Symptoms and treatment of specific poisons vary (see Table: symptoms and treatment of specific toxins); to consider all the specific features and details, is impossible. is generally for all poisonings unless they are lightweight and are treated standardized, contact a Poison Control Center recommended. Symptoms and treatment of specific toxins poison * Symptoms Treatment ACE inhibitor angioedema, hypotension activated carbon, supportive care, a bradykinin inhibitors (Icatibant) If angioedema: epinephrine, antihistamines or corticosteroids are hardly effective If hypotension: administration of Flüsssigkeit acephate s. Organophosphates – acetaminophen Paracetamolvergiftungen Paracetamolvergiftungen acetanilide, aniline dyes and oil chloroaniline phenacetin (acetophenetidine phenylacetamide) Inhalation O2, respiratory support, Bluttransfusionn acetic Low Concentration: Slight mucosal irritation High Concentration: contact with acids or alkalis Supportive care with flushing and dilution Acetone ketones model adhesives or cements nail polish remover Ingestion: As with inhalation, except the direct pulmonary effects Inhalation: bronchial irritation, pneumonia (pulmonary congestion and edema, decreased breathing, shortness of breath), drunkenness, drowsiness, ketosis, cardiac arrhythmias distance from the source Atemunterstützjng, O2 and fluids, correction of metabolic acidosis acetonitrile Cosmetic nail glue converted to cyanide, with characteristic symptoms and complaints See cyanide acetophenetidine See acetanilide – acetylsalicylic acid poisoning with aspirin and other salicylates – acids and alkalis See specific acids and alkalis (eg. As boric acid, fluorides) and contact with acids or alkalis eye contact injuries at a glance skin contact: Burns – model adhesives or cements See acetone, benzene (toluene) and petroleum distillates – alcohol, ethyl alcohol (ethanol) Brandy Whiskey Other Spirits Emotional lability, incoordination, flushing, nausea, vomiting, drowsiness to coma, respiratory depression Supportive monitoring, intravenous glucose to avoid hypoglycemia Alcohol, isopropyl rubbing alcohol dizziness, incoordination, drowsiness to coma, gastroenteritis, hemorrhagic gastritis, hypotension ketosis without acidosis No retinal injury or acidosis supportive supervision, i.v. Glucose, correction of dehydration and electrolyte abnormalities In gastritis: iv H2-blockers or proton pump inhibitors alcohol, methyl (methanol, wood alcohol) antifreeze brush cleaner solid alcohol paint severe toxicity with about 60-250 ml (2-8 oz) in adults or 8-10 ml (2 teaspoons) in children latency 12-18 h headache, weakness, leg cramps, dizziness, convulsions, retinal injury, vision disorders, metabolic acidosis, respiratory problems Fomepizole (15 mg / kg, then 10 mg / kg every 12 h) hemodialysis (the final treatment) Aldrin See chlorinated and halogenated hydrocarbons – Alkalis See acids and alkalis – alphaprodine See opioids – aminophylline caffeine guarana theophylline alertness, restlessness, loss of appetite, vomiting, dehydration, seizures, tachycardia In adults: higher toxicity following acute overdose with chronic administration of activated carbon (when taken orally), drug withdrawal , measurement of the concentration of theophylline in the blood, diazepam, lorazepam or phenytoin for seizure, parenteral fluids, blood pressure control in Th eophyllin, serum concentration> 50-100 mg / L (> 278 to 555 mol / L): acidosis, seizures or coma, possibly dialysis for patients without asthma, possibly a ?