TY  - CHAP
M1  - Book, Section
TI  - Clinical Toxicology
A1  - Chyka, Peter A.
A2  - DiPiro, Joseph T.
A2  - Talbert, Robert L.
A2  - Yee, Gary C.
A2  - Matzke, Gary R.
A2  - Wells, Barbara G.
A2  - Posey, L. Michael
PY  - 2017
T2  - Pharmacotherapy: A Pathophysiologic Approach, 10e
AB  - KEY  CONCEPTS  Poisoning  can  result  from  exposure  to  excessive  doses  of  any  chemical,  with  medicines  being  responsible  for  most  childhood  and  adult  poisonings.  The  total  number  and  rate  of  poisonings  have  been  increasing,  but  preventive  measures,  such  as  child-resistant  containers,  have  reduced  mortality  in  young  children.  Immediate  first  aid  may  reduce  the  development  of  serious  poisoning,  and  consultation  with  a  poison  control  center  may  indicate  the  need  for  further  therapy.  The  use  of  ipecac  syrup,  gastric  lavage,  whole  bowel  irrigation,  and  cathartics  has  fallen  out  of  favor  as  routine  therapies,  whereas  activated  charcoal  remains  useful  for  gastric  decontamination  of  appropriate  patients.  Antidotes  can  prevent  or  reduce  the  toxicity  of  certain  poisons,  but  symptomatic  and  supportive  care  is  essential  for  all  patients.  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.  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.  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.  Poisoning  with  iron-containing  drugs  produces  vomiting,  gross  gastrointestinal  bleeding,  shock,  metabolic  acidosis,  and  coma  and  can  be  treated  with  supportive  care  and  deferoxamine.  Acute  opioid  poisoning  and  overdose  can  produce  life-threatening  respiratory  depression  that  can  be  treated  with  assisted  ventilation  and  naloxone.  Chemicals  can  be  used  for  mass  poisonings  by  acts  of  terrorism  and  warfare  and  typically  produce  life-threatening  effects  within  minutes  to  hours,  which  warrant  emergency  preparedness  at  healthcare  facilities  and  communities.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/16
UR  - accesspharmacy.mhmedical.com/content.aspx?aid=1145218589
ER  -