The easier it is to get poisoned. Fatal overdose of pills

Our expert - toxicologist Alexey Pivovarov.

Poisons, conditioned and unconditioned

Most dangerous poisoning- mushrooms. Moreover, unconditionally poisonous, and the so-called conditionally edible mushrooms are terrible. The former include a satanic mushroom, false mushrooms, fly agaric, and also a pale grebe, which is often confused with russula or champignon. To the second: milk mushrooms, volnushki, valui, bitters, rows, pushers, violinists. These forest gifts become safe only after special treatment (long-term soaking with multiple changes of water, and then salting with a 6-week exposure). However, ordinary russula can become poisonous if collected near industrial plants and highways or eaten damaged, wormy or withered. Any mushrooms, except champignons, which, in principle, can be eaten raw, must first be held in salt water and then boiled. In order not to take risks once again, salting and pickling forest delicacies is better than one type.

Mushroom poisoning is accompanied by all the signs of intoxication characteristic of acute gastroenteritis: vomiting, diarrhea, abdominal pain, and a feeling of weakness. Sometimes acute heart failure can develop, which is especially dangerous for the elderly and debilitated people, as well as for children. Sometimes the action of fungal toxins does not affect immediately, but after 12-14 hours. At the first sign of malaise, you need to call an ambulance.

Other foods can also be poisonous. For example, caviar and milk of some fish caught during spawning (burbot, pike, perch and mackerel) acquire toxic properties during this period. The dangerous glycoalkaloid solanine is found in sprouted or green potatoes, undercooked or immature beans. It is better to throw away green potatoes and beans immediately, and sprouted tubers should at least be thoroughly peeled. Bitter almonds, apricot kernels, peaches and plums are dangerous. They contain the glucoside amygdalin, which, when broken down, releases hydrocyanic acid in the stomach. And, of course, vegetables and fruits containing pesticides and nitrates are toxic.

Go away, mold!

Food poisoning is most often caused by bacteria that live on food. The most common of them are: yeasts and molds, streptococci, staphylococci, salmonella, proteus, enterococci, etc. It is not the bacteria themselves that are dangerous, but the toxins formed as a result of their vital activity. It is they who call inflammatory process in the mucous membrane of the stomach, small and large intestine (gastritis and enterocolitis). To avoid bacterial contamination, food must be stored properly.

Mold is the most unpretentious microorganism. A whitish and slightly greenish, fluffy coating is most often formed on bread, cheese and sweets. Molds require air, darkness, warmth and moisture to reproduce. They die in the heat. Prevention of mycotoxicosis - food poisoning caused by molds - consists in storing food at low humidity.

Yeast fungi require only two conditions for reproduction: a lot of moisture and sugar. These microorganisms are destroyed by boiling and stop their growth in the cold. Therefore, all products containing liquid and sugar (fruit juices, compotes, jelly, syrups) must be kept in the refrigerator.

Bacteria enter food from dirty hands, from kitchen equipment, from food waste not removed on time. They can be carried by insects and pets. Therefore, it is very important to keep the kitchen and all the equipment located there in perfect cleanliness. Garbage bins must be closed with a lid. Take out the trash as often as possible. The entrance to the room where food is being prepared should be closed not only for flies, but also for beloved Bobik or Murka. Well, and, of course, when preparing food, you need to wash your hands thoroughly, and try not to keep cooked food in the open air. Immediately after cooking, food that has passed heat treatment, it is better to cool and put in the refrigerator.

Keep it like the apple of an eye!

Unfortunately, not all bacteria are afraid of the cold. For example, salmonella at -20 °C can persist for up to several months. And she is not afraid of heat: the bacterium can withstand heating to +60 ° C for an hour, at +75 ° C - 10 minutes, and only at +100 ° C it dies instantly. Dairy products, eggs, fish, minced meat products, offal, sausages, jellies, salads can be infected with salmonella. The insidiousness of salmonella is that they do not change the appearance, taste and smell of dishes. Infection with bacteria (especially putrefactive, salmonella and coli) often occurs when finished foods are cut with the same knife and on the same cutting board as raw meat and fish.

Botulinus stick poisoning is very dangerous, causing severe damage to the central nervous system. Botulinum toxin is many times more poisonous than hydrocyanic acid, this poison does not destroy either salting or pickling. And even when boiled, a botulinum stick can live for as long as 15 minutes. The infection develops without access to air, therefore main danger represent home-made preparations of mushrooms and vegetables in hermetically sealed jars. You can get poisoned and canned meat, as well as lard, salted and dried fish of home cooking. The presence of botulinum sticks reveals the taste of the product: a faint smell of rancid fat can be felt in canned food, sometimes the product itself softens and changes color. Often, cans with such canned food swell and even explode.

The main measure for the prevention of botulism is the use of only fresh and high-quality products, their careful processing, reliable sterilization of containers, and storage of canned food in the cold. The shelf life of canned food in metal containers is no more than two years. Do not buy canned food in a crumpled jar without a label. After opening the jar, the products must be immediately transferred to an enamel bowl. It is dangerous to keep food containing acids (sauerkraut, sour-milk products) in galvanized or copper dishes.

It is very important to eat only properly prepared foods. Fruits and vegetables must first be thoroughly washed with warm water, and then poured over with boiled water. For greater safety, berries and fruits are rinsed in acidified water.

Particular attention should be paid to treats from meat, fish, poultry and eggs. It is better to feast on the dishes of raw meat and fish that have become fashionable today (for example, carpaccio or sushi) in establishments that inspire special confidence. Otherwise, you can become infected with helminths.

At home, it’s better not to take risks and cook something not so exotic. Cooking provides the highest guarantee: it ensures uniform heating of the product to a temperature of +80 ° C, at which most microorganisms die. When frying, a high temperature is reached only on the surface of the product, and inside it can be only +60 ° C. Meat should be cooked for 2.5 hours, poultry - 1.5 hours. On the state of readiness of meat and fish dishes indicates the colorless juice that stands out when pierced with a fork.

You need to defrost meat in a room with a temperature not higher than +18 ° C. You can not thaw it in water, in small pieces. After defrosting, the meat should be cooked as soon as possible. Eggs should be thoroughly washed in warm water before being boiled or used raw.

To prevent salmonellosis, it is also necessary to thoroughly wash eggs, and greens and fresh vegetables rinse with acidified water before use. Raw and cooked foods should be stored separately. It is not recommended to store ready meals for a long time, it is forbidden - reheated.

Important

If poisoning is accompanied by severe pain, convulsions, high temperature need to call an ambulance immediately. Before the arrival of doctors, you need to rinse the stomach, for this, drinking at least 1 liter of water, and then inducing vomiting. You can give the victim several tablets of crushed activated charcoal (1 for every 10 kg of weight), and after vomiting - a laxative (for example, Castor oil). Healthy plentiful drink: hot tea, alkaline mineral waters.

What pills can be poisoned? Any medications, if used improperly, can lead to severe poisoning and intoxication. In severe cases, instant death can occur. This article discusses an overdose of fatal pills, symptoms of poisoning with various drugs, methods of first aid, components of treatment in a hospital setting.

Reasons for the development of drug poisoning

Drug overdose can develop for many reasons. It most often develops in people who take drugs without consulting a doctor or change their dosage without permission. Below are the main reasons why pill poisoning can develop.

• Self-medication, taking drugs that are not agreed with the attending physician. Sometimes people drink drugs on the advice of friends, neighbors, relatives.
• Taking large doses of the drug in critical or emergency situations. For example, with an increase in body temperature, people, trying to bring it down quickly, drink large doses of drugs, combine them with each other. Such uncontrolled use of drugs often leads to fatal poisoning.
• A person taking drugs that are contraindicated for him due to age or health status. For example, the drug aspirin (acetylsalicylic acid) is deadly for children, it causes Reye's syndrome in them and leads to rapid death from internal bleeding.
• A fatal overdose of pills can develop in children who have eaten pills left by adults. Kids love to taste everything, they are interested in everything. All medicines that are at home should be kept in inaccessible place for kids.
• An overdose of drugs for the purpose of suicide (suicide). Most often, people use sleeping pills and tranquilizers for this purpose. From them comes a relatively easy death from an overdose.
• Drug poisoning due to taking them together with alcoholic beverages.
• Dangerous drug combination. In the instructions for the drugs, you should carefully read the list of drugs with which they cannot be combined.
• Intentional murder. Medicines can deliberately poison a person. Some drugs in large doses are potent poisons for humans.

Please note that for each person, the lethal dosage of any drug is purely individual. It depends on the weight and age of the person, whether he has any diseases.

Features of the clinical picture in case of drug overdose

Anyone can get poisoned by pills to death. Fatal outcome possible with a certain dose of any drug. Below we will look at the symptoms of poisoning by the most common medications.

Sleeping pills, sedatives

Sleeping pills and sedatives are dangerous to human life. You can get an overdose of them unintentionally, during some kind of stressful situation. A person, wanting to calm down or fall asleep after an emotional overstrain, may take a large dose of the drug, striving for a quick effect of the drug.

to potent sedatives and sleeping pills relate:

• bubbled;
• phenobarbital;
• bromital;
• medinal;
• teraligen;
• barbital.

These substances enter digestive system are rapidly absorbed and act. They can cause the death of a person in 15-30 minutes. The following are the symptoms that develop with an overdose of sleeping pills.

• Increased drowsiness, weakness and lethargy. At the initial stage of poisoning, you can still establish contact with a person, talk, ask him something. Then deep sleep develops, in severe cases - coma. As a rule, when poisoned by these drugs, people die in their sleep.
• A decrease in all reflexes develops due to depression of the central nervous system.
• Hyperthermia. For poisoning with sleeping pills, a rise in body temperature up to 40 degrees is characteristic.
• Perhaps the development of vomiting in a dream. Due to a decrease in the severity of the swallowing and gag reflex, aspiration of vomit into the respiratory tract may occur and respiratory arrest may develop.
• Slow breathing. The person begins to breathe slowly and shallowly, with a frequency of less than 10 breaths per minute. This change is associated with inhibition of the respiratory center in the brain. When poisoned with sleeping pills, you can die from respiratory arrest.
• Bradycardia (slow heart rate) and hypotension (decreased blood pressure) blood pressure).
• Perhaps the development of seizures and hallucinations.

tranquilizers

Severe overdose of tranquilizers often results in death. These drugs act on the central and peripheral nervous system, as well as on breathing and heart function. Tranquilizers are taken strictly by prescription, and even slight deviation from the dosage prescribed by the doctor can cause poisoning. Below is a list of drugs in this group:

• elenium;
• napoton;
• seduxen;
• diazepam;
• oxazepam;
• tazepam;
• eunoctin;
• librium;
• radedorm.

The clinical picture of poisoning with tranquilizers is the same as with poisoning with sleeping pills.

Non-steroidal anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used drugs. These drugs include:

• paracetamol (efferalgan, panadol);
• acetylsalicylic acid (aspirin);
• analgin;
• ibuprofen (nurofen);
• ketorolac (ketanov, ketolong);
• nimesulide (nimesil);
• indomethacin.

The drugs in this group have analgesic and anti-inflammatory effects. Some reduce body temperature (paracetamol, ibuprofen). Aspirin is used to thin the blood.

Poisoning is not for death NSAIDs most often develops as a result of an overdose in order to accelerate their action. For example, feeling severe pain, a person takes a larger amount of medicine.

Please note that when used by children acetylsalicylic acid(aspirin) rapid death may develop. Children do not have the enzyme to process this drug. They develop Reye's syndrome. Therefore, this drug is strictly prohibited for children.

Symptoms of poisoning with NSAID drugs resemble intestinal poisoning. The patient has a stomach ache, vomiting and diarrhea, general weakness, dizziness. It is also possible a decrease in body temperature, the development of hand trembling, the appearance of a feeling of anxiety and restlessness. By themselves, drugs in this group rarely lead to death. Dangerous are the complications that can be provoked by taking these drugs in large dosages, namely:

• gastrointestinal bleeding. All NSAIDs irritate the gastric mucosa and duodenum. If you drink a lot of these drugs, damage to the integrity of the vascular wall in the submucosal ball of these organs may develop. Gastrointestinal bleeding is manifested by dark vomiting, black stools (chalky), pallor and blue of the skin, severe weakness, drowsiness, rapid pulse and lower blood pressure. A person may die due to large blood loss;
• acute pancreatitis is a non-infectious inflammation of the pancreas, in which necrotic death of its tissues develops. This pathology can be caused by an overdose of NSAIDs. The patient develops severe girdle pain in the abdomen, nausea, vomiting, flatulence and diarrhea. Small purple hemorrhagic spots may appear on the skin of the abdomen. Body temperature rises to 39 degrees. This disease is without surgical intervention leads to death;
• acute liver failure may develop as a result of a large number drugs that the liver is unable to neutralize. The patient's skin, mucous membranes and sclera of the eyes turn yellow, pain appears in the right hypochondrium. Consciousness may be impaired. Death may occur due to liver failure;
• kidney failure, in which the kidneys are unable to cope with their function and purify the blood. This pathology can occur with toxic damage to nephrons (structural units of the kidneys) with anti-inflammatory drugs.

