs

  3. Management of Poisoning • Poisoning – pathologic state caused by toxic agent • Sources – medications, plants, environmental sources, pollutants, and drugs of abuse • Entry – oral, inhalation, injection, absorption through skin • Unintentional or accidental • Symptoms often mimic a disease

  4. Fundamentals of Treatment • Poisoning is an emergency that requires rapid treatment • Supportive care • Identification of poison • Prevention of further absorption • Poison removal • Antidotes

  5. Drugs and Procedures Used to Minimize Poison Absorption • Activated charcoal • Syrup of ipecac • Gastric lavage and aspiration • Whole-bowel irrigation • Catharsis • Surface decontamination

  6. Drugs and Procedures Used for Poison Removal • Drugs that enhance renal excretion • Sodium bicarbonate • Ammonium chloride • Nondrug methods of poison removal • Peritoneal dialysis • Hemoperfusion • Exchange transfusion

  7. Specific Antidotes • Heavy metal antagonists • Most common poisonings: iron, lead, mercury, arsenic, gold, and copper • Environmental exposure, intentional overdose, therapeutic use of heavy metals • Antidote drugs are “chelating agents” or “chelators” • Interact to form chelates

  8. Heavy Metal Poisoning • Drug therapy • Deferoxamine (Desferal) • Deferasirox (Exjade) • Dimercaprol (BAL In Oil) • Edetate calcium disodium (EDTA) • Penicillamine (Depen) • Fomepizole (Antizole)

  9. Fig. 108-1. Chelation of mercury by dimercaprol.

  10. Poison Control Centers • American Association of Poison Control Centers (AAPCC)

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