Drug Poisoning and Misuse Flashcards
what is a poison?
a poison is any substance, including medications, that is harmful to your body if too much is eaten, inhaled, injected, or absorbed through the skin. (CDC,2015)
what is an acute poisoning?
single contact with a toxin
what is a chronic poisoning?
repeated contacts with a toxin which is not or is poorly excreted from the body, thus permitting accumulation
what are the three types of poisoning?
- accidental
- intentional
- iatrogenic
when does accidental poisoning usually occur?
- mostly in children
- high risk age 12-36 months
- most common poison is household bleach
when does intentional poisoning usually occur?
- most common in adults with suicidal/parasuicidal intention
- number of occurrence is higher in accidental but fatality rate is higher in intentional poisoning
what percent of poisonings does unintentional account for?
84%
what is iatrogenic poisoning?
includes the vast array of adverse drug reactions, many of which are preventable
accounting for 3% of reported poisonings
what are the most common drugs enquired about?
paracetamol and ibuprofen
what is the most common household item enquired about?
laundry products/detergents
what are the signs and symptoms of poisoning?
- burns or redness around the mouth
- chemical smelling breath
- burns, stains and odors on the person or surrounding area
- empty medication bottles or scattered pills
- vomiting, difficulty breathing, sleepiness, seizures, confusion
what are some non-specific treatments?
- maintenance of ventilation
- reduce absorption of poison
- maintenance of BP
- increasing elimination
- nutrition, hydration and electrolyte disturbance
what are the signs of aspirin poisoning?
- tinnitus and impaired hearing
- hyperventilation
- vomiting
- dehydration
- fever
- double vision
what is given as treatment in a significant aspirin overdose?
sodium bicarbonate given until urine pH is between 7.5-8
what is classified as a significant aspirin overdose?
salicylate levels greater than 35mg/dl after 6 hours of injestion
what are the goals in poison control treatments?
- hemodynamically stabilize the patient
- identify the toxic substance
- minimize further absorption
how would you treat inhaled poison substances?
treat with high oxygen administration
how would you treat ingested poison substances?
treat with administration of activated charcoal and a cathartic orally or by nasogastric route
how would you treat injected poison substances?
treat with the administration of specific antagonistic medications if available
how would you treat poisoning by skin absorption?
removal of the toxic substance through irrigation
what does supportive care involve?
- maintenance of vital body function in a physiological state until the intoxicant is eliminated
- management of CNS depression
- management of seizures
- management arrhythmias
- management pH & electrolyte imbalance
when does a drug become medicine?
when it is used in a prescribed way by the advise of a doctor or pharmacist with a specifically controlled dosage
what are the most commonly used substances among young people?
alcohol and tobacco
what is the most common drug of misuse in the west?
cannabis
what are the risk factors in drug addiction?
- personality (predisposition)
- social environment (early use/lack of family involvement)
- anxiety, depression and loneliness
- genetics/family history
- type of drug
what would you assess for in a drug use emergency?
- head injury
- hypoglycemia (mimics intoxication)
- ineffective breathing patterns
- risk of violence
what is treatment drug use emergency?
- blood specimen for blood alcohol level
- sleep off intoxication
- observe for central system depression
- if sedation is required, observe for hypotension and reduce consciousness
- non-judgement attitude
what are the aims of drug use treatment?
- to decrease level of drug use
- decease offending
- decrease overdose risk
- prevent spread of blood borne viruses
- improve health of individual
- improve health of family
discuss replacement therapy?
opioid replacement therapy is a medical procedure of replacing illegal opioid drug such as heroin with a longer acting ,less euphoric opioid (like methadone or buprenorphine) taken under medicine supervsion
what is the aim of screening and brief interventions?
identify current or potential problems with substance use and motivate those at risk to change their substance use behaviour
what are some strategies to prevent spread of blood borne?
- not sharing needles (needle exchange program)
- safe sex
- screening for blood borne viruses
- opportunistic vaccination
what are the principles of drug treatment? (1-6)
- addiction is complex but treatable disease that affect brain function and behaviour
- no single treatment is appropriate for everyone
- treatment needs to be readily
- effective treatment is holistic not just surrounding the drug abuse
- remaining in treatment for an adequate amount of time is critical
- behavioral therapies - including family or group - are the most commonly used forms of treatment
- medications are important elements of treatment with therapies
- treatment plans must be assessment continually
- many drug-addicted people suffer from mental illness which must be address
- medically assisted detoxification is only the first stage of treatment
- treatment does not need to be voluntary to be effective
- drug use monitoring during treatment is essential
- treatment programs should test patients for infectious such HIV/AIDS