Antibiotics

Antibiotics are drugs that are widely used in the treatment of bacterial infectious diseases. They are appointed by a doctor who negotiates with the patient the rules for both admission and dosing.

The table below shows the features of the clinical picture with an overdose of various antibacterial agents.

Group name antibacterial drugs and medicines	Symptoms and signs
Penicillins, cephalosporins (amoxil, ceftriaxone, cefodox)	nausea, vomiting and diarrhea; attacks of general convulsions (as in an epileptic seizure); redness and itching of the skin (acute urticaria); arrhythmia (due to an imbalance of potassium in the blood); mental agitation or falling into a stupor.
Tetracycline	strong pain in the region of the stomach; nausea, profuse vomiting; arrhythmia; convulsions; angioedema.
Levomycetin	nausea and vomiting; headache; anorexia (lack of appetite); heartburn; diarrhea; With the use of this drug in high doses, the development of acute cardiovascular insufficiency.
Fluoroquinolones	kidney failure (edema, decreased amount of urine) disruption of the heart, breathing; fainting, impaired consciousness.

Antihistamines

Antihistamines are used for allergic pathologies. They may be assigned to allergic dermatitis, hives, atopic dermatitis etc. These drugs block the production of histamine, the main mediator that triggers allergic reactions. Some drugs also have a mild sedative effect. When treating them, a person is forbidden to drive a car.

The drugs in this group include:

• loratadine;
• suprastin;
• diphenhydramine;
• diazolin;
• pipolfen.

Symptoms of poisoning with antihistamines appear in 15-30 minutes. With a lethal dose, a person can die within an hour.

With an overdose of antihistamines, the nervous system is primarily affected. Symptoms of poisoning with these drugs include:

• feeling severe dryness in the mouth and eyes, thirst;
• increase in body temperature up to 38-39 degrees;
• nausea followed by vomiting;
• first, a general excitation develops, which sharply changes with lethargy;
• hand trembling;
• convulsions of the type of epilepsy;
• tachycardia, possibly a violation of the heart rhythm;
• change in blood pressure, at first it rises sharply, and then also quickly decreases to critical numbers;
• incoordination, staggering;
• increased drowsiness;
• gradual sinking into deep coma.

Drugs to lower blood pressure

Heart pill poisoning is very common in the general population. At heart attack or a sudden rise in blood pressure, a person can drink a lot different drugs fearing for your life.

Also, an overdose of such drugs can develop in older people who can forget that they took the drug and take it again.

Please note that when taking beta-blockers (for example, anaprilin) ​​by people who are ill bronchial asthma, rapid death may develop.

Names of popular antihypertensive drugs:

• captopril;
• lozap;
• enalapril;
• amiodarone;
• anaprilin;
• magnesium sulfate;
• metoprolol;
• nebivolol;
• nifedipine.

In case of poisoning with antihypertensive drugs, the patient's blood pressure drops sharply, nausea and vomiting may develop, and consciousness is disturbed. This condition is deadly, it can lead to respiratory arrest and heartbeat.

What to do in case of drug overdose

At the slightest suspicion of an overdose of any drug, you should urgently call an ambulance. By phone, inform the dispatcher about what happened, list the symptoms of the patient and accurately name your location.

Remember that trying to cure a person of a drug overdose on your own is very dangerous. He may die in your arms and there is nothing you can do to help him. In order not to endanger his life, immediately seek medical help.

What to do while waiting for doctors? The arrival time of the ambulance team depends on many factors (for example, traffic congestion, the availability of free doctors at the time of the call). While waiting for the ambulance crew, you need to start providing first aid to the poisoned person at home. It is from her that the prognosis for the life of the patient may depend. Below are its main components.

In order to clear the stomach of the rest of the drugs you have drunk, you need to drink a liter of water in one gulp and provoke vomiting. For best result this washing should be repeated several times.

This procedure is not carried out with:

• disturbed consciousness of the patient;
• the appearance of black or bloody vomiting.

It is not necessary to add potassium permanganate solution or any other components to the gastric lavage solution. You cannot know what chemical reaction they will enter into with the drugs that poisoned the person.

Cleansing enema

An enema is made on the basis of ordinary boiled water. The temperature of the bowel lavage fluid should be neutral (room temperature).

Sorbents

These drugs will help bind and flush out any medications that are left in the digestive tract.

Sorbents that are taken in liquid form act faster (for example, smectite or atoxyl). But if you don’t have these at home, give the patient any other sorbent, even activated charcoal will do.

Before you give a person to drink the drug, read the dosing rules that are listed in the instructions for it.

Drink

The liquid will reduce the concentration of the drug in the blood and accelerate its excretion by the kidneys, reduce dehydration. You can drink mineral water or plain water, tea with sugar.

Actions in case of loss of consciousness

If the patient loses consciousness, you need to monitor him until the arrival of the doctors so that he does not choke on vomit or his tongue. Turn his head to the side, in this position the risk of aspiration is minimal.

To improve blood flow to the head and heart, lift his legs and fix them in this position.

Before the arrival of doctors, monitor the presence of his pulse and breathing. If they stop, start an indirect closed heart massage.

What to do with the development of seizures

The only thing you can do is hold the person's head so that he does not hit her on the floor.

Remember that a person during a convulsive attack should not put anything in his mouth, especially his fingers.

medical treatment

Doctors from the ambulance, having arrived at the call, will conduct a quick examination and assessment of the condition of the poisoned person. Show them the drug that he took, and as accurately as possible name the number of pills he took. You should also describe the amount of assistance that you yourself managed to provide to the victim.

Medics will try to stabilize the condition of the victim and take him to the nearest hospital. In case of drug poisoning, treatment is carried out in the condition of the toxicological department. Patients in critical condition are hospitalized in the intensive care unit (reanimation).

Treatment may include hemodialysis, antidotes, drips, and respiratory and cardiac support. What will happen to a person and what result to expect from treatment, only a doctor can say after examining the patient and an objective assessment of his condition.

Drug poisoning can be fatal. Treatment of this condition is carried out in a hospital setting. The prognosis depends on the amount of the drug taken, active ingredient timeliness of seeking medical help. It is impossible to treat a drug overdose on your own.

How to poison a person with poison is asked not only by potential attackers, but also by ordinary Internet users.

10 deadly poisons and their effect on humans

Today, the pharmaceutical market offers consumers a variety of drugs, some of which are available for purchase without a prescription.

And also there are toxic substances, allowing to eliminate the opponent quickly or, conversely, to provoke a chronic disease. Age-old knowledge and modern technologies become dangerous weapons in the hands of competent people.

Potassium cyanide is known to almost everyone; at the beginning of the 20th century, a dangerous powder was a common way to get rid of unwanted faces.

The poison belongs to the group of hydrocyanic acid derivatives and is highly soluble in water. Some sources point to the specific smell of this substance, however, not all people are able to feel it. Potassium cyanide causes poisoning if ingested, and it is also dangerous to inhale powder particles and solution vapors. The lethal dose of poison is only a few grams, but in most cases it depends on weight and individual characteristics organism.

With the help of potassium cyanide, you can quickly poison a person. Death is affected by the way the substance enters the body, so when particles are inhaled, the action of the toxin manifests itself instantly, and when it enters the stomach, the poison begins to cause irreversible consequences after 15 minutes.

The victim goes through several stages of intoxication. At first, a sore throat is felt, then nausea and vomiting begin, and numbness of the pharynx is possible. Over time, general weakness increases, a feeling of fear arises, and the pulse slows down. Subsequently, signs such as convulsions and loss of consciousness are noted. As a rule, if a sufficient dose of poison is ingested, a person dies within 4 hours.

With the advent of new drugs on the pharmaceutical market, people are interested in how to poison a person with pills. The list of dangerous poisons, if used incorrectly, includes the following drugs:

sleeping pills "Phenazepam";

hellebore water;

drops "Corvalol".

The medicine "Phenazepam" is prescribed by doctors as a remedy for insomnia, panic attacks and stress. It refers to psychotropic drugs, and offenders use this drug in order to poison a person in a dream.

Like many other drugs, "Phenazepam" is incompatible with alcohol - this is what criminals use, since sharing of these pills and alcoholic drinks leads to respiratory arrest and death. But it is not easy to get the described drug, since it is dispensed exclusively by medical prescription.

Hellebore water is freely sold in a pharmacy and is used not only in traditional medicine, but also as a remedy for alcohol addiction. However, some cases of intentional intoxication are not taken into account, which is why such a remedy is suitable for those who want to poison a person without determining the poison.

Fatal outcome occurs when ingested 2 years. raw materials, hellebore water adversely affects the functioning of the heart and blood pressure. Thus, the supply of oxygen to the brain gradually decreases.

As a rule, alcohol accelerates the absorption of poison and signs of intoxication with hellebore water develop within 20 minutes after taking the remedy. Vomiting begins, and symptoms such as intense thirst, slow heart rate, mental disorder. Death occurs on average after 8 hours, such a drug allows the criminal to poison a person without determining the exact cause of death.

Drops of "Corvalol" can be purchased at any pharmacy, which makes them an affordable and effective medicine for poisoning. The lethal dose of the drug depends on the weight and age of the person, on average it is 150 drops.

Intoxication is characterized by prolonged sleep, lowering blood pressure and dilated pupils. The joint use of this drug with alcohol is especially dangerous, in which case tachycardia appears, the skin turns blue. Most likely, it will not work to poison a person slowly with the help of Corvalol drops, a fatal outcome occurs within a day, which is used by various asocial elements of society.

How to cause food poisoning

Lung food poisoning can be obtained if you eat expired or incompatible foods.

Expired Products

Using expired products is risky because it can give you a few days of "vacation in the bathroom". However, if the main thing for you is to avoid participating in another event, this method is quite suitable.

You can prepare in advance - buy a product that will last longer than the expiration date. At the same time, it should be borne in mind that the violation of the storage periods must be significant. If, for example, milk can be stored for 14 days, it does not mean at all that on the 15th it is no longer suitable. It is necessary that at least half of the term has passed beyond what the product is designed for.

For example, if purchased milk can be stored for 14 days, you can drink it on the 21st, etc.

Also, not for every product, using it after the expiration date leads to poisoning.

Terrible poison: TOP 10 most terrible poisons

For example, flour products only stale, but do not bring tangible harm. But dairy products can cause indigestion.

The easiest way is to use expired milk or kefir. The main thing is that they are not noticed by the family and not thrown into the trash.

You can even get poisoned by products that have not expired, but they were stored incorrectly. The same milk or kefir, if stored not in the refrigerator but on a battery, can turn sour the very next day. And then their use will cause severe frustration.

Precautionary measures. You should never eat foods on which mold has formed - this is fraught not only with poisoning, but also with more serious consequences.

Incompatible products

Some foods do not mix well, and their joint use also leads to poisoning. The easiest way is to eat lightly salted or pickled cucumbers, washed down with milk. The dose is selected individually.

The method provides a stable diarrhea with a good smell (frightening parents).

Usually, if you start eating foods during the day, by the evening a persistent indigestion is formed. If the performance is intended for family members, it is effective to continue it at night. you can just go to the toilet so that others can see it and spend a lot of time there. The absence of diarrhea and, as a result, the smell, can be hidden if you use an air freshener abundantly - a complete illusion is created that you really have real diarrhea.

The performance also needs to be continued in the morning - complaining of fatigue, and feigning weakness of the stomach.

You can store a bottle of sour milk in advance (see above) and drink it early in the morning - then you will have real diarrhea that you can show your parents.

The main thing is to convince your family that you cannot go anywhere in this state.

Household poisons, as the name implies, can often be found in everyday life, even where they cannot be in theory. But whoever is warned is armed, so we are slowly studying the material on household poisons.

ADRENALIN

Adrenaline (epinephrine, suprarenin). Neurotropic and psychotropic action. The lethal dose is 10 mg. rapidly inactivated in gastrointestinal tract. With parenteral administration, detoxification in the liver, excretion in the form of metabolites in the urine.

B. Symptoms of poisoning.

Symptoms of intoxication appear within the first 10 minutes after administration of the drug. Nausea, vomiting, pallor of the skin, cyanosis, chills, dilated pupils, blurred vision, tremor, convulsions, difficulty breathing, coma. Tachycardia and initially a significant increase in blood pressure. Then its sharp decrease, fibrillation of ventricles are possible. Sometimes psychosis develops with hallucinations and a sense of fear.

