The most useful poisons in the world. Historical sketch. Origin of medical knowledge. Household poisons - reference book
Side effects of pills: which organs are affected by drugs?
We all live in a “world of drugs”. Manufacturers annually release new products onto the market. Thanks to this, fewer and fewer diseases are classified as incurable. But every medal has a downside. After all, a drug with exceptional selectivity is an ideal, a “magic bullet” precisely aimed at sore spot and does not harm healthy tissue. In real life, most medicines are shot with buckshot, which hits large areas.
Planned harm
Various manifestations of drug intolerance were described at the beginning of the twentieth century. In 1901 the term was introduced into practice « drug disease» , which accumulated all possible adverse reactions to drugs. These are currently referred to as “adverse drug events” (ADEs).
Usually, the PDLs are well known already at the time of release of drugs and are indicated in the instructions for them, however, without exception, it is impossible to take into account all the effects of the drug on the human body in experiments and during preliminary testing. For example, the ototoxic (hearing-impairing) effect of streptomycin was revealed only when treating patients in the clinic, and this property is indeterminable in animals. According to modern guidelines, medications newly introduced into medical practice are considered new for 5 years, and when using them, especially careful medical supervision of patients is carried out.
Most side effects are mild and disappear after stopping or reducing the dosage of the drug, but there are some that can cause significant harm. Side effects can be direct (for example, irritation of the mucous membrane) or indirect (for example, a lack of vitamins when the natural human microflora is suppressed by antibiotics). Such effects can occur when taking any medications.
Adverse reactions to medications are varied as follows:
- increased risk of cancer diseases due to various mutations in the cells of the body;
- damaging effects on the fetus, which can lead to congenital deformities and even fetal death;
- persistent changes in metabolism, manifested by drug dependence, when abstinence occurs upon abrupt cessation of use (corticosteroids, tranquilizers, etc.);
- immunodeficiency states due to negative influence drugs for immunity.
Target organs
When a medicine is administered orally, the gastrointestinal tract is the first to experience its effects. In such cases side effects There may be destruction of tooth enamel, stomatitis, gastrointestinal disorders - irritation of the mucous membrane, nausea, feeling of bloating, loss of appetite, constipation or diarrhea, indigestion, etc.
A number of medications can stimulate the secretion of hydrochloric acid, slow down the production of protective mucus or the processes of natural renewal of the gastric mucosa, which creates the preconditions for the formation of ulcerations. Corticosteroids, analgesics, drugs with pronounced anti-inflammatory, analgesic and antipyretic effects (non-steroidal anti-inflammatory drugs), caffeine and others have this effect.
Relatively often suffers from medications liver. It is she who takes the first blow, and it is here that most drugs accumulate and undergo biotransformation. Complications to the liver often occur when using arsenic preparations, some antibiotics, and so on.
Kidneys are also often exposed to unwanted drug effects. Through them, many are eliminated from the body medicinal substances- unchanged or after a series of transformations. The accumulation of these substances in the kidneys is a good basis for the manifestation of toxic effects on this organ. This is how some antibiotics, sulfa drugs, and vasoconstrictors work.
Side effects of medications may also result in disruption of certain functions. nervous system . Nerve cells are especially sensitive to chemicals, so medications that penetrate the barrier separating the central nervous system from the blood can cause headaches, dizziness, lethargy, and impair performance. Long-term use of some drugs is dangerous due to more serious complications. Thus, drugs that have an inhibitory effect on the central nervous system (neuroleptics) can cause the development of depression and parkinsonism, while those that reduce feelings of fear and tension (tranquilizers) can disrupt gait, stimulants can cause prolonged insomnia, etc.
By the way
Allergic reactions account for more than 70% of all side effects. They can manifest as anaphylactic shock, fever, lesions of the skin, mucous membranes, internal organs, respiratory and nervous systems, and changes in blood composition. The most powerful substances causing allergies, are penicillin antibiotics, sulfa drugs, local painkillers, analgesics.
At the same time, in 50% of cases, it is possible to prevent PDL, since they are associated with unjustified doses and prescription without taking into account the individual characteristics of the patient.
Reduce risk
Many side effects occur due to improper use of medications.
Overdose- a serious problem, especially in the case of taking such drugs, for which the maximum tolerated dose is not much higher than the therapeutic dose. The risk of overdose is often the reason why doctors choose one drug over another if the effectiveness of both is similar, but one is safer in case of accidental or intentional overdose. The rate of development of side effects depends on the route of administration of the drug: application and inhalation cause more quick response with rarer dangerous conditions, and parenteral administration (injections) is slower, but also more unfavorable.
The type used also plays an important role. food, since it affects the rate of absorption of drugs, slows it down or, conversely, increases it. Nutrients can interact with medications and increase their negative effects. For example, cheese contains biologically active substances - tyramine, histamine, and when using similarly active drugs, side effects occur. In addition, some medications (antibiotics) inhibit the absorption of substances necessary for the body, for example, B vitamins, as they suppress the natural intestinal flora. And the presence of food in the intestines weakens antimicrobial effect sulfonamides.
During treatment, you need to give up alcoholic beverages, since ethyl alcohol, acting as a solvent, enhances the absorption of many drugs, and an allergy may occur to the impurities contained in drinks (for example, in wine).
It is also necessary to take into account that with the simultaneous use of many drugs, their interaction occurs, during which highly allergenic complexes can arise. Some drugs inhibit enzymes, thereby preventing the dissolution and removal of other drugs from the body, and thus contribute to the development of toxic and allergic reactions. When taking medications, remember this!
But, even if you do everything correctly, and problems arise, be sure to consult a doctor. He may reduce the dose, change how often you take the medicine, or replace it with another one. All this will minimize unwanted effects.
Painkillers kill kidneys
If a person swallows handfuls of painkillers, then he probably has good reasons for this. Pain relief drugs bring joy to patients quick effect, however, independent researchers claim that painkillers sometimes have the opposite effect.
For several years, scientists observed a group of runners who decided to run a more than 150-kilometer marathon through the Sierra Nevada mountains in... Six kilometers uphill, seven kilometers downhill, the rest along rough terrain. The race lasted approximately 26 hours, so it is not surprising that professional runners supported their performance with painkillers - in particular, ibuprofen. According to the test results, it turned out that seven out of ten people took it, and many took a dose three times the maximum allowable in order to reach the finish line, and not fall ill in the middle of the distance.
To find out whether ibuprofen is beneficial for runners, the scientists initially wanted to ask some of them to give up the drug both during training and for the duration of the race itself, and to ask others to do whatever they wanted, implying that they would not hesitate to use the opportunity to get rid of it. pain. Alas, the plan failed: the practice of taking ibuprofen turned out to be so widespread and athletes were so addicted to it that the medical commission considered the scientists’ request to abandon the pills unethical.
Study author Dr. David Nieman decided to go a different route. He focused on 50 runners who regularly took ibuprofen in preparation for the race. About half of them drank 600 milligrams the day before the race, and on the day of the race - 1,200 milligrams at once, 200 milligrams every four hours. The second group of athletes found the strength to stop taking the drug the day before the marathon and held on for another week after it.
The suffering was in vain
Blood and urine tests taken from runners immediately after the marathon amazed scientists. It turned out that ibuprofen lovers immediately after the race had kidney problems, and endotoxemia was discovered - quite dangerous condition, in which toxins from the colon enter the blood. The saddest thing is that all this suffering was completely in vain, since the athletes who took ibuprofen had joint pain exactly the same as those who refused the painkiller. Wherein consequences Taking ibuprofen turned out to be long-lasting: athletes from the first group showed 50% more various inflammations, although ibuprofen is also taken as an anti-inflammatory agent.
The drug also did not provide athletes with any benefits during running or subsequent recovery. Scientists don't yet know whether other nonsteroidal anti-inflammatory painkillers have the same effect on the body as ibuprofen, but there are still reasons for concern, he writes. medpulse.ru.
“I don’t think there is a window in which athletes can take ibuprofen without side effects,” Nieman says. “So until we know more about its effects on the body, I urge all athletes don't take it. And the most important thing - it just doesn't work…»
Since ancient times, poison and man have lived hand in hand. They were treated with poisons, sometimes poisoned and poisoned, solving political, amorous and hereditary matters. In the latter case, they acted with special sophistication: compared to other means of eliminating opponents, poisons had an undeniable advantage - the unfortunate person went to his forefathers only from “indigestion.” Quiet, peaceful, no shocks.
But it is worth noting that poisonings did not always occur from the malicious intent of ill-wishers. Much more often, the drugs themselves were to blame for untimely death. Even in ancient Egyptian manuscripts it is written that, depending on the method of preparation, the drug can be either harmful or beneficial. Medieval medicines were such that it was enough to increase the dose a little, and it became poison without any hope of survival.
The Dark Middle Ages have sunk into oblivion, taking with it unsolved secrets, poisoned boxes, rings and gloves. People have become more pragmatic, medicines have become more diverse, doctors have become more humane. However, there was still no order with potent and toxic substances. Peter the Great tried to restore order by banning trading in “herbal shops” and ordering the opening of the first free pharmacies. In July 1815, the Russian Empire published “Catalogs for Pharmaceutical Materials and Poisonous Substances” and “Rules for the Sale of Pharmaceutical Materials from Herbal and Mosquito Shops”
Historical sketch. Origin of medical knowledge
Since the times of Ancient Rome, anyone whose body had a bluish-black tint or was covered in spots was considered to have died from poisoning. Sometimes it was considered sufficient that it smelled “bad.” They believed that a poisoned heart does not burn. Killer poisoners were equated with sorcerers. Many have tried to penetrate the secrets of the poison. Someone dreamed of eliminating a rival on the path to wealth and power. Someone was simply jealous of their neighbor. Supreme rulers They often held secret services of poisoners who studied the effects of poisons on slaves. Sometimes the rulers themselves did not hesitate to participate in such research. Thus, the legendary Pontic king Mithridates, together with his court physician, developed a universal antidote, experimenting on prisoners sentenced to death. The antidote they found included 54 components, including opium and dried organs of poisonous snakes. Mithridates himself, as ancient sources testify, managed to develop immunity to poisons and, after defeat in the war with the Romans, trying to commit suicide, he was never able to poison himself. He threw himself on the sword, and his "Secret Memoirs", containing information about poisons and antidotes, were taken to Rome and translated into Latin language. So they became the property of other nations.
They resorted to deliberate poisoning no less often in the East. The perpetrator of the crime was often one of the slaves, who had previously developed immunity to the poison. Quite a lot of attention is paid to poisons and antidotes in the works of Avicenna and his students.
History has left evidence of the outstanding poisoners of their time. The attackers' arsenal included plant and animal poisons, compounds of antimony, mercury and phosphorus. But white arsenic was destined for the role of “King of Poisons”. It was used so often in resolving dynastic disputes that the name “hereditary powder” was assigned to it. It was especially widely used at the French court in the fourteenth century, among the Italian princes of the Renaissance and in papal circles of that time, when few wealthy people were not afraid of dying from poison.
Until the middle of the last century, poisoners could feel relatively safe. If they were tried, it was only on the basis of circumstantial evidence, and arsenic itself remained elusive.
In 1775, Swedish pharmacist Carl Schiele discovered a garlic-smelling gas - arsenic hydrogen (arsine). Ten years later, Samuel Hahnemann treated an extract from the tissues of a person who died from arsenic poisoning with hydrochloric acid and hydrogen sulfide and precipitated the poison in the form of a yellowish precipitate. Since then, hydrogen sulfide has become one of the main reagents for detecting metal poisons. But the first serious work on toxicology was published only in 1813 in France. Its author, Mathieu Orfilla, became the first forensic expert on poisons.
In 1900, there was a mass beer poisoning in Manchester. An examination found arsenic in the beer. A special investigative commission began to figure out how he got there and was horrified: there was arsenic in both artificial yeast and malt. There was no time for beer here - arsenic was found in vinegar, marmalade, bread and, finally, in the body of completely healthy people (approximately 0.0001%).
Arsenic was truly ubiquitous. Marsh's test (chemist at the British Royal Arsenal) made it possible to detect it even in the acid and zinc used for analysis, if they were not previously purified.
The rapid development of physicochemical methods of analysis made it possible by the middle of the last century to solve the problem of quantitative determination of trace amounts of arsenic. Now it was possible to reliably distinguish the background, natural content of arsenic from poisonous doses, which were much higher.
Having harvested a terrible harvest of death, arsenic turned to humanity in a completely different direction in the second half of the nineteenth century. Beginning in 1860, arsenic-containing stimulants became widespread in France. However, a real revolution in the understanding of this ancient poison occurred after the work of Paul Ermech, which marked the beginning of synthetic chemotherapy. As a result, arsenic-containing drugs were obtained that were effective in the treatment of many human and animal diseases.
We can't help but mention poisons plant origin. At the beginning of the nineteenth century, alkaloids broke free from laboratories and clinics, and the world, as a result, entered a period of mysterious murders and suicides. Plant poisons left no traces. The French prosecutor de Brohe made a desperate speech in 1823: “We should warn the murderers: do not use arsenic and other metal poisons. They leave traces. Use plant poisons!!! Poison your fathers, your mothers, poison your relatives - and the inheritance will be yours. Do not be afraid of anything! You will not have to bear punishment for this. There is no crime, because it cannot be established."
Even in the mid-nineteenth century, doctors could not say with certainty what dose of morphine is lethal, what symptoms accompany poisoning plant poisons. Orfilla himself, after several years of unsuccessful research, was forced to admit defeat to them in 1847.
But less than four years later, Jean Stae, a professor of chemistry at the Brussels Military School, found a solution to the problem. The insight that made him famous came to the professor while investigating a murder committed with the help of nicotine. The victim of the crime that Jean Stae was investigating received a dose much higher than the lethal one, but the criminal, frightened, tried to hide the traces of poisoning with wine vinegar. This accident helped discover a method for extracting alkaloids from body tissues...
The founder of homeopathy, S. Hahnemann, very sensitively felt the quantitative side of the action of substances on the body. He noticed that small doses quinine causes signs of malaria in a healthy person. And since, according to Hahnemann, two similar diseases cannot coexist in one organism, then one of them must certainly displace the other. “Like should be treated with like,” Hahnemann taught, using sometimes incredibly low concentrations of the drug for treatment. Today, such views may seem naive, but they are filled with new content if we take into account the paradoxical effects known to toxicologists, when the strength of the toxic effect increases as the concentration of the active substance decreases.
The variety of poisons and their mechanism of action
Lethal doses of some poisons:
White arsenic60.0 mgkg
Muscarine (fly agaric poison) 1.1 mgkg
Strychnine0.5 mgkg
Rattlesnake venom0.2 mgkg
Cobra venom0.075mgkg
Zorin (combat agent) 0.015 mgkg
Palytoxin (marine coelenterate toxin) 0.00015 mgkg
Botulism neurotoxin0.00003 mgkg
What is the reason for such a difference between poisons?
First of all, in the mechanism of their action. One poison, once in the body, behaves like a bull in a china shop, destroying everything. Others act more subtly, more selectively, hitting a specific target, for example, the nervous system or metabolic nodes. Such poisons, as a rule, exhibit toxicity in much lower concentrations.
Finally, one cannot ignore the specific circumstances surrounding the poisoning. Highly poisonous salts of hydrocyanic acid (cyanides) may turn out to be harmless due to their tendency to hydrolysis, which begins already in a humid atmosphere. The resulting hydrocyanic acid either evaporates or undergoes further transformations.
