Painkillers and prescribed drugs

An aspirin overdose may lead to stomach pain, vomiting, sweating and a raised temperature, perhaps with deafness and ringing in the ears. Delirium and hallucinations may also develop. Aspirin poisoning may be fatal: prompt medical attention is essential. Paracetamol in excess can be fatal because of its effects on the liver. The symptoms of nausea and vomiting, with loss of appetite, appear within 24 hours following an overdose; liver failure usually develops two to seven days later. There is an effective antidote, provided it is administered within 12 hours: urgent hospitalization is therefore crucial.

Extremely poisonous insecticides and pesticides are still used to protect crops against pests and diseases.

Lead enters a person’s body in many ways (A). One important source is inhalation of exhaust fumes from traffic and industry. Another is inhaling gases from paint that contains lead. In addition, lead may get into the body through eating fruit that has been treated with pesti- cides containing lead or eating lead-contaminated soil or paint. Besides measures intended to limit the amount of lead in one’s living environment, lead can be eliminated from the body by injecting a substance (calcium disodium EDTA; 1) into a vein (B). The calcium in this molecule is exchanged for lead and the – inactive – molecule complex that is formed enters the urine via the kidneys and is excreted .

Sleeping tablets, sedatives, tranquillizers, heart drugs, antidepressants, anticonvulsants and so on all have serious effects if taken in large doses. Medical advice should be urgently sought.

Drug and solvent abuse

An overdose of opiate drugs usually results in the casualty stopping breathing and losing consciousness; the pupils contract to pin-point size. First aid should be given, and medical help sought urgently.

Many different substances apart from glue can be ‘sniffed’, from dry-cleaning fluids to nail-polish remover and petrol. In the case of glue, the fumes of which are inhaled out of a plastic bag, confusion and hallucinations are the usual result, followed by drowsiness and unconsciousness. Signs of glue sniffing include red, puffy eyes and face, a rash around the mouth, slurred speech and dilated pupils.

Alcohol

Alcohol poisoning may lead to the person affected becoming unconscious and choking on his or her vomit. Place the casualty in the recovery position; if you think it wise, arrange a transfer to hospital.

Household chemicals

The most dangerous of these are bleach, kettle de-scaler, sink and oven cleaners, and dishwasher powders. Urgent medical attention should be sought in every case, and the casualty given a large amount of water to drink in the meantime.

Pesticides

Many pesticides are dangerous if ingested, or if absorbed in large quantities through the skin. In the case of accidental spillage, remove the casualty’s clothing and wash the skin with soap and water, or just water; avoid contact yourself with the pesticide. Milk should not be given to drink because it enhances the uptake of the poison in the intestines. If the person stops breathing, give artificial respiration and arrange urgent transfer to hospital, identifying the chemical in question if at all possible.

Plant and animal poisons

Although poisoning from plants is rare, anyone who has ingested unfamiliar plant material or berries should seek medical advice, particularly if they are suffering from drowsiness, nausea, vomiting or diarrhoea. Laburnum, deadly nightshade, yew and mistletoe, although rarely fatal, may cause poisoning. The commonest poisonous snake in Europe is the European adder, although people are sometimes poisoned by other species kept as pets. If someone has been bitten, the snake should be identified or taken to the hospital with the casualty, if this can be done safely, so that it can be correctly identified and the corresponding antivenom can be given. Following a snake bite, calm the casualty, who may be in a state of shock. The bitten limb should be immobilized, and covered by a cold, wet cloth, to limit the spread of poison via the blood circulation. A tourniquet may be used in some instances for this purpose, but it should be loosened at intervals of fifteen minutes, because otherwise a fatal tourniquet-shock may be the result. To attempt to cut out the bite is rarely advisable, nor is sucking out the poison.

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