| |
Article Title |
Author(s) |
Pages |
|
|
|
Contents
|
|
OFC
|
|
|
|
Editorial Board
|
|
i
|
|
| Introduction |
| |
Article Title |
Author(s) |
Pages |
|
|
|
Poisoning: introduction
In the minds of many doctors, exposure to a substance is equated with poisoning. However, systemic absorption is usually necessary for there to be a toxic effect and, even if this occurs, the amount a...
|
Allister Vale,
D. Nicholas Bateman
|
41
|
|
| Epidemiology |
| |
Article Title |
Author(s) |
Pages |
|
|
|
The epidemiology of poisoning
Abstract: The epidemiology of poisoning can be studied from different perspectives. These include overall mortality, hospital admission rates, and enquiries to Poisons Information Services. Accidental...
|
D. Nicholas Bateman
|
42-45
|
|
| Assessment |
| |
Article Title |
Author(s) |
Pages |
|
|
|
Is the cause toxicological?
Abstract: The diagnosis of poisoning is usually evident (e.g. in a patient presenting with drug overdose), but can occasionally be obscure. This article describes some clinical presentations where poi...
|
S.H.L. Thomas
|
46-47
|
|
|
|
Assessment and diagnosis of the poisoned patient
Abstract: Assessment of an acutely poisoned patient involves the taking of an appropriate history, assessment of the level of consciousness, ventilation and circulation, a physical examination, and re...
|
Allister Vale,
Sally Bradberry
|
48-52
|
|
|
|
Low-toxicity ingestions
Abstract: Accidental ingestion of products found in the environment is common. It particularly affects young children aged 1–4 years, especially boys. Fortunately, many substances that are taken by ac...
|
S.H.L. Thomas
|
53-54
|
|
| Complications of poisoning |
| |
Article Title |
Author(s) |
Pages |
|
|
|
Metabolic effects of poisoning
Abstract: Biochemical abnormalities due to disturbed metabolic processes are common in severely poisoned patients. These may be of diagnostic value, but most importantly their recognition and treatmen...
|
Alan Jones
|
55-58
|
|
|
|
Methaemoglobinaemia
Abstract: Methaemoglobin is formed when ferrous haemoglobin iron (II) is oxidized to ferric iron (III), which cannot participate in oxygen transport. Methaemoglobin-forming chemical groups of particul...
|
Sally Bradberry
|
59-60
|
|
|
|
Rhabdomyolysis
Abstract: Non-traumatic rhabdomyolysis may be caused by a direct insult to the cell membrane, affecting its ability to maintain ion gradients, or be secondary to local muscle compression as a result o...
|
Allister Vale
|
61-62
|
|
|
|
Serotonin syndrome
Abstract: The serotonin syndrome is the clinical manifestation of serotonin toxicity in patients taking one or more serotonergic agents. It is characterized by features of neuromuscular hyperactivity,...
|
Ruben Thanacoody
|
63-64
|
|
| Management |
| |
Article Title |
Author(s) |
Pages |
|
|
|
Management of poisoning: initial management and need for admission
Abstract: Initial management involves the treatment of any potentially life-threatening conditions, such as airway compromise, breathing difficulties, haemodynamic instability and serious dysrhythmias...
|
Allister Vale,
Sally Bradberry
|
65-66
|
|
|
|
Reducing absorption and increasing elimination
Abstract: There is no evidence that the use of single-dose activated charcoal, gastric lavage, syrup of ipecacuanha, cathartics or whole-bowel irrigation improves the clinical outcome in poisoned pati...
|
Allister Vale
|
67-68
|
|
|
|
Management of poisoning: antidotes
Abstract: Antidotes exert their beneficial effects by a variety of mechanisms, including forming an inert complex with the poison, accelerating detoxification of the poison, reducing the rate of conve...
