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Acute Poisoning, Drug Overdoses, Direct Patient Care

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Find Your Poison Center, If you have a poisoning emergency, call 1-800-222-1222, American Association of Poison Control Centers:"There are three ways to find out about Poison Centers in your area. You can click on a map and find out about Poison Centers in that state, enter your zip code, or look in a directory to find out which Poison Center serves your area."
American Association of Poison Control Centers
3201 New Mexico Avenue, Suite 310 Washington, DC 20016
(202) 362-7217,


Update on Management of the Patient With Poisoning or Drug Overdose, American College of Chest Physicians:"General management of poisoning and drug overdose continues to rely largely on supportive care, with attention to the airways, ventilation, cardiovascular stability, glucose and electrolyte balance, and the treatment of hyperthermia and seizures. The purpose of this lesson will be to present a general review of the above topics as they relate to the severely poisoned patient likely to require critical care management. This will be followed by a brief review of current approaches to gastric decontamination and antidote therapy."
rican College of Chest Physicians
3300 Dundee Rd Northbrook, IL 60062-2348
United States of America
General Number 847-498-1400 Products and Registration


Acute Poisoning and Drug Overdose: Slide presentation with supporting links. added 09/09/00


GENERAL MANAGEMENT OF ACUTE POISONING, CLINICAL PHARMACOLOGY UNIT, Department of Medicine in the University of Cambridge:"When confronted with any poisoning seek advice from the regional Poisons Unit (listed on the front cover of the BNF) - The Guy's Unit in London is contacted on 0207 - 6359191/9555095 Per annum in the UK there are: some 300,000 cases of poisoning 100,000 hospital admissions for poisoning (in-patient mortality 3,500-4000 deaths from poisoning (1000 of these are due to CO)."


Clinical Management of Poisoning and Drug Overdose, 3rd Ed :"The third edition of Clinical Management of Poisoning and Drug Overdose finds toxicology an essential subject for practicing emergency physicians; primary care physicians in family medicine, internal medi cine, and pediatrics; and physicians in public health. The dramatic advances in the care of the toxicology patient, such as new and specific antidotal therapy, improved standards in the specialty of emergency medicine, and the organization of regional poison centers over the past 25 years are most gratifying to those of us dedicated to the field."


Toxic, Metabolic and Nutritional Disorders of the Nervous System - Internet Handbook of Neurology:


NPAT GP Emergency Guidelines Sept 2001 DRUG OVERDOSAGE / ACUTE POISONING:"Poisoning can be accidental or intentional. Whatever the cause the episode should be taken seriously as prompt action can be lifesaving. If there any doubts about the poison, the risks or the management consult."


Poisoning, Karolinska Institutet, Library:"Patients and laypersons looking for guidance among the target sources of this collection of links are strongly advised to review the information retrieved with their professional health care providers."
Karolinska Institutet, Library,
P.O.Box 200, S-171 77 Stockholm, Sweden.
Tel: +46-8-728 80 00, Fax: +46-8-34 87 06, E-mail:


Drug Overdose, Edgren, Altha Roberts, Principal Health News:"All drugs have the potential to be misused, whether legally prescribed by a doctor, purchased over-the-counter at the local drug store, or bought illegally on the street. Taken in combination with other drugs or with alcohol, even drugs normally considered safe can cause death or serious long term consequences. Children are particularly at risk for accidental overdose, accounting for over 1 million poisonings each year from drugs, alcohol, and other chemicals and toxic substances. People who suffer from depression and who have suicidal thoughts are also at high risk for drug overdose."


General Toxic Poisoning and Drug Overdose Clinical Resources, University of Alabama, Health Sciences:


December 2001, Poisoning and Acute Intoxications, Jess Mandel, M.D. University of Iowa Healthcare:"Accidental and intentional poisonings or drug overdoses constitute a significant source of aggregate morbidity, mortality, and health care expenditure. An estimated 2 to 5 million poisonings and drug overdoses occur annually in the United States, although the true incidence is unknown due to underdiagnosis and underreporting. Many of these patients end up in the ICU. Additionally, many of these toxicologic issues show up on the boards. Thus, for several reasons, it behooves you to have a passable grasp of the fundamentals of common poisonings."


The Statistics Of Acute Poisoning Admitted In The Clinical Toxicology Department Of Clinical Emergency Hospital Bucharest In 1997:"The morbidity by acute poisonings occupies an important place in human pathology. The diversity of clinical symptoms can make the establishing of clinical diagnosis very difficult. Also, the absence of a typical antidote in 90% of poisonings establishes a specific intensive therapy action that aim to stabilise the vital functions. The epidemiological study of acute poisonings showed data regarding the total number of poisonings, theirs ethiology, the reasons of poisonings, the death rate, the repartition on age and sex, the frequency of incriminated substances, the routes of administration."


