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  • Image not available. Poisoning can result from exposure to excessive doses of any chemical, with medicines being responsible for most childhood and adult poisonings.
  • Image not available. The total number and rate of poisonings have been increasing, but preventive measures, such as child-resistant containers, have reduced mortality in young children.
  • Image not available. Immediate first aid may reduce the development of serious poisoning, and consultation with a poison control center may indicate the need for further therapy.
  • Image not available. The use of ipecac syrup, gastric lavage, and cathartics has fallen out of favor as routine therapies, whereas activated charcoal and whole-bowel irrigation still are useful for gastric decontamination of appropriate patients.
  • Image not available. Antidotes can prevent or reduce the toxicity of certain poisons, but symptomatic and supportive care is essential for all patients.
  • Image not available. Acute acetaminophen poisoning produces severe liver injury and occasionally kidney failure. A determination of serum acetaminophen concentration may indicate whether there is risk of hepatotoxicity and the need for acetylcysteine therapy.
  • Image not available. Anticholinesterase insecticides may produce life-threatening respiratory distress and paralysis by all routes of exposure and can be treated with symptomatic care, atropine, and pralidoxime.
  • Image not available. An overdose of calcium channel antagonists will produce severe hypotension and bradycardia and can be treated with supportive care, calcium, insulin with supplemental dextrose, and glucagon.
  • Image not available. Poisoning with iron-containing drugs produces vomiting, gross gastrointestinal bleeding, shock, metabolic acidosis, and coma and can be treated with supportive care and deferoxamine.
  • Image not available. Overdoses of tricyclic antidepressants can cause arrhythmias, such as prolonged QRS intervals and ventricular dysrhythmias, coma, respiratory depression, and seizures and are treated with symptomatic care and intravenous sodium bicarbonate.

Upon completion of the chapter, the reader will be able to:

  • 1. Contrast the circumstances of adult and childhood poisoning.
  • 2. Propose several preventive approaches to reduce unintentional poisonings.
  • 3. Describe the first aid that should be performed for an ocular exposure, skin exposure, inhalation, or ingestion of a potentially toxic substance.
  • 4. Compare the benefits and risks of using ipecac syrup, gastric lavage, and activated charcoal for the treatment of acute poisoning.
  • 5. For multiple-dose activated charcoal therapy (charcoal intestinal dialysis), describe its hypothetical mechanism of action, dosage schedule, contraindications, and cautions.
  • 6. Correlate the symptoms of acute overdosage with acetaminophen and their time of appearance.
  • 7. Given a serum acetaminophen concentration and time that it was collected after ingestion, interpret the results with the acetaminophen nomogram.
  • 8. Describe the rationale and procedure for the administration of acetylcysteine and the relationship of the time of initiating treatment and patient outcome.
  • 9. Contrast the pharmacologic actions of organophosphate insecticides, atropine, and pralidoxime.
  • 10. Correlate the symptoms of poisoning with organophosphates and the pharmacologic actions of these agents.
  • 11. Describe the general treatment measures that should be employed for an acute poisoning of an organophosphate insecticide.
  • 12. Correlate the pharmacologic action of calcium channel antagonists with toxic effects found on overdosage.
  • 13. Compare the rationale, indications and adverse effects for the use of parenteral calcium, insulin-dextrose and glucagon for calcium channel antagonist poisoning.
  • 14. Contrast the treatment ...

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