It has long been noted that when working with cyanide it is useful to hold a piece of sugar under your cheek. The secret here is that sugars convert cyanides into relatively harmless cyanohydrins (hydroxynitrile).
Poisonous animals contain in their bodies constantly or periodically substances that are toxic to individuals of other species. In total, there are about 5 thousand species of poisonous animals: protozoa - about 20, coelenterates - about 100, worms - about 70, arthropods - about 4 thousand, mollusks - about 90, echinoderms - about 25, fish - about 500, amphibians - about 40, reptiles - about 100, mammals - 3 species. There are about 1,500 species in Russia.
Of the poisonous animals, the most studied are snakes, scorpions, spiders, etc., the least studied are fish, mollusks and coelenterates. Three species of mammals are known: two species of shrews, three species of shrews, and the platypus.
Paradoxically, gaptooths are not immune to their own poison and die even from light bites received during fights among themselves. Shrews are also not immune to their own poison, but they do not fight among themselves. Both snaptooths and shrews use a toxin, the paralytic clickcrene-like protein. Platypus venom can kill small animals. For humans as a whole, it is not fatal, but it causes very severe pain and swelling that gradually spreads to the entire limb. Hyperalgia can last for many days or even months. Some of the poisonous animals have special glands that produce poison, others contain toxic substances in certain tissues of the body. Some animals have a wounding apparatus that facilitates the introduction of poison into the body of an enemy or victim.
Some animals are insensitive to certain poisons, for example, pigs - to the venom of a rattlesnake, hedgehogs - to the venom of a viper, rodents living in deserts - to the venom of scorpions. There are no poisonous animals that are dangerous to everyone else. Their toxicity is relative.
More than 10,000 species of poisonous plants are known in the world flora, mainly in the tropics and subtropics; there are many of them in countries of temperate and cold climates. In Russia, about 400 species of poisonous plants are found among mushrooms, horsetails, mosses, ferns, gymnosperms and angiosperms. Basic active ingredients poisonous plants - alkaloids, glycosides, essential oils, organic acids, etc. They are usually found in all parts of plants, but often in unequal quantities, and with the general toxicity of the whole plant, some parts are more poisonous than others. Some poisonous plants (for example, ephedra) can only be poisonous if consumed for a long time, since the active principles in their body are not destroyed or eliminated, but accumulate. Most poisonous plants simultaneously affect various organs, but one organ or center is usually more affected.
Plants that are absolutely poisonous apparently do not exist in nature. For example, belladonna and dope are poisonous to humans, but harmless to rodents and birds; sea onion, poisonous to rodents, is harmless to other animals; Pyrethrum is poisonous to insects, but harmless to vertebrates.
Plant poisons. Alkaloids
It is known that medicines and poisons were prepared from the same plants. In Ancient Egypt, the pulp of peach fruits was part of medicines, and from the kernels of the seeds and leaves, the priests prepared a very strong poison containing hydrocyanic acid. A person sentenced to the “peach punishment” was obliged to drink a bowl of poison.
IN Ancient Greece criminals could be sentenced to death by a cup of poison derived from aconite. Greek mythology connects the origin of the name aconite with the word "akon" (translated from Greek - poisonous juice). According to legend, the guardian of the underground kingdom, Cerberus, became so furious during a battle with Hercules that he began to emit saliva, from which aconite grew.
Alkaloids are nitrogen-containing heterocyclic bases with strong and specific activity. In flowering plants, several groups of alkaloids are most often present simultaneously, differing not only in chemical structure, but also on biological effects.
To date, over 10,000 alkaloids of various structural types have been isolated, which exceeds the number of known compounds of any other class of natural substances.
Once in the body of an animal or human, alkaloids bind to receptors intended for regulatory molecules of the body itself, and block or trigger various processes, for example, signal transmission from nerve endings to muscles.
Strychine (lat. Strychninum) is a C21H22N2O2 indole alkaloid isolated in 1818 by Peltier and Caventu from vomiting nuts - the seeds of chilibukha (Strychnos nux-vomica).
Strychnine.
When poisoned with strychnine, a pronounced feeling of hunger appears, fearfulness and anxiety develop. Breathing becomes deep and frequent, and a feeling of chest pain appears. Painful muscle twitching develops and, accompanied by visual sensations of lightning flashing, an attack of tetanic convulsions occurs (simultaneous contraction of all skeletal muscles - both flexors and extensors) - causing opisthonus. Pressure in abdominal cavity sharply increases, breathing stops due to tetanus of the pectoral muscles. Due to the contraction of the facial muscles, a smiling expression appears (sardonic smile). Consciousness is preserved. The attack lasts several seconds or minutes and is replaced by a state of general weakness. After a short interval, a new attack develops. Death occurs not during the attack, but somewhat later from respiratory depression.
Strychnine leads to increased excitability of the motor parts of the cerebral cortex. Strychnine, even in therapeutic doses, causes aggravation of the senses. There is an exacerbation of taste, tactile sensations, smell, hearing and vision.
In medicine it is used for paralysis associated with damage to the central nervous system, with chronic disorders gastrointestinal tract and, mainly, as a general tonic for various states nutritional disorders and weakness, as well as for physiological and neuroanatomical studies. Strychnine also helps with poisoning with chloroform, hydrochloride, etc. For cardiac weakness, strychnine helps in cases where the lack of cardiac activity is caused by insufficient vascular tone. Also used for incomplete optic nerve atrophy.
Tubocurarine. The name “curare” is a poison prepared by Indians living in the tropical forests of Brazil along the tributaries of the Amazon and Orinoco rivers, used for hunting animals. This poison is absorbed extremely quickly from the subcutaneous tissue and it is enough to anoint an insignificant scratch on the body with curare for a person or animal to die. The drug paralyzes the peripheral endings of the motor nerves of all striated muscles, therefore, the muscles that control breathing, and death occurs due to suffocation with complete and almost unimpaired consciousness.
Tubocurarine.
The Indians prepare curare according to different recipes depending on the purpose of the hunt. There are four varieties of curare. They got their name from the packaging method: calabash-curare (“pumpkin”, packed in large dried pumpkins, i.e. calabashes), pot-curare (“potted”, i.e. stored in clay pots), “bag” (in small wicker bags) and tubokurare ("tube", packed in bamboo tubes 25 cm long). Since curare, packaged in bamboo tubes, had the most powerful pharmacological effect, the main alkaloid was named tubocurarine.
The first alkaloid curarine was isolated from tubocurare in 1828 in Paris.
Toxiferin.
Subsequently, the presence of alkaloids in all types of curare was proven. Curare alkaloids, obtained from plants of the genus Strychnos, like strychnine, are derivatives of indole (C8H7N). These are, in particular, the alkaloids contained in pumpkin curar (dimeric C-toxiferine and other toxiferins). Curare alkaloids, obtained from plants of the genus Chodrodendron, are derivatives of bisbenzyliquinol - such, in particular, is B-tubocurarine, contained in pipe curare.
Pharmacologists use curare in animal experiments when it is necessary to immobilize muscles. Currently, they have begun to use this property - to relax skeletal muscles during operations necessary to save people's lives. Curare is used to treat tetanus and convulsions, as well as for strychnine poisoning. It is also used for Parkinson's disease and some nervous diseases accompanied by seizures.
Morphine is one of the main alkaloids of opium. Morphine and other morphine alkaloids are found in plants of the genus poppy, stephania, sinomenium, and moonseed.
Morphine was the first alkaloid obtained in pure form. However, it became widespread after the invention of the injection needle in 1853. It was (and continues to be) used to relieve pain. In addition, it was used as a “treatment” for opium and alcohol addiction. The widespread use of morphine during the American Civil War is believed to have led to the development of "army sickness" (morphine addiction) in more than 400,000 people. In 1874, diacetylmorphine, better known as heroin, was synthesized from morphine.
Morphine has a strong analgesic effect. By reducing the excitability of pain centers, it also has an anti-shock effect in case of injuries. IN large doses ah causes hypnotic effect, which is more pronounced in sleep disorders associated with pain. Morphine causes pronounced euphoria, and with repeated use, a painful addiction quickly develops. It has an inhibitory effect on conditioned reflexes, reduces the summative ability of the central nervous system, enhances the effect of narcotic, sleeping pills and local anesthetics. It reduces the excitability of the cough center. Morphine stimulates the center vagus nerves with the appearance of bradycardia. As a result of the activation of neurons in the oculomotor nerves under the influence of morphine, miosis occurs in humans. Under the influence of morphine, the tone of the smooth muscles of internal organs increases. There is an increase in the tone of the sphincters of the gastrointestinal tract, the tone of the muscles of the central part of the stomach, small and large intestines increases, and peristalsis is weakened. There is a spasm of the muscles of the biliary tract. Under the influence of morphine, the secretory activity of the gastrointestinal tract is inhibited. Basic metabolism and body temperature decrease under the influence of morphine. Characteristic of the action of morphine is depression of the respiratory center. Large doses cause a slowdown and decrease in the depth of breathing with a decrease in pulmonary ventilation. Toxic doses cause periodic breathing and its subsequent stop.
The possibility of developing drug addiction and respiratory depression are major disadvantages of morphine, which in some cases limit the use of its powerful analgesic properties.
Morphine is used as a painkiller for injuries and various diseases accompanied by severe pain, in preparation for surgery and in postoperative period, with insomnia associated with severe pain, sometimes with severe coughing, severe shortness of breath due to acute heart failure. Morphine is sometimes used in x-ray practice when examining the stomach, duodenum, gallbladder.
Cocaine C17H21NO4 is a powerful psychoactive stimulant derived from the South American coca plant. The leaves of this shrub, containing from 0.5 to 1% cocaine, have been used by people since ancient times. Chewing coca leaves helped the Indians of the ancient Inca Empire endure the high-altitude climate. This method of using cocaine did not cause drug addiction, which is so widespread today. The cocaine content in the leaves is still not high.
Cocaine was first isolated from coca leaves in Germany in 1855 and was long considered a “miracle cure.” It was believed that cocaine could be used to treat bronchial asthma, digestive system disorders, “general weakness” and even alcoholism and morphinism. It also turned out that cocaine blocks the conduction of nerve endings pain impulses and therefore is a powerful anesthetic. Previously, it was often used for local anesthesia during surgical operations, including eye surgeries. However, when it became clear that cocaine use leads to drug addiction and serious mental disorders, and sometimes to fatal outcome, its use in medicine has sharply declined.
Like other stimulants, cocaine reduces appetite and can lead to physical and mental destruction. Most often, cocaine addicts resort to inhaling cocaine powder; through the nasal mucosa it enters the blood. The impact on the psyche appears within a few minutes. A person feels a surge of energy, feels new possibilities. The physiological effect of cocaine is similar to mild stress - blood pressure increases slightly, heart rate and breathing increase. After a while, depression and anxiety set in, leading to the desire to take a new dose, no matter the cost. For cocaine addicts, delusional disorders and hallucinations are common: the feeling of insects and goosebumps running under the skin can be so clear that heavy drug addicts, trying to free themselves from it, often harm themselves. Because of its unique ability to simultaneously block pain and reduce bleeding, cocaine is still used in medical practice for surgical operations in the oral and nasal cavities. In 1905, it was possible to synthesize novocaine from it.
Animal poisons
A symbol of a good deed, health and healing is a snake wrapped around a bowl and bowing its head over it. The use of snake venom and the snake itself is one of the most ancient techniques. There are various legends according to which snakes perform various positive deeds, which is why they have earned their perpetuation.
Snakes in many religions are luminous. It was believed that the gods conveyed their will through snakes. Nowadays, a huge number of medicines have been created based on snake venom.
Snake poison. Poisonous snakes are equipped with special glands that produce poison (in different species different composition poison), causing very serious damage to the body. These are one of the few living creatures on Earth that can easily kill a person.
The strength of snake venom is not always the same. The more enraged the snake is, the stronger the poison acts. If, when inflicting a wound, the snake's teeth must bite through clothing, then some of the venom can be absorbed by the fabric. In addition, the strength of the individual resistance of the bitten subject does not remain unaffected. It happens that the effect of poison can be compared to the effect of a lightning strike or taking hydrocyanic acid. Immediately after the bite, the patient shudders with an expression of suffering on his face and then falls dead. Some snakes inject venom into the victim's body, which turns the blood into a thick jelly. It is very difficult to save the victim; you have to act within a few seconds.
But most often, the bitten area swells and quickly acquires a dark purple hue, the blood becomes liquid and the patient develops symptoms similar to those of rotten blood. The number of heart contractions increases, but their strength and energy weakens. The patient experiences extreme loss of strength; the body becomes covered in cold sweat. Dark spots from subcutaneous hemorrhages appear on the body, the patient weakens from depression of the nervous system or from decomposition of the blood, falls into a typhoid state and dies.
Snake venom appears to primarily affect the vagus and adnexal nerves, so characteristic effects negative symptoms from the larynx, breathing and heart.
One of the first pure cobra venom with therapeutic purpose for malignant diseases about 100 years ago it was used by the French microbiologist A. Calmette. Received positive results attracted the attention of many researchers. It was later found that cobrotoxin does not have a specific antitumor effect, and its effect is due to its analgesic and stimulating effect on the body. Cobra venom can replace the drug morphine. It has a longer lasting effect and is not addictive to the drug. Cobrotoxin, after being freed from hemorrhages by boiling, was successfully used to treat bronchial asthma, epilepsy and neurotic diseases. For these same diseases, a positive effect was obtained after the patient was prescribed rattlesnake venom (crotoxin). Employees of the Leningrad Research Psychoneurological Institute named after V.M. Bekhterev concluded that in the treatment of epilepsy, snake venoms are one of the first among known ones in their ability to suppress foci of excitation. pharmacological drugs. Preparations containing snake venoms are used mainly as painkillers and anti-inflammatory drugs for neuralgia, arthralgia, radiculitis, arthritis, myositis, and periarthritis. And also for carbuncle, gangrene, adynamic conditions, typhoid-type fevers and other diseases. The drug Lebetox was created from the venom of the viper, which stops bleeding in patients with various forms of hemophilia.
Spider venom. Spiders are very useful animals that destroy harmful insects. The venom of most spiders is harmless to humans, even if it is a tarantula bite. It used to be believed that the antidote to a bite could be dancing until you drop (hence the name of the Italian dance - “tarantella”). But a karakurt bite causes sharp pain, convulsions, suffocation, vomiting, salivation and sweating, and disruption of the heart.
Poisoning by tarantula spider venom is characterized by severe pain that spreads from the site of the bite throughout the body, as well as involuntary contractions of the skeletal muscles. Sometimes a necrotic lesion develops at the site of the bite, but it can also be a consequence of mechanical damage to the skin and secondary infection.
Spiders living in Tanzania have neurotoxic venom and cause severe local pain, anxiety, and increased sensitivity to external irritations in mammals. Then the poisoned animals develop hypersalivation, rhinorrhea, priapis, diarrhea, convulsions, respiratory failure occurs, followed by the development of severe respiratory failure.
