(SYNOPTIC) Poisoning & Antidotes Flashcards
Define poisoning.
Exposure to drug/ chemical/ pollutant in sufficient quantity to produce an adverse effect
Can be acute OR chronic
What is the most common type of poisoning?
Accidental
47%
What are some of the least common types of poisoning?
Drugs of misuse - 2.6%
What are the types of poisoning?
(1) Accidental
(2) Therapeutic error
(3) Deliberate
(4) Drugs of misuse
What are some types of accidental poisoning?
- Duplication of therapy
- Household chemicals (children)
- Prescribing/ dispensing errors
- Counterfeit drugs
What is the main motive for deliberate poisoning?
To cause others harm
What is a medicine that is commonly overtaken deliberately, leading to poisoning?
Thyroxine for weightloss
Or paracetamol
What is environmental poisoning?
Air/ water/ soil pollution
e.g. carbon monoxide
What is the lowest amount of nicotine that can be fatal in an adult?
40mg
What is occupational poisoning?
Overexposure to chemicals in the place of work
e.g. x-rays/ pesticides
What is the EU Tobacco Product Directive (2014)?
- No advertising on TV/ radio/ newspapers
- Only advertising at point of sale
- Max. 20mg of nicotine
What is the most common drug taken in overdose?
Paracetamol
What are the top 5 most common drugs taken in overdose?
(1) Paracetamol
(2) Ibuprofen
(3) Codeine
(4) Sertraline
(5) Diazepam
What are some of the most common household poisons?
(1) Fabric tablets
(2) Reed diffusers
(3) Bleach
(4) Air fresheners
(5) Dishwasher tablets
What is the pharmacist’s role in prevention of self-poisoning?
- Limit stock piling of medicines
- Review home medicine’s cupboard
- Safe storage of medicines and caustic substances
- Dispose of expired/ unused medicines
What is the pharmacist’s role in treatment of poisoning?
- Recognition of poisoning
- Establish drug history
- ID the agents involved
- Give advice on antidote use
- Ensure availability of appropriate antidotes
- Provide patient information
What is the general treatment of poisoning?
- Symptomatic and supportive care
- Check for infection/ trauma/ metabolic derangements
What is toxidrome?
Disorientations/ hallucinations
What is gut decontamination?
(1) Activated charcoal
- Absorbs ingested substances
- Must be fully conscious + have a protected airway
(2) Whole bowel irrigation
- e.g. polyethylene glycol
- High doses of iron
What are some therapeutic methods of enhanced elimination, with regard to patients with renal failure?
(1) Urinary alkalisation
- e.g. NaHCO3
- Increases elimination of weak acids
(2) Haemodialysis/ Haemoperfusion
- Limited subset of drugs/ chemicals
How do antidotes function?
- Inert complex with poison
- Accelerated detoxification of poison
- Reduced rate of conversion to more toxic compound
- Compete with poison at essential target sites
- Bypass effect of poison
What is N-acetylcysteine?
Antidote
Accelerates detoxification of paracetamol
What website would you use to find guidance on poisoning regarding a drug?
Toxbase
What is DigiFab?
Antidote for digoxin
How does DigiFab work?
Forms an inert complex with digoxin
What is naloxone used for?
Reversal of respiratory depression in opioid overdose
Specifically, heroine/ oxycodone
What is phytomenadione used for?
Competes with warfarin at essential receptor sites
Warfarin antidote
