| APPROACH in Poisoning | 1 Taking an appropriate history
2 Assessing vital functions and correcting any
impairment
3 Examining the patient and observing
4 Identifying complications and treating
them
5. Requesting appropriate investigations
6. Assessing the patient psychiatrically and
offering appropriate management
7. Management of Poisoned Patient |
| when in normal position, foods may enter airways instead of esophagus which may cause drowning and
block airway.
→ minimize the risk of
aspiration of the gastric contents into their
lungs. | Left Lateral Recumbent |
| 1 cause increase body temp. in
fatal levels causing hypertonia and
rhabdomyolysis
2 for
sedation | 1 Cocaine, amphetamines, shabu,
ecstasy
2 diazepam and dantrolene |
| → A constellation of clinical signs that may
suggest a particular type of ingestion.
→ Through this, it may indicate what type of drugs
a patient has taken if they are unable or unwilling
to tell, unconscious. | TOXIDROMES |
| Anticholinergic
→ block the muscarinic and nicotinic
acetylcholine receptors.
→ Antihistamines (1st generations) –
Ex:
Diphenhydramine (Benadryl), tricyclic
antidepressants, antitussives, antipsychotics,
anticonvulsants, antimuscarinic drugs
→ Ex. Atropine, Scopolamine and Ipratropium
bromide, plant
→ Ex. Mushroom Datura
GIVE THE MANIFESTATIONS OF THIS POISONING | Manifestation: the patient can have delirium
peripheral antimuscarinic effects that is
described as:
MAD AS A HATTER – hallucination,
confused, sometimes seizure, worst coma
RED AS A BEET – red flushing of the skin
BLIND AS A BAT – pupils are dilated,
mydriasis
HOT AS A HARE – hyperthermia
DRY AS A BONE – dry skin, urinary
retention |
| Cholinergic toxidrome
→ stimulate muscarinic and nicotinic
acetylcholine
receptors.
GIVE THE MANIFESTATIONS OF THIS POISONING | Manifestation: DUMBELS
1 Diaphoresis: diarrhea + abdominal
cramps–excessive sweating
2 Urination: excessive urination
3 Miosis/mydriasis
4 Bronchospasm, bronchorrhea (excessive
amount of watery mucus), bradycardia (slower than normal heart rate)
5 Emesis
6 Lacrimation
7 Salivation |
| Sedative or Hypnotic toxidrome
→ Benzodiazepines, Barbiturates, Alcohols,
Opioids, Anticonvulsants, Antipsychotics
GIVE THE MANIFESTATIONS OF THIS POISONING | Manifestation:
Decrease level of consciousness,
worst lead to coma,
hypoventilation,
hypotension,
bradycardia. |
| Hallucinogenic toxidrome
→ caused by drugs and agents that cause
hallucination
→ Amphetamine, Cannabinoids, Cocaine, LSD
(lysergic acid diethylamide), PCP (phencyclidine),
Magic mushrooms (Psilocybin spp.)
GIVE THE MANIFESTATIONS OF THIS POISONING | Manifestation: Alter the behavior and thinking of
individuals.
Frank psychosis - mood disorder or
schizophrenia
Tachycardia, hypertension, fever
Panic attacks and anxiety |
| Serotonergic Toxidrome
→ Collection of signs and symptoms produced by excess serotonin in the central, peripheral, and autonomic nervous system
→ Selective serotonin reuptake (paroxetine and fluoxetine), Serotonin noradrenaline reuptake inhibitors (venlafaxine and citalopram), Tricyclic antidepressants, Monoamine oxidase inhibitors (moclobemide)– blocks serotonin breakdown, Analgesic (pethidine, tramadol, fentanyl), Antiemetics (metoclopramide and ondansetron), Anticonvulsants (valproic acid), Dietary
supplements (ginseng and st. john’s wort)
GIVE THE MANIFESTATIONS OF THIS POISONING | Manifestation: wide variation of signs and
symptoms,
dysfunction of areas in nervous system,
tremor,
hyperreflexia,
muscle rigidity,
clonus (involuntary or rhythmic muscular contraction and relaxation),
fever,
tachycardia,
hypertension |