Nowadays, spider venom is increasingly used in medicine. The discovered properties of the poison demonstrate their immunopharmacological activity. The distinct biological properties of tarantula venom and its predominant effect on the central nervous system make it promising to study the possibility of its use in medicine. In the scientific literature there are reports of its use as a means of regulating sleep. It selectively acts on the reticular formation of the brain and has advantages over similar drugs of synthetic origin. Probably similar spiders are used by the inhabitants of Laos as psychostimulants. The ability of spider venom to influence blood pressure is used for hypertension. Spider venom causes necrosis muscle tissue and hemolysis.
Scorpion poison. There are about 500 species of scorpions in the world. These creatures have long been a mystery to biologists, as they are capable of maintaining a normal lifestyle and motor activity, go without food for more than a year. This feature indicates the uniqueness metabolic processes in Scorpios. Poisoning from scorpions is characterized by damage to the liver and kidneys. According to many researchers, the neurotope component of the poison acts like strychnine, causing convulsions. Its influence on the autonomic center of the nervous system is also pronounced: in addition to disturbances in heartbeat and breathing, vomiting, nausea, dizziness, drowsiness, and chills are observed. Neuropsychic disorders are characterized by fear of death. Poisoning with scorpion venom is accompanied by an increase in blood glucose, which in turn affects the function of the pancreas, in which the secretion of insulin, amylase and trypsin increases. This condition often leads to the development of pancreatitis. It should be noted that scorpions themselves are also sensitive to their poison, but in much larger doses. This feature was previously used to treat their bites. Quintus Serek Samonik wrote: “When a scorpion burns when it inflicts a cruel wound, they immediately grab it, and deservedly deprived of life, it, as I heard, is suitable to cleanse the wound from poison.” The Roman physician and philosopher Celsus also noted that the scorpion itself is an excellent remedy for its own bite.
The literature describes recommendations for the use of scorpions for treatment various diseases. Chinese doctors advised: “If live scorpions are infused with vegetable oil, then the resulting product can be used for inflammatory processes middle ear." Preparations from scorpion are prescribed in the east as a sedative; its tail part has an antitoxic effect. Non-poisonous pseudoscorpions that live under the bark of trees are also used. Residents of Korean villages collect them and prepare a potion for the treatment of rheumatism and radiculitis. The poison of some types of scorpions can have a beneficial effect on the body of a person suffering from cancer.Research results indicate that preparations based on scorpion venom have destructive effect on malignant tumors, it has an anti-inflammatory effect and, in general, improves the well-being of patients suffering from cancer.
Batrachotxin.
Bufotoxin.
Toad poison. Toads are poisonous animals. Their skin contains many simple saccular venom glands, which accumulate behind the eyes in “parotids”. However, toads do not have any piercing or wounding devices. To protect itself, the reed toad contracts its skin, causing it to become covered with an unpleasant-smelling white foam secreted by the poisonous glands. If the aga is disturbed, its glands also secrete a milky-white secretion; it can even “shoot” it at the predator. Agi poison is potent, affecting mainly the heart and nervous system, causing profuse salivation, convulsions, vomiting, arrhythmia, increased blood pressure, sometimes temporary paralysis and death from cardiac arrest. Simple contact with poisonous glands is sufficient for poisoning. The poison, which penetrates the mucous membrane of the eyes, nose and mouth, causes severe pain, inflammation and temporary blindness.
Toads have been used in folk medicine since ancient times. In China, toads are used as a heart remedy. Dry venom secreted by the cervical glands of toads can slow the progression of cancer. Substances from toad venom do not help cure cancer, but they can stabilize the condition of patients and stop tumor growth. Chinese therapists claim that toad venom can improve the functions of the immune system.
Bee venom. Bee venom poisoning can occur in the form of intoxication caused by multiple bee stings, and can also be allergic in nature. When massive doses of poison enter the body, damage to internal organs is observed, especially to the kidneys, which are involved in removing poison from the body. There have been cases where kidney function was restored through repeated hemodialysis. Allergic reactions to bee venom occur in 0.5 - 2% of people. Sensitive individuals have a strong reaction up to anaphylactic shock may develop in response to one sting. The clinical picture depends on the number of stings, location, and functional state of the body. As a rule, local symptoms come to the fore: sharp pain, swelling. The latter are especially dangerous when the mucous membranes of the mouth and respiratory tract are damaged, as they can lead to asphyxia.
Bee venom increases the amount of hemoglobin, reduces blood viscosity and coagulability, reduces the amount of cholesterol in the blood, increases diuresis, dilates blood vessels, increases blood flow to the diseased organ, relieves pain, increases overall tone, performance, improves sleep and appetite. Bee venom activates the pituitary-adrenal system, has an immunocorrective effect, and improves adaptive capabilities. Peptides have a preventive and therapeutic anticonvulsant effect, preventing the development of epileptiform syndrome. All this explains the high effectiveness of bees in treating Parkinson’s disease, multiple sclerosis, post-stroke, post-infarction, and cerebral palsy. Bee venom is also effective in treating diseases of the peripheral nervous system (radiculitis, neuritis, neuralgia), joint pain, rheumatism and allergic diseases, at trophic ulcers and flaccid granulating wounds, with varicose veins veins and thrombophlebitis, with bronchial asthma and bronchitis, with coronary disease and consequences radiation exposure and other diseases.
"Metal" poisons. Heavy metals... This group usually includes metals with a density greater than that of iron, namely: lead, copper, zinc, nickel, cadmium, cobalt, antimony, tin, bismuth and mercury. Their release into the environment occurs mainly during the combustion of mineral fuels. Almost all metals have been found in coal and oil ash. In coal ash, for example, according to L.G. Bondarev (1984), the presence of 70 elements was established. 1 ton contains on average 200 g of zinc and tin, 300 g of cobalt, 400 g of uranium, 500 g of germanium and arsenic. The maximum content of strontium, vanadium, zinc and germanium can reach 10 kg per 1 ton. Oil ash contains a lot of vanadium, mercury, molybdenum and nickel. Peat ash contains uranium, cobalt, copper, nickel, zinc, and lead. So, L.G. Bondarev, taking into account the current scale of fossil fuel use, comes to the following conclusion: it is not metallurgical production, but the combustion of coal that represents main source release of many metals into the environment. For example, with the annual combustion of 2.4 billion tons of hard coal and 0.9 billion tons of brown coal, 200 thousand tons of arsenic and 224 thousand tons of uranium are dispersed along with ash, while the world production of these two metals is 40 and 30 thousand. t per year respectively. It is interesting that the technogenic dispersion of such metals as cobalt, molybdenum, uranium and some others during the combustion of coal began long before the elements themselves began to be used. “To date (including 1981), continues L.G. Bondarev, about 160 billion tons of coal and about 64 billion tons of oil have been mined and burned throughout the world. Together with the ash, they are scattered in surrounding a person environment of many millions of tons of various metals."
It is well known that many of these metals and dozens of other microelements are found in the living matter of the planet and are absolutely necessary for the normal functioning of organisms. But, as they say, “everything is good in moderation.” Many of these substances, when present in excess quantities in the body, turn out to be poisons and begin to be hazardous to health. For example, the following are directly related to cancer: arsenic (lung cancer), lead (kidney, stomach, intestinal cancer), nickel (oral cavity, colon), cadmium (almost all forms of cancer).
The conversation about cadmium should be special. L.G. Bondarev cites alarming data from the Swedish researcher M. Piscator that the difference between the content of this substance in the body of modern adolescents and the critical value when it is necessary to reckon with impaired kidney function, diseases of the lungs and bones, turns out to be very small. Especially for smokers. During its growth, tobacco accumulates cadmium very actively and in large quantities: its concentration in dry leaves is thousands of times higher than the average values for the biomass of terrestrial vegetation. Therefore, with each puff of smoke, along with such harmful substances Just like nicotine and carbon monoxide, cadmium also enters the body. One cigarette contains from 1.2 to 2.5 micrograms of this poison. World tobacco production, according to L.G. Bondarev, is approximately 5.7 million tons per year. One cigarette contains about 1 g of tobacco. Consequently, when smoking all the cigarettes, cigarettes and pipes in the world, from 5.7 to 11.4 tons of cadmium are released into the environment, getting not only into the lungs of smokers, but also into the lungs of non-smoking people. Concluding this brief information about cadmium, it should also be noted that this substance increases blood pressure.
The relatively higher number of cerebral hemorrhages in Japan, compared to other countries, is naturally associated, among other things, with cadmium pollution, which is very high in the Land of the Rising Sun. The formula “everything is good in moderation” is also confirmed by the fact that not only an excess amount, but also a deficiency of the substances mentioned above (and others, of course) is no less dangerous and harmful to human health. For example, there is evidence that a lack of molybdenum, manganese, copper and magnesium can also contribute to the development of malignant tumors.
Lead. In acute lead intoxication, the most common neurological symptoms are lead encephalopathy, lead colic, nausea, constipation, pain throughout the body, decreased heart rate and increased blood pressure. With chronic intoxication, there is increased excitability, hyperactivity (impaired concentration), depression, decreased IQ, hypertension, peripheral neuropathy, loss or decreased appetite, stomach pain, anemia, nephropathy, “lead border”, dystrophy of the muscles of the hands, decreased levels of the body calcium, zinc, selenium, etc.
Once in the body, lead, like most heavy metals, causes poisoning. And yet, medicine needs lead. Since the time of the ancient Greeks, they have remained in medical practice lead lotions and plasters, but this is not limited to the medical service of lead...
Bile is one of the important fluids of the body. The organic acids it contains - glycolic and taurocholic acids - stimulate liver activity. And since not always and not everyone’s liver works with the precision of a well-oiled mechanism, these acids in their pure form are needed by medicine. They are isolated and separated using lead acetic acid. But the main work of lead in medicine is related to radiotherapy. It protects doctors from constant x-ray exposure. To almost completely absorb X-rays, it is enough to place a 2-3 mm layer of lead in their path.
Lead preparations have been used in medicine since ancient times as astringents, cauterizing and antiseptic agents. Lead acetate is used in the form of 0.25-0.5% aqueous solutions for inflammatory diseases of the skin and mucous membranes. Lead plasters (simple and complex) are used for boils, carbuncles, etc.
Mercury. The ancient Indians, Chinese, and Egyptians knew about mercury. Mercury and its compounds were used in medicine; red paints were made from cinnabar. But there were also quite unusual “applications”. So, in the middle of the tenth century, the Moorish king Abd al-Rahman built a palace, in the courtyard of which there was a fountain with a continuously flowing stream of mercury (to this day, Spanish mercury deposits are the richest in the world). Even more original was another king, whose name history has not preserved: he slept on a mattress that floated in a pool of mercury! At that time, the strong toxicity of mercury and its compounds was apparently not suspected. Moreover, not only kings, but also many scientists were poisoned with mercury, including Isaac Newton (at one time he was interested in alchemy), and even today, careless handling of mercury often leads to sad consequences.
For mercury poisoning characterized by headache, redness and swelling of the gums, the appearance of a dark border of mercury sulfide on them, swelling of the lymphatic and salivary glands, digestive disorders. In case of mild poisoning, after 2-3 weeks, impaired functions are restored as mercury is removed from the body. If mercury enters the body in small doses but over a long period of time, chronic poisoning occurs. It is characterized, first of all, by increased fatigue, weakness, drowsiness, apathy, headaches and dizziness. These symptoms are very easy to confuse with the manifestation of other diseases, or even with a lack of vitamins. Therefore, it is not easy to recognize such poisoning.
Currently, mercury is widely used in medicine. Despite the fact that mercury and its components are poisonous, it is added in the manufacture of medicines and disinfectants. About a third of all mercury production goes into medicine.
We know mercury from its use in thermometers. This is due to the fact that it responds quickly and evenly to temperature changes. Today, mercury is also used in thermometers, dentistry, in the production of chlorine, caustic salt, and electrical equipment.
Arsenic. In acute arsenic poisoning, vomiting, abdominal pain, diarrhea, and depression of the central nervous system are observed. The similarity of the symptoms of arsenic poisoning with the symptoms of cholera for a long time made it possible to successfully use arsenic compounds as a lethal poison.
CONCLUSION IN THE COMMENT
| Categories: | medicines and poisons for 1 user |
Snake venom has long been used in medical purposes. About him healing properties people who lived thousands of years ago knew. In modern medicine, this substance is used in pharmacology for the manufacture of ointments and creams. The venoms of cobras, vipers and vipers are suitable for these purposes. Since the substance, in addition to its beneficial properties, contains toxins that can kill a person, it is used in minute doses.
Containing drugs have a high cost. This is due to the labor-intensive process of extracting the substance. Today, there are special farms where cobras and vipers are raised.
Snake venom is not used in its pure form. Before entering the drug, the substance is subjected to special processing.
Composition of the poison
It often becomes fatal to humans, which is why many are wary of using drugs based on the venom of these reptiles. However, fears are in vain, since modern medicine has learned to isolate useful enzymes from this substance and apply their beneficial properties.
Snake venom is produced by a special gland located behind the reptile's eyes. It has a specific yellowish color. Depending on the type of snake, the composition of the substance may vary slightly. In general, the poison contains:
- proteins;
- lipids;
- nucleotides;
- amino acids;
- peptides;
- Sahara;
- inorganic salts;
- guanine derivatives.
Characteristics of substance properties
The use of poison was practiced by the ancient Romans and Greeks. In their search for a cure for smallpox and leprosy, doctors discovered the beneficial properties of the substance. With the development of medicine, it was found that the poison has a wound-healing and hemostatic effect.
If the substance is used unwisely, it may result in:
- to paralysis of the respiratory system;
- serious disturbances in the functioning of the heart and blood vessels;
- lethal outcome.
In minimal doses, the poison is not dangerous and has a positive effect on the human body.
Characteristic features of the poison are properties such as:
- anesthesia;
- wound healing;
- disinfection;
- normalization of metabolic processes in the body;
- reduction of swelling;
- stop bleeding.
Types of snake venom
In modern pharmacology, reptile venom is used to create medicines. The doses used are minimal, so they are safe for humans. According to their effects on the body, snake venoms are divided into two groups:
- Poisons, which include cardiotropic and neurotoxic substances. Such poisons can paralyze the nervous system and respiratory organs.
- Poisons that have hemocoagulative and necrotizing effects negatively affect the functioning of the cardiovascular system. The effect of the poison affects tissues and promotes cell death.
The substance is used in the preparation of injections and ointments. Poisons of the first group are effective in the treatment of neuralgia. They are an excellent pain reliever. But to treat such a rare disease as hemophilia, substances belonging to the second group of poisons are used.
Indications for use
Medicines containing snake venom are used for pain relief, as well as for inflammatory processes. These medications treat:
- diseases of the cardiovascular system;
- blood diseases (hemophilia);
- rheumatic conditions;
- leprosy neuritis.
Venom-based medications stimulate the immune system. Also, small doses of the substance are used as an antidote. Such drugs are administered to people whose activities involve snakes and who are at high risk of being bitten.
Based on snake venom, they can be a good substitute for narcotic drugs, since they have the same properties and the body does not get used to them.
To treat bruises, various types of injuries and rheumatism, you can use ointment with snake venom.
Diseases and pathologies for which the use of such drugs is indicated:
- complications caused by diabetes;
- migraine;
- allergic manifestations of various types;
- neuralgia;
- myositis;
- multiple sclerosis;
- hypertension;
- inflammatory processes in the gastrointestinal tract;
- neurodermatitis;
- rheumatoid conditions;
- radiculitis;
- Alzheimer's syndrome;
- bronchial asthma.