|
Sally Bradberry,
Allister Vale
|
69-70
|
|
|
|
Psychiatric assessment and management of deliberate self-poisoning patients
Abstract: Deliberate self-poisoning is one of the most common for general hospital presentation. The majority of the individuals involved are young, with females outnumbering males. Self-poisoning occ...
|
Keith Hawton
|
71-73
|
|
| Substance abuse |
| |
Article Title |
Author(s) |
Pages |
|
|
|
Substance abuse: routes, hazards and body packing
Abstract: Substances taken to alter the mental state may be ingested, inhaled, absorbed through mucous membranes or injected. Accidental overdose is common. Complications result either from the presen...
|
Allister Vale
|
74-76
|
|
| Chemical terrorism |
| |
Article Title |
Author(s) |
Pages |
|
|
|
Chemical terrorism and nerve agents
Abstract: Sarin and VX were released on civilians in Japan on 11 occasions in the period 1994 to 1995. Clinicians must be prepared, therefore, to treat casualties from nerve agent exposure. This requi...
|
Allister Vale,
Timothy C. Marrs,
Paul Rice
|
77-79
|
|
|
|
Ricin and abrin
Abstract: Ricin is derived from the beans of the castor oil plant, Ricinus communis. Many of the features seen in poisoning can be explained by ricin-induced endothelial cell damage, which leads to fl...
|
Sally Bradberry
|
80-81
|
|
|
|
Sulphur mustard
Abstract: Sulphur mustard is a powerful vesicant (blistering agent) which was used extensively in World War I and in the Iran–Iraq conflict (1984–1987). In addition to causing characteristic blisterin...
|
Paul Rice
|
82-83
|
|
| Drugs of abuse |
| |
Article Title |
Author(s) |
Pages |
|
|
|
Drugs of abuse (amfetamines, BZP, cannabis, cocaine, GHB, LSD)
Abstract: The features of amfetamine poisoning are related predominantly to stimulation of central and peripheral adrenergic receptors, and in severe cases, excitability, agitation, paranoid delusions...
|
Allister Vale
|
84-87
|
|
| Specific substances |
| |
Article Title |
Author(s) |
Pages |
|
|
|
Acetone
Abstract: Acetone is a mucous membrane irritant, which can be absorbed by inhalation, ingestion and through the skin. Its metabolism leads to increased glucose production. At high concentrations it is...
|
Sally Bradberry
|
88
|
|
|
|
Alcohols and glycols
Abstract: Ethanol is a central nervous system depressant and a peripheral vasodilator, thereby causing coma, hypothermia and hypotension in severe poisoning. Hypoglycaemia, particularly in children, i...
|
Allister Vale
|
89-93
|
|
|
|
Ammonia
Abstract: Ammonia is a frequently used industrial agent. Ammonia is highly soluble in water and has toxic and corrosive actions caused by its alkalinity. It is easily absorbed through mucous membranes...
|
Jan Meulenbelt
|
94-95
|
|
|
|
Anticonvulsants
Abstract: Generally, phenytoin and carbamazepine have greater toxicity in overdose than sodium valproate and the newer anticonvulsants, though case reports confirm that severe toxicity can occur uncom...
|
Allister Vale
|
96-97
|
|
|
|
Antidiabetic drugs
Abstract: Over recent years, there has been rapid expansion of different classes of antihyperglycaemic drugs. These drugs have diverse toxicological profiles because each possesses a unique pharmacolo...
|
W. Stephen Waring
|
98-99
|
|
|
|
Antidepressants
Abstract: Antidepressant drugs differ in their relative toxicities. The most hazardous are tricyclics, citalopram, venlafaxine and the rarely used monamine oxidase inhibitors. Features include arrhyth...
|
D. Nicholas Bateman
|
100-102
|
|
| Self-assessment |
| |
Article Title |
Author(s) |
Pages |
|
|
|
Self-assessment/CPD
This CPD section was prepared by Eric Beck FRCP FRCP(Ed) FRCP(Gl)
|
|
103
|
|