C. Emergency care:

2. Antidote treatment.

3. Symptomatic therapy.

1. When taken orally, gastric lavage. Forced diuresis.

2. Phentolamine 5-10 mg IV (1-2 ml 0.5%

solution), chlorpromazine 50-100 mg intramuscularly or intravenously.

3. with tachycardia - obzidan, inderal 1-2 ml of 0.1% solution intravenously repeatedly until clinical effect.

ACACIA WHITE.

Ialovite roots and bark containing toxalbumin. Gastroenterotoxic action. .

B. Symptoms of poisoning

Nausea, vomiting, tenesmus, abdominal pain, diarrhea. In severe cases bloody stool, hematuria, acute cardiovascular insufficiency.

C. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

D. Symptomatic therapy

1. Gastric lavage, inside activated charcoal

2. Intravenous administration of 5-10% glucose solution, 0.9% sodium chloride solution, electrolyte solution used for forced diuresis. Cardiovascular agents, calcium chloride, vikasol.

ACONITE.

Aconite (borech, blue buttercup, Issyk-Kul root). The active principle is the alkaloid aconitine. Neurotoxic (curare-like, ganglioblocking), cardiotactic action. The lethal dose is about 1g of the plant, 5 ml of tincture, 2mg of aconite alkaloid.

B. Symptoms of poisoning

Nausea, vomiting, numbness of the tongue, lips, cheeks, tips of the fingers and toes, a feeling of crawling, sensation of heat and cold in the limbs, transient disorders vision (seeing objects in green light), dry mouth, thirst, headache, anxiety, convulsive twitching of the muscles of the face, limbs, loss of consciousness. Breathing is rapid, shallow, difficult inhalation and exhalation, may be sudden stop breathing. Decreased blood pressure (especially diastolic). In the initial stage, bradyarrhythmia, extrasystole, then paroxysmal tachycardia, turning into ventricular fibrillation

C. Emergency care:

1. Active detoxification methods 2. Antidote treatment

D. Symptomatic therapy

1. Gastric lavage, saline laxative, oral activated charcoal, forced diuresis, detoxification hemosorption

2. Intravenously 20-50 ml of 1% solution of novocaine, 500 ml of 5% glucose. Intramuscularly 10 ml of a 25% solution of magnesium sulfate. With convulsions, diazepam (seduxen) 5-10 mg orally. With heart rhythm disorders - intravenously 10 mg of a 10% solution of novocainamide (with normal blood pressure!) Or 1-2 ml of a 0.1% solution of obzidan, 20 ml of a 40% glucose solution with 1 ml of a 0.06% solution of corglicon. With bradycardia -0, 1% solution of atropine subcutaneously. Intramuscularly cocarboxylase - 100 mg, 1% ATP solution - 2 ml, 5% ascorbic acid solution - 5 ml, 5% solutions of vitamins B1 - 4 ml, B6 - 4 ml.

ALCOHOL

A. The name of the chemical, its synonyms and characteristics

Alcohol

B. Symptoms of poisoning - see Ethyl alcohol. Surrogates of alcohol

ALDEHYDES

A. The name of the chemical, its synonyms and characteristics

Formaldehyde, acetaldehyde, paraldehyde, metaldehyde. Psychotropic (narcotic), neurotoxic (convulsive) locally irritating, hepatoxic effect. Absorbed through mucous membranes respiratory tract and gastrointestinal tract. are excreted in the lungs and in the urine as non-toxic metabolites.

B. Symptoms of poisoning

See formalin. When ingested - salivation, nausea, vomiting, abdominal pain, chills, drowsiness, tremor, tonic convulsions, coma, respiratory depression. Jaundice, enlargement and tenderness of the liver on palpation. When inhaling vapours, severe irritation mucous membranes of the eyes and upper respiratory tract, a sharp cough, suffocation, impaired consciousness, in severe cases, coma.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage with the addition of sodium bicarbonate

2. Forced diuresis

3. See Formalin. For convulsions, diazepam 10 mg IV

The name of the chemical, its synonyms and characteristics

AMIDOPIRINE

Amidopyrine (pyramidone). Neurotoxic (convulsive), psychotropic action. The lethal dose is 10-15 gr. Rapidly absorbed from the gastrointestinal tract, 15% binds to plasma proteins. Metabolism in the liver, excretion mainly in the urine.

Symptoms of poisoning.

With mild poisoning, tinnitus, nausea, vomiting, general weakness, fever, shortness of breath, palpitations. In severe poisoning - convulsions, drowsiness, delirium, loss of consciousness and coma with dilated pupils, cyanosis, hypothermia, lowering blood pressure. Perhaps the development of peripheral edema, acute agranulocytosis, gastric bleeding, hemorrhagic rash.

Urgent care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Lavage of the ventricle through the probe. Salt laxative inside. Forced diuresis, alkalization of the blood (sodium bicarbonate 10-15 g orally). Detoxification hemorrhage.

2. Vitamin B1 solution 6% - 2 ml intramuscularly. Cardiovascular agents. For convulsions, diazepam 10 mg intravenously.

AMINAZINE.

A. The name of the chemical, its synonyms and characteristics.

Aminazine (plegomazine, largactyl, chlorpromazine). psychotropic, neurotoxic effect(gangliolytic, adrenolytic). The toxic dose is more than 500 ml. The lethal dose is 5-10g. Toxic concentration in blood 1-2 mg/l, lethal 3-12 mg/l. Detoxification in the liver, excretion through the intestines and urine - no more than 8% of the dose taken for 3 days.

B. Symptoms of poisoning.

Severe weakness, dizziness, dry mouth, nausea. Perhaps the appearance of convulsions, loss of consciousness. The coma is shallow, tendon reflexes are increased, the pupils are constricted. Increased heart rate, lowering blood pressure without cyanosis. Skin allergic reactions. After leaving the coma, the phenomena of parkinsonism are possible. When chewing chlorpromazine dragees, hyperemia and swelling of the oral mucosa occur, in children - expressing an effect on the mucous membrane of the digestive tract.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage, saline laxative. Forced diuresis bases of plasma alkalization.

3. In case of hypotension: 10% caffeine solution - 1-3 ml or 5% ephedrine solution - 2 ml subcutaneously, 6% vitamin B1 solution - 4 ml intramuscularly. With parkinsonism syndrome: cyclodol 10-20 mg / day orally. Treatment of acute cardiovascular insufficiency.

AMITRIPTYLINE.

Amitriptyline (Triptisol), Imizine (Melipramine, Imipramine, Tofranil) and other tricyclic natideprepressants. Psychotropic, neurotoxic (anticholinergic, antihistamine), cardiotoxic action. Toxic dose 500 mg, lethal 1200 mg. Rapid absorption from the gastrointestinal tract Binds to plasma proteins, partial metabolism in the liver, urinary excretion within 24 hours - 4 days

B. Symptoms of poisoning.

In mild cases, dry mouth, blurred vision, psychomotor agitation, weakening of intestinal motility, urinary retention. Muscle twitches and hyperkinesis. In severe poisoning - confusion up to a deep coma, attacks of colonic-tonic convulsions of the epileptiform type. Disorders of cardiac activity: brady - and tachyarrhythmias, intracardiac blockade, ventricular fibrillation. Acute cardiovascular failure (collapse). Perhaps the development of toxic hepatopathy, hyperglycemia, intestinal paresis.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Repeated gastric lavage, forced diuresis.

2. 3. With tachyarrhythmia - 0.05% prozerin - 1 ml intramuscularly or 0.1% solution of physiostigmine - 1 ml subcutaneously again in an hour until the pulse rate is 60 - 70 per 1 min, lidocaine - 100 mg, 0.1% solution Inderal 1-5 ml intravenously. With bradiathermia - 0.1% solution of atropine subcutaneously or intravenously again in an hour. With convulsions and agitation - 5 - 10 mg of diazepam intravenously or intramuscularly. Sodium bicarbonate solution 4% - 400 ml intravenously.

A. The name of the chemical, its synonyms and characteristics.

AMMONIA.

B. Symptoms of poisoning: see. Alkalis are caustic.

A. The name of the chemical, its synonyms and characteristics

ANALGIN.

B. Symptoms of poisoning: see Amidopyrine.

A. Name of a chemical substance, its synonyms and characteristics

ANESTHESIN.

Anestezin (benzocaine, ethylaminobenzoate). Hemotoxic (methemoglobin-forming) action. The lethal dose is 10-15 g.

Rapidly absorbed through the gastrointestinal tract, metabolism in the liver, excreted by the kidneys.

B. Symptoms of poisoning.

When ingesting a toxic dose - pronounced cyanosis of the lips, ears, face, extremities due to acute methemoglobinemia. Psychomotor agitation. With methglobinemia over 50% of the total hemoglobin content, a coma, hemolysis, and exotoxic shock may develop. High risk of anaphylactic reactions, especially in children

B. Emergency care:

2. Antidote treatment.

3. Symptomatic therapy.

1. Gastric lavage through a probe, forced diuresis with alkalization of the blood (sodium bicarbonate 10-15 g orally)

2. Methylene blue 1% solution of 1-2 ml per 1 kg of body weight with 250-300 ml of 5% glucose solution intravenously, 5% ascorbic acid solution - 10 ml intravenously.

3. Oxygen therapy, hyperbaric oxygen therapy.

ANDAKSIN.

A. Names of the chemical, its synonyms and characteristics.

Andaxin (meprotan, meprobamate). Psychotropic neurotoxic (central muscle relaxation), antipyretic action. The lethal dose is about 15 g. The toxic concentration in the blood is 100 mg/l, the lethal dose is 200 mg/l. Rapidly absorbed from the gastrointestinal tract, excreted in the urine within 2-3 days

B. Symptoms of poisoning.

Drowsiness, muscle weakness, decreased body temperature. In severe cases - coma, dilated pupils, decreased blood pressure, respiratory failure. See also barbiturates.

B. Emergency care:

1. Methods of active detoxification.

2. Antidote treatment.

3. Symptomatic therapy.

1. Gastric lavage, saline laxative. Forced diuresis without plasma alkalinization. With the development of a coma - peritoneal dialysis, hemodialysis, detoxification hemosorption. At severe violations breathing - artificial lung ventilation.

ANILINE.

A. The name of the chemical, its synonyms and characteristics

Aniline (amidobenzene, phenylamine). Psychotropic, neurotoxic, hemotoxic (methemoglobin-forming, secondary hemolysis), hepatotoxic action. The lethal dose when taken orally is 1 g. When the content of methemoglobin from total hemoglobin is 20-30%, symptoms of intoxication appear, 60-80% is a lethal concentration. Intake through the respiratory tract, the digestive tract, the skin. Most of it is metabolized with the formation of intermediate products that cause methemoglobin formation. It is deposited in adipose tissue, relapses of intoxication are possible. It is excreted through the lungs, kidneys (paraaminophenol).

B. Symptoms of poisoning.

Bluish coloration of the mucous membranes of the lips, ears, nails due to acute methemoglobinemia. Severe weakness, dizziness, headache, euphoria with motor excitation, vomiting, shortness of breath. The pulse is frequent, the liver is enlarged and painful. In severe poisoning, a violation of consciousness and a coma quickly sets in, the pupils are narrowed, without reaction to light, salivation and bronchorrhea, hemic hypoxia. The danger of developing paralysis of the respiratory center and exotoxic shock. On the 2-3rd day of the disease, relapses of methemoglobinemia, clonic-tonic convulsions, toxic anemia, parenchymal jaundice, and acute hepatic-renal failure are possible.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. In case of contact with the skin - washing with a solution of 1: 1000 potassium permanganate. When taken orally - abundant gastric lavage, the introduction of 150 ml of vaseline oil through a tube. Forced diuresis, hemosorption, hemodialysis.

2. Treatment of methemoglobinemia: 1% solution of methylene blue 1-2 ml per 1 kg of body weight with 5% glucose solution 200-300 ml intravenously repeatedly. A solution of ascorbic acid 5% to 60 ml per day intravenously. Vitamin B12 600 mcg intramuscularly. Sodium thiosulfate 30% solution - 100 ml intravenously.

3. Treatment of exotoxic shock, acute liver and kidney failure. Oxygen therapy, hyperbaric oxygenation.

ANTABUS.

A. The name of the chemical, its synonyms and characteristics.

Antabuse (teturam, disulfiram). Psychotropic, hepatotoxic action. Lethal dose: without alcohol in the blood about 30g with a blood alcohol concentration of more than 1% - 1g. Slowly absorbed from the gastrointestinal tract, excretion is slow in the urine (in unchanged form). It leads to the accumulation in the body of acetaldehyde, the main metabolite of ethyl alcohol.