Contraindications
Despite its numerous beneficial properties, ointment with snake venom can cause side effects in a certain category of people in the form of:
- allergic reaction;
- burning;
- itching;
- dermatitis.
Therefore, before using the product, you need to carefully read the instructions for use and the composition of the drug. If the patient has an intolerance to any component, you should stop using the medicine.
When starting therapy, you can do a preliminary test that will show how your body reacts to the substances of the drug. To do this, ointment with snake venom is applied to a small area of the epidermis. If no adverse reactions occur after a while, you can safely begin treatment.
There are also a number of contraindications for the use of drugs that contain snake venom. It is prohibited to use the medicine:
- if the patient is diagnosed with pulmonary tuberculosis;
- during feverish conditions;
- people with circulatory problems;
- for skin diseases;
- if there are wounds or cuts on the epidermis;
- pregnant and lactating women;
- with severe pathologies of the kidneys and liver;
- if there is a tendency to vasospasm;
- for the treatment of children.
"Cobratox"
"Cobratox" is an ointment based on snake venom for joints and muscles. The drug has an analgesic effect and is effectively used to treat various pathologies:
- muscle strains;
- arthritis;
- neuralgia;
- inflammatory processes in joints and muscles;
- dislocations;
- meniscus injuries;
- arthrosynovitis;
- bursitis;
- periarthritis.
Cobratoxan ointment is especially popular among dancers and professional athletes.
The main components of the product are:
- salicylic acid;
- cobra venom;
- menthol and various essential oils.
The ointment should not be used while bearing and feeding a child, or if there are serious kidney and liver diseases. The medicine is prohibited for patients with tuberculosis and in the presence of damage to the epidermis.
Ointment "Viprosal": instructions for use, price
Medicines containing snake venom should not be used uncontrolled. Such medications should be prescribed by the attending physician.
Viprosal ointment is used as an anti-inflammatory in the following pathologies and diseases:
- arthritis;
- radiculitis;
- neuralgia;
- lumbago, accompanied by severe pain;
- sciatica;
- tendovaginitis;
- myalgia;
- arthralgia;
- dislocation and sprain;
- bruise and soft tissue injury;
- bursitis.
The insert included with the Viprosal ointment contains instructions for use. The price of the drug depends on the volume of the tube. The average cost of the medicine is 330 rubles for 50 g, and 250 rubles for 30 g of ointment.
The average course of therapy is 10 days. The medicine contains the following components:
- viper venom;
- salicylic acid;
- camphor oil;
- and other auxiliary ingredients.
Do not use if you have allergies or purulent diseases skin. Ointment with snake venom is strictly contraindicated for people with pulmonary tuberculosis, as well as with severe liver and kidney pathologies. It is not recommended to use if you are prone to vasospasms and have circulatory disorders in the brain. The ointment should not be applied to open wounds. Do not use the product during pregnancy and breastfeeding. Also a contraindication is the body’s high sensitivity to any component of the product.
Ointment "Nayatox"
Ointment with snake venom "Nayatoks" is used in the treatment of bruises, diseases of the musculoskeletal system, sciatica and neuralgia. The product is also effective for pain syndromes muscles and joints.
The ointment contains one of the strongest poisons in the world, which is obtained from cobras.
The medicine has the same contraindications as Cobratox ointment.
Today, these substances are used not only in pharmacology. Cosmetics that have a rejuvenating effect are produced based on snake venom. These are various serums and creams for skin care.
The most expensive and at the same time the most effective ointments are those that use viper venom.
Historical evidence of outstanding poisoners, their arsenal of plant and animal poisons, compounds of antimony, mercury and phosphorus. The variety of poisons and their mechanism of action. Groups of alkaloids, their differences in chemical structure and biological effect.
Plan
- INTRODUCTION
- Historical sketch. Origin of medical knowledge
- The variety of poisons and their mechanism of action
- Plant poisons. Alkaloids
- Animal poisons
- Conclusion
1. Journal "Psychosphere" No. 1, 1999
2. Journal of Russian Pharmacies" No. 3 2003
3. Brief Medical Encyclopedia, ed. " Soviet encyclopedia" - second edition, 1989, Moscow.
4. Nemodruk A.A. "Analytical chemistry of arsenic", ed. Science, 1976, Moscow
5. Orlov B.N., Gelashvili D.B. "Zoointoxicology. Poisonous animals and their poisons" ed. Science, 1985, Moscow
6. Popular library of chemical elements. Book 2. Ed. Science, 1983, Moscow
7. Trakhtenberg T.M., Korshun M.N. "Mercury and its compounds in the environment" 1990, Kyiv.
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03.08.2014
Household poisons- reference book
Household poisons, as the name suggests, can often be found in everyday life even where in theory they cannot exist. But forewarned is forearmed, so let’s slowly study the material on household poisons.
ADRENALIN
Adrenaline (epinephrine, suprarenin). Neurotropic and psychotropic effects. Lethal dose 10 mg. Quickly inactivated in the gastrointestinal tract. When administered parenterally, it is detoxified in the liver and excreted in the form of metabolites in the urine.
B. Symptoms of poisoning.
Symptoms of intoxication appear within the first 10 minutes after administration of the drug. Nausea, vomiting, pale skin, cyanosis, chills, dilated pupils, blurred vision, tremors, convulsions, difficulty breathing, coma. Tachycardia and initially a significant increase in blood pressure. Then a sharp decrease in it and ventricular fibrillation are possible. Sometimes psychosis develops with hallucinations and a feeling of fear.
C. Emergency care:
2. Antidote treatment.
3. Symptomatic therapy.
1. When taken orally, gastric lavage. Forced diuresis.
2. Phentolamine 5-10 mg intravenously (1-2 ml 0.5%
solution), aminazine 50-100 mg intramuscularly or intravenously.
3. for tachycadria, obzidan, inderal 1-2 ml of 0.1% solution intravenously repeatedly until a clinical effect is obtained.
ACACIA WHITE.
Yalovite roots and bark containing toxalbumin. Gastroenterotoxic effect. .
B. Symptoms of poisoning
Nausea, vomiting, tenesmus, abdominal pain, diarrhea. In severe cases, bloody stools, hematuria, acute cardiovascular failure.
C. Emergency care:
1. Active detoxification methods
2. Antidote treatment
D. Symptomatic therapy
1. Gastric lavage, activated carbon orally
2. Intravenous administration of 5-10% glucose solution, 0.9% sodium chloride solution, electrolyte solution used for forced diuresis. Cardiovascular drugs, calcium chloride, vikasol.
ACONITE.
Aconite (borech, blue buttercup, Issykul root). The active principle is the alkaloid aconitine. Neurotoxic (curare-like, ganglion-blocking), cardiotactic effect. Lethal dose - about 1 g of plant, 5 ml of tincture, 2 mg of aconite alkaloid.
B. Symptoms of poisoning
Nausea, vomiting, numbness of the tongue, lips, cheeks, tips of the fingers and toes, a feeling of crawling, sensations of heat and cold in the extremities, transient visual disturbances (seeing objects in green light), dry mouth, thirst, headache, anxiety, convulsive twitching of the muscles of the face, limbs, loss of consciousness. Breathing is rapid, shallow, difficulty inhaling and exhaling, there may be a sudden stop in breathing. Decrease in blood pressure (especially diastolic). IN initial stage bradyarrhythmia, extrasystole, then paroxysmal tachycardia, turning into ventricular fibrillation
C. Emergency care:
1. Active detoxification methods 2. Antidote treatment
D. Symptomatic therapy
1. Gastric lavage, saline laxative, activated carbon orally, forced diuresis, detoxification hemosorbium
2. Intravenous 20-50 ml of 1% novocaine solution, 500 ml of 5% glucose. Intramuscularly 10 ml of 25% magnesium sulfate solution. For convulsions, diazepam (Seduxen) 5-10 mg internally. For heart rhythm disorders - intravenously 10 mg of 10% solution of novocainamide (with normal blood pressure!) or 1-2 ml of 0.1% solution of obsidan, 20 ml of 40% glucose solution with 1 ml of 0.06% solution of corglycone. For bradycardia -0.1% atropine solution subcutaneously. Intramuscular cocarboxylase - 100 mg, 1% ATP solution - 2 ml, 5% ascorbic acid solution - 5 ml, 5% solutions of vitamins B1 - 4 ml, B6 - 4 ml.
ALCOHOL
A. Title chemical substance, its synonyms and characteristics
Alcohol
B. Symptoms of poisoning - see Ethyl alcohol. Alcohol substitutes
ALDEHYDES
A. Name of the chemical substance, its synonyms and characteristics
Formaldehyde, acetaldehyde, paraldehyde, metaldehyde. Psychotropic (narcotic), neurotoxic (convulsive), locally irritating, hepatoxic effect. Absorbed through the mucous membranes of the respiratory tract and gastrointestinal tract. excreted in the lungs and in the urine in the form of non-toxic metabolites.
B. Symptoms of poisoning
See Formalin. When taken orally - salivation, nausea, vomiting, abdominal pain, chills, drowsiness, tremor, tonic convulsions, coma, respiratory depression. Jaundice, enlargement and tenderness of the liver on palpation. When inhaling vapors - severe irritation of the mucous membranes of the eyes and upper respiratory tract, sharp cough, suffocation, impaired consciousness, and in severe cases, coma.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage with the addition of sodium bicarbonate
2. Forced diuresis
3. See Formalin. For seizures - diazepam 10 mg intravenously
Name of the chemical substance, its synonyms and characteristics
AMIDOPYRINE
Amidopyrine (pyramidon). Neurotoxic (convulsive), psychotropic effect. Lethal dose 10-15 g. Rapidly absorbed from the gastrointestinal tract, 15% is bound to plasma proteins. Metabolism in the liver, excretion mainly in the urine.
Symptoms of poisoning.
In case of mild poisoning, tinnitus, nausea, vomiting, general weakness, decreased temperature, shortness of breath, palpitations. In severe poisoning - convulsions, drowsiness, delirium, loss of consciousness and coma with dilated pupils, cyanosis, hypothermia, decreased blood pressure. The development of peripheral edema, acute agranulocytosis, gastric bleeding, and hemorrhagic rash is possible.
Urgent Care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Flushing the ventricle through a probe. Saline laxative orally. Forced diuresis, alkalization of the blood (sodium bicarbonate 10 -15 g orally). Detoxification hemosrbia.
2. Vitamin B1 solution 6% - 2 ml intramuscularly. Cardiovascular drugs. For seizures, diazepam 10 mg intravenously.
AMINAZINE.
A. Name of the chemical substance, its synonyms and characteristics.
Aminazine (plegomazine, largactil, chlorpromazine). Psychotropic, neurotoxic effects (gangliolytic, adrenolytic). Toxic dose is more than 500 ml. Lethal dose 5-10g. Toxic concentration in the blood is 1-2 mg/l, lethal 3-12 mg/l. Detoxification in the liver, excretion through the intestines and urine - no more than 8% of the dose taken for 3 days.
B. Symptoms of poisoning.
Severe weakness, dizziness, dry mouth, nausea. Convulsions and loss of consciousness may occur. The comatose state is shallow, tendon reflexes are increased, the pupils are constricted. Increased heart rate, decreased blood pressure without cyanosis. Skin allergic reactions. Upon recovery from a coma, symptoms of parkinsonism are possible. When chewing chlorpromazine tablets, hyperemia and swelling of the oral mucosa occurs; in children, this has an expressive effect on the mucous membrane of the digestive tract.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage, saline laxative. Forced diuresis of plasma alkalization bases.
3. For hypotania: 10% caffeine solution - 1-3 ml or 5% ephedrine solution - 2 ml subcutaneously, 6% vitamin B1 solution - 4 ml intramuscularly. For parkinsonism syndrome: cyclodol 10-20 mg/day orally. Treatment of acute cardiovascular failure.
AMITRYPTYLINE.
Amitriptyline (tryptisol), imizin (melipramine, imipramine, tofranil) and other tricyclic natidepressants. Psychotropic, neurotoxic (anticholinergic, antihistamine), cardiotoxic effects. Toxic dose 500 mg, lethal 1200 mg. Rapid absorption from the gastrointestinal tract Binds to plasma proteins, partial metabolism in the liver, excretion in urine within 24 hours - 4 days
B. Symptoms of poisoning.
In mild cases, dry mouth, blurred vision, psychomotor agitation, weakened intestinal motility, urinary retention. Muscle twitching and hyperkinesis. In severe poisoning - confusion up to deep coma, attacks of colonic-tonic convulsions of the epileptiform type. Cardiac disorders: brady and tachyarrhythmias, intracardiac blockade, ventricular fibrillation. Acute cardiovascular failure (collapse). The development of toxic hepatopathy, hyperglycemia, and intestinal paresis is possible.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Repeated gastric lavage, forced diuresis.
2. 3. For tachyarrhythmia - 0.05% proserin - 1 ml intramuscularly or 0.1% solution of physiostigmine - 1 ml subcutaneously again an hour later until the pulse rate is 60 - 70 per minute, lidocaine - 100 mg, 0.1% solution inderal 1-5 ml intravenously. For bradyathermia - 0.1% atropine solution subcutaneously or intravenously again after an hour. For convulsions and agitation - 5 - 10 mg of diazepam intravenously or intramuscularly. Sodium bicarbonate solution 4% - 400 ml intravenously.
A. Name of the chemical substance, its synonyms and characteristics.
AMMONIA.
B. Symptoms of poisoning: see. Alkalis are caustic.
A. Name of the chemical substance, its synonyms and characteristics
ANALGIN.
B. Symptoms of poisoning: see Amidopyrine
A. Name of the chemical substance, its synonyms and characteristics
ANESTHESIN.
Anestezin (benzocaine, ethylaminobenzoate). Hemotoxic (methemoglobin-forming) effect. Lethal dose 10-15 g.
Rapidly absorbed through the gastrointestinal tract, metabolized in the liver, and excreted by the kidneys.
B. Symptoms of poisoning.
When a toxic dose is ingested, there is severe cyanosis of the lips, ears, face, and limbs due to acute methemoglobinemia. Psychomotor agitation. When methglobinemia exceeds 50% of the total hemoglobin content, the development of a coma, hemolysis, and exotoxic shock is possible. High danger anaphylactic reactions, especially in children
B. Emergency care:
2. Antidote treatment.
3. Symptomatic therapy.
1. Gastric lavage through a tube, forced diuresis with blood alkalization (sodium bicarbonate 10-15 g orally)
2. Methylene blue 1% solution, 1-2 ml per 1 kg of body weight with 250-300 ml of 5% glucose solution intravenously, 5% ascorbic acid solution - 10 ml intravenously.
3. Oxygen therapy, hyperbaric oxygenation.
ANDAXIN.
A. Names of the chemical substance, its synonyms and characteristics.
Andaxin (meprotan, meprobamate). Psychotropic neurotoxic (central muscle relaxation), antipyretic effect. The lethal dose is about 15 g. The toxic concentration in the blood is 100 mg/l, lethal 200 mg/l. Rapidly absorbed from the gastrointestinal tract and excreted in the urine within 2-3 days
B. Symptoms of poisoning.
Drowsiness, muscle weakness, decreased body temperature. In severe cases - coma, dilated pupils, decreased blood pressure, respiratory failure. See also barbiturates.