-blocker (eg. B. esmolol) amitriptyline See tricyclic antidepressants – ammonia gas (anhydrous ammonia [NH3]) Irritation of the eyes and respiratory tract, cough, shortness of breath, abdominal pain eye rinsing at least for 15 minutes with tap water or saline in severe toxicity. O2 – pressure for treatment a pulmonary edema, respiratory support ammonia water (ammonium hydroxide [NH 4 OH]) burns by acids or alkalis – Ammoniated mercury (NH2HgCl) See mercury – ammonium carbonate ([NH4] 2CO3) burns by acids or alkalis – ammonium fluoride (NH4F) See fluorides – amobarbital See barbiturates – amphetamines (stimulants) amphetamine sulfate or phosphate Dextroamphetamine Methamphetamine phenmetrazine Synthetic cathinones (bath salts) Increased excitement, cheerfulness, talkativeness, insomnia, irritability, exaggerated reflexes, loss of appetite, sweating, tachyarrhythmia, angina pectoris-chest pain, psychotic states, inability to concentrate or sit still, paranoia activated carbon may be effective for a long time after taking account of the recycling via the enterohepatic circulation. Benzodiazepines are used for sedation and against spasms, further reducing external stimuli, external cooling, prevention of brain edema ?-blockers may possibly be helpful for patients without asthma, but are rarely necessary amyl nitrite See nitrites – aniline See acetanilide – anticoagulants, direct thrombin inhibitors argatroban bivalirudin, dabigatran etexilate desirudin bleeding resulting from a thrombin inhibition Supportive measures (eg. As complete blood transfusion, administration of prothrombin complex concentrates or hemodialysis are considering) anticoagulants, factor Xa inhibitors fondaparinux apixaban, rivaroxaban Bleeding secondary Xa factor inhibiting For control of bleeding complications. Supportive care (eg, complete blood transfusion) and / or transfer of Prothrombin Complex Oral activated carbon and supportive treatment anticoagulants heparin and low molecular weight heparins, heparin (fractionated) dalteparin, enoxaparin tinzaparin bleeding as a result of the reduced thrombin and e ne of fibrin clot formation Supportive measures (eg. B. blood transfusion) protamine sulfate (for reversal of unfractionated heparin, but neutralized only partially Niedermolekulre heparins) anticoagulants, phenprocoumon, warfarin dicumarol Superwarfarine warfarin See warfarin – antidepressants See bupropion, mirtazapine, SSRI, trazodone, tricyclic antidepressants and venlafaxine – antifreeze See alcohol, methyl – and ethylene glycol – Antihistamines Anticholinergic symptoms (eg. B. tachycardia, hyperthermia, mydriasis, warm and dry skin, urinary retention, ileus, delirium) for diagnostic or therapeutic trials or for the treatment of severe intractable symptoms and for sedation (Cave: Seizures – s physostigmine), consideration of physostigmine 0.5. -2.0 mg in adults or 0.02 mg / kg iv in children (Slow) Antihyperglycemic drugs orally See hypoglycemic drugs, oral – antimony Stibophen tartar emetic throat constriction, dysphagia, burning gastrointestinal pain, vomiting, diarrhea, gastrointestinal bleeding, dehydration, pulmonary edema, renal failure, lactic acidosis, liver failure, shock chelating dimercaptopropanesulfonic acid (DMPS) i.v. for patients who can not take drugs orally, hydration, treatment of shock and pain cytostatics Mercaptopurine Methotrexate Vincristine> 50 additional effects on hematopoiesis (granulocytes, Lymphzyten, platelets, red blood cells), nausea, vomiting, acute specific versus chronic effects depending on the medication supportive care, leucovorin rescue only when methotrexate, observation post acute problems (> 24-48 h) antipsychotics (conventional) chlorpromazine, fluphenazine, haloperidol loxapine mesoridazine Molindone Pe rphenazin pimozide prochlorperazine, thioridazine thiothixene trifluoperazine triflupromazine A wide range of effects (eg. As sedation, seizures, agitation, coma, dystonia, hypotension, tachycardia, ventricular arrhythmias or torsades de pointes, anticholinergic effects, hyperthermia, agranulocytosis or hypothermia) In dystonia: biperiden If hypotension does not respond to liquid addition: norepinephrine In ventricular arrhythmias: consideration of alkalizing antipsychotics (2nd generation), clozapine, olanzapine, quetiapine, risperidone, ziprasidone CNS depression (especially olanzapine), miosis, anticholinergic