B. Symptoms of poisoning

After a course of treatment with Antabuse, alcohol intake causes a sharp vegetovascular reaction - flushing of the skin, a feeling of heat in the face, difficulty breathing, palpitations, a feeling of fear of death, chills. Gradually, the reaction ends and, after 1-2 hours, sleep sets in. After taking large doses of alcohol, a severe reaction may develop - a sharp pallor of the skin, cyanosis, repeated vomiting, increased heart rate, a drop in blood pressure, signs of myocardial ischemia.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. When taking a toxic dose - gastric lavage, forced diuresis.

3. Put the patient in horizontal position. Intravenous influence 40% glucose solution - 40 ml with 5% ascorbic acid solution - 10 ml. Sodium bicarbonate 4% solution 200 ml - intravenous drip. Vitamin B1 5% solution - 2 ml intramuscularly. Lasix - 40 mg intravenously. Cardiovascular agents

ANTIBIOTICS.

A. The name of the chemical, its synonyms and characteristics.

Antibiotics (streptomycin, monomycin, kanamycin). Neurotoxic otoxic effect

B. Symptoms of poisoning.

At the same time, ingestion of an over high dose of antibiotics (over 10 g) can cause deafness due to damage to the auditory nerve (streptomycin) or oliguria due to renal failure (kanamycin, monomycin). These complications develop 6 as a rule, with a noticeable decrease in diuresis against the background of various infections with a lower daily dose of the drug, but its longer use. At hypersensitivity to antibiotics when using the usual therapeutic doses, anaphylactic shock may develop.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. With hearing loss: 1-3 days after poisoning, hemodialysis or forced diuresis is indicated.

3. With oliguria: for the first time, forced diuresis. Treatment of acute renal failure.

ANTICOAGULANTS.

A. The name of the chemical, its synonyms and characteristics.

Direct acting anticoagulants - heparin.

B. Symptoms of poisoning

When injected into a vein, the action is immediate, into the muscle or under the skin - after 45-60 minutes.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. In severe cases - blood replacement surgery, forced diuresis

2. Vikasol - 5 ml of a 1% solution intravenously under the control of the content of promthrombin. Calcium chloride - 10 ml of a 10% solution intravenously. In case of an overdose of heparin - 5 ml of a 1% solution of protamine sulfate intravenously, if necessary, repeatedly (1 ml for every 100 IU of heparin)

3. Aminocaproic acid 5% solution - 250 ml intravenously. Antihemophilic plasma - 500 ml intravenously. Blood transfusion of 250 ml repeatedly. Cardiovascular drugs as indicated.

Anticoagulants indirect action- dicoumarin (dicumarol), neodicoumarin (pelentan), syncumar, phenylin, etc. Hemotoxic effect (blood hypocoagulation).

B. Symptoms of poisoning

It is rapidly absorbed from the gastrointestinal tract, the effect is manifested after 12-72 hours. Excreted in the urine. Bleeding of the nose, uterine, stomach, intestines. Hematuria. Hemorrhage into the skin, muscles, sclera, hemorrhagic anemia. A sharp increase in blood clotting time (heparin) or a drop in the prothrombin index (other drugs)

A. The name of the chemical, its synonyms and characteristics.

Antifreeze

B. Symptoms of poisoning.

See ethylene glycol.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

See ethylene glycol.

ARSENITES.

Arsenites: sodium arsenite, calcium, double salt of acetic and metaarsenic copper (Schweinfurt or Parisian greens). See Arsenic.

B. Symptoms of poisoning.

See Arsenic.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

See Arsenic.

ASPIRIN.

A. The name of the chemical and its characteristics.

Aspirin (acetylsolicylic acid). It is also included in the preparations: askofen, asfen, citramon, sodium salicylate. Psychotropic, hemotoxic (anticoagulant) action. The lethal dose is about 30-40g, for children 10g. Toxic concentration in blood 150 - 300 mg/l, lethal 500 mg/l. Rapidly absorbed in the stomach and small intestine. Deacetylated in the blood plasma, excreted in the urine 80% within 24 - 28 h. B. Symptoms of poisoning.

Excitement, euphoria. Dizziness, tinnitus, hearing loss, blurred vision. Breathing is noisy, rapid. Delirium, suparous state, coma. Sometimes subcutaneous hemorrhages, nasal, nasal, gastrointestinal, uterine bleeding. Perhaps the development of methemoglobinemia, toxic nephropathy. Metabolic acidosis, peripheral edema

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage, vaseline oil 50 ml inside. Forced diuresis, alkalization of the blood. Early hemodialysis, hemosorption.

3. With bleeding - 1 ml of 1% solution of vikasol, 10 ml of 10% solution of calcium chloride intravenously. When excited - 2 ml of 2.5% solution of chlorpromazine subcutaneously or intramuscularly. With methemoglobinemia - see Aniline.

ATROPINE.

A. The name of the chemical and its characteristics.

Atropine (also found in bellaldonna, henbane, dope). Psychotropic, neurotoxic (anticholinolytic) action. The lethal dose for adults is 100 mg, for children (under 10 years old) - about 10 ml. Rapidly absorbed through the mucous membranes and skin, hydrolyzed in the liver. Excreted in the urine about 13% unchanged within 14 hours.

B. Symptoms of poisoning.

Dry mouth and pharynx, speech and swallowing disorder, near vision impairment, diplopia, photophobia, palpitations, shortness of breath, headache. The skin is red, dry, the pulse is frequent, the pupils are dilated, do not react to light. Mental and motor agitation, visual hallucinations, delirium, epileptiform convulsions with subsequent loss of consciousness, the development of a coma, especially in children.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. When taken orally - gastric lavage through a probe, richly lubricated with vaseline oil, forced diuresis.

2. In a coma in the absence of a sharp excitation - 1 ml of a 1% solution of pilocarpine again, prozerin 1 ml of a 0.05% solution or 1 ml of a 0.1% solution of eserin subcutaneously again.

3. When excited, 2.5% solution of chlorpromazine - 2 ml intramuscularly, 1% solution of diphenhydramine - 2 ml intramuscularly, 1% solution of promedol 2 ml subcutaneously, 5 - 10 mg diazepam intravenously. With a sharp hyperthermia - a 4% solution of amidopyrine - 10 - 20 ml intramuscularly, ice packs on the head and inguinal regions, wrapping with a wet sheet and blowing with a fan.

ACETONE.

A. The name of the chemical and its characteristics.

Acetone (dimethyl ketone, propanol). Psychotropic (narcotic) nephrotoxic, local irritant effect. The lethal dose is more than 100 ml. The toxic concentration in the blood is 200 - 300 mg / l, lethal - 550 mg / l. It is quickly adsorbed by mucous membranes, excreted through the lungs, with urine.

B. Symptoms of poisoning.

In case of ingestion and inhalation of vapors, the state of intoxication, dizziness, weakness, unsteady gait, nausea, vomiting, abdominal pain, collapse, coma. Perhaps a decrease in diuresis, the appearance of protein and red blood cells in the urine. When leaving a coma, pneumonia often develops.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. When ingested - gastric lavage, with inhalation poisoning - washing the eyes with water, oxygen inhalation. Forced diuresis with alkalization of the blood (sodium bicarbonate 10-15 g orally).

3. Treatment of acute cardiovascular insufficiency (toxic shock), pneumonia. For pain in the abdomen, subcutaneously 2% papaverine solution - 2 ml, 0.2% solution of platiflin - 1 ml, 0.1 solution of atropine -1 ml.

BABITURATES.

A. The name of the chemical and its characteristics.

Long-acting barbiturates (8 - 12 hours) - phenobarbital (luminal), medium-acting (6 - 8 hours) - barbital (veronal), sodium barbital (medinal), sodium amytal (barbamil), short-acting (4 - 6 hours) - etaminal sodium ( nembutal).

Preparations containing barbiturates: tardil, bellaspon, Sereysky powders, verodon, bromital, andipal, dipasalin, camphotal, tepafilin, etc. Psychotropic (narcotic, hypnotic) effect. The lethal dose is about 10 therapeutic doses with large individual differences. Absorption in the stomach and small intestine, sometimes in patients in an unconscious state, drugs are found unchanged in the stomach for 2-3 days after administration. Short-acting barbiturates are almost completely (90%) metabolized in the liver, 50-60% are protein-bound. Long-acting barbiturates bind to proteins (8-10%), 90-95% are not metabolized, excreted in the urine.

B. Symptoms of poisoning.

There are 4 clinical stages of intoxication. Stage 1 - falling asleep: drowsiness, lethargy, contact with the patient is possible, moderate miosis with a live reaction to light, bradycardia with superficial sleep, hypersalivation. Stage 2 - superficial coma (a - uncomplicated, b - complicated): complete loss of consciousness, preserved reaction to pain irritation, weakening of pupillary and corneal reflexes. Intermittent neurological symptoms: decreased or increased reflexes, muscle hypotension or hypertension, pathological reflexes of Babinsky, Rossolimo, which are of a transient nature. Violation of breathing due to hypersalivation, bronchorrhea, retraction of the tongue, aspiration of vomit. There are no pronounced hemodynamic disturbances. Stage 3 - deep coma (a - uncomplicated, b - complicated): a sharp absence or decrease in eye and tendon reflexes, no response to pain irritation. The pupils are narrow. Breathing is rare, superficial, the pulse is weak, cyanosis. Diuresis is reduced. In the case of a prolonged coma (12 hours), the development of bronchopneumonia, collapse, deep bedsores and septic complications. Impaired liver and kidney function. Stage 4 - post-coma period: non-permanent neurological symptoms (prose, unsteady gait, etc.), emotional lability, depression, thromboembolic complications.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage (in patients in a coma - after preliminary intubation) again after 3-4 days until consciousness is restored, water-alkaline load, forced diuresis in combination with alkalization of the blood. In IIb, III stages - early application hemodialysis in case of long-acting barbiturate poisoning, detoxification hemosorption, short-acting barbiturate poisoning or mixed poisoning. In stage IV - water electrolyte load, diuretics

2. In the stage of complicated coma, the use of bemegrid is contraindicated. Enter 20% camphor solution, caffeine 10% solution, ephedrine 5% solution, cardiamine 2-3 ml subcutaneously after 3-4 hours.

3. Intense infusion therapy. Plasma substitutes (polyglucin, gemodez). Antibiotics. Intramuscularly: vitamins B1 and B6 5% solutions - 6-8 ml, B12 - 500 mcg (do not administer B vitamins at the same time), vitamin C 5% solution - 5-10 ml, ATP 1% solution - 6 ml per day. With low blood pressure - 0.2% norepinephrine in combination with a 0.5% dopamine solution, 1 ml intravenously in 400 ml of polyglucin. cardiac glycosides.

BARIUM.

A. The name of the chemical and its characteristics.

Barium. Neurotoxic (paralytic), cardiotoxic action. All soluble barium salts are toxic; insoluble barium sulfate used in radiology is practically non-toxic. The lethal dose is about 1g. Soluble barium salts are rapidly absorbed in the small intestine, excreted mainly through the kidneys.

B. Symptoms of poisoning.

Burning in the mouth and esophagus, abdominal pain, nausea, vomiting, profuse diarrhea, dizziness, profuse sweat. The skin is pale. The pulse is slow, weak. Extrasystole, bbigeminia, atrial fibrillation, arterial hypertension, followed by a drop in blood pressure. Shortness of breath, cyanosis. 2-3 hours after poisoning - increasing muscle weakness, especially muscles upper limbs and neck. Possible hemolysis, weakening of vision and hearing, clonic-tonic convulsions with preserved consciousness.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1, 2. Gastric lavage through a probe with a 1% solution of sodium or magnesium sulfate to form insoluble barium sulfate, magnesium sulfate or barium 30 g orally (100 ml of a 30% solution). Forced diuresis, hemodialysis. Intravenous 10-20 ml of 10% sodium or magnesium sulfate solution. Tetacin - calcium - 20 ml of a 10% solution with 500 ml of a 5% glucose solution intravenously.

3. Promedol - 1 ml of 2% solution. Atropine - 1 ml of 0.1% solution intravenously with 300 ml of 5% glucose solution. In case of rhythm disturbances - potassium chloride 2.5 g in 500 ml of 5% glucose solution intravenously, if necessary, repeatedly. Cardiovascular agents. Vitamins B1 and B6 intramuscularly (not simultaneously). Oxygen therapy. Treatment of toxic shock. Cardiac glycosides are contraindicated.

HENBANE.

See Atropine.

BELLADONNA.

See Atropine.

BELLOOID, BELLASPON.

A. The name of the chemical and its characteristics.

Psychotropic (narcotic) and neurotoxic (anticholinergic) action. The composition of the drugs includes barbiturates, ergotamine, atropine. Lethal dose - more than 50 tablets.