B. Emergency care:
1. Methods of active detoxification.
2. Antidote treatment.
3. Symptomatic therapy.
1. Gastric lavage, saline laxative. Forced diuresis without plasma alkalization. With the development of a coma - peritoneal dialysis, hemodialysis, detoxification hemosorption. In case of severe breathing disorders - artificial ventilation.
ANILINE.
A. Name of the chemical substance, its synonyms and characteristics
Aniline (amidobenzene, phenylamine). Psychotropic, neurotoxic, hemotoxic (methemoglobin-forming, secondary hemolysis), hepatotoxic effect. The lethal dose when taken orally is 1 g. When the methemoglobin content of total hemoglobin is 20-30%, symptoms of intoxication appear, 60-80% is a lethal concentration. Entry through the respiratory tract, digestive tract, skin. Most of it is metabolized to form intermediate products that cause methemoglobin formation. Deposited in adipose tissue, relapses of intoxication are possible. Excreted through the lungs and kidneys (para-aminophenol).
B. Symptoms of poisoning.
Bluish discoloration of the mucous membranes of the lips, ears, and nails due to acute methemoglobinemia. Severe weakness, dizziness, headache, euphoria with motor excitement, vomiting, shortness of breath. The pulse is frequent, the liver is enlarged and painful. In severe poisoning, impaired consciousness and coma quickly occur, the pupils are constricted, without reaction to light, salivation and bronchorrhea, hemic hypoxia. Danger of developing paralysis of the respiratory center and exotoxic shock. On the 2-3rd day of the disease, relapses of methemoglobinemia, clonic-tonic convulsions, toxic anemia are possible, parenchymal jaundice, acute hepatic-renal failure.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. In case of contact with skin, wash with a solution of 1:1000 potassium permanganate. When taken orally - abundant gastric lavage, administration of 150 ml of petroleum jelly through a tube. Forced diuresis, hemosorption, hemodialysis.
2. Treatment of methemoglobinemia: 1% solution of methylene blue, 1-2 ml per 1 kg of body weight with 5% glucose solution 200-300 ml intravenously. Ascorbic acid solution 5% to 60 ml per day intravenously. Vitamin B12 600 mcg intramuscularly. Sodium thiosulfate 30% solution - 100 ml intravenously.
3. Treatment of exotoxic shock, acute hepatic-renal failure. Oxygen therapy, hyperbaric oxygenation.
ANTABUS.
A. Name of the chemical substance, its synonyms and characteristics.
Antabuse (teturam, disulfiram). Psychotropic, hepatotoxic effect. Lethal dose: without alcohol in the blood about 30g with a blood alcohol concentration of more than 1% - 1g. Slowly absorbed from the gastrointestinal tract, excreted slowly in the urine (in unchanged form). Leads to the accumulation of acetaldehyde in the body, the main metabolite of ethyl alcohol.
B. Symptoms of poisoning
After a course of treatment with Antabuse, drinking alcohol causes a sharp vegetative-vascular reaction - hyperemia of the skin, a feeling of heat in the face, difficulty breathing, palpitations, a feeling of fear of death, chills. Gradually the reaction ends and after 1-2 hours sleep sets in. After taking large doses of alcohol, a severe reaction may develop - severe pallor of the skin, cyanosis, repeated vomiting, increased heart rate, drop in blood pressure, signs of myocardial ischemia.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. When taking a toxic dose - gastric lavage, forced diuresis.
3. Place the patient in a horizontal position. Intravenous influence of a 40% glucose solution - 40 ml with a 5% ascorbic acid solution - 10 ml. Sodium bicarbonate 4% solution 200 ml - intravenous drip. Vitamin B1 5% solution - 2 ml intramuscularly. Lasix - 40 mg intravenously. Cardiovascular drugs
ANTIBIOTICS.
A. Name of the chemical substance, its synonyms and characteristics.
Antibiotics (streptomycin, monomycin, kanamycin). Neurotoxic otoxic effect
B. Symptoms of poisoning.
At the same time, ingestion of an excessively high dose of antibiotics (over 10 g) can cause deafness due to damage to the auditory nerve (streptomycin) or oliguria due to renal failure (kanamycin, monomycin). These complications develop 6 as a rule, with a noticeable decrease in diuresis against the background of various infections with less daily dose drug, but longer use. With increased sensitivity to antibiotics when using normal therapeutic doses, anaphylactic shock may develop.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. For hearing loss: 1-3 days after poisoning, hemodialysis or forced diuresis is indicated.
3. For oliguria: forced diuresis for the first day. Treatment of acute renal failure.
ANTICOAGULANTS.
A. Name of the chemical substance, its synonyms and characteristics.
Direct anticoagulants - heparin.
B. Symptoms of poisoning
When administered into a vein, the effect is immediate, into a muscle or under the skin - after 45-60 minutes.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. In severe cases - blood replacement surgery, forced diuresis
2. Vikasol - 5 ml of 1% solution intravenously under the control of prothrombin content. Calcium chloride - 10 ml of 10% solution intravenously. In case of heparin overdose - 5 ml of 1% protamine sulfate solution intravenously, repeated if necessary (1 ml for every 100 units of heparin administered)
3. Aminocaproic acid 5% solution - 250 ml intravenously. Antihemophilic plasma - 500 ml intravenously. Repeated blood transfusion of 250 ml. Cardiovascular drugs as indicated.
Indirect anticoagulants - dicoumarin (dicoumarol), neodicoumarin (pelentan), syncumar, phenylin, etc. Hemotoxic effect (blood hypocoagulation).
B. Symptoms of poisoning
It is quickly absorbed from the gastrointestinal tract, the effect appears after 12-72 hours. It is excreted in the urine. Bleedings from the nose, uterus, stomach, intestines. Hematuria. Hemorrhage into the skin, muscles, sclera, hemorrhagic anemia. A sharp increase in blood clotting time (heparin) or a decrease in the prothombin index (other drugs)
A. Name of the chemical substance, its synonyms and characteristics.
Antifreeze
B. Symptoms of poisoning.
See ethylene glycol.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
See ethylene glycol.
ARSENITES.
Arsenites: sodium arsenite, calcium arsenite, double salt of acetic and metaarsenic copper (Schweinfurt or Paris green). See Arsenic.
B. Symptoms of poisoning.
See Arsenic.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
See Arsenic.
ASPIRIN.
A. Name of the chemical substance and its characteristics.
Aspirin (acetylsolicylic acid). Also included in the preparations: askofen, asphen, citramon, sodium salicylate. Psychotropic, hemotoxic (anticoagulant) effect. The lethal dose is about 30 - 40g, for children 10g. Toxic concentration in the blood is 150 - 300 mg/l, lethal 500 mg/l. Rapidly absorbed in the stomach and small intestine. Deacetylated in blood plasma, 80% is excreted in urine within 24 - 28 hours. B. Symptoms of poisoning.
Excitement, euphoria. Dizziness, tinnitus, hearing loss, visual impairment. Breathing is noisy and rapid. Delirium, suparosis, coma. Sometimes subcutaneous hemorrhages, nasal, nasal, gastrointestinal, uterine bleeding. The development of methemoglobinemia and toxic nephropathy is possible. Metabolic acidosis, peripheral edema
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage, Vaseline oil 50 ml orally. Forced diuresis, alkalization of the blood. Early hemodialysis, hemosorption.
3. For bleeding - 1 ml of 1% solution of Vikasol, 10 ml of 10% solution of calcium chloride intravenously. When excited - 2 ml of a 2.5% solution of aminazine subcutaneously or intramuscularly. For methemoglobinemia - see Aniline.
ATROPINE.
A. Name of the chemical substance and its characteristics.
Atropine (also found in bellaldonna, henbane, datura). Psychotropic, neurotoxic (anticholinergic) effect. The lethal dose for adults is 100 mg, for children (under 10 years old) - about 10 ml. Rapidly absorbed through mucous membranes and skin, hydrolyzed in the liver. About 13% is excreted unchanged in urine within 14 hours.
B. Symptoms of poisoning.
Dry mouth and throat, speech and swallowing disorders, impaired near vision, diplopia, photophobia, palpitations, shortness of breath, headache. The skin is red, dry, the pulse is rapid, the pupils are dilated and do not respond to light. Mental and motor agitation, visual hallucinations, delirium, epileptiform convulsions followed by loss of consciousness, development of a coma, especially in children.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. When taken orally - gastric lavage through a tube generously lubricated with petroleum jelly, forced diuresis.
2. In a comatose state in the absence of sudden excitement - 1 ml of a 1% solution of pilocarpine again, 1 ml of a 0.05% solution of proserine or 1 ml of a 0.1% solution of eserine subcutaneously again.
3. When excited, 2.5% solution of aminazine - 2 ml intramuscularly, 1% solution of diphenhydramine - 2 ml intramuscularly, 1% solution of promedol 2 ml subcutaneously, 5 - 10 mg diazepam intravenously. For severe hyperthermia - 4% amidopyrine solution - 10 - 20 ml intramuscularly, ice packs on the head and groin areas, wrapping in a damp sheet and blowing with a fan.
ACETONE.
A. Name of the chemical substance and its characteristics.
Acetone (dimethylketone, propanol). Psychotropic (narcotic) nephrotoxic, local irritant effect. Lethal dose is more than 100 ml. Toxic concentration in the blood is 200 - 300 mg/l, lethal - 550 mg/l. It is quickly adsorbed by mucous membranes and excreted through the lungs in the urine.
B. Symptoms of poisoning.
If ingested and inhaled, intoxication, dizziness, weakness, unsteady gait, nausea, vomiting, abdominal pain, collapse, coma. There may be a decrease in diuresis, the appearance of protein and red blood cells in the urine. When recovering from a comatose state, pneumonia often develops.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. For oral administration, gastric lavage; for inhalation poisoning, rinse eyes with water and inhale oxygen. Forced diuresis with blood alkalization (sodium bicarbonate 10-15 g orally).
3. Treatment of acute cardiovascular failure (toxic shock), pneumonia. For abdominal pain, subcutaneously 2% solution of papaverine - 2 ml, 0.2% solution of platiflline - 1 ml, 0.1 solution of atropine -1 ml.
BABITURATES.
A. Name of the chemical substance and its characteristics.
Long-acting barbiturates (8 - 12 hours) - phenobarbital (luminal), medium-acting (6 - 8 hours) - barbital (veronal), sodium barbital (medinal), sodium amytal (barbamyl), short-acting (4 - 6 hours) - sodium etaminal ( Nembutal).
Preparations containing barbiturates: tardil, bellaspon, Sereysky powders, verodone, bromital, andipal, dipasalin, camphotal, tepafilin, etc. Psychotropic (narcotic, hypnotic) effect. The lethal dose is about 10 therapeutic doses with large individual differences. Absorption in the stomach and small intestine, sometimes in patients with unconscious drugs are found unchanged in the stomach 2-3 days after administration. Barbiturates short acting almost completely (90%) are metabolized in the liver, 50-60% are bound to proteins. Long-acting barbiturates are protein bound (8-10%), 90-95% are not metabolized and are excreted in the urine.
B. Symptoms of poisoning.
There are 4 clinical stages of intoxication. Stage 1 - falling asleep: drowsiness, apathy, contact with the patient is possible, moderate miosis with a lively reaction to light, bradycardia during shallow sleep, hypersalivation. Stage 2 - superficial coma (a - uncomplicated, b - complicated): complete loss of consciousness, preserved reaction to painful stimulation, weakened pupillary and corneal reflexes. Variable neurological symptoms: decreased or increased reflexes, muscle hypotonia or hypertension, pathological reflexes of Babinsky, Rossolimo, which are transient in nature. Breathing disorders due to hypersalivation, bronchorrhea, tongue retraction, aspiration of vomit. There are no pronounced hemodynamic disturbances. Stage 3 - deep coma (a - uncomplicated, b - complicated): a sharp absence or decrease in eye and tendon reflexes, lack of response to painful stimulation. The pupils are narrow. Breathing is rare, superficial, pulse is weak, cyanosis. Diuresis is reduced. In the case of a prolonged coma (12 hours), the development of bronchopneumonia, collapse, deep bedsores and septic complications is possible. Impaired liver and kidney function. Stage 4 - post-comatose period: unstable neurological symptoms (prose, unsteady gait, etc.), emotional lability, depression, thromboembolic complications.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage (in comatose patients - after preliminary intubation) again after 3 - 4 days until consciousness is restored, water-alkaline load, forced diuresis in combination with blood alkalization. In stages IIb, III - early use of hemodialysis in case of poisoning with long-acting barbiturates, detoxification hemosorption, in case of poisoning with short-acting barbiturates or mixed poisoning. In stage IV - water-electrolyte load, diuretics
2. In the stage of complicated coma, the use of bemegride is contraindicated. A 20% solution of camphor, a 10% solution of caffeine, a 5% solution of ephedrine, and 2-3 ml of cardamine are administered subcutaneously after 3-4 hours.
3. Intensive infusion therapy. Plasma substitutes (polyglucin, hemodez). Antibiotics. Intramuscularly: vitamins B1 and B6 5% solutions - 6-8 ml, B12 - 500 mcg (B vitamins should not be administered at the same time), ascorbic acid 5% solution - 5-10 ml, ATP 1% solution - 6 ml per day. For low blood pressure - 0.2% norepinephrine in combination with a 0.5% dopamine solution, 1 ml intravenously in 400 ml of polyglucin. Cardiac glycosites.
BARIUM.
A. Name of the chemical substance and its characteristics.
Barium. Neurotoxic (paraletic), cardiotoxic effect. All soluble barium salts are toxic; insoluble barium sulfate, used in radiology, is practically nontoxic. Lethal dose is about 1g. Soluble barium salts are quickly absorbed in the small intestine and excreted primarily through the kidneys.
B. Symptoms of poisoning.
Burning in the mouth and esophagus, abdominal pain, nausea, vomiting, profuse diarrhea, dizziness, profuse sweating. The skin is pale. The pulse is slow and weak. Extrasystole, bbbigeminia, atrial fibrillation, arterial hypertension followed by a drop in blood pressure. Shortness of breath, cyanosis. 2-3 hours after poisoning - increasing muscle weakness, especially muscles upper limbs and neck. Hemolysis, weakened vision and hearing, and clonic-tonic convulsions are possible with preserved consciousness.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1, 2. Gastric lavage through a tube with a 1% solution of sodium or magnesium sulfate to form insoluble barium sulfate, magnesium or barium sulfate 30 g orally (100 ml of a 30% solution). Forced diuresis, hemodialysis. Intravenous 10-20 ml of 10% solution of sodium or magnesium sulfate. Tetacin - calcium - 20 ml of 10% solution with 500 ml of 5% glucose solution intravenously.
3. Promedol - 1 ml of 2% solution. Atropine - 1 ml of 0.1% solution intravenously with 300 ml of 5% glucose solution. For rhythm disturbances - potassium chloride 2.5 g in 500 ml of 5% glucose solution intravenously, repeated if necessary. Cardiovascular drugs. Vitamins B1 and B6 intramuscularly (not simultaneously). Oxygen therapy. Treatment of toxic shock. Cardiac glycosides are contraindicated.
HENBANE.
See Atropine.
BELLADONNA.
See Atropine.
BELLOOID, BELLASPON.
A. Name of the chemical substance and its characteristics.
Psychotropic (narcotic) and neurotoxic (cholinergic) effects. The drugs contain barbiturates, ergotamine, atropine. Lethal dose - more than 50 tablets.
