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Common poisons

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Introduction

Poison is any substance (liquid, solid, gas), that is harmful to the body, when ingested, inhaled, injected or absorbed through the skin. It is estimated that about 7 in 100,000 people in Tanzania die due to unintentional poisoning. Pesticides were important cause of poisoning in the east Africa region followed by snake bites. Otherwise, poisoning is under-reported and data are very scarce in Tanzania.

These can be intentional or accidental. Suspect poisoning in any unexplained illness in a previously healthy child/adult. Traditional medicines can also be a source of poisoning. The common poisoning in our setting are:

Household agents:

o Organophosphate e.g malathion (insecticide)
o Pesticides - nuvan top, rat poison, hydrocarbons e.g kerosene
o Disinfectants and bleach

• Medicines - Aspirin, paracetamol, anticonvulsants (carbamazpine), haematinic (Iron and Vitamins)
• Major tranquilizers and herbal products
• Foods-eg Mushroom, infected foods

Sympathomimetic toxidrome (Possible toxins)

• Cocaine
• Amphetamines,
• Phencyclidine (PCP),
• Lysergic acid (LSD) Withdrawal from narcotics,
• Benzodiazepine
• Alcohol
• Long term beta-blocker therapy

Cholinergic toxidrome (Possible toxins)

• Organophosphate compounds
• Carbamate insecticides


Risk Factors

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Signs and symptoms

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Diagnostic criteria

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Investigations

Sympathomimetic toxidrome

• RBG-bedside ECG Serum electrolytes and renal function Liver function test Creatinine kinase
• Clotting screen: PT/PTT/INR
• Full Blood Count
• Arterial blood gas
• Serum osmolality and osmolality gap
• Abdominal X-ray may be useful in diagnosing

Treatment

  • Non-pharmacological

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  • Pharmacological

    In managing a patient who has been exposed to toxins holistic approach should be considered. These include

    • Resuscitation and stabilization
    • Diagnosis
    • Treatment of a poison (specific antidotes)
    • Supportive care
    • Psychosocial intervention

    The investigations depend on the poison ingested:

    If the toxin cannot be identified then toxidrome (signs and symptoms) can be used

Prevention

Educate the patient on Dos and Don’ts of poisoning prevention.

Do’s

• Keep medicines and poison in proper containers and out of reach of children
• Use containers with child resistant caps
• Keep all products in their original container
• Read medicine labels carefully to avoid mistake

Don’ts

• Leave container open
• Transfer products from their origin
• Remove labels from the medicine products
• Put tablets into another containers such as purse or envelope
• Medicine/tablets as sweet
• Take your medicine in front of children as they often copy

Updated on,

14 Novemba 2020 15:04:01

References

    1. STG
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