effects, hypotension, dystonia, QT prolongation (occasionally), fatal bone marrow suppression (rare) case of dystonia: biperiden If hypotension that does not respond to liquid addition: Nora Drenalin In ventricular arrhythmias: Consideration of alkalizing ant poison See arsenic (sodium arsenate) and boric acid – Arsenic Donovan solution Fowler solution herbicides pig Furer green pesticides selenium sodium arsenate as antimony As with antimony arsine gas Acute anemia transfusions, diuresis Artificial bitter almond oil See cyanide – Asphalt See petroleum distillates – aspirin poisoning with aspirin and other salicylates – atropine See Belladonna – car exhaust carbon monoxide See – Barbiturates amobarbital meprobamate pentobarbital phenobarbital secobarbital bradycardia, hypothermia, confusion, delirium, loss of corneal reflex, respiratory failure, somnolence, ataxia, coma coal up to 24 hours after ingestion, supportive treatment, forced alkaline diuresis for Phenobarbital (to support the elimination) In severe cases: hemodialysis barium (soluble) barium barium carbonate barium barium barium nitrate barium sulfide depilatories explosives fireworks Rat poisons vomiting, abdominal pain, diarrhea, tremors, convulsions, colic, high blood pressure, cardiac arrest, dyspnea, and cyanosis, ventricular fibrillation, severe hypokalemia, skeletal muscle weakness KCl 10-15 mmoL / h iv, Na or Mg-sulfate 60 g po to barium in the stomach prevent, then possibly gastric lavage diazepam to control seizures for dyspnea and cyanosis: O2 belladonna atropine hyoscyamine Hyoscyamus scopolamine (hyoscine) Stramonium anticholinergic symptoms (eg. B. tachycardia, hyperthermia, mydriasis, warm and dry skin, urinary retention, ileus, delirium) for diagnostic or therapeutic trials or for the treatment of severe intractable symptoms and for sedation (Cave:. Seizures, s physostigmine), consideration of physostigmine 0.5 -2.0 mg in adults or 0.02 mg / kg iv in children (Slow) benzene benzene hydrocarbons Model adhesive Toluene Toluene Xylene dizziness, weakness, headache, euphoria, nausea, vomiting, ventricular arrhythmia, paralysis, seizures In chronic poisoning: aplastic anemia, hypokalemia, leukemia, CNS depression decontamination with water, avoid vomiting and aspiration, O2, respiratory support, ECG monitoring (ventricular fibrillation may occur at an early stage) to control seizures diazepam In severe anemia: blood transfusions replacement of potassium required epinephrine is contraindicated ?-hexachloro Hexachkorocyclohexan ocyclohexan hexachlorocyclohexane lindane irritability, CNS excitement, muscle spasms, atonic, tonic-clonic seizures, respiratory failure, pulmonary edema, nausea, vomiting, impaired consciousness, coma, symptomatic therapy, activated carbon for airway control Diazepam to control seizures gasoline See petroleum distillates – benzodiazepines alprazolam, chlordiazepoxide diazepam flurazepam sedation to coma, in particular when, in addition alcohol hypotension respiratory control was drunk when H ypotonie be fluid and vasopressors infused intravenously. Avoidance of flumazenil (. Caution: If tricyclic antidepressants are involved, flumazenil can trigger any seizures in patients taking benzodiazepines, can flumazenil withdrawal trigger) benzene See benzene – Beta blockers hypotension, bradycardia, convulsions, cardiac arrhythmias, hypoglycemia, altered mental state Tight monitoring and control of the airways in symptomatic patients: dopamine, adrenaline, other vasopressors, glucagon 3-5 mg iv followed by an infusion, CaCl2, i.v. Insulin and glucose, pacemakers, intra-aortic balloon pump sublimate See mercury – bichromate See chromic acid – Bidrin (Dicrotophos) See Organophosphates – bifenthrin See pyrethroids – bishydroxycoumarin See warfarin – bismuth / bismuth compounds Acute: abdominal pain, oliguria, acute renal failure Chronic: Poor absorption, ulcerative stomatitis, anorexia, progressive encephalopathy respiratory support, considering the chelation therapy with Dimercaptopropansulfonsäue (s. Guidelines for chelation therapy) bitter almond oil See cyanide – chlorine bleach See hypochlorite – ?