B. Symptoms of poisoning.
The earliest symptoms of atropine poisoning (see Atropine) appear, followed by the development of a severe coma, similar to a barbiturate coma (see barbiturates), with severe dryness of the skin and mucous membranes, dilated pupils, and skin hyperemia, hyperthermia. Poisoning is especially dangerous in children.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage. Forced diuresis, in case of severe poisoning - detoxification hemosorption.
3. When excited - see Atropine. If coma develops, see Barbiturates.
PETROL.
A. Name of the chemical substance and its characteristics.
Petrol. Psychotropic (narcotic), hepatotoxic, nephrotoxic, pneumotoxic effects. Leaded gasoline containing tetraethyl lead is especially dangerous. Rapidly absorbed in the lungs and gastrointestinal tract. It is excreted primarily through the lungs.
B. Symptoms of poisoning.
When inhaling vapors - dizziness, headache, feeling of intoxication, agitation, nausea, vomiting. In severe cases - breathing problems, loss of consciousness, convulsions, smell of gasoline from the mouth. If swallowed - abdominal pain, vomiting, enlarged and painful liver, jaundice, toxic hepatopathy, nephropathy. With aspiration - chest pain, bloody sputum, cyanosis, shortness of breath, fever, severe weakness (gasoline toxic pneumonia). Poisoning is especially severe in children. Chronic inhalation intoxication is possible.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Removing the victim from a room saturated with gasoline vapors. If gasoline gets inside, lavage the stomach through a 200 ml tube. Vaseline oil or activated carbon.
3. In case of inhalation of vapors or aspiration - oxygen inhalation, antibiotics (10,000,000 units of penicillin and 1 g of streptomycin intramuscularly), cups, mustard plasters. Subcutaneously camphor - 2 ml of a 20 (percent) solution, cordiamine - 2 ml, caffeine - 2 ml of a 10 (percent) solution. Intravenous 30-50 ml of 40 (percent) glucose solution with corglycon (0.06 (percent) solution - 1 ml) or strophanthin (0.05 (percent) solution - 0.5 ml). For pain - 1 ml of 1 (percent) solution of promedol, 1 ml of 1 (percent) solution of atropine subcutaneously. In a comatose state with respiratory failure - intubation and artificial respiration, oxygen.
BENZODIAZEPINES.
A. Name of the chemical substance and its characteristics.
Benzodiazepines - elenium (chlordiazepoxide, Napotom, Librium), diazepam (Seduxen, Valium), oxazepam (Tazepam), nitrazepam (Eunoctin, Radedorm). Psychotropic, neurotoxic effect. Lethal dose - 1-2g (large individual differences. Absorbed in the stomach and small intestine, binds to plasma proteins, detoxification in the liver, excretion in urine and feces.
B. Symptoms of poisoning.
See Barbiturates.
BENZENE.
A. Name of the chemical substance and its characteristics.
Bezol. Psychotropic (narcotic), hemotoxic, hepatotoxic effects. Lethal dose 10-20 ml. The lethal concentration in the blood is 0.9 mg/l. Rapidly absorbed from the lungs and gastrointestinal tract. 15-30% is oxidized and excreted by the kidneys in the form of metabolites, the remaining portion is excreted unchanged through the lungs and in the urine. Depanation is possible in red blood cells, glandular organs, muscles, and fatty tissue.
B. Symptoms of poisoning.
When inhaling benzene vapors - excitement similar to alcohol, clinical-tonic convulsions, pallor of the face, red mucous membranes, dilated pupils. Shortness of breath with irregular breathing rhythm. Increased pulse rate, often arrhythmic, decreased blood pressure. Bleeding from the nose and gums, hemorrhage into the skin, and uterine bleeding are possible. When taking benzene orally - burning in the mouth, behind the sternum, in the epigastric region, vomiting, abdominal pain, dizziness, headache, agitation followed by depression, coma, enlarged liver, jaundice (toxic hepatopathy). Chronic inhalation intoxication is possible.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Removing the victim from the danger zone. If poison is ingested, gastric lavage through a tube, Vezelin oil orally - 200 ml. Forced diuresis, blood replacement surgery.
2. 30% sodium thiosulfate solution - 200 ml intravenously.
3. Intramuscular vitamins B1 and B6 - up to 1000 mcg/day (B vitamins should not be administered at the same time). Cardiovascular drugs. Ascorbic acid - 10-20 ml of 5% solution with 5% glucose solution intravenously. Oxygen inhalation. For bleeding - 1% solution of Vikasol intramuscularly up to 5 ml.
BORIC ACID.
A. Name of the chemical substance and its characteristics.
Boric acid (borax), borax, sodium borate. Local irritant, weak cytotoxic, convulsive effect. The lethal dose for adults is 10-20g. Toxic concentration in the blood is 40 mg/l, lethal 50 mg/l. Absorbed through the gastrointestinal tract and damaged skin. They are excreted unchanged by the kidneys and through the intestines within a week. Deposited in bone tissue and liver.
B. Symptoms of poisoning.
Symptoms of intoxication develop 1 to 48 hours after ingestion. Abdominal pain, vomiting, diarrhea, general weakness, headache. Dehydration of the body, loss of consciousness, generalized twitching of the muscles of the face, limbs, convulsions. Cardiovascular failure. Possible damage to the liver and kidneys. Poisoning is especially severe in children.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage through a tube. Forced diurcz. Hemodialysis for severe poisoning.
3. Riboflavin mononucleotide 10 g per day into the muscle. Correction of wine-electrolyte balance and acidosis: infusion of sodium bicarbonate solution, plasma-substituting solutions, glucose, sodium chloride. For abdominal pain - 0.1% atropine solution - 1 ml, 0.2% platifilin solution - 1 ml, 1% promedol solution - 1 ml subcutaneously. Novocaine 2% solution - 50 ml with glucose - 5% solution - 500 ml intravenously. Cardiovascular drugs.
VEGH IS POISONOUS.
A. Name of the chemical substance and its characteristics.
Veh poisonous (hemlock, water hemlock, water omega). The most poisonous rhizomes of the plant, especially in late autumn and early spring. Contains cycototoxin. Neurotoxic (cholinergic, convulsive) effect. The lethal dose is about 50 mg of plant per 1 kg of body weight.
B. Symptoms of poisoning.
Rapidly absorbed from the gastrointestinal tract. Initial symptoms of poisoning appear after 1.5 - 2 hours, sometimes after 20 - 30 minutes. Salivation, nausea, vomiting, abdominal pain, dilated pupils, tachycardia, clonic-tonic convulsions, respiratory depression. Loss of consciousness, collapse. Most often, poisoning develops in children, who usually eat rhizomes, mistaking them for carrots.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage through a tube, saline laxative, activated carbon orally, hemosorption.
3. Intramuscular injection of 25% magnesium sulfate solution - 10 ml. For seizures - diazepam 5 - 10 mg intravenously. Artificial respiration. For cardiac arrhythmias - 10 ml of 10% solution of novocainamide intravenously.
HYDROGEN IS ARSENIC.
A. Name of the chemical substance and its characteristics.
Arsenic hydrogen (arsine) is a colorless gas with a garlic odor. Neurotoxic, hemotoxic (hemolytic), hepatotoxic effects. The lethal concentration in the air is 0.05 mg/l with an exposure of 1 hour; at a concentration of 5 mg/l, several breaths lead to death.
B. Symptoms of poisoning.
In case of poisoning with low doses, the development of poisoning is preceded by a latent period of about 6 hours; in case of severe intoxication, the latent period is less than 3 hours. General weakness, nausea, vomiting, chills, anxiety, headache, parasthesia in the limbs, suffocation. After 8 - 12 hours - hemoglobinuria (red or brown urine), cyanosis, possible convulsions, impaired consciousness. On the 2-3rd day - toxic hepatotopathy, nephropathy, hemolytic anemia.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Early hemodialysis. Blood replacement surgery.
2. Mecaptide 40% solution - 1-2 ml every 4 hours with 0.25% navocaine solution intramuscularly for the first 2 days, then 2 times a day until 5 - 6 days, after which - unithiol 5% solution 5 ml 3 - 4 times per day.
For hemoglobinuria - intravenous glucozone-novocaine mixture (glucose 5% solution - 500 ml, novocaine 2% solution - 50 ml), hypertonic 20-30% glucose solutions - 200 - 300 ml, aminophylline 2, 4% solution - 10 ml, sodium bicarbonate 4 % solution - 100 ml intravenously. Forced diuresis. Cardiovascular drugs.
VITAMIN D2.
A. Name of the chemical substance and its characteristics.
Vitamin D2 (ergocalciferol, calciferol). Disturbance of calcium and phosphorus metabolism in the body, cytotoxic (membrane), nephrotoxic effect. Toxic dose for a single dose of 1,000,000 IU - 25 mg (20 ml of oil solution, 5 ml alcohol solution). Vitamin D is metabolized in the liver and kidneys to form active metabolites that cause the toxicity of the drug. Cumulates in the body.
B. Symptoms of poisoning.
Intoxication can develop as a result of a single dose of the drug or repeated consumption of the drug (sometimes instead of sunflower oil). In children - as a result of exceeding the course of preventive and therapeutic doses. Nausea, repeated vomiting, dehydration, malnutrition, lethargy, increased body temperature, general adynamia, muscle hypotension, drowsiness, followed by severe anxiety, clonicotonic convulsions. Increased blood pressure, muffled heart sounds, sometimes rhythm and conduction disturbances. Hematuria, leukocyturia, proteinuria, azotemia, acute heart failure. Hypercalcemia (calcium content in blood serum up to 20 mg% or more), hypercholesterolemia, hyperphosphatemia, hyperproteinemia. Fluoroscopy of cadaveric bones reveals osteoporosis of the diaphyseal part. Possible metastatic calcification of the kidneys, myocardium, heart valves, vascular wall.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. At a high dose - hemodialysis, detoxification hemosorption.
3. Hydrocotisone - 250 mg/day or prednisolone - 60 mg/day intramuscularly. Thyrocalcitonia - 5D 2-3 times a day, vitamins A (oil solution) 3000-50000 IU 2 times a day intramuscularly. Tocopherol (vitamin E) 30% solution - 2 ml intramuscularly 2 times a day. Cardiovascular drugs. For increased blood pressure - 1% dibazole solution, 2-4 ml intramuscularly. Calcium-disodium salt ELTA 2-4 g per 500 ml of 5% glucose solution intravenously. Glucose with insulin - 8D, isotonic sodium chloride solution 40% - 20 ml, plasma and plasma-substituting solutions.
CARDIAC GLYCOSIDES.
A. Name of the chemical substance and its characteristics.
Cardiac glycosides: preparations of various types of foxglove (the active principle is glycosides ditoxin, digoxin), adonis, lily of the valley, jaundice, strophanthus, hellebore, sea onion, etc. Cardiotoxic effect. Rapidly absorbed from the gastrointestinal tract, with intravenous administration are excreted slowly in the urine.
B. Symptoms of poisoning.
Dyspeptic disorders (nausea, vomiting). Bradycardia, ventricular and atrial extrasystoles, conduction disturbances, various types of tachycardia, fibrillation and ventricular fibrillation. Fall in blood pressure, cyanosis, convulsions, blurred vision, mental disorders, loss of consciousness.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage, saline laxative, activated carbon orally. Detoxification hemosorption.
2. Atropine 0.1% solution - 1 ml subcutaneously for bradycardia. Intravenously drip administration potassium chloride (only for hypokalemia!) - 0.5% solution 500 ml. Unithiol 5% solution, 5 ml intramuscularly 4 times a day.
For arrhythmias: 0.1% atropine solution - 1-2 ml intravenously, lidocaine - 100 ml every 3 - 5 minutes intravenously (until the arrhythmia is eliminated), diphenin - 10 - 12 mg/kg for 12-24 hours intravenously .
GRANOSAN.
A. Name of the chemical substance and its characteristics.
Granosan (2% ethyl mercuric chloride). Enterotoxic, hepatotoxic effects.
B. Symptoms of poisoning.
Poisoning develops when consuming granosan-treated sunflower seeds, peas, flour from treated seeds, and fruits from untimely treated trees. Symptoms of poisoning develop gradually - 1-3 weeks after eating contaminated foods. Loss of appetite, unpleasant taste and dry mouth, thirst, lethargy, insomnia, headache. Then nausea, vomiting, abdominal pain, diarrhea, lethargy, adynamia, hallucinations, and sometimes paresis of the limbs appear. Possible visual impairment, anisocaria, strabismus, ptosis (damage to the cranial nerves), tremor, epileptic syndrome, vomiting, diarrhea with blood. Symptoms of toxic nephropathy and toxic hepatopathy appear (enlarged and painful liver, jaundice).
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1, 2. See Sulema.
H. Vitamins B1 and B12. Prozerin - 0.05% solution, 1 ml subcutaneously.
MUSHROOMS ARE POISONOUS.
A. Name of the chemical substance and its characteristics.
Mushrooms are poisonous. 1. Toadstool - contains toxic alkaloids phalloin, phalloidin, amanitin. Hepatotoxic, nephrotoxic, enterotoxic effects. 100 g of fresh mushrooms (5 g of dry) contains 10 mg of phalloidin, 13.5 mg of amanitin. The lethal dose of amanitin is 0.1 mg/kg. Toxins are not destroyed by heat treatment or drying; they are quickly absorbed from the gastrointestinal tract and deposited in the liver.
2. Fly agaric - active ingredient - muscarine, muscaridine. Neurotoxic (cholinergic effect). Toxins are partially destroyed during heat treatment.
3. Strings, morels - contain gelvelic acid. Hemotoxic (hemolytic) effect. The toxin is destroyed by heat treatment.
B. Symptoms of poisoning.
The latent period before the development of pronounced symptoms of intoxication is 6 - 24 hours. Uncontrollable vomiting, abdominal pain, diarrhea, hemolysis, hemoglobinuria (red urine). Damage to the liver, kidneys. Hemolytic jaundice.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Sodium bicarbonate - 1000 ml of 4% solution into a vein. Forced diuresis.
DIKUMARIN.
A. Name of the chemical substance and its characteristics.
Dicumarin.
B. Symptoms of poisoning. See Anticoagulants
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
See Anticoagulants.
DIMEDROL.
A. Name of the chemical substance and its characteristics.
Diphenhydramine (diphenhydramine) and other antihistamines.
Neurotoxic (parasympatholytic, central anticholinergic), psychotropic (narcotic) effect. The lethal dose is 40 mg/kg. Toxic concentration in the blood is 10 mg/l. Rapidly absorbed, reaches maximum concentration in tissues within the first 6 hours, detoxification in the liver, excreted in the urine mainly in the form of metabolites within 24 hours.
B. Symptoms of poisoning.
Dry mouth and throat, drowsiness and dizziness, nausea, nausea, muscle twitching, tachycardia, blurred vision. The pupils are dilated, there may be horizontal nystagmus, the skin is dry and pale. Motor and psychological agitation, convulsions followed by loss of consciousness. Comatose state, drop in blood pressure, respiratory depression. Oral numbness may occur when taking premedimedrol by mouth.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. When taken orally, lavage the stomach through a tube lubricated with petroleum jelly. Forced diuresis.