B. Symptoms of poisoning.

The earliest symptoms of atropine poisoning (see Atropine) are manifested, followed by the development of a severe coma, similar to a barbiturate coma (see barbiturates), with severe dryness of the skin and mucous membranes, dilated pupils, and flushing of the skin, hyperthermia. Poisoning is especially dangerous in children.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage. Forced diuresis, in severe poisoning - detoxification hemosorption.

3. When excited - see Atropine. With the development of coma - see Barbiturates.

PETROL.

A. The name of the chemical and its characteristics.

Petrol. Psychotropic (narcotic), hepatotoxic, nephrotoxic, pneumotoxic action. Especially dangerous leaded gasoline containing tetraethyl lead. Rapidly absorbed in the lungs and gastrointestinal tract. It is excreted mainly through the lungs.

B. Symptoms of poisoning.

When inhaled vapors - dizziness, headache, feeling of intoxication, agitation, nausea, vomiting. In severe cases - respiratory failure, loss of consciousness, convulsions, the smell of gasoline from the mouth. When swallowed - abdominal pain, vomiting, liver enlargement and tenderness, jaundice, toxic hepatopathy, nephropathy. On aspiration, chest pain, bloody sputum, cyanosis, dyspnea, fever, severe weakness(gasoline toxic pneumonia). Poisoning is especially severe in children. Chronic inhalation intoxication is possible.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Removing the victim from a room saturated with gasoline vapors. If gasoline is ingested - gastric lavage through a 200 ml tube. vaseline oil or activated charcoal.

3. When inhaling vapors or aspiration - oxygen inhalation, antibiotics (10,000,000 IU of penicillin and 1 g of streptomycin intramuscularly), jars, mustard plasters. Subcutaneously camphor - 2 ml of 20 (percent) solution, cordiamine - 2 ml, caffeine - 2 ml of 10 (percent) solution. Intravenously 30-50 ml of 40 (percent) glucose solution with corglycon (0.06 (percent) solution - 1 ml) or strophanthin (0.05 (percent) solution - 0.5 ml). For pain - 1 ml of 1 (percent) solution of promedol, 1 ml of solution 1 (percent) of atropine subcutaneously. In a coma with respiratory failure - intubation and artificial respiration, oxygen.

BENZODIAZEPINES.

A. The name of the chemical and its characteristics.

Benzodiazepines - Elenium (Chlordiazepoxide, Napot, Librium), Diazepam (Seduxen, Valium), Oxazepam (Tazepam), Nitrazepam (Eunoctin, Radedorm). Psychotropic, neurotoxic action. Lethal dose - 1-2 g (large individual differences. Absorbed in the stomach and small intestine, binds to plasma proteins, detoxifies in the liver, excreted in urine and feces.

B. Symptoms of poisoning.

See Barbiturates.

BENZENE.

A. The name of the chemical and its characteristics.

Bezol. Psychotropic (narcotic), hemotoxic, hepatotoxic effect. The lethal dose is 10-20 ml. The lethal concentration in the blood is 0.9 mg/l. Rapidly absorbed in the lungs, gastrointestinal tract. 15-30% is oxidized and excreted by the kidneys as metabolites, the rest is excreted unchanged through the lungs and in the urine. Depanation is possible in erythrocytes, in glandular organs, muscles, fatty tissue.

B. Symptoms of poisoning.

When benzene vapor is inhaled, excitation similar to alcohol, clinical-tonic convulsions, pallor of the face, red mucous membranes, pupils are dilated. Shortness of breath with a violation of the rhythm of breathing. The pulse is rapid, often arrhythmic, lowering blood pressure. Bleeding from the nose and gums, hemorrhage into the skin, uterine bleeding. When taking benzene inside - burning in the mouth, behind the sternum, in the epigastric region, vomiting, abdominal pain, dizziness, headache, agitation, followed by depression, coma, liver enlargement, jaundice (toxic hepatopathy). Chronic inhalation intoxication is possible.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Removal of the victim from the danger zone. When poison enters - gastric lavage through a probe, veseline oil inside - 200 ml. Forced diuresis, blood replacement surgery.

2. 30% sodium thiosulfate solution - 200 ml intravenously.

3. Intramuscularly vitamins B1 and B6 - up to 1000 mcg / day (do not administer B vitamins at the same time). Cardiovascular agents. Ascorbic acid - 10-20 ml of a 5% solution with a 5% glucose solution intravenously. oxygen inhalation. With bleeding - 1% solution of vikasol intramuscularly up to 5 ml.

BORIC ACID.

A. The name of the chemical and its characteristics.

Boric acid (borax), borax, sodium borate. Local irritant, weak cytotoxic, convulsive action. The lethal dose for adults is 10-20g. Toxic concentration in blood 40 mg/l, lethal 50 mg/l. Absorbed through the gastrointestinal tract, damaged skin. Excreted by the kidneys unchanged and through the intestines within a week. Deposited in bone tissue, liver.

B. Symptoms of poisoning.

Symptoms of intoxication develop 1-48 hours after ingestion. Abdominal pain vomiting, diarrhea, general weakness headache. Dehydration of the body, loss of consciousness, generalized twitching of the muscles of the face, limbs, convulsions. Cardiovascular insufficiency. Possible damage to the liver and kidneys. Children are especially susceptible to poisoning.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage through a probe. Forced Diurkz. Hemodialysis in severe poisoning.

3. Riboflavin mononucleotide 10g per day into the muscle. Correction of wine-electrolyte balance and acidosis: infusion of sodium bicarbonate solution, plasma-substituting solutions, glucose, sodium chloride. For pain in the abdomen - 0.1% solution of atropine - 1 ml, 0.2% solution of platifilin - 1 ml, 1% solution of promedol - 1 ml subcutaneously. Novocain 2% solution - 50 ml with glucose - 5% solution - 500 ml intravenously. Cardiovascular agents.

MILESTONES POISONOUS.

A. The name of the chemical and its characteristics.

Milestones are poisonous (hemlock, water hemlock, water omega). The most poisonous rhizomes of the plant, especially in late autumn and early spring. Contain cytotoxin. Neurotoxic (anticholinergic, convulsive) action. The lethal dose is about 50 mg of the plant per 1 kg of body weight.

B. Symptoms of poisoning.

Rapidly absorbed from the gastrointestinal tract. Initial symptoms poisoning appear after 1, 5 - 2 hours, sometimes after 20 - 30 minutes. Salivation, nausea, vomiting, abdominal pain, dilated pupils, tachycardia, tonic-clonic convulsions, respiratory depression. Loss of consciousness, collapse. Most often, poisoning develops in children, who usually eat rhizomes, mistaking them for carrots.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage through a probe, saline laxative, activated charcoal inside, hemosorption.

3. Intramuscularly 25% solution of magnesium sulfate - 10 ml. With convulsions - diazepam 5 - 10 mg intravenously. Artificial hardware respiration. With a heart rhythm disorder - 10 ml of a 10% solution of novocainamide intravenously.

HYDROGEN ARSENIC.

A. The name of the chemical and its characteristics.

Arsenic hydrogen (arsine) is a colorless gas with a garlic odor. Neurotoxic, hemotoxic (hemolytic), hepatotoxic action. The lethal concentration in the air is 0.05 mg/l at an exposure of 1 hour, at a concentration of 5 mg/l several breaths lead to death.

B. Symptoms of poisoning.

In case of poisoning with low doses, the development of poisoning is preceded by a latent period of about 6 hours, in case of severe intoxication, the latent period is less than 3 hours. General weakness, nausea, vomiting, chills, anxiety, headache, paresthesia in the extremities, suffocation. After 8 - 12 hours - hemoglobinuria (red or brown urine), cyanosis, convulsions, impaired consciousness are possible. On the 2-3rd day - toxic hepatopathy, nephropathy, hemolytic anemia.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Early hemodialysis. Blood replacement operation.

2. Mecaptide 40% solution - 1-2 ml every 4 hours with 0.25% solution of navocaine intramuscularly for the first 2 days, then 2 times a day until 5-6 days, after which - unitiol 5% solution 5 ml 3-4 times per day.

With hemoglubinuria - glucosone-vocaine mixture intravenously (glucose 5% solution - 500 ml, novocaine 2% solution - 50 ml), hypertonic 20-30% glucose solutions - 200 - 300 ml, aminophylline 2, 4% solution - 10 ml, sodium bicarbonate 4 % solution - 100 ml intravenously. Forced diuresis. Cardiovascular agents.

VITAMIN D2.

A. The name of the chemical and its characteristics.

Vitamin D2 (ergocalciferol, calciferol). Violation of calcium and phosphorus metabolism in the body, cytotoxic (membrane), nephrotoxic effect. Toxic dose at a single dose of 1,000,000 IU - 25 mg (20 ml oil solution, 5 ml alcohol solution). Vitamin D is metabolized in the liver and kidneys with the formation of active metabolites that cause the toxicity of the drug. accumulates in the body.

B. Symptoms of poisoning.

Intoxication can develop as a result of a single dose of a large dose of the drug or by repeated eating (sometimes instead of sunflower oil). In children - as a result of exceeding the course preventive and therapeutic doses. Nausea, repeated vomiting, dehydration, malnutrition, lethargy, fever, general adynamia, muscle hypotension, drowsiness, followed by severe anxiety, clonic tonic convulsions. Increased blood pressure, muffled heart sounds, sometimes rhythm and conduction disturbances. Hematuria, leukocyturia, proteinuria, azotemia, acute heart failure. Hypercalcemia (calcium content in blood serum up to 20 mg% or more), hypercholesterolemia, hyperphosphatemia, hyperproteinemia. X-ray of cadaveric bones reveals osteoporosis of the diaphyseal part. Possible metastatic calcification of the kidneys, myocardium, heart valves, vascular wall.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. When high dose- hemodialysis, detoxification hemosorption.

3. Hydrocotison - 250 mg / day or prednisolone - 60 mg / day intramuscularly. Thyrocalcitonia - 5D 2-3 times a day, vitamins A (oil solution) 3000-50000 IU 2 times a day intramuscularly. Tocopherol (vitamin E) 30% solution - 2 ml intramuscularly 2 times a day. Cardiovascular agents. With an increase in blood pressure - 1% dibazol solution, 2-4 ml intramuscularly. Calcium-disodium salt of ELTA, 2-4 g per 500 ml of 5% glucose solution intravenously. Glucose with insulin - 8D, isotonic sodium chloride solution 40% - 20 ml, plasma and plasma-substituting solutions.

GLYCOsideS CARDIAC.

A. The name of the chemical and its characteristics.

Cardiac glycosides: preparations different types foxglove (the active principle is glycosides ditoxin, digoxin), adonis, lily of the valley, jaundice, strophanthus, hellebore, sea onion, etc. Cardiotoxic effect. Rapidly absorbed from the gastrointestinal tract intravenous administration excreted slowly in the urine.

B. Symptoms of poisoning.

Dyspeptic disorders (nausea, vomiting). Bradycardia, ventricular and atrial extrasystoles, conduction disturbances, various types of tachycardia, ventricular fibrillation and fibrillation. drop in blood pressure, cyanosis, convulsions, blurred vision, mental disorders loss of consciousness.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage, saline laxative, activated charcoal inside. Detoxification hemosorption.

2. Atropine 0.1% solution - 1 ml subcutaneously for bradycardia. Intravenous drip of potassium chloride (only with hypokalemia!) - 0.5% solution of 500 ml. Unitiol 5% solution 5 ml intramuscularly 4 times a day.

For arrhythmias: 0.1% solution of atropine - 1-2 ml intravenously, lidocaine - 100 ml every 3 - 5 minutes intravenously drip (until the arrhythmia is eliminated), diphenin - 10 - 12 mg / kg for 12-24 hours intravenously drip .

GRANOSAN.

A. The name of the chemical and its characteristics.

Granosan (2% ethylmercuric chloride). Enterotoxic, hepatotoxic action.

B. Symptoms of poisoning.

Poisoning develops with the use of sunflower seeds treated with granosan, peas, flour from pickled seeds, fruits from untimely processed trees. Symptoms of poisoning develop gradually - 1-3 weeks after eating contaminated foods. Loss of appetite, bad taste and dry mouth, thirst, lethargy, insomnia, headache. Then nausea, vomiting, abdominal pain, diarrhea, lethargy, weakness, hallucinations, and sometimes paresis of the extremities appear. Visual disturbances, anisocaria, strabismus, ptosis (damage to the cranial nerves), tremor, epileptic syndrome, vomiting, bloody diarrhea are possible. There are symptoms of toxic nephrorpathy, toxic hepatopathy (enlargement and tenderness of the liver, jaundice).

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1, 2. See sublimate.

Z. Vitamins B1 and B12. Prozerin - 0.05% solution, 1 ml subcutaneously.

MUSHROOMS POISONOUS.

