2. •GENERAL TREATMENT IN THE CASES OF POISONING IS PERFORMED WHEN THE
SPECIFIC
NATURE OF POISON IS NOT KNOWNED.
-) AIMS OF GENERAL TREATMENT
> TO REMOVE UNABSORBED POISON.
> TO TREAT & EXCRETE THE ABSORBED POISON.
- 6 PRINCIPLES OF GENERAL TREATMENT
1)RESUSCITATIVE MEASURES IN COMATOSE PATIENT.
2) REMOVAL OF UNABSORBED POISON.
3) PREVENTION OF ABSORPTION.
4) ELEMINATION OF ABSORBED POISON BY EXCRETION.
3. • 5) SYMPTOMATIC TREATMENT.
• 6) FOLLOWUPS / GENERAL CARE.
1) RESUSCITATIVE MEASURES IN COMATOSE PATIENTS
RESUSCITATIVE MEASURES → ACT OF BRINGING SOMEONE
BACK TO LIFE.
→) RESUSCITATIVE MEASURES ARE PERFORMED
• TO STABILIZE RESPIRATION (AIRWAY &
BRETHING).(A&B)
• TO CORRECT CIRCULATION ( BY IV FLUIDS).(C)
4. • A)AIRWAY
• OPENING THE AIRWAYS (ORAL CAVITY, NOSTRILS)&
CLEANING THE SECRETIONS SUCH AS VOMIT, FOREIGN
BODY, ETC…..
• ENSURING THE CLEAR AIRWAY BY ENDOTRACHEAL
INTUBATIONS (PLACING TUBE IN WINDPINE “(TRANCHES)
TO PREVENT COLLAPSE)
• B) BREATHING
• → IF GAS EXCHANGE (ARTERIAL BLOOD GAS) IS NOT
EFFECTIVE IN THE PATIENT, THEN THE PATIENT IS
SUBJECTED TO OXYGEN THERAPIES BY USING
5. • C)CIRCULATION
• BLOOD CIRCULATION IN POISONING CASES IS CORRECTED
BY ADMINSTRING IV FLUIDS.
•D)DEPRESSION OF CNS
•UN CONSCIOUS PATIENTS ARE TURNED TO LIE ON ONE
SIDE TO STOP REVERSE FLOW OF TONGUE BLOCKING THE
THORAT.
•MOST CASES ARE RECOVERED BY SUPPORTIVE CARE.
6. • 2) REMOVAL OF UNABSORBED POISON
• -UNABSORBED POISON CAN BE REMOVED BASED ON
ROUTE OF ADMINISTRATION.
• A)INHALED POISON
• B) INJECTED POISON
• C) CONTACT POISON
• D) INGESTED POISON
7. • A) INHALID POISON
• ISOLATING THE PATIENT FROM EXPOSURE TO FRESH
AIR.
• CLOTHS OF THE PATIENT ARE LOOSENED.
• CLEAR AIRWAY SHOULD BE ENSURED
• -ADMINISTRATION OF ARTIFICIAL RESPIRATION
(MIXTURE OF O₂ & C0₂ WITH 95% & 5%
RESPECTIVELY).
8. • B) INJECTED POISON
• USE OF TOURNIQUET BELTS.
• INCISION & SUCTION, (BY MECHANICAL PUMP).
• C) CONTACT POISON
•WASHING SKIN WITH PLAIN,WARM,& SOAP WATER.
•USE OF SUITABLE ANTIDOTE.
9. • C) INGESTED POISON
• – OBJECTIVES: TO REMOVE POISON FROM STOMACH.
• VOMITING IS TRIED.(EMETICS)
• IF VOMITING IS FAILED THEN STOMACH TUBE OR RYLES
TUBE IS USED. (GASTRIC LAVAGE)
10. • 3) PREVENTION OF ABSORPTION
• ABSORPTION OF POISON CAN BE PREVENTED BY USING
ANTIDOTES (TRIYAK) WHICH ARE AS FOLLOWS.
A) MECHANICAL ANTIDOTES
B)CHEMICAL ANTIDOTES
C) PHYSIOGICAL ANTIDOTES
D) CHELATING AGENTS
E) UNIVERSAL ANTIDOTE
11. • A) MECHANICAL ANTIDOTES
• THESE POISON OBSTRUCT THE ABSORPTION OF POISON.
• EG: ✓EMOLIENT’S : ALBUMIN, FAT.
✓ACTIVATED CHARCOAL(CREATE BARRIER BETWEEN
STOMACH WALL & POISON).
12. B) CHEMICAL ANTIDOTES
• THESE ANTIDOTES BINDS WITH CHEMICAL STRUCTURE OF
POISON & NEUTRALISES IT’S EFFECTS & ABSORPTION.
EG- >FRESHLY PREPARED HYDRATED FERRIC OXIDE -> IN
ARSENIC POISONING.