2. Physostigmine - 0.1% solution, 1 ml subcutaneously, again, in the absence of sudden excitement - pilocarpine - 1 ml of 1% solution subcutaneously.
3. For agitation - aminazine or tizercin - 2.5% solutions, 2 ml intramuscularly, for convulsions - diazepam - 5 - 10 mg intravenously.
DIMETHYL PHTHALATE.
A. Name of the chemical substance and its characteristics.
Dimethyl phthalate. Local irritant, psychotropic (narcotic), neurotoxic, nephrotoxic effect. Absorbed through the gastrointestinal tract and respiratory tract. In the body in short time undergoes metabolism to form methyl alcohol.
B. Symptoms of poisoning.
See Methyl alcohol.
Inhalation of vapors causes irritation of the mucous membranes of the eyes and nose.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
See Methyl alcohol.
DICHLOROETHANE.
A. Name of the chemical substance and its characteristics.
Dichloroethane (ethylene dichloride) exists in the form of 2 isomers: 1 - 1-dichloroethane and the most toxic 1 - 2-dichloroethane. Psychotropic (narcotic), neurotoxic, hepatotoxic, nephrotoxic, local irritant effect. The lethal dose when taken orally is 15 - 20 ml. Toxic concentration in the blood - traces of dichloroethane, lethal 5 mg/l. Quickly absorbed through the gastrointestinal tract, respiratory tract, and skin. After oral administration, the maximum concentration in the blood is reached in the first 6 hours, the rate of absorption increases with joint reception with alcohol and fats. It is metabolized in the liver with the formation of toxic metabolites chloroethylene and monochloroacetic acid. Deposited in adipose tissue. Excreted in exhaled air, urine, and feces.
B. Symptoms of poisoning.
Symptoms of intoxication appear in the first 1 - 3 hours. Upon admission - nausea, vomiting (persistent) with an admixture of bile, blood, pain in the epigastric region, salivation, loose, flaky stool with the smell of dichloroethane, scleral hyperemia, severe weakness, headache, psychomotor agitation, coma, exotoxic shock (1 - 2 days), on days 2 - 3 - toxic hepatopathy (pain in the right hypochondrium, liver enlargement, jaundice, nephropathy, hepatic-renal failure, hemorrhagic diathesis (stomach, nosebleeds) With inhalation poisoning - headache, dizziness, drowsiness, dyspeptic disorders, increased salivation, hepatopathy, nephropathy. In severe cases - coma, exotoxic shock. In case of contact with the skin - dermatitis, bullous rashes.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Abundant repeated gastric lavage through a tube, followed by the introduction of vaseline oil (150 - 200 ml) into the stomach. Detoxification hemosorbium, forced diuresis with blood alkalization. Vitamin E 1 - 2 ml 30% intramuscularly 4 times in the first 3 days.
3. In the presence of deep coma - intubation, artificial respiration. Cardiovascular drugs. Treatment of toxic shock. On the first day - hormone therapy (prednisolone up to 120 mg intravenously repeatedly. Vitamin therapy: B12 - up to 1500 mcg; B1 - 4 ml of a 5% solution intramuscularly; B15 up to - 5 g orally. Ascorbic acid - 5-10 ml of a 5% solution intravenously. Tetacin calcium - 40 ml of a 10% solution with 300 ml of a 5% glucose solution intravenously. Unithiol 5% solution, 5 ml intramuscularly repeatedly. Lipoic acid- 20 - 30 mg/kg intravenously per day. Antibiotics (levomytin, penicillin).
In case of sudden excitement, 2 ml of 2.5% solution of pipolfen intravenously. Treatment of toxic nephropathy and hepatopathy is carried out in a hospital.
Datura.
A. Name of the chemical substance and its characteristics.
Datura. See atropine.
B. Symptoms of poisoning. See Atropine.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
See Atropine
LUCK.
A. Name of the chemical substance and its characteristics.
Zamanikha (araliaceae seeds). Rhizomes and roots contain saponins, traces of alkaloids and glycosides, and essential oil. Available as a 5% alcohol tincture. Cardiotoxic local irritant, psychotropic (stimulating) effect.
B. Symptoms of poisoning.
If you take a toxic dose, you may experience nausea, repeated vomiting, loose stools, bradycardia, dizziness, anxiety, and a possible decrease in blood pressure. Bradyarrhythmia, ventricular extrasystole.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
3. Atropine - 1 ml of 0.1% solution subcutaneously or intravenously again until bradycardia is relieved.
ISOMIAZIDE.
A. Name of the chemical substance and its characteristics.
Isoniazid (GINK, isonicotinic acid hydrazide); derivatives: tubazide, ftivazide, saluzide, larusan, etc. Neurotoxic (convulsive) effect. Lethal dose - 10 g. Rapidly absorbed from the gastrointestinal tract, maximum concentration in the blood 1-3 hours after administration. 50 - 75% of the drug in acetylated form is excreted in the urine within 24 hours, 5 - 10% through the intestines.
B. Symptoms of poisoning.
Nausea, vomiting, abdominal pain, weakness, headache, paresthesia, dry mouth, tremor, ataxia, shortness of breath, bradycardia, then tachycardia. In severe poisoning - epileptiform-type convulsions with loss of consciousness and respiratory distress. The development of toxic nephropathy and hepotopathy is possible.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage through a tube, saline laxative. Forced diuresis with blood alkalization. Detoxification hemosorption.
2. B6 - 5% solution, 10 ml intravenously repeatedly.
3. Essential oxygen anesthesia with muscle relaxants, mechanical breathing. Correction of acidosis - 4% sodium bicarbonate solution 1000 ml into a vein.
INDIAN HEMP.
A. Name of the chemical substance and its characteristics.
Indian hemp (hashish, plan, marijuana, anasha).
B. Symptoms of poisoning.
Initially, psychomotor agitation, dilated pupils, tinnitus, vivid visual hallucinations, then general lethargy, weakness, tearfulness and long, deep sleep with a slow pulse and a drop in body temperature.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
Gastric lavage if poison is taken orally, forced diuresis. In case of sudden excitement - 4 - 5% ml of 2.5% chlorpromazine solution intramuscularly.
INSULIN.
A. Name of the chemical substance and its characteristics.
Insulin. Hypoglycemic effect.
B. Symptoms of poisoning.
Active only when administered parenterally. In case of an overdose, symptoms of hypoglycemia occur - weakness, increased sweating, hand tremors, feeling of hunger. In case of severe poisoning (blood sugar level below 50 mg%) - psychomotor agitation, clinical-tonic convulsions, coma. When emerging from a comatose state, prolonged encephalopathy (schizophrenia-like syndrome) is observed.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Phosphorus diuresis with blood alkalization.
2. Immediate intravenous administration of a 20% glucose solution in the amount necessary to restore normal blood sugar levels. Glucagon - 0.5 - 1 mg intramuscularly.
3. For coma, adrenaline - 1 ml of 0.1% solution subcutaneously. Cardiovascular drugs.
A. Name of the chemical substance and its characteristics.
Iodine. Local cauterizing effect. The lethal dose is about - - 3g.
B. Symptoms of poisoning.
When inhaling iodine vapor, the upper respiratory tract is affected.
(see Chlorine). When concentrated solutions get inside, severe burns of the digestive tract occur; the mucous membrane has a characteristic color. The development of hemolysis and hemoglobinuria is possible.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
Gastric lavage through a tube, preferably 0.5% sodium thiosulfate solution.
2. Sodium thiosulfate 30% solution - up to 300 ml per day intravenously, 10% sodium chloride solution 30 ml intravenously.
3. Treatment of burns of the digestive tract (see Strong acids)
POTASSIUM PERMANGANATE.
A. Name of the chemical substance and its characteristics.
Potassium permanganate. Local cauterizing, resorptive, hemotoxic (methemoglobinemia) effects. The lethal dose for children is about 3 g, for adults - 0.3 - 0.5 g / kg.
B. Symptoms of poisoning.
If ingested, sharp pain occurs in the oral cavity, along the esophagus, in the abdomen, vomiting, and diarrhea. The mucous membrane of the oral cavity and pharynx is swollen, dark brown, purple. Possible swelling of the larynx and mechanical asphyxia, burn shock, motor agitation, and convulsions. Severe pneumonia, hemorrhagic colitis, nephropathy, hepatopathy, and parkinsonism often occur. At low acidity gastric juice possible methemoglobinemia with severe cyanosis and shortness of breath.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. See Strong acids.
2. For severe cyanosis (methemoglobinemia) - methyl blue 50 ml of 1% solution, ascorbic acid - 30 ml of 5% solution intravenously.
3. Vitamin therapy: B12 up to 1000 mcg, B6 - 3 ml of 5% solution intramuscularly. Treatment of toxic nephropathy, hepatopathy in the hospital.
ACIDS ARE STRONG.
A. Name of the chemical substance and its characteristics.
Strong acids: inorganic (nitric, sulfuric, hydrochloric, etc.), organic (acetic, oxalic, etc.). Oxalic acid is part of a number of household chemicals used to remove rust: liquid "Vaniol" (10%), "Antirzhavin", paste "Prima" (19.7%), powder "Sanitary" (15%), "Tartarene" "(23%). Local cauterizing effect (coagulative necrosis), hemotoxic (hemolytic) and nephrohepatotoxic - for organic acids. Lethal dose - 30 -50 ml.
B. Symptoms of poisoning.
When ingested, a chemical burn develops in the oral cavity, pharynx, pharynx, stomach, esophagus, and sometimes intestines - sharp pain in the oral cavity along the esophagus, in the abdomen. Significant salivation, repeated vomiting with blood, esophageal bleeding. Mechanical asphyxia due to burns and swelling of the larynx. Phenomena of toxic burn shock (compensated or decompensated). In severe cases, especially in case of poisoning with vinegar essence, hemolysis, hemoglobinuria are observed (urine becomes red-brown, dark brown), and by the end of the first day, yellowness of the skin and sclera appears. Against the background of hemolysis, toxic coagulopathy develops (short-term phase of hypercoagulation and secondary fibrinolysis). On days 2 - 3, the phenomena of exogenous toxemia (fever, agitation), the phenomena of active peritonitis, pancreatitis predominate, then the phenomenon of nephropathy against the background of acute hemoglobinuric nephrosis (in case of poisoning acetic acid), hepatopathy, infectious complications (purulent tracheobronchitis, pneumonia. For 2 - 3 weeks, late esophageal-gastric bleeding can be a complication of burn disease. By the end of 3 weeks, with severe burns (ulcerative-necrotic inflammation), signs appear cicatricial narrowing esophagus or, more often, the outlet of the stomach (in case of poisoning with inorganic acids). Burn asthenia, weight loss, and protein and water-electrolyte imbalance are noted. Ulcerative-necrotizing gastritis and esophagitis often become chronic.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage with cold water through a lubricated tube vegetable oil. Before gastric lavage - subcutaneous morphine - 1 ml of 1% solution and atropine - 1 ml of 0.1% solution. Forced diuresis with alkalization of the blood. Swallow pieces of ice.
2. Injection of 4% sodium bicarbonate solution up to 1500 ml into a vein when dark urine appears and metabolic acidosis develops.
3. Treatment burn shock. Polyglucin - 800 ml intravenously. Glucose-novocaine mixture (glucose - 300 ml of 5% solution, novocaine - 30 ml of 2% solution) intravenous drip. Papaverine - 2 ml of 2% solution, platifilin - 1 ml of 0.2% solution, atropine - 0.5 - 1 ml of 0.1% solution subcutaneously up to 6 - 8 times a day. Cardiovascular drugs (cordiamin - 2 ml, caffeine - 2 ml of 10% solution subcutaneously). If bleeding develops, use ice inside. In cases of significant blood loss, repeat blood transfusion. Antibiotic therapy (penicillin - up to 8,000,000 units per day). Hormone therapy: hydrocartisone - 125 mg, ACTH - 40 units intramuscularly per day. For local treatment of the burned surface, 20 ml of the mixture of the following composition is given orally after 3 hours: 10% sunflower oil emulsion - 200 ml, anesthesin - 2 ml, chloramphenicol - 2 g. Vitamin therapy: B12 - 400 mcg, B1 - 2 ml of 5% solution intramuscularly (do not enter at the same time). Treatment of toxic nephropathy, hepatopathy - in a hospital. For the treatment of toxic coagulopathy after stopping bleeding - heparin up to 30,000 - 60,000 units per day intravenously intramuscularly for 2 - 3 days (under the control of a coagulogram). For swelling of the larynx - inhalation of aerosols: novokina - 3 ml of 0.5% solution with ephedrine - 1 ml of 5% solution or adrenaline - 1 ml of 0.1% solution. If this measure fails, tracheostomy is performed.
CAFFEINE.
A. Name of the chemical substance and its characteristics.
Caffeine and other xanthines - theophylline, theobromine, aminophylline, aminophylline. . Psychotropic, neurotoxic (convulsive) effect. The lethal dose is 20 g with large individual differences, the lethal concentration in the blood is more than 100 mg/l. It is quickly absorbed in the gastrointestinal tract, demethylated in the body, and excreted in the urine in the form of metabolites, 10% unchanged.
B. Symptoms of poisoning.
Tinnitus, dizziness, nausea, vomiting, increased body temperature, palpitations. Severe psychomotor agitation and clonicotonic convulsions are possible. In the future, depression of the nervous system may develop up to a soporous state, severe tachycardia (sometimes paroxysmal, accompanied by hypotension), and cardiac arrhythmias. In case of an overdose of drugs, especially when administered intravenously, an attack of clonic-tonic convulsions and a drop in blood pressure are possible. Orthostatic collapse.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage through a tube, saline laxative. Forced diuresis. In severe cases - detoxification hemosorption.
3. Aminazine - 2 ml of 2.5% solution intramuscularly. In severe cases - intramuscular injection lytic mixture: aminazine - 1 ml of 2.5% solution, promedol - 1 ml of 1% solution, diprazine (pipolfen) - 2.5% solution. For convulsions - barbamyl - 10 ml of 10% solution intravenously. To relieve paroxysmal tachycardia - novocainamide 10% solution 5 ml intravenously slowly.
LITHIUM.
A. Name of the chemical substance and its characteristics.
Lithium - lithium carbonate. Psychotropic, neurotoxic, cardiotoxic effects. Lethal dose - 20 g. Toxic concentration in the blood - 13.9 mg/l, lethal dose -34.7 mg/l. Absorbed in the gastrointestinal tract, distributed evenly in the body in intracellular and extracellular fluid, 40% is excreted in the urine, a small part through the intestines.
B. Symptoms of poisoning.
Nausea, vomiting, abdominal pain, diarrhea, muscle weakness, tremor of the limbs, adynamia, ataxia, drowsiness, stuporous state, coma. Heart rhythm disturbances, bradyarrhythmia, decreased blood pressure, acute cardiovascular failure (collapse). On days 3 - 4 - manifestations of toxic nephropathy. The wavy course of intoxication is characteristic.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage through a tube. Forced diuresis. In severe cases, early hemodialysis.
2. Into a vein - sodium bicarbonate - 1500 - 2000 ml of 4% solution, sodium chloride - 20 - 30 ml of 10% solution after 6 - 8 hours for 1 - 2 days.
3. When blood pressure decreases - 0.2% norepinephrine solution intravenously until a clinical effect is obtained. B vitamins, ATP - 2 ml of 1% solution intramuscularly 2 - 3 times a day. Treatment of toxic nephropathy.