A. The name of the chemical and its characteristics.

Mushrooms are poisonous. 1. Pale grebe - contains toxic alkaloids phalloin, phalloidin, amanitin. Hepatotoxic, nephrotoxic, enterotoxic action. 100 g of fresh mushrooms (5 g of dry) contains 10 mg of phalloidin, 13.5 mg of amanitin. The lethal dose of amanitin is 0.1 mg/kg. Toxins are not destroyed during heat treatment and during drying, they are quickly absorbed from the gastrointestinal tract, deposited in the liver.

2. Fly agaric - active principle - muscarine, muscaridine. Neurotoxic (cholinergic action). Toxins are partially destroyed during heat treatment.

3. Lines, morels - contain gelvelic acid. Hemotoxic (hemolytic) action. The toxin is destroyed by heat treatment.

B. Symptoms of poisoning.

The latent period before the development of severe symptoms of intoxication is 6-24 hours. Indomitable vomiting, abdominal pain, diarrhea, hemolysis, hemoglobinuria (red urine). Damage to the liver, kidneys. Hemolytic jaundice.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Sodium bicarbonate - 1000 ml of a 4% solution in a vein. Forced diuresis.

DIKUMARIN.

A. The name of the chemical and its characteristics.

Dicoumarin.

B. Symptoms of poisoning. See Anticoagulants

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

See Anticoagulants.

DIMEDROL.

A. The name of the chemical and its characteristics.

Diphenhydramine (diphenhydramine) and other antihistamines.

Neurotoxic (parasympatholytic, central anticholinergic), psychotropic (narcotic) action. The lethal dose is 40 mg/kg. Toxic concentration in blood — 10 mg/l. Rapidly absorbed, reaches maximum concentration in tissues during the first 6 hours, detoxification in the liver, excreted in the urine mainly as metabolites within 24 hours.

B. Symptoms of poisoning.

Dry mouth and throat, drowsiness and dizziness, nausea, nausea, muscle twitching, tachycardia, blurred vision. The pupils are dilated, there may be horizontal nystagmus, the skin is dry, pale. Motor and psychological agitation, convulsions with subsequent loss of consciousness. Coma, drop in blood pressure, respiratory depression. With oral premedimedrol, numbness of the oral cavity may occur.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. When taken orally - gastric lavage through a probe lubricated with vaseline oil. Forced diuresis.

2. Physostigmine - 0.1% solution of 1 ml subcutaneously, repeatedly, in the absence of a sharp excitation - pilocarpine - 1 ml of a 1% solution subcutaneously.

3. When excited - chlorpromazine or tizercin - 2.5% solutions of 2 ml intramuscularly, with convulsions - diazepam - 5 - 10 mg intravenously.

DIMETHYLPHTHALATE.

A. The name of the chemical and its characteristics.

Dimethyl phthalate. Local irritant, psychotropic (narcotic), neurotoxic, nephrotoxic action. Absorbed through the gastrointestinal tract, respiratory tract. In the body in a short time is metabolized with the formation of methyl alcohol.

B. Symptoms of poisoning.

See Methyl alcohol.

When inhaled vapors - irritation of the mucous membranes of the eyes, nose.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

See Methyl alcohol.

DICHLOROETHANE.

A. The name of the chemical and its characteristics.

Dichloroethane (ethylene dichloride) exists in the form of 2 isomers: 1-1-dichloroethane and the most toxic 1-2-dichloroethane. Psychotropic (narcotic), neurotoxic, hepatotoxic, nephrotoxic, local irritant effect. The lethal dose when taken orally is 15-20 ml. Toxic concentration in the blood - traces of dichloroethane, lethal 5 mg / l. Rapidly absorbed through the gastrointestinal tract, respiratory tract, skin. After oral administration, the maximum concentration in the blood is reached in the first 6 hours, the absorption rate increases with joint admission with alcohol and fats. It is metabolized in the liver with the formation of toxic metabolites of chlorethnaol and monochloroacetic acid. deposited in adipose tissue. Excreted with exhaled air, urine, feces.

B. Symptoms of poisoning.

Symptoms of intoxication appear in the first 1 - 3 hours. Upon ingestion - nausea, vomiting (persistent) with an admixture of bile, blood, pain in the epigastric region, salivation, loose, flaky stools with the smell of dichloroethane, hyperemia of the sclera, severe weakness, headache, psychomotor agitation, coma, exo toxic shock(1 - 2 days), 2 - 3rd day - toxic hepatopathy (soreness in the right hypochondrium, liver enlargement, jaundice, nephropathy, hepatic-renal failure, hemorrhagic diathesis (gastric, nasal bleeding) In case of inhalation poisoning - headache, dizziness, drowsiness, dyspeptic disorders, increased salivation, hepatopathy, nephropathy.In severe cases, coma, exotoxic shock.If it comes into contact with the skin, dermatitis, bullous rashes.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Abundant repeated gastric lavage through a probe, followed by the introduction of vaseline oil into the stomach (150-200 ml). Detoxification hemosorption, forced diuresis with alkalization of the blood. Vitamin E 1 - 2 ml 30% intramuscularly 4 times in the first 3 days.

3. In the presence of a deep coma - intubation, artificial respiration. Cardiovascular agents. Treatment of toxic shock. On the first day - hormone therapy (prednisolone up to 120 mg intravenously repeatedly. Vitamin therapy: B12 - up to 1500 mcg; B1 - 4 ml of a 5% solution intramuscularly; B15 up to - 5 g orally. Ascorbic acid - 5-10 ml of a 5% solution intravenously. Tetacin calcium - 40 ml of 10% solution with 300 ml of 5% glucose solution intravenously Unithiol 5% solution 5 ml intramuscularly repeatedly Lipoic acid - 20 - 30 mg / kg intravenously per day Antibiotics (levomycetin, penicillin).

With a sharp excitation, 2 ml of 2. 5% pipolfen solution intravenously. Treatment of toxic nephropathy and hepatopathy is carried out in a hospital.

DURMAN.

A. The name of the chemical and its characteristics.

Datura. See atropine.

B. Symptoms of poisoning. See Atropine.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

See Atropine

Tempting.

A. The name of the chemical and its characteristics.

Zamaniha (seeds of Araliaceae). Rhizomes and roots contain saponins, traces of alkaloids and glycosides, essential oil. Produced in the form of tincture of 5% alcohol. Cardiotoxic local irritant, psychotropic (excitatory) action.

B. Symptoms of poisoning.

When using a toxic dose - nausea, repeated vomiting, loose stools, bradycardia, dizziness, anxiety, possibly lowering blood pressure. Bradyarrhythmia, ventricular extrasystole.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

3. Atropine - 1 ml of 0.1% solution subcutaneously or intravenously repeatedly until the bradycardia stops.

ISOMYAZIDE.

A. The name of the chemical and its characteristics.

Isoniazid (GINK, isonicotinic acid hydrazide); derivatives: tubazid, ftivazid, saluzid, larusan, etc. Neurotoxic (convulsive) action. The lethal dose is 10 g. It is rapidly absorbed from the gastrointestinal tract, the maximum concentration in the blood is 1-3 hours after ingestion. 50 - 75% of the drug in acetylated form is excreted in the urine within 24 hours, 5 - 10% - through the intestines.

B. Symptoms of poisoning.

Nausea, vomiting, abdominal pain, weakness, headache, paresthesia, dry mouth, tremor, ataxia, shortness of breath, bradycardia, then tachycardia. In severe poisoning - convulsions of the epileptiform type with loss of consciousness and respiratory distress. Perhaps the development of toxic nephropathy, hepatopathy.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage through a probe, saline laxative. Forced diuresis with alkalization of the blood. Detoxification hemosorption.

2. B6 - 5% solution of 10 ml intravenously repeatedly.

3. Ether-oxygen anesthesia with muscle relaxants, apparatus breathing. Correction of acidosis - 4% sodium bicarbonate solution 1000 ml in a vein.

INDIAN HEMP.

A. The name of the chemical and its characteristics.

Indian hemp (hashish, plan, marijuana, marijuana).

B. Symptoms of poisoning.

Initially, psychomotor agitation, dilated pupils, tinnitus, vivid visual hallucinations, then general lethargy, weakness, tearfulness and a long, deep sleep with a slow pulse and a decrease in body temperature.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

Gastric lavage in case of ingestion of poison, forced diuresis. With a sharp excitation - 4 - 5% ml of 2.5% solution of chlorpromazine intramuscularly.

INSULIN.

A. The name of the chemical and its characteristics.

Insulin. hypoglycemic action.

B. Symptoms of poisoning.

Active only when administered parenterally. In case of an overdose, symptoms of hypoglycemia occur - weakness, increased sweating, hand tremors, hunger. In severe poisoning (blood sugar level below 50 mg%) - psychomotor agitation, clinical tonic convulsions, coma. When from a coma, prolonged encephalopathy (schizophrenia-like syndrome) is noted

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Focused diuresis with alkalization of the blood.

2. Immediate intravenous administration of 20% glucose solution, in the amount necessary to restore normal blood sugar levels. Glucagon - 0.5 - 1 mg intramuscularly.

3. In coma adrenaline - 1 ml of 0.1% solution subcutaneously. Cardiovascular agents.

A. The name of the chemical and its characteristics.

Iodine. Local cauterizing effect. The lethal dose is about - - 3g.

B. Symptoms of poisoning.

Inhalation of iodine vapors affects the upper respiratory tract.

(see Chlorine). When concentrated solutions get inside, severe burns of the digestive tract occur, the mucous membrane has a characteristic color. Perhaps the development of hemolysis, hemoglobinuria.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

Gastric lavage through a probe, preferably 0.5% sodium thiosulfate solution.

2. Sodium thiosulfate 30% solution - up to 300 ml per day intravenously, 10% sodium chloride solution 30 ml intravenously.

3. Treatment of burns of the digestive tract (see Strong acids)

POTASSIUM PERMANGANATE.

A. The name of the chemical and its characteristics.

Potassium permanganate. Local cauterizing, resorptive, hemotoxic (methemoglobinemia) action. The lethal dose for children is about 3 g, for adults - 0.3 - 0.5 g / kg.

B. Symptoms of poisoning.

When ingested, there is a sharp pain in the mouth, along the esophagus, in the abdomen, vomiting, diarrhea. The mucous membrane of the oral cavity and pharynx is edematous, dark brown, purple. Possible swelling of the larynx and mechanical asphyxia, burn shock, motor agitation, convulsions. Often occur severe pneumonia, hemorrhagic colitis, nephropathy, hepatopathy, parkinsonism phenomena. With low acidity gastric juice possible methemoglobinemia with severe cyanosis and shortness of breath.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. See strong acids.

2. With a sharp cyanosis (methemoglobinemia) - methyl blue 50 ml of a 1% solution, ascorbic acid - 30 ml of a 5% solution intravenously.

3. Vitamin therapy: B12 up to 1000 mcg, B6 - 3 ml of a 5% solution intramuscularly. Treatment of toxic nephropathy, hepatopathy in a hospital.

ACIDS ARE STRONG.

A. The name of the chemical and its characteristics.

Strong acids: inorganic (nitric, sulfuric, hydrochloric, etc.), organic (acetic, oxalic, etc.). Oxalic acid is part of a number of products household chemicals used to remove rust: liquid "Vaniol" (10%), "Antirust", paste "Prima" (19. 7%), powder "Sanitary" (15%), "Tartarene" (23%). Local cauterizing effect (coagulative necrosis), hemotoxic (hemolytic) and nephrohepatotoxic - for organic acids. The lethal dose is 30-50 ml.

B. Symptoms of poisoning.

When ingested, a chemical burn of the oral cavity, pharynx, pharynx, stomach, esophagus, sometimes intestines develops - a sharp pain in the oral cavity along the esophagus, in the abdomen. Significant salivation, repeated vomiting with an admixture of blood, esophageal bleeding. Mechanical asphyxia due to burns and laryngeal edema. Phenomena of toxic burn shock (compensated or decompensated). In severe cases, especially with poisoning vinegar essence, hemolysis, hemoglobinuria are observed (urine acquires a red-brown, dark brown color), by the end of the first day, yellowness of the skin and sclera appears. Against the background of hemolysis, toxic coagulopathy develops (a short-term phase of hypercoagulability and secondary fibrinolysis). On the 2nd - 3rd day, the phenomena of exogenous toxemia (fever, agitation), the phenomena of active peritonitis, pancreatitis, then the phenomenon of nephropathy against the background of acute hemoglobinuric nephrosis (with acetic acid poisoning), hepatopathy, infectious complications (purulent tracheobronchitis, pneumonia) predominate. - 3 weeks late esophageal-gastric bleeding can be a complication of a burn disease.By the end of 3 weeks, with severe burns (ulcer-necrotic inflammation), there are signs of cicatricial narrowing of the esophagus or, more often, the gastric outlet (in case of poisoning with inorganic acids). weight loss, violation of protein and water-electrolyte balance.Ulcer-necrotic gastritis and esophagitis often become chronic.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage with cold water through a probe, lubricated vegetable oil. Before gastric lavage - subcutaneously morphine - 1 ml of 1% solution and atropine - 1 ml of 0.1% solution. Forced diuresis with alkalization of the blood. Swallow ice cubes.

