Pharmaceutical Poisoning: Treatment Strategies

Poisoning management involves immediate exposure cessation, thorough skin and eye washing, and GI decontamination.

GI decontamination prevents poison absorption through adsorption, whole-bowel irrigation, and gastric lavage.

Adsorption happens when the poison binds to an adsorbent’s surface. Activated charcoal, a common adsorbent with surface carbon moieties, is effective in most acute drug overdoses.

Whole-bowel irrigation involves enteral administration of an iso-osmotic polyethylene glycol solution to purge the intestines.

Gastric lavage uses a tube inserted into the stomach to flush and remove its contents with normal saline.

These decontamination procedures carry risks such as pulmonary aspiration, mechanical injury, and death.

On the other hand, if poison is absorbed, elimination enhancement procedures are used.

Urine alkalinization using sodium bicarbonate expedites weakly acidic drug elimination.

Antidotal therapy employs specific antagonists like N-acetyl-L-cysteine for acetaminophen poisoning and naloxone for heroin overdose.

Finally, hemodialysis removes waste and toxic metabolites from the blood.