MERCURY OINTMENT.
A. Name of the chemical substance and its characteristics.
Mercury ointment: gray (contains 30% metallic mercury, white (10% mercury amide chloride), yellow (2% yellow mercuric oxide).
B. Symptoms of poisoning.
Poisoning develops when the ointment is rubbed into the skin, especially into the hairy parts of the body and when there are excoriations, abrasions on the skin or during prolonged exposure (more than 2 hours). On days 1–2, signs of dermatitis appear and body temperature rises, which may be a manifestation of hypersensitivity to mercury preparations. On days 3–5, symptoms of toxic nephropathy and acute renal failure develop. At the same time, manifestations of stomatitis, gingivitis, enlargement of regional nodes occur, and on the 5th - 6th day - enterocolitis.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Forced diuresis. Early hemodialysis in the presence of toxic concentrations of mercury in the blood and severe intoxication.
2. Unithiol - 5% solution, 10 ml intramuscularly repeatedly.
3. Treatment of toxic nephropathy in a hospital setting. Apply ointment dressings with hydrocortisone and anesthesin to the affected areas of the skin. Treatment of stomatitis.
COPPER.
A. Name of the chemical substance and its characteristics.
Copper and its compounds (copper sulfate). Copper-containing toxic chemicals: Bordeaux liquid (a mixture of copper sulfate and lime), Burgud liquid (a mixture of copper sulfate and sodium carbonate), cupronafte (a combination of copper sulfate with a solution of methylonaphtha), etc. Local cauterizing, hemotoxic (hemolytic), nephrotoxic, hepatotoxic effect. The lethal dose of copper sulfate is 30 - 50 ml. The toxic concentration of copper in the blood is 5.4 mg/l. About 1/4 of the dose administered orally is absorbed from the gastrointestinal tract and binds to plasma proteins. Most of it is deposited in the liver. Excretion with bile, feces, urine.
B. Symptoms of poisoning.
When copper sulfate is ingested, nausea, vomiting, abdominal pain, frequent bowel movements, headache, weakness, tachycardia, and toxic shock develop. With severe hemolysis (hemoglobin), acute renal failure (anuria, nuremia). Texas hepotopathy. Hemolytic jaundice, anemia. When non-ferrous metals (highly dispersed copper dust (zinc and chromium)) enter the upper respiratory tract during welding, acute “foundry fever” develops: chills, dry cough, headache, weakness, shortness of breath, persistent fever. Possible allergic reaction(red rash on the skin, itching).
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage through a tube. Forced diuresis. Early hemodialysis.
2. Unithiol - 10 ml of a 5% solution, then 5 ml every 3 hours intramuscularly for 2 - 3 days. Sodium thiosulfate - 100 ml of 30% solution intravenously.
3. Morphine - 1 ml of 1% solution, atropine - 1 ml of 0.1% solution subcutaneously. For frequent vomiting - aminazine - 1 ml of 2.5 solution intramuscularly. Glucose-novocaine mixture (glucose 5% - 500 ml, novocaine 2% - 50 ml intravenously). Antibiotics. Vitamin therapy. For hemoglobinuria - sodium bicarbonate - 1000 ml of 4% solution intravenously. Treatment of acute renal failure and toxic hepatopathy - in a hospital setting. For foundry fever - acetylsolicylic acid - 1 g, codeine - 0.015 g orally. For allergic rash - diphenhydramine - 1 ml of 1% solution subcutaneously, calcium gluconate 10 ml of 10% solution intravenously.
MORPHINE.
A. Name of the chemical substance and its characteristics.
Mlorphine and other narcotic analgesics of the opium group: opium, pantopon, heroin, dionine, codeine, tecodin, fenadone. Preparations containing substances of the opium group - gastric drops and tablets, codeterpin, cotermops. Psychotropic (narcotic), neurotoxic effect. The lethal dose when morphine is taken orally is 0.5 - 1 g, when administered intravenously - 0.2 g. The lethal concentration in the blood is 0.1 - 4 mg/l. All drugs are especially toxic for children younger age. The lethal dose for children under 3 years of age is 400 ml, phenadone - 40 mg, heroin - 20 mg. Rapidly absorbed from the gastrointestinal tract and when administered parenterally, detoxification in the liver by conjugation with glucoronic acid (90%), 75% is excreted in the urine on the first day in the form of conjugants.
B. Symptoms of poisoning.
When ingesting or parenterally administering toxic doses of drugs, a coma develops, which is characterized by significant constriction of the pupils with a weakened reaction to light, skin hyperemia, muscle hypertonicity, and sometimes clonic-tonic convulsions. In severe cases, breathing disturbances and the development of asphyxia are often observed - severe cyanosis of the mucous membranes, dilated pupils, bradycardia, collapse, hypothermia. In case of severe cadeine poisoning, breathing problems are possible while the patient remains conscious, as well as a significant decrease in blood pressure.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Repeated gastric lavage (even with pantheral administration of morphine), activated charcoal orally, saline laxative. Forced diuresis with blood alkalization. Detoxification hemosorption.
2. Administration of nalorphine (anthorphine) - 3 - 5 ml of 0.5% solution intravenously.
3. Subcutaneously atropine - 1 - 2 ml of 0.1% solution, caffeine - 2 ml of 10% solution, cordiamine - 2 ml. Vitamin B1 - 3 ml of 5% solution intravenously again. Oxygen inhalation, artificial respiration. Warming the body.
ARSENIC.
A. Name of the chemical substance and its characteristics.
Arsenic and its compounds. Nephrotoxic, hepatotoxic, enterotoxic, neurotoxic effects. The most toxic compounds are trivalent arsenic. The lethal dose of arsenic when taken orally is 0.1 - 0.2 g. Toxic concentration in the blood is 1 mg/l, lethal - 15 mg/l. Slowly absorbed from the intestine and after parenteral administration. Deposited in the liver, kidneys, spleens, thin intestinal walls, and lungs. When inorganic compounds are consumed, arsenic appears in the urine within 2–8 hours and is excreted in the urine within 10 days. Organic compounds are excreted in urine and feces within 24 hours.
B. Symptoms of poisoning.
When ingested, a gastrointestinal form of poisoning is more often observed. Metallic taste in mouth, vomiting, strong pain in a stomach. Vomit is greenish in color. Loose stools resembling rice water. Severe dehydration of the body, accompanied by chlorpenic convulsions. Hemoglobinuria as a result of hemolysis, jaundice, hemolytic numbness, acute hepatic-renal failure. In the terminal phase - collapse, coma. A paralytic form is possible: stunning, stuporous state, convulsions, loss of consciousness, coma, respiratory paralysis, collapse. In case of inhalation poisoning with arsenous hydrogen, severe hemolysis, hemoglobinuria, cyanosis quickly develop, and on the 2nd - 3rd day - hepatic-renal failure.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage through a tube, repeated siphon enemas. Early hemodialysis with simultaneous intravenous administration of 150 - 200 ml of 5% unithiol solution.
2. Unithiol - 5% solution, 5 ml 8 times a day intramuscularly; 10% solution of thetacine-calcium - 30 ml in 500 ml of 5% glucose intravenously.
3. Vitamin therapy: ascorbic acid, vitamins B1, B6, B15. 10% sodium chloride solution intravenously, repeated 10 ml (under ionogram control). At sharp pain in the intestines - platifilin -1 ml 0.2% rasta, atropine 1 ml 0.1% solution subcutaneously, perirenal block with novocaine. Cardiovascular drugs. Treatment of exotoxic shock. For hemoglobinuria - glucose-novocaine mixture (glucose 5% - 500 ml, novocaine 2% - 50 ml) intravenously, hypertonic solution (20 - 30%) glucose - 200 - 300 ml, aminophylline 2, 4% solution - 10 ml, bicarbonate sodium 4% - 1000 ml intravenously. Forced diuresis.
NAPHTHALENE.
A. Name of the chemical substance and its characteristics.
Naphthalene has a local irritant, hemotoxic (hemolytic) effect. The lethal dose when taken orally is about 10 g, for children - 2 g. Poisoning is possible through inhalation of vapors and dust, through penetration through the skin, or into the stomach. Excretion in urine in the form of metabolites.
B. Symptoms of poisoning.
When inhaled - headache, nausea, vomiting, lacrimation, cough, superficial clouding of the cornea. The development of hemolysis and hemoglobinuria is possible. Upon contact with skin - erythema, dermatitis phenomena. If ingested - abdominal pain, vomiting, diarrhea. Anxiety, in severe cases - coma, convulsions. Tachycardia, shortness of breath, hemolysis, hemoglobinuria, toxic nephropathy. The development of toxic hepatopathy is possible. Poisoning is especially dangerous in children.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. When taken orally - gastric lavage through a tube, saline laxative. Forced diuresis with blood alkalization.
2. Sodium bicarbonate 5 g orally in water every 4 hours or intravenously 4% solution 1 - 1.5 liters per day.
3. Calcium chloride- 10 ml of 10% solution intravenously, orally - rutin - 0.01 g, riboflavin 0.01 g repeated. Treatment of toxic nephropathy.
AMMONIA.
Ammonia - see Caustic alkalis.
NICOTINE.
A. Name of the chemical substance and its characteristics.
Nicotine. Psychotropic (stimulating), neurotoxic (cholinergic, convulsive) effect. Toxic concentration in the blood is 5 ml/l, lethal dose is 10 - 22 mg/l. It is quickly absorbed by the mucous membranes and quickly metabolized in the body. Detoxification in the liver. 25% are excreted unchanged in the urine and through the lungs with sweat.
B. Symptoms of poisoning.
Headache, dizziness, nausea, vomiting, diarrhea, drooling, cold sweat. The pulse is slow at first, then rapid and irregular. Constriction of the pupils, visual and hearing disturbances, muscle fibrillations, clonic-tonic convulsions. Coma, collapse. Non-smokers are more sensitive to nicotine than long-term smokers.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage with a solution of potassium permanganate 1:1000, followed by the administration of a saline laxative. Activated carbon inside. Forced diuresis. In case of severe poisoning - detoxification hemosorption.
3. Intravenous 50 ml of 2% novocaine solution, 500 ml of 5% glucose solution. Intramuscularly - magnesium sulfate 25% - 10 ml. For convulsions with difficulty breathing - 10 ml of 10% barbamyl solution intravenously or 2 ml of 2% ditilin and artificial respiration. For severe bradycardia - 1 ml of 0.1% atropine solution subcutaneously.
NITRITES.
A. Name of the chemical substance and its characteristics.
Nitrites: sodium nitrite (saltpeter), potassium, ammonium, amyl nitrite, nitroglycerin. Hemotoxic (direct hemoglobin formation), vascular effect (relaxation of the smooth muscles of the vascular wall). The lethal dose of sodium nitrite is 2 g. It is quickly absorbed in the gastrointestinal tract and is excreted mainly unchanged through the kidneys and intestines. They are not deposited in the body.
B. Symptoms of poisoning.
First, redness of the skin, then cyanosis of the mucous membranes and skin. The clinical picture is mainly due to the development of methemoglobinemia (see Aniline). A decrease in blood pressure is possible up to the development of acute cardiovascular failure (collapse).
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage through a tube. Forced diuresis.
2. Treatment of methemoglobinemia (see Aniline).
3. When blood pressure decreases, administer 1 - 2 ml of cordiamine, 1 - 2 ml of a 10% caffeine solution subcutaneously, 1 - 2 ml of a 0.2% solution of norepinephrine in 500 ml of a 5% glucose solution - intravenously.
CARBON MONOXIDE.
A. Name of the chemical substance and its characteristics.
Carbon monoxide ( carbon monoxide). Hypotoxic, neurotoxic, hemotoxic effects (carboxyhemoglobinemia). The lethal concentration of carboxyhemoglobin in the blood is 50% general content hemoglobin. Poisoning by exhaust gases of internal combustion engines (cars), “burning out” due to malfunctions of the stove heating system, poisoning at the source of the fire.
B. Symptoms of poisoning.
Mild degree - headache of a girdling nature (symptom of a hoop), pounding in the temples, dizziness, nausea, vomiting. A transient increase in blood pressure and the phenomenon of trachyobronchitis (poisoning in a fire) are possible. The concentration of carboxyhemoglobin in the blood taken at the scene of the incident is 20 - 30%. Moderate severity - short-term loss of consciousness at the scene, followed by agitation with visual and auditory hallucinations or retardation, adynamia. Hypertension syndrome, tachycardia, toxic damage to the heart muscle. The phenomenon of tracheobronchitis with impaired external respiration function (poisoning in a fire). The concentration of carboxyhemoglobin in blood taken at the scene of the incident is 30 - 40%.
Severe poisoning - prolonged coma, convulsions, cerebral edema, disturbances in external respiration with symptoms of respiratory failure (aspiration-obstruction syndrome, burn of the upper respiratory tract - fire poisoning), hypertensive syndrome, toxic damage to the heart muscle, possible development of myocardial infarction. Sometimes trophic skin disorders, development of myorenal syndrome, acute renal failure. The concentration of carboxyhemoglobin in the blood taken at the scene was 50%.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Take the victim to fresh air. Continuous inhalation for 2 - 3 hours.
2. For moderate and severe poisoning - hyperboric oxygenation at a pressure in the chamber of 2 - 3 atm for 50 - 60 minutes.
3. For cerebral edema - lumbar punctures with removal of 10 - 15% of the cerebrospinal fluid at elevated pressure, craniocerebral hypothermia (ice application or cold apparatus) for 6 - 8 hours, osmotic diuretics (mannitol, urea). For agitation, 1 ml of a 1% solution subcutaneously, aminazine - 2 ml of a 2.5% solution intramuscularly, for convulsions - 2 ml of a 0.5% solution of diazepam or 5 ml of a 10% solution of barbamyl intravenously. In case of damage to the upper respiratory tract - therapeutic and diagnostic tracheobronchoscopy, sanitation. Prevention of pulmonary complications: antibiotics, heparin (up to 25,000 units per day intramuscularly). In case of severe respiratory failure - artificial respiration, aminophylline - 10 ml of 2.4% solution intravenously, ascorbic acid - 10 - 20 ml, 5% glucose solution - 500 ml. Vitamin therapy.
PAHICARPIN.
A. Name of the chemical substance and its characteristics.
Pahikarpin. Neurotoxic (ganglionic blocking) effect. The lethal dose is about 2 g. The lethal concentration in the blood is more than 15 mg/l. Rapidly absorbed when taken orally and parenterally. Excreted in urine.
B. Symptoms of poisoning.
Stage I - nausea, vomiting, abdominal pain, dizziness, weakness, dry mucous membranes; stage II - impaired neuromuscular conduction: dilated pupils, impaired vision, hearing, severe weakness, ataxia, psychomotor agitation, clonic-toxic convulsions, muscle fibrillations, tachycardia, pallor, acrocyanosis, hypotension; stage III - coma, respiratory failure, collapse, cardiac arrest with sudden brachycardia.
B. Emergency care:
1. Active detoxification methods
2. Antidote treatment
3. Symptomatic therapy
1. Gastric lavage through a tube, saline laxative, forced diuresis, detoxification hemosorption.
2. In stage I, specific therapy is not performed. In stage II: 0.05% proserin solution subcutaneously 10 - 15 ml (days 1 - 2), 2 - 3 ml (days 3 and 4), ATP - 12 - 15