2. The introduction of a 4% solution of sodium bicarbonate up to 1500 ml into a vein with the appearance of dark urine and the development of metabolic acytosis.

3. Treatment of burn shock. Poliglukin - 800 ml intravenous drip. Glucose-novocaine mixture (glucose - 300 ml of a 5% solution, novocaine - 30 ml of a 2% solution) intravenously. Papaverine - 2 ml of a 2% solution, platifilin - 1 ml of a 0.2% solution, atropine - 0.5 - 1 ml of a 0.1% solution subcutaneously up to 6 - 8 times a day. Cardiovascular agents (cordiamin - 2 ml, caffeine - 2 ml of a 10% solution subcutaneously). With the development of bleeding - ice inside. In cases of significant blood loss - repeated blood transfusion. Antibiotic therapy (penicillin - up to 8,000,000 IU per day). Hormone therapy: hydrocartisone - 125 mg, ACTH - 40 IU intramuscularly per day. For local treatment of the burned surface, 20 ml of a mixture of the following composition is given inside after 3 hours: 10% emulsion of sunflower oil - 200 ml, anestezin - 2 ml, chloramphenicol - 2 g. Vitamin therapy: B12 - 400 mcg, B1 - 2 ml of a 5% solution intramuscularly (do not enter at the same time). Treatment of toxic nephropathy, hepatopathy - in a hospital. For the treatment of toxic coagulopathy after bleeding stops - heparin up to 30,000 - 60,000 IU per day intravenously intramuscularly for 2 - 3 days (under the control of a coagulogram). With laryngeal edema - inhalation of aerosols: Novokina - 3 ml of 0.5% solution with ephedrine - 1 ml of 5% solution or adrenaline - 1 ml of 0.1% solution. If this measure fails, a tracheostomy is performed.

CAFFEINE.

A. The name of the chemical and its characteristics.

Caffeine and other xanthines - theophylline, theobromine, aminophylline, aminophylline. . Psychotropic, neurotoxic (convulsive) action. Lethal dose - 20 g with large individual differences, lethal concentration in the blood - more than 100 mg / l. Rapidly absorbed in the gastrointestinal tract, demethylated in the body, excreted in the urine as metabolites, 10% unchanged.

B. Symptoms of poisoning.

Tinnitus, dizziness, nausea, vomiting, fever, palpitations. Perhaps pronounced psychomotor agitation, clonic tonic convulsions. In the future, depression of the nervous system may develop up to a soporous state, severe tachycardia (sometimes paroxysmal, accompanied by hypotension), and cardiac arrhythmias. With an overdose of drugs, especially with intravenous administration, an attack of clonic-tonic convulsions, a drop in blood pressure is possible. orthostatic collapse.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage through a probe, saline laxative. Forced diuresis. In severe cases - detoxification hemosorption.

3. Aminazine - 2 ml of 2.5% solution intramuscularly. In severe cases - intramuscular injection lytic mixture: chlorpromazine - 1 ml of 2.5% solution, promedol - 1 ml of 1% solution, diprazine (pipolfen) - 2.5% solution. With convulsions - barbamil - 10 ml of a 10% solution intravenously. For the relief of paroxysmal tachycardia - novocainamide 10% solution of 5 ml intravenously slowly.

LITHIUM.

A. The name of the chemical and its characteristics.

Lithium is lithium carbonate. Psychotropic, neurotoxic, cardiotoxic action. Lethal dose - 20 g. Toxic concentration in the blood - 13.9 mg / l, lethal dose-34.7 mg/l. It is absorbed in the gastrointestinal tract, distributed evenly in the body in the intracellular and extracellular fluid, 40% is excreted in the urine, a small part - through the intestines.

B. Symptoms of poisoning.

Nausea, vomiting, abdominal pain, diarrhea, muscle weakness, limb tremor, adynamia, ataxia, drowsiness, constipation, coma. Violation of the heart rhythm, bradyarrhythmia, lowering blood pressure, acute cardiovascular failure (collapse). On the 3rd - 4th day - manifestations of toxic nephropathy. The undulating course of intoxication is characteristic.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage through a probe. Forced diuresis. In severe cases, early hemodialysis.

2. In a vein - sodium bicarbonate - 1500 - 2000 ml of a 4% solution, sodium chloride - 20 - 30 ml of a 10% solution after 6 - 8 hours for 1 - 2 days.

3. With a decrease in blood pressure - 0.2% solution of noradrenaline intravenously drip until a clinical effect is obtained. Vitamins of group B, ATP - 2 ml of 1% solution intramuscularly 2 - 3 times a day. Treatment of toxic nephropathy.

OINTMENT MERCURY.

A. The name of the chemical and its characteristics.

Mercury ointment: gray (contains 30% metallic mercury, white (10% mercury amide chloride), yellow (2% yellow mercury oxide).

B. Symptoms of poisoning.

Poisoning develops when the ointment is rubbed into the skin, especially into the hairy parts of the body and if there are excoriations, abrasions on the skin, or with prolonged exposure (more than 2 hours). On days 1-2, signs of dermatitis appear and body temperature rises, which may be a manifestation of hypersensitivity to mercury preparations. On the 3rd - 5th day, symptoms of toxic nephropathy, acute renal failure develop. At the same time, there are manifestations of stomatitis, gingivitis, an increase in regional nodes, on the 5th - 6th day - enterocolitis.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Forced diuresis. Early hemodialysis in the presence of a toxic concentration of mercury in the blood and severe intoxication.

2. Unithiol - 5% solution of 10 ml intramuscularly repeatedly.

3. Treatment of toxic nephropathy in a hospital setting. On the affected areas of the skin - ointment bandages with hydrocortisone, anestezin. Treatment of stomatitis.

COPPER.

A. The name of the chemical and its characteristics.

Copper and its compounds (copper sulfate). Copper-containing pesticides: Bordeaux mixture (mixture blue vitriol and lime), burgundy liquid (a mixture of copper sulfate and sodium carbonate), cupronaft (compound of copper sulfate with a solution of methylonaphth), etc. Local cauterizing, hemotoxic (hemolytic), nephrotoxic, hepatotoxic effect. The lethal dose of copper sulfate is 30 - 50 ml. The toxic concentration of copper in the blood is 5.4 mg/l. About 1/4 of the oral dose is absorbed from the gastrointestinal tract and binds to plasma proteins. Most of it is deposited in the liver. Excretion with bile, feces, urine.

B. Symptoms of poisoning.

When copper sulphate is ingested, nausea, vomiting, abdominal pain develop, frequent stool, headache, weakness, tachycardia, toxic shock. With severe hemolysis (hemoglobin), acute renal failure (anuria, nuremia). Texic hepatopathy. Hemolytic jaundice, anemia. When non-ferrous metals (highly dispersed dust of copper (zinc and chromium)) get into the upper respiratory tract during welding, acute “casting fever” develops: chills, dry cough, headache, weakness, shortness of breath, persistent fever. An allergic reaction is possible (red rash on the skin , itching).

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage through a probe. Forced diuresis. early hemodialysis.

2. Unitiol - 10 ml of a 5% solution, then 5 ml every 3 hours intramuscularly for 2 - 3 days. Sodium thiosulfate - 100 ml of a 30% solution intravenously.

3. Morphine - 1 ml of 1% solution, atropine - 1 ml of 0.1% solution subcutaneously. At frequent vomiting- chlorpromazine - 1 ml 2.5 solution intramuscularly. Glucose-novocaine mixture (glucose 5% - 500 ml, novocaine 2% - 50 ml intravenously). Antibiotics. Vitamin therapy. With hemoglobinuria - sodium bicarbonate - 1000 ml of a 4% solution intravenously. Treatment of acute kidney failure and toxic hepatopathy - in a hospital. With foundry fever - acetylsolicylic acid - 1 g, codeine - 0.015 g inside. With an allergic rash - diphenhydramine - 1 ml of a 1% solution subcutaneously, calcium gluconate 10 ml of a 10% solution intravenously.

MORPHINE.

A. The name of the chemical and its characteristics.

Mlorfin and others narcotic analgesics opium groups: opium, pantopon, heroin, dionine, codeine, tecodin, phenadone. Preparations containing substances of the opium group - gastric drops and tablets, codterpine, cotermops. Psychotropic (narcotic), neurotoxic effect. The lethal dose when administered orally morphine - 0.5 - 1 g, with intravenous administration - 0.2 g. The lethal concentration in the blood - 0.1 - 4 mg / l. All drugs are especially toxic to young children. Lethal dose for children under 3 years old - 400 ml, fenadone - 40 mg, heroin - 20 mg. It is rapidly absorbed from the gastrointestinal tract and when administered parenterally, detoxification in the liver by conjugation with glucuronic acid (90%), 75% is excreted in the urine on the first day in the form of conjugants.

B. Symptoms of poisoning.

When taken orally or with parenteral administration of toxic doses of drugs, a coma develops, which is characterized by a significant narrowing of the pupils with a weakening reaction to light, skin hyperemia, muscle hypertonus, and sometimes clonic-tonic convulsions. In severe cases, there is often a violation of breathing and the development of asphyxia - a sharp cyanosis of the mucous membranes, dilated pupils, bradycardia, collapse, hypothermia. In severe poisoning with cadeine, respiratory disorders are possible with the patient's consciousness preserved, as well as a significant decrease in blood pressure.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Repeated gastric lavage (even with pantheral administration of morphine), activated charcoal orally, saline laxative. Forced diuresis with alkalization of the blood. Detoxification hemosorption.

2. The introduction of nalorphine (anthorphine) - 3 - 5 ml of 0.5% solution intravenously.

3. Subcutaneously atropine - 1 - 2 ml of 0.1% solution, caffeine - 2 ml of 10% solution, cordiamine - 2 ml. Vitamin B1 - 3 ml of a 5% solution intravenously repeatedly. Oxygen inhalation, artificial respiration. Body warming.

ARSENIC.

A. The name of the chemical and its characteristics.

Arsenic and its compounds. Nephrotoxic, hepatotoxic, enterotoxic, neurotoxic effects. The most toxic compounds are trivalent arsenic. The lethal dose of arsenic when taken orally is 0.1 - 0.2 g. The toxic concentration in the blood is 1 mg / l, the lethal one is 15 mg / l. Slowly absorbed from the intestine and when administered parenterally. Deposited in the liver, kidneys, spleens, thin walls of the intestines, lungs. With the use of inorganic compounds, arsenic appears in the urine after 2-8 hours, and is excreted in the urine within 10 days. Organic compounds are excreted in urine and feces within 24 hours.

B. Symptoms of poisoning.

When ingested, the gastrointestinal form of poisoning is more often observed. Metallic taste in the mouth, vomiting, severe abdominal pain. Vomit greenish color. Loose stools resembling rice water. Severe dehydration of the body, accompanied by chlorpenic convulsions. Hemoglobinuria as a result of hemolysis, jaundice, hemolytic onemia, acute liver and kidney failure. In the terminal phase - collapse, coma. Possible paralytic form: stunning, soporous state, convulsions, loss of consciousness, coma, respiratory paralysis, collapse. With inhalation poisoning with arsenic hydrogen, severe hemolysis, hemoglobinuria, cyanosis develop rapidly, and liver and kidney failure occurs on days 2-3.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage through a probe, repeated siphon enemas. Early hemodialysis with simultaneous intravenous administration of 150 - 200 ml of a 5% unithiol solution.

2. Unitiol - 5% solution of 5 ml 8 times a day intramuscularly 10% solution of tetacin-calcium - 30 ml in 500 ml of 5% glucose intravenously.

3. Vitamin therapy: ascorbic acid, vitamins B1, B6, B15. 10% sodium chloride solution intravenously repeatedly in 10 ml (under the control of the ionogram). At sharp pains in the intestine - platifilin -1 ml 0.2% rastaor, atropine 1 ml 0.1% solution subcutaneously, pararenal blockade with novocaine. Cardiovascular agents. Treatment of exotoxic shock. With hemoglobinuria - glucose-novocaine mixture (glucose 5% - 500 ml, novocaine 2% - 50 ml) intravenously, hypertonic solution (20 - 30%) glucose - 200 - 300 ml, aminofillin 2, 4% solution - 10 ml, bicarbonate sodium 4% - 1000 ml intravenously. Forced diuresis.

NAPHTHALENE.

