Poisoning

• pesticide - lead to muscle paralysis - after 2 hours exposure = develop n/v, diarrhea, excessive salivation, weakness of respiratory muscles, confusion, depressed reflexes, and possibly seizures
• pesticide - ED activated charcoal may be administered if the pesticide was swallowed
• • IV atropine and cholinesterase reactivator, pralidoxime (Program Chloride) are antidotes
• English Ivy: nausea, vomiting, excess salivation, diarrhea, abdominal pain
• Holly (berries): vomiting, diarrhea, abdominal pain
• Hydrangea: nausea, vomiting, muscular weakness, seizures, dyspnea
• Lily of the Valley: vomiting, abdominal pain, diarrhea, cardiac disturbances
• Mistletoe: vomiting, diarrhea, bradycardia
• Morning Glory (seeds): nausea, diarrhea, hallucinations
• Philodendron: swelling of the tongue, lips, irritation of mouth
• Poinsettia: nausea, vomiting
• Rhododendron: nausea, vomiting, abdominal pain, seizures, limb paralysis
• Rhubarb (leaves): irritant action on gastrointestinal tract
• Poisoning by Drugs of Abuse - Obtain blood specimens from electrolyte levels and a toxicology screen
• administer: oxygen, IV fluid, electrolyte replacement
• Can occur from over-the-counter drugs, such as vitamins, iron compounds, aspirin, or acetaminophen, or from prescription drugs, such as antidepressants
• Acetaminophen Poisoning - Drug most involved in childhood poisoning today, because parents use it to treat childhood fevers
• Acetaminophen Poisoning - After ingestion, will experience anorexia, nausea and vomiting, then serum aspartate transaminase (AST [SGOT]) and serum alanine transaminase (ALT [SGPT]), liver enzymes, become elevate - liver toxicity occurs
• Caustic Poisoning - Ingestion of a strong alkali e.g. lye (toilet bowl cleaners or hair care products) = cause burns and tissue necrosis in the mouth, esophagus, and stomach
• Caustic Poisoning - Immediate pain in the mouth and throat and drools saliva because of oral edema and an inability to swallow - mouth turns white then turns brown as edema and ulceration occur vomit blood, mucus, and necrotic tissue lead to systemic signs of tachycardia, tachypnea, pallor, and hypotension
• caustic poisoning - chest x ray and esophagoscopy, intubation
• caustic poisoning - Analgesic, such as morphine, may need to be ordered and administered to achieve pain relief
• Iron Poisoning - Frequently swallowed by small children because it is an ingredient in vitamin preparations, particularly pregnancy vitamins
• Iron Poisoning - corrosive to the gastric mucosa and leads to S/S of gastric irritation
• Iron poisoning - Hemorrhagic necrosis of the lining of the GI tract has occurred

  • Melena and hematemesis are present
  • Lethargy and coma, cyanosis, and vasomotor collapse may occur
  • Coagulation defects may occur, and hepatic injury also can result
  • Shock resulting from an increase in peripheral vascular resistance and decreased cardiac output can occur
• Therapeutic Management of iron poisoning - stomach lavage, cathartic, maaloxor mylanta
• Lead Poisoning - interferes with RBC function
• iron p - Two successive blood levels greater then 10 ug/dL ingested lead are paint 

  chips or paint dust, home-glazed pottery, or fumes from burning or swallowed batteries

  • Fishing communities, swallowing lead sinkers can be a common source
  • Lead plumbing also may contaminate the drinking water
• Lead Poisoning - 5.39 to 67.6 ug/dL
• Test for iron poisoning - serum ferritin, spectrophotometry
• iron poisoning - proteinuria, ketonuria, glycosuria
• lead levels greater than 20 - succimer
• lead levels greater than 45 - chelation therapy: dimercaprol, calcium disodium
• pesticide poisoning - lead to muscle paralysis - after 2 hours exposure = develop n/v, diarrhea, excessive salivation, weakness of respiratory muscles, confusion, depressed reflexes, and possibly seizures
• antidotes of lead - IV atropine and cholinesterase reactivator, pralidoxime
• Poisoning by Drugs of Abuse - Typical drugs involved include codeine and antidepressant drugs