-blocker See beta blockers – INDIGO See selenium __ boric nausea, vomiting, diarrhea, huh morrhagische gastroenteritis, weakness, lethargy CNS depression, seizures, cancer red rash, shock decontamination of the skin, prevention or treatment of electrolyte abnormalities and shock, control of seizures Severe poisoning (rare): Dialysis brandy See ethyl alcohol – Bromates vomiting, diarrhea, pain upper abdomen, acidosis, numbness symptomatic therapy, thiosulfate to reduce bromate to less toxic bromide In kidney failure: hemodialysis bromide nausea, Vomiting, acne-like skin rash, slurred speech, ataxia, confusion, psychotic behavior, coma, paralysis, negative anion discontinuation of the drug, liquid and NaCl i.v., to promote diuresis; Furosemide 10 mg i.v. every 6 h Severe poisoning: hemodialysis bromine Stark corrosive If exposed to liquid or vapor: burns of the skin and mucous membrane Aggressive decontamination, supportive care Bupropion HCl respiratory depression, ataxia, seizures charcoal, benzodiazepine, supportive care butyl nitrate See nitrites – Cadmium cadmium oxide vapors ( z. B. welding) Ingestion: Severe stomach cramps, vomiting, diarrhea, dry throat, cough, shortness of breath, headache, shock, coma, brown urine, kidney failure Inhalation: pneumonitis with dyspnea and bilateral pulmonary infiltrates, hypoxia, death dilution with milk or albumin, respiratory support, hydration Dimercaptoprpansulfonsäure: not proven benefits for inhalation: O2; sometimes bronchodilators and corticosteroids caffeine SieheAminophylline – calcium channel blockers diltiazem, nifedipine, verapamil Others nausea, vomiting, confusion, bradycardia, hypotension, total circulatory collapse toxicity sometimes after a Hyperglycemia preparations sustained release: Consider an intestinal lavage glucagon 5-10 mg iv In hypotension or severe arrhythmias: Possibly Administration of CaCl2 (z. B. 1 g and 10 ml of a 10% solution) and 3 times as much calcium gluconate i.v. with additional doses as required, pacemakers or intraaortic balloon pump, if necessary Administration of insulin 10-100 IU iv and 50-100 mL of 50% dextrose plus. 50-100 mL / h 10% dextrose i.v. Infusion into account the i.v. Lipid emulsion calomel See mercury – camphor camphor oils camphor smell in the breath, headache, confusion, delirium, hallucinations, convulsions, coma diazepam to prevent and treat seizures, respiratory support cannabinoids research chemicals cannabicyclohexanol CP-47 JWH-018, JWH-073, JWH-200 high blood pressure, tachycardia, MI, nausea, vomiting, agitation, hallucinations, psychosis, seizures, K rämpfe, Schlaganfall Unterstützende Behandlungsmaßnahmen mit Infusionslösungen, Benzodiazepin bei Erregungszuständen und Anfällen, Phenorbital bei Anfällen Betablocker können helfen, Herzsymptome zu lindern, sind aber nur selten erforderlich Hartspiritus (verfestigter Brennspiritus) Siehe Alkohol, Methyl — Canthariden Cantharidin Spanische Fliege Gereizte Haut und Schleimhäute, Hautbläschen, Übelkeit, Erbrechen, blutiger Durchfall, brennende Schmerzen in Rücken und Harnröhre, Atemdepression, Krämpfe, Koma, Fehlgeburt, Menorrhagie Vermeidung aller Öle, Unterstützung der Atmu ng, Behandlung von Anfällen, Aufrechterhaltung des Flüssigkeitshaushalts Kein spezifisches Antidot Carbamate Aldicarb Bendiocarb Benomyl Carbaryl Carbofuran Fenothiocarb Methiocarb Methomyl Oxamyl Propoxur Geringe bis hoch toxische Wirkungen, ähnlich denen der Organophosphate, außer dass die Cholinesterasehemmung nicht dauerhaft ist Siehe Organophosphate Carbamazepin Progressive ZNS-Depression, Krampfanfälle (gelegentlich), Herzrhythmusstörungen (selten) Unterstützende Pflege nach der Dekontamination, Herzfrequenzmessung B

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