A. The name of the chemical and its characteristics.

Naphthalene is a local irritant, hemotoxic (hemolytic) action. The lethal dose when taken orally is about 10 g, for children - 2 g. Poisoning is possible by inhalation of vapors and dust, by penetration through the skin, by ingestion. Excreted in the urine as metabolites.

B. Symptoms of poisoning.

When inhaled - headache, nausea, vomiting, lacrimation, cough, superficial clouding of the cornea. Perhaps the development of hemolysis, hemoglobinuria. In contact with skin - erythema, dermatitis phenomena. When ingested - abdominal pain, vomiting, diarrhea. Anxiety, in severe cases - coma, convulsions. tachycardia, dyspnea, hemolysis, hemoglobinuria, toxic nephropathy. Perhaps the development of toxic hepatopathy. Especially dangerous poisoning in children.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. When taken orally - gastric lavage through a tube, saline laxative. Forced diuresis with alkalization of the blood.

2. Sodium bicarbonate inside 5 g in water every 4 hours or intravenously 4% solution 1 - 1.5 liters per day.

3. Calcium chloride - 10 ml of a 10% solution intravenously, inside - rutin - 0.01 g, riboflavin 0.01 g repeated. Treatment of toxic nephropathy.

AMMONIA.

Ammonia - see Caustic alkalis.

NICOTINE.

A. The name of the chemical and its characteristics.

Nicotine. Psychotropic (exciting), neurotoxic (anticholinergic, convulsive) action. The toxic concentration in the blood is 5 ml / l, the lethal dose is 10 - 22 mg / l. It is rapidly absorbed by the mucous membranes, it is rapidly metabolized in the body. Detoxification in the liver. 25% are excreted unchanged in the urine, through the lungs with sweat.

B. Symptoms of poisoning.

Headache, dizziness, nausea, vomiting, diarrhea, salivation, cold sweat. The pulse is slow at first, then rapid, irregular. Constriction of the pupils, visual and hearing disorders, muscle fibrillations, clonic-tonic convulsions. Coma, collapse. Non-smokers are more sensitive to nicotine than long-term smokers.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage with a solution of potassium permanganate 1:1000, followed by the introduction of a saline laxative. Activated charcoal inside. Forced diuresis. In severe poisoning - detoxification hemosorption.

3. Intravenously 50 ml of 2% novocaine solution, 500 ml of 5% glucose solution. Intramuscularly - magnesium sulfate 25% - 10 ml. With convulsions with difficulty breathing - 10 ml of a 10% solution of barbamil intravenously or 2 ml of 2% dithylin and artificial respiration. With a sharp bradycardia - 1 ml of a 0.1% solution of atropine subcutaneously.

NITRITES.

A. The name of the chemical and its characteristics.

Nitrites: sodium nitrite (nitrate), potassium, ammonium, amyl nitrite, nitroglycerin. Hemotoxic (direct ethemoglobin formation), vascular action(relaxation of the smooth muscles of the vascular wall). The lethal dose of sodium nitrite is 2 g. It is rapidly absorbed in the gastrointestinal tract, excreted mainly unchanged through the kidneys and intestines. They are not deposited in the body.

B. Symptoms of poisoning.

First, redness of the skin, then cyanosis of the mucous membranes and skin. The clinical picture is mainly due to the development of methemoglobinemia (see Aniline). It is possible to reduce blood pressure up to the development of acute cardiovascular insufficiency (collapse).

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage through a probe. Forced diuresis.

2. Treatment of methemoglobinemia (see Aniline).

3. With a decrease in blood pressure - the introduction of 1 - 2 ml of cordiamine, 1 - 2 ml of 10% caffeine solution subcutaneously, 1 - 2 ml of 0.2% solution of norepinephrine in 500 ml of 5% glucose solution - intravenously drip.

CARBON MONOXIDE.

A. The name of the chemical and its characteristics.

Carbon monoxide ( carbon monoxide). Hypotoxic, neurotoxic, hemotoxic effect (carboxyhemoglobinemia). The lethal concentration of carboxyhemoglobin in the blood is 50% of the total hemoglobin content. Poisoning by exhaust gases of internal combustion engines (cars), "burning out" in case of malfunctions of the furnace heating system, poisoning in the fire.

B. Symptoms of poisoning.

Mild degree - headache encircling the head character (hoop symptom), pounding in the temples, dizziness, nausea, vomiting. A transient increase in blood pressure and the phenomenon of trachiobronchitis (poisoning in a fire) are possible. The concentration of carboxyhemoglobin in the blood taken at the scene is 20 - 30%. Average degree severity - a short-term loss of consciousness at the scene, followed by agitation with visual and auditory hallucinations or lethargy, adynamia. hypertension, tachycardia, toxic injury heart muscles. The phenomenon of tracheobronchitis with dysfunction external respiration(poisoning in case of fire). The concentration of carboxyhemoglobin in the blood taken at the scene is 30-40%.

Severe poisoning - prolonged coma, convulsions, cerebral edema, external respiration disorders with respiratory failure (aspiration-obstructive syndrome, burns of the upper respiratory tract - fire poisoning), hypertension, toxic damage to the heart muscle, myocardial infarction may develop. Sometimes skin and trophic disorders, the development of myorenal syndrome, acute renal failure. The concentration of carboxyhemoglobin in the blood taken at the scene is 50%.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Remove the victim to fresh air. Continuous inhalation for 2-3 hours.

2. In case of moderate and severe poisoning - hyperboric oxygenation at a pressure in the chamber of 2 - 3 atm for 50 - 60 minutes.

3. With cerebral edema - lumbar punctures with the removal of 10 - 15% of the cerebrospinal fluid when high blood pressure, craniocerebral hypothermia (ice application or cold apparatus) for 6-8 hours, osmotic diuretics (mannitol, urea). When excited, 1 ml of a 1% solution subcutaneously, chlorpromazine - 2 ml of a 2.5% solution intramuscularly, with convulsions - 2 ml of a 0.5% solution of diazepam or 5 ml of a 10% solution of barbamil intravenously. In case of damage to the upper respiratory tract - therapeutic and diagnostic tracheobronchoscopy, sanitation. Prevention of pulmonary complications: antibiotics, heparin (up to 25,000 IU per day intramuscularly). When expressed respiratory failure- artificial respiration, aminofillin - 10 ml of 2, 4% solution intravenously, ascorbic acid - 10 - 20 ml of 5% glucose solution - 500 ml. Vitamin therapy.

PAHIKARPIN.

A. The name of the chemical and its characteristics.

Pachycarpin. Neurotoxic (ganglioblocking) action. The lethal dose is about 2 g. The lethal concentration in the blood is more than 15 mg / l. Rapidly absorbed when taken orally and parenterally. Excreted with urine.

B. Symptoms of poisoning.

Stage I - nausea, vomiting, abdominal pain, dizziness, weakness, dry mucous membranes; stage II - impaired neuromuscular conduction: dilated pupils, impaired vision, hearing, severe weakness, ataxia, psychomotor agitation, clonic-toxic convulsions, muscle fibrillations, tachycardia, pallor, acrocyanosis, hypotension; stage III- coma, respiratory failure, collapse, cardiac arrest with sudden brachycardia.

B. Emergency care:

1. Methods of active detoxification

2. Antidote treatment

3. Symptomatic therapy

1. Gastric lavage through a tube, saline laxative, forced diuresis, detoxification hemosorption.

2. In stage I specific therapy not produced. In stage II: 0.05% prozerin solution subcutaneously 10-15 ml (1-2 days), 2-3 ml (3rd and 4th days), ATP - 12-15

A noisy neighbor, an unfaithful husband, a successful colleague are the main victims of poisoning in detective series. But life sometimes twists such stories that the directors never dreamed of! Of course, the river is full of whirlpools, and the freshly washed marble steps are very insidious ... But for criminals, the attraction of poisoning as a method of murder lies in the invisibility of poisons. That's just modern expertise is able to detect most of them. How poisons are recognized, the correspondent of "R" found out.

At the request "How to poison a person?" google gives 387 thousand results. In the top - arsenic. Until the 19th century, poisoning by this "king of poisons" was difficult to diagnose, since the symptoms are similar to those of cholera. Getting arsenic was then easy - just send a servant to the pharmacy for a deadly vial. Today, getting this poison is extremely difficult: due to its toxicity in dentistry, for example, it has been replaced with safer drugs.

- Arsenic, or rather, its compounds are powdered crystalline substances. Upon contact with aqueous media, they form an extremely toxic compound of arsenic with hydrogen - arsine. Arsin kills all living things in its path, - brings me up to date with the head of the department of forensic chemical examinations of the central office of the State Committee for Forensic Examinations Yury Sinkevich.

The expert must not only confirm the fact of poisoning, but also determine the substance. These can be heavy metals, and household solvents, and alcohol surrogates, and drugs, and even pesticides. Heavy metals, for example, accumulate in the hair. Using them, you can determine exactly when a person was poisoned:

The average human hair growth rate is 1.5 centimeters per month. Based on this, we cut the hair into sections and examine them for the presence of substances. We can determine, to the nearest month, when a person was exposed to the poison. Hair can tell if a person smokes, uses drugs, and even likes coffee.

Yury Sinkevich loads samples into a special device, which we will analyze for the presence of arsenic in them. The device creates a temperature of 2.5 thousand degrees, at which substances are atomized. If there are arsenic atoms in the atomic vapor, the device will show this. The device is so sensitive that it will detect arsenic in the samples of a person who ate seafood the day before, which is characterized by increased content this element. After a few minutes, we get the result - arsenic was not detected in the samples.

... Phosphine is widely used in everyday life for pest control. This poisonous gas is also used to kill insects and other living creatures during quarantine measures with fruits brought from abroad.

We received samples of three dead people and dogs - Yury Sinkevich comments on the case of group poisoning. - It turned out that all the dead spent the night in one of the warehouses, where quarantine measures were taking place at that time. The warehouse owner applied phosphorus compounds throughout. Those in contact with air released phosphine. The poisonous gas killed not only the insects in the fruit crates, but also the people who spent the night in the warehouse.

Some substances can become extremely toxic if dosed incorrectly. No wonder the famous medieval physician Paracelsus wrote that "everything is poison, and nothing is devoid of poison." Sodium nitrite, for example, is widely used in the manufacture of sausages. It gives the product an appetizing pinkish tint. But one teaspoon of sodium nitrite is a lethal dose for humans. Once they poisoned the whole family: grandfather, grandmother and grandson died at home, the mother managed to get to work.

- Having studied their food products, we found out that all soups and cereals were salted not with food salt, but with sodium nitrite,– the expert recalls the circumstances of the group poisoning. - Outwardly, the substance looks like table salt"Extra". The same finely granulated crystalline, but the taste is the same salty. At first glance, the difference - a small characteristic yellowish tint of salt - will be caught only by a specialist.

Poisoning is often accidental. But they deliberately poison people. So, a corporate party for one Minsker ended with an examination. “I drank thirty grams of vodka, and I got carried away like from half a bottle. And then a colleague persistently put me behind the wheel ... ”she complained, giving the experts samples of her blood for analysis. The examination found sleeping pills in her samples.

Sometimes karma intervenes in the insidious plan of the poisoner. A woman tried to poison a friend by adding mercury from a thermometer to her soup. The failed criminal did not take into account the laws of chemistry and, having inhaled mercury fumes, she herself pleased with severe poisoning in hospital.

About 70% of all poisonings are caused by ethyl alcohol and alcoholic liquids. Methyl alcohol in appearance, smell and taste almost no different from ethanol. But for a lethal outcome, 30-50 milliliters is enough. And "mistake" is tantamount to death. This is confirmed by the recent mass death of people from the "Hawthorn" product containing methanol.

There are also mass poisonings. One of the loudest happened in 2007. In the blood of the victims, the content of bilirubin, indicating liver damage, went off scale for 500 units at a rate of about 10. The experts found that the alcohol-containing liquid that the victims drank was technical.

Sometimes in the laboratory of the State Committee, stories are twisted worse than detective stories. Experts remember how in the 1980s an employee of the Opera and Ballet Theater took revenge on a colleague by pouring thallium into his champagne. But the poisoned bottle was taken by other people each time. Based on this crime, they even filmed the issue “The investigation was conducted ...” on NTV. After the arrest, the offender admitted that he got thallium from his chemist brother.

In the past, poisoning as a method of killing was widespread. It was easy to buy poison, but it was difficult to confirm poisoning. Now there are few truly poisonous drugs in pharmacies, and most of them require a prescription to buy. Enter "buy deadly poison" into the search engine - and this request will remain in your search history, giving you away. Yes, and the examination has stepped far forward: as soon as a way to detect a certain poison is found, the criminal interest in it immediately disappears.

Inna Gorbatenko, Respublika, September 1, 2017
(photo - Arthur Prupas)