> COMMON SALT – DECOMPOSE SILVER NITRATE BY
DIRECT
CHEMICAL ACTION (FORMING INSOLUBLE SILVER CHLORIDE).
> ALBUMIN PRECIPITATE IN MERCURIC CHLORIDE
POISONING.
13. C) PHYSIOLOGICAL ANTIDOTE
-> THESE ANTIDOTES SHOW’S PHYSIOLOGICAL EFFECTS
IE: THEY ACT ON THE TISSUES & PERFORM FUNCTIONS
OPPOSITE TO THAT OF POISON, THERE BY NEUTRALISE
THE EFFECT OF POISON.
→ THESE ANTIDOTES ARE USED AFTER THE ABSORPTION
OF POISON IN CIRCULATION.
EG > MORPHINE FOR ATROPINE & VICE VERSA.
14. •D)CHELATING AGENTS
>METAL COMPLEXING AGENTS (CHELTING AGENTS) ARE USED
IN THE
TREATMENT OF HEAVY METAL POISONING.
> THESE AGENTS HAVE GREATER AFFINITY FOR METALS AS
COMPARE TO OTHE ENDOGENOUS ENZYMES.
EG>BAL (BRITISH ANTI LEWISITE)
>DIMER CAPROL (DIMER CAPTO PROPANOL) → USED AS
PHYSIOLOGICAL ANTIDOTE IN ARSENIC, LEAD, COPPER,
15. → EDTA(ETHYLENE DIAMINE TETRA ACETONE ACID] & ITS
DERIVATIVES CALCIUM EDETATE – USED IN MERCURY &
LEAD POISONING.
→ PENICILLAMINE ( CUPRIMINE DIMETHYL CYSTEINE) → IT
IS HYDROLYTIC PRODUCT OF PENICILLIN, USED AS
CHELATING AGENT IN COPPER, LEAD & MERCURY
POISONING.
→ DMSA (2,3 DIMERCAPTO SUCCINIC ACID) > USED IN
LEAD, MERCURY & ARSENIC POISONING. IT IS MORE
16. >DMPS (2,3 DIMER CAPTO PROPANE 1SULFONATE)
EFFECTIVE IN TREATMENT OF MERCURY, LEAD &
ARSENIC POISONING.
E) UNIVERSAL ANTIDOTE
→ IT IS THE ANTIDOTE WHICH CAN BE PREPARED IN
THE HOUSE & CAN BE ADMINISTRATED TO THOSE
POISONING CASES IN WHICH IDENTITY OF POISON
IS NOT CLEAR.
17. Ingredients Parts Actions
Powered charcoal
(burned Toast)
2 parts Absorb alkaloids
Milk of
magnesia{mg(oh)2}
1 part Neutralise acid
Tannic acid(strong
tea)
1 part Neutralise Alkalies
glycosides etc…
18. • 4)ELIMINATION OF ABSORBED POISON BY EXCRETION :
• INDICATIONS
• > SEVERE POISONING
• > PROGRESSIVE DETERIORATION (WORSENING OF COND”)
INSPITE OF FULL SUPPORTIVE CARE.
• > HIGH RISK OF SERIOUS MORBIDITY OR MORTALITY.
• >WHEN POISON PRODUCES DELAYED & SERIOUS TOXIC
EFFECTS
• > WHEN PATIENT HAS HISTORY OF ANY CVS, RESPIRATORY
OTHER DISEASES THAT INCREASES THE HAZARDS.
19. • ROUTES OF ELIMINATION:
• 1) RENAL EXCRETION.
• 2) PURGING (REMOVAL OF THINGS FROM PARTICULAR
PART).
• 3) WHOLE BOWEL IRRIGATION ( CLEANING OF ENTIRE
BOWEL BY ADMINISTRATING OSMOTICALLY BALANCED
POLY ETHYLENE GLYCOL ELECTROLYTE SOLUT ION)
• 4) DIPHORETICS (EXCESSIVE PERSPIRATION / SWEATING).
• 5) FORCED ALKALINE DIURESIS (INCREASING GFR IN
RENAL TUBULES).
20. • 7)HAEMODIALYSIS, (ARTIFICIAL BLOOD FILTERING
PROCEDURE).
• 8) CHARCOAL HAEMOPERFUSION (USE OF ACTIVATED
CHARCOAL IN DIALYSIS).
• 5) SYMPTOMATIC TREATMENT
• - IT REFERS TO SYMPTOMATIC ADMINISTRATION OF
MEDICINE TO THE PATIENT TO DECREASE THE ILLNESS
CAUSED BY POISON.
• EG: >IV FLUIDS FOR SHOCK.
21. >NA & K FOR ELECTROLYTE IMBALANCE.
>ANESTHESIA FOR CONVULSIONS, ETC...
6)FOLLOW UPS / GENERAL CARE
>GENERAL MONITORING OF PATIENT.
> PHYSIOTHERAPHY FOR REHABILITATION.
> PSYCHOTHERAPY IN SUCIDAL CASES.
THANK
