القرآن والذكر والاستغفار أدوية ناجحة لكل كدر وضيق
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بسم الله الرحمن الرحيم. القرآن والذكر والاستغفار أدوية ناجحة لكل كدر وضيق. General management of poisoning. What is Toxicology What is a poison poison is any product or substance that can harm someone if it is used in the wrong way . by the wrong person or in the wrong amount. - PowerPoint PPT PresentationTRANSCRIPT
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القرآنالقرآنوالذكروالذكر
واالستغفارواالستغفارأدوية ناجحةأدوية ناجحة
لكل كدر وضيقلكل كدر وضيق
الرحيم الرحمن الله بسم
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General management of General management of poisoningpoisoning
– What is Toxicology What is Toxicology – What is a poison What is a poison
poisonpoison is any product or substance that is any product or substance that can harm someone if it is used can harm someone if it is used
• in the wrong way .in the wrong way .• by the wrong person by the wrong person • or in the wrong amount .or in the wrong amount .
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Examples of possible poisons Examples of possible poisons includeinclude,,
• some household productssome household products
• chemicals at work or in the chemicals at work or in the environment environment
• drugs drugs (prescription, over-the-counter, (prescription, over-the-counter, herbal) .herbal) .
• Snake bites, spider bites, and Snake bites, spider bites, and scorpion stings scorpion stings
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Classification of poisonClassification of poison
1-According to their mode of action1-According to their mode of action::
• Poisons with local action:Poisons with local action:
• Poisons with remote action:Poisons with remote action:
• Poisons with both local and remote Poisons with both local and remote actionsactions
2-According to the organs affected2-According to the organs affected hepatotoxic – cardiotoxic- nephrotoxichepatotoxic – cardiotoxic- nephrotoxic
3-According to the chemical nature3-According to the chemical nature::
• Acidic poison – organic -etcAcidic poison – organic -etc
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Factors affecting the action of Factors affecting the action of poisons:poisons:• Age of the personAge of the person
• Personal hypersensitivityPersonal hypersensitivity
• Tolerance Tolerance
• IdiosyncrasyIdiosyncrasy
• State of health State of health
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Factors affecting the action of poisons:
• Condition of the stomachCondition of the stomach
• SynergismSynergism
• State of the poisonState of the poison
• Methods of administrationMethods of administration
• Dose of the poison:Dose of the poison:
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Diagnosis of PoisoningDiagnosis of Poisoning1- History and circumstantial evidences:1- History and circumstantial evidences: 2- Clinical picture (signs and symptoms):2- Clinical picture (signs and symptoms):• Contracted pupils in morphine, organophosphorousContracted pupils in morphine, organophosphorous, , • Dilated pupils in atropine, cocaine,Dilated pupils in atropine, cocaine,• Red skin in carbon monoxide and cyanide Red skin in carbon monoxide and cyanide
poisoning.poisoning.• Flushed face in atropine and alcohol poisoningFlushed face in atropine and alcohol poisoning
• Patches around the mouth in corrosives.Patches around the mouth in corrosives.• Characteristic smell of the mouth Characteristic smell of the mouth • Fever in atropine, salicylate, Fever in atropine, salicylate,
antidepressants.antidepressants.• Convulsions in oxalic acid, strychnine, ergot, Convulsions in oxalic acid, strychnine, ergot,
insecticides insecticides
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3- Radiopacity of poisons3- Radiopacity of poisons
There are a number of tablets with There are a number of tablets with different chemical compositions that different chemical compositions that exhibit varying degrees of exhibit varying degrees of Radiopacity. Radiopacity.
• Barium,Barium,
• Enteric coated tablets,Enteric coated tablets,
• Tricyclics antidepressants ,Tricyclics antidepressants ,
• Antihistamines ,Antihistamines ,
• Heavy metalsHeavy metals
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4- Chemical analysis:4- Chemical analysis:
The most important evidence of poisoning is by The most important evidence of poisoning is by chemical analysis .chemical analysis .
111111A- A- In the livingIn the living:: Samples are taken from vomit, gastric lavage, Samples are taken from vomit, gastric lavage,
blood, urine and stool.blood, urine and stool.B- B- In the deadIn the dead ::• Blood from the heart or femoral vein. Blood from the heart or femoral vein. • Stomach and its contents and parts of the Stomach and its contents and parts of the
intestines intestines • Parts of the liver, kidney, brain, lungParts of the liver, kidney, brain, lung
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Screening testsScreening tests
• These are various tests to evaluate These are various tests to evaluate the type (and roughly measure the the type (and roughly measure the amount) of legal and illegal drugs a amount) of legal and illegal drugs a person has taken.person has taken.
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General treatment of General treatment of poisoningpoisoning
• There are eight essentials of overdose There are eight essentials of overdose management that may be considered for the management that may be considered for the
patients with poisoning. All or some of them may patients with poisoning. All or some of them may be used for the patient according to his clinical be used for the patient according to his clinical
state.state.1.1. DecontaminationDecontamination2.2. Supportive care.Supportive care.
3.3. Prevent further exposure to the poison.Prevent further exposure to the poison.4.4. Removal of the unabsorbed poison from Removal of the unabsorbed poison from
the stomach.the stomach.5.5. Inactivation of the poison remaining in the Inactivation of the poison remaining in the
stomach.stomach.6.6. Enhancement of excretion.Enhancement of excretion.
