Drug poisoning

Introduction

Introduction to drug poisoning

Poisoning caused by the amount of the drug exceeding the maximum amount. Drug abuse can result from misuse or overdose and drug abuse. Common poisoning drugs are Western medicine, Chinese medicine and pesticides. Or mistakenly take large doses of drugs, or misuse of drugs and misuse of drugs, or the incompatibility of drugs, etc., with the development of the chemical pharmaceutical industry, if management can not keep up, drug poisoning occurs Will increase.

basic knowledge

Sickness ratio: 0.1%

Susceptible people: no special people

Mode of infection: non-infectious

Complications: respiratory failure

Pathogen

Cause of drug poisoning

Disease factors (25%):

For example, in China, schistosomiasis endemic areas, hexachloro-p-xylene is widely used, the incidence of toxic neuropathy and neurosis is also high, the medication time is long, and the incidence of toxic side effects of drugs is also large.

Genetic factors (30%):

It is an important cause of toxicity of certain drugs. Patients with glucose 6-phosphate dehydrogenation (G6PD) deficiency play an important role in the hemolytic anemia that occurs when quinine antimalarials are used. China's G6PD defects are widely distributed, with positive rates in the southwest and coastal provinces. About 23% of patients with chronic acetylated patients have multiple peripheral neuritis. European whites are 60% slower, and China is about 20%. In patients with deficient cholinestere, after the same dose of the muscle relaxant succinylcholine, the interval between exhalation and inspiratory is prolonged, and severe suffocation is caused. Alcohol metabolism in the body mainly relies on dehydrogenation of acetaldehyde, and dehydrogenation of acetaldehyde is prone to alcoholism. There is almost no shortage of Europeans. Asians lack more acetaldehyde dehydrogenation than Europeans, and Chinese people are about 35%.

Gender and age differences (30%):

Sensitivity to drug toxicity varies widely. Chloramphenicol can cause aplastic anemia, and the incidence of women is three times higher than that of men. Children should pay more attention to the drug, because children's drug metabolism is not fully developed, and the toxicity to drugs is highly sensitive. For example, chloramphenicol can cause gray infantile syndrome, and children may die several hours after the onset of symptoms. Kidney excretion of streptomycin is slow, and long-term application can cause deafness. The heart, liver and kidney function of the elderly are declining and prone to allergic reactions or poisoning. The same dose of digoxin, plasma half-life is prolonged, and the incidence of digitalis poisoning is high. The renal excretion function of the elderly decreased, and the plasma concentration after intramuscular injection of penicillin was 13 times higher than that of young people. The dose of barbiturate-type hypnotics in the elderly should be adjusted because of the decreased metabolic activity of the liver in the elderly.

Prevention

Drug poisoning prevention

1. Strengthen the promotion of poisons: popularize the prevention and first aid knowledge about poisoning.

2. Strengthen the management of poisons: strictly abide by the protection and management system of poisons, strengthen the storage of poisons, and prevent the leakage of poisons.

3, to prevent inadvertent consumption of poison or overdose: drugs and chemical containers must be labeled, hospital medication should be strictly checked against the system, so as not to accidentally or overdose.

Complication

Drug poisoning complications Complications, respiratory failure

Drug poisoning, such as treatment failure, can cause complications such as heart failure and respiratory failure, and severe cases can lead to death.

Symptom

Symptoms of drug poisoning Common symptoms Anesthetic poisoning Nausea and vomiting Nausea Respiratory skin Itching, dizziness, systemic allergy and fever... Arrhythmia Functional tremor coma

Clinical features:

1. Mild poisoning: The main manifestations are headache, dizziness, nausea, vomiting, excitement or inhibition of the central nervous system, prone to illusion, loss of time and space.

2, severe poisoning: there may be coma, respiratory depression, convulsions, closed jaws, angulation, and pupil diminution such as needle size and difficulty breathing.

3, chronic poisoning: symptoms are mainly loss of appetite, constipation, weight loss, aging and sexual dysfunction.

Examine

Drug poisoning check

The characteristic symptoms and signs of poisoning are similar to common medical emergencies, and the clinical manifestations of different toxic poisons may be similar or overlapping, and the performance of the same poison poisoning in different organisms may also be different. Therefore, misdiagnosis or missed diagnosis is easy. The key points of acute poisoning diagnosis are combined with medical history and on-site investigation, clinical and physical examination, poison test and other data to falsify the truth and comprehensive analysis.

Diagnosis

Diagnosis and identification of drug poisoning

1. The inquiry and clinical examination of medical history are basically the same as general diseases, but the differential diagnosis of drug poisoning is more complicated. First of all, it should be distinguished whether the patient's toxic symptoms are caused by the development of the disease, or caused by medication, such as headache, dizziness, nausea, vomiting. In the event of a sudden onset of a rash, consideration should be given to drugs or poisons. Doctors should specifically ask about the history of medication, the variety, dose and time of use, and be familiar with the adverse reactions of each drug to understand the history of family drug toxicity. The incubation period of poisoning symptoms has great reference value for diagnosis, most of which are 1 to 2 days, and the maximum is no more than 10 to 12 days.

2. Comprehensive analysis based on medical history: collecting detailed history of poisoning is the primary link in diagnosis. Productive poisoning should ask about occupation history, job types, production processes, types of poisons exposed, quantities, ways of poisoning, and the incidence of others. Non-productive poisoning To understand personal life and mental state, I and my family often take drugs and pesticides, and must investigate the poisoning environment. All drugs or chemicals on the patient's site, as well as pockets and containers. Try to collect information about the patient's usual life, study, work, and recent emotional changes to determine whether or not to take or use a certain drug. For the exact history of poisoning, the type of the drug, the route and time of poisoning should be determined in detail, and the dose of the drug should be roughly estimated. According to the clinical manifestations, the types of poisoning drugs are specifically determined.