Download e-book for kindle: Poisoning Diagnosis and Treatment by J. A. Vale, T. J. Meredith (auth.), J. A. Vale MD, MRCP, T.

By J. A. Vale, T. J. Meredith (auth.), J. A. Vale MD, MRCP, T. J. Meredith MA, MRCP (eds.)

In the decade, the prevalence of acute poisoning within the constructed international has risen significantly, in order that health center admissions from this reason now repre~ despatched an important a part of the paintings load of so much clinical devices. the aim of this publication is to supply an up to date account of the diag­ nosis and remedy of all of the clinically very important poisons. in the course of the textual content the purpose has been to stress the mechanisms of toxicity - at any place they're recognized - in order that a rational method of treatment could be devised. furthermore, significant chapters were dedicated to the psychiatric determine­ ment of self-poisoned sufferers and to the position of the laboratory. sorts of presentation were followed. sure themes are mentioned extensive both due to their medical value or simply because contemporary information became on hand touching on pathophysiology or remedy. by contrast, while topics were good defined formerly often scientific texts, for instance, carbon monoxide poisoning, the dialogue is way extra short and to the purpose. the same kind has been followed with lately brought medications, the place little is understood concerning the results in overdose. the price of cer­ tain chapters, particularly these on toxic crops and snake bites, has been superior through the inclusion of a big variety of color photographs.

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1. A potentially toxic dose of poison has been ingested. 2. Treatment can be given within four hours of ingestion (longer for salicylates and anticholinergic drugs including tricyclic antidepressants) . 3. Patient unconscious and time of ingestion not known. 4. g. concentrated paraquat solutions or formic acid. Contraindications 1. Poisoning due to petroleum distillates. Sodium chloride. Sodium chloride has been widely used as an emetic, but its efficacy is low and its toxicity is high. 5 lists cases where death occurred due to hypernatraemia because an excessive dose of salt was given, either at the outset or because vomiting did not occur.

Drug Ther Bull 1979; 17:2;7- 8. Editorial Dopamine in cardiac failure and shock. Br' Med J 1977; 2:1563-4. Goulding R, Volans GN. Emergency treatment of common poisons: emptying the stomach. Proc Roy Soc Med 1977; 70:766-70. Ilett KF, Gibb SM, Unsworth RW. Syrup of ipecacuanha as an emetic in adults. Med J Aust 1977; 2:91-3. Manoguerra AS, Krenzelok EP. Rapid emesis from high dose ipecacuanha syrup in adults and children intoxicated with antiemetics or other drugs. Am J Hosp Pharm 1978; 35: 1360-2.

Inhalation of amyl nitrite has been recommended in the past to produce methaemoglobinaemia, but it is poorly tolerated and only low circulating levels of methaemoglobin may be achieved before profound hypotenSion occurs. Methaemoglobinemia is therefore best achieved by the intravenous administration of sodium nitrite. Traditionally a combination of intravenous sodium nitrite and sodium thiosulphate is used in the treatment of cyanide poisoning. Experiments in dogs have shown that the LDso for cyanide may be increased three-fold by sodium thiosulphate alone, five-fold by sodium nitrite alone and eighteen-fold by the use of the two antidotes together.

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