7.7. Administration of an antidote.Administration of an antidote.8.8. Symptomatic treatment.Symptomatic treatment.
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11--DECONTAMINATIONDECONTAMINATION
• Skin Skin
1.1. Wear protective clothes & gloves Wear protective clothes & gloves
2.2. Remove the patient’s contaminated Remove the patient’s contaminated clothing clothing
3.3. Flush exposed areas with copious Flush exposed areas with copious quantities of water quantities of water
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EyesEyes::
• Corrosive agents Corrosive agents
• Toxins that are readily eye absorbed Toxins that are readily eye absorbed
1.1. Flush exposed eyes with copious Flush exposed eyes with copious quantities of water or saline quantities of water or saline
2.2. check the pH of the tears check the pH of the tears
3.3. Do not instill any neutralizing Do not instill any neutralizing solution solution
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InhalationInhalation::• Irritating gases and fumes e.g. chlorine Irritating gases and fumes e.g. chlorine
gas.gas.
• Toxin that are absorbed through the Toxin that are absorbed through the respiratory tract respiratory tract
1.1. Remove the victim from exposure Remove the victim from exposure
2.2. Observe for evidence of upper Observe for evidence of upper respiratory edema respiratory edema
3.3. Administer humidified 02 Administer humidified 02
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22--Supportive careSupportive care
•A large group of acutely A large group of acutely poisoned patients can be treated poisoned patients can be treated with supportive care. The drug with supportive care. The drug will be progressively eliminated will be progressively eliminated over the next 12 to 36 hours in over the next 12 to 36 hours in most patients, and usually this is most patients, and usually this is all the care that is necessary.all the care that is necessary.
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33--Prevent further exposure to the Prevent further exposure to the poisonspoisons
• Suicidal cases must be hospitalized Suicidal cases must be hospitalized
• In industrial or agricultural exposure In industrial or agricultural exposure
• In cases of toxic inhalants In cases of toxic inhalants
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44--Removal of the unabsorbed Removal of the unabsorbed poisonpoison
1- Emesis 1- Emesis
• (chemical – mechanical )(chemical – mechanical )
• Contraindication Contraindication
2- Gastric lavage2- Gastric lavage
• Contraindication of gastric Contraindication of gastric lavagelavage
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55 - -Inactivation of poison remaining Inactivation of poison remaining in the stomachin the stomach
1-Physical antidotes1-Physical antidotes
(demulcents – Diluents – Adsorbing )(demulcents – Diluents – Adsorbing )
2-Chemical antidotes 2-Chemical antidotes
A- precipitating antidotesA- precipitating antidotes
B- Oxidizing antidotesB- Oxidizing antidotes
C-Reducing antidotesC-Reducing antidotes
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Household antidotes
•Substances that are available Substances that are available
in a house and can be used as in a house and can be used as
a first aid treatment of poisoninga first aid treatment of poisoning
•What do u think ?What do u think ?
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66--Enhancement of Enhancement of excretionexcretion
• Poisons eliminated through the lungPoisons eliminated through the lung
(in expired air)(in expired air)
• Poisons excreted through intestine (in Poisons excreted through intestine (in stool)stool)
(purgatives )(purgatives )
• Poisons excreted through bile e.g. Poisons excreted through bile e.g. morphinemorphine
(Multiple-dose activated charcoal (Multiple-dose activated charcoal ((
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•Poisons excreted by the kidney (in Poisons excreted by the kidney (in
urine)urine)
1.1. Fluid diuresisFluid diuresis
2.2. Forced diuresisForced diuresis
• Forced osmotic dieresis
• Forced acid diuresis
• Forced alkaline diuresis
3. 3. Hemodialysis (artificial kidney) Hemodialysis (artificial kidney)
4. 4. Peritoneal dialysis: Peritoneal dialysis:
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77 - -Administration of physiological Administration of physiological antidote if availableantidote if available
• Diazepam in strychnine poisoning.Diazepam in strychnine poisoning.
• Atropine in organophosphorous Atropine in organophosphorous (antagonize muscarinic action).(antagonize muscarinic action).
• Pilocarpine - peripheral action of atropine Pilocarpine - peripheral action of atropine BAL (British antilewisite) in arsenic.BAL (British antilewisite) in arsenic.
• EDTA (Ethylene Diamine Tetra-AcetateEDTA (Ethylene Diamine Tetra-Acetate ) )
• Naloxone in morphine poisoning Naloxone in morphine poisoning
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8- Symptomatic treatment8- Symptomatic treatment..
1- coma :1- coma :• Definition Definition
• Grades Grades
• Treatment Treatment
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33 - -Respiratory failureRespiratory failure
• DefinitionDefinition
• Diagnosis (Blood Gases )Diagnosis (Blood Gases )
• Treatment Treatment
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4- Acid – base disturbances4- Acid – base disturbances
• DefinitionDefinition
• Diagnosis (Blood Gases - PH )Diagnosis (Blood Gases - PH )
• Treatment Treatment
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55 - -ConvulsionConvulsion
• DefinitionDefinition
• Differential DiagnosisDifferential Diagnosis
• Treatment Treatment
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6- Disturbances in body 6- Disturbances in body temptemp
• HypothermiaHypothermia
Rectal temperature is below Rectal temperature is below 3636C,C, treat the treat the patient in warm room & wrapping with patient in warm room & wrapping with blanketsblankets
• Hyperthermia Hyperthermia
Keep the patient in a cool, well ventilated room, Keep the patient in a cool, well ventilated room, ice bag, antipyretics and antibiotics may be ice bag, antipyretics and antibiotics may be neededneeded. .