Mass Foodborne Poisoning Incidents: Clinical and Screening Laboratory Data May Differentiate Cyanide from Arsenic Poisoning:"On 25 July 1998, 100 persons ate curry and rice at a festival in Wakayama, Japan. Four persons died and about 75 persons became ill. Cyanide poisoning originally was the suspected cause, but the final diagnosis was deliberate arsenic contamination. Acute arsenic and cyanide poisoning have similar non-specific, clinical effects, including mouth and throat irritation or burning, nausea, vomiting, central nervous system (CNS) depression, muscle spasms, and seizures. Diarrhea is common with arsenic, but rare with cyanide. Cyanide poisoning causes anxiety, agitation, hyperpnea, hyperventilation, giddiness, headache, and mild hypertension, which are rare with arsenic poisoning. Screening laboratory tests aid in suspicion of acute cyanide poisoning: serum electrolytes (anion gap 12-16 mmol/L), plasma lactate levels (1 mmol/L), decreased arterial pH (often severe), relatively normal PaO2 and SaO2 saturation with elevated peripheral venous pO2 (40 mmHg) or SaO2 saturation (70%)."


Problems in Assessment of Acute Melatonin Overdose, Southern Medical Journal:"ABSTRACT: Melatonin is sold in the United States as a dietary supplement and is promoted primarily as an aid for insomnia, stress, jet lag, and aging. Cases of acute poisoning have not been reported, partially because of problems in assessment of toxicity. We report the case of a 66-year-old man who became lethargic and disoriented after taking 24 mg melatonin to aid relaxation and sleep the evening before prostate surgery. He recovered uneventfully, and after the scheduled surgery he resumed his regular practice of taking 6 mg melatonin with prescription sedative drugs. Although melatonin is not regulated as a drug, it may interact with benzodiazepines, be antagonized by naloxone and flumazenil, and interact with melatonin receptors in the central nervous system and elsewhere in the body. Melatonin appears to be pharmacologically active and should not be considered a benign agent on overdose."


Visual Toxicity in Acute Isoniazid Overdose:"Case Report: Isoniazid neurotoxicity has been well studied. Acute and chronic effects have been characterized with isoniazid use. The classic clinical triad of acute isoniazid neurotoxicity includes seizures, metabolic acidosis and coma is well recognized. However, more subtle signs of this neurotoxicity do exist. We report a case of attempted suicide by acute isoniazid ingestion that resulted in visual toxicity lasting 20 hours. The neuritis resolved after pyridoxine administration. Clinicians should be aware that acute isoniazid neurotoxicity may potentially present with less classical neurological signs and symptoms. In addition, certain symptoms, such as visual toxicity, may respond to pyridoxine administration."
Paul Lockman RN, CSPI
1501 South Coulter, Amarillo Texas 79106
(806) 354-1633


Mercury Poisoning:

    Mercury and its Many Forms, California Poison Control System:"Broken thermometers are the cause of numerous calls to the Poison Center. Thermometers with a silver line contain elemental mercury. Thermometers with a red or blue liquid do NOT contain mercury. There is much misinformation about mercury, its various forms and its dangers. Three different types of mercury exist, varying in their levels of toxicity. They are elemental mercury, inorganic mercury and organic mercury."
    California Poison Control System
    A single toll-free 800 number is available to all areas of California. By calling 1-800-876-4766

    Mercury Poisoning, Infoplease:"Mercury poisoning can cause severe neurological and kidney damage. Acute exposure can affect the respiratory and gastrointestinal systems. Organic mercury can cross the blood-brain barrier and cause irreversible nervous system and brain damage, e.g., loss of motor control, numbness in limbs, blindness, and inability to speak. Some studies have connected maternal mercury exposure to fetal damage. Mercury poisoning can be confirmed by urine tests. Chelation therapy is used for poisoning with elemental mercury and mercury salts; there is no treatment for organic mercury poisoning."
    160 Gould St.
    Needham, MA 02494 USA

    Mercury In the Environment, United States Environmental Protection Agency:"What is mercury? How can mercury affect my health? What happens to mercury when it enters the environment? How can people be exposed to mercury? Who is at risk from mercury exposure? What EPA has done to safeguard human health Fish Consumption Advisories Ritual Use of Mercury Program What can I do to reduce Mercury in the Environment? Links to Other Sources of Information."
    290 Broadway New York, NY 10007-1866
    Phone: 212-637-5000

    Update on Mercury Poisoning from Vaccine:"The Dallas-based law firm of Waters & Kraus announced today that it has received documents as a result of the discovery process in the case of Counter v. Eli Lilly & Company, et al, currently pending in Brazoria County, Texas that come from the archives of Eli Lilly & Company. The documents clearly demonstrate that Lilly's thimerosal product, the mercury-based vaccine preservative implicated in a number of recent law suits as causing neurological injury to infants, was known as early as April 1930 to be dangerous."

    How are humans exposed to mercury?:"Because mercury is an element that occurs naturally and abundantly, people are regularly exposed to it at low levels. Some mercury exists in the air as a result of natural processes, such as erosion and soil decomposition. Human activities, such as burning fuel and garbage, add to the atmospheric mercury. Mercury is also returned to soil and water through precipitation. People may come into contact with mercury in any of these locations and in any of mercury's three forms: metallic, inorganic, and organic."
    6675 Mesa Ridge Road
    San Diego, CA 92121
    Phone: 888-757-0117 858-362-5688 Fax: 858-362-4807



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Created on September 8, 2000

Last updated by Andrew Lopez, RN on December 1, 2017

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