Poisoning Identification

Poisoning identification is the clinical process of recognizing toxic exposure, determining the likely substance and dose, and assessing its effects on the body. Clinicians combine the exposure history, timing of symptoms, physical examination, and characteristic toxidromes with targeted laboratory tests, toxicology screens, and sometimes imaging to distinguish poisoning from other medical conditions. Rapid identification guides supportive care, monitoring, decontamination, and the selective use of antidotes while limiting unnecessary testing or treatment. In emergency and clinical settings, this approach helps predict complications, prioritize interventions, and improve outcomes when the substance is unknown, multiple agents are involved, or symptoms evolve over time.

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JoVE Core - Pharmacology

Prevention of Further Absorption of Poison

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2023

In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...

Enhanced Elimination of Poison

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2023

Poison can be effectively removed from the gastrointestinal (GI) tract through various decontamination procedures. Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death. Renal excretion is the...

Anticholinesterase Agents: Poisoning and Treatment

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2023

Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action. Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is slower than the...

Pharmaceutical Poisoning: Potential Scenarios

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2026

Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...

Pharmaceutical Poisoning: Treatment Strategies

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2026

Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...

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