Drug poisoning: what to do and first aid

Here we will consider the poisoning of the most common drugs - opium, morphine, omnipon and heroin, what to do if a person has overdosed and poisoned with a drug and how to give him the first first aid. This opiate and morphine drug group has an elective psychoactive and neurotoxic effect on the body.

Symptoms of poisoning

Morphine is the main alkaloid of opium. The minimum toxic dose for oral administration is 0.1 g, and the lethal dose is 0.3;for parenteral application, the toxicity increases approximately 2-fold. Morphine is rapidly absorbed and exerts an effect 10-15 minutes after subcutaneous administration and after 20-30 minutes with ingestion. The action lasts 3-5 hours. Morphine affects the central nervous system, inhibiting the thalamic centers of pain sensitivity and the center of respiration, while simultaneously excitating the centers of wandering and oculomotor nerves. The analgesic effect of morphine, as a rule, is accompanied by euphoria. Large doses cause a hypnotic effect. Morphine is excreted from the body with feces, urine, saliva and sweat( and also with the milk of a nursing mother).

Most susceptible to this group of drugs are weakened persons, elderly, newborns, patients with atherosclerosis.

When ingestion, morphine is rapidly absorbed in the gastrointestinal tract( opium - through the lungs during smoking).Narcotic substances in the liver are neutralized, and they are excreted through the kidneys.

When morphine or its derivatives are poisoned, there is face hyperemia, dizziness, a feeling of heat and thirst, nausea. Often the victim( or drug addict) sees dreams in reality. In the next phase there is a pallor of the skin, bradycardia, a state of deafness, narrowing of the pupils. The poisoned person loses consciousness and can stay in this state for up to two days. At the same time, his breathing is shallow, scarcely perceptible, rare and irregular, he is pale, pupils are as narrow as possible, do not react to light.

In case of severe poisoning, the pulse becomes frequent, intermittent, then paralysis of swallowing muscles occurs, convulsions and the patient dies at the phenomena of respiratory failure and from cardiac arrest.

Complications: pulmonary edema, cerebral edema, pneumonia development.

First-aid first aid

1. Give the patient any emetic that will be at hand( root ipecacuanas, vomiting root).Repeat the dosing of the emetics every 15 minutes;
2. when poisoning with opium, give inside flour from mustard seeds of Sorepian by 1 pinch every 10-15 minutes( powder of mustard helps induce vomiting and diarrhea);
3. after the patient well vomit, give him two glasses of water, slightly tinted with grains of potassium permanganate;
4. in no case should not be given to the patient to fall asleep. It should be sprinkled with water, led around the room, beat on the cheeks, stabbed with pins, and sniffed with ammonia. For a opium poisoned or morphine, sleep is death;
5. lower the victim's feet in hot water, put a cold compress or ice pack on his head;
6. inside give a decoction of oak bark, strong tea, coffee;
7. antidote for drug poisoning is Atropine( give 20 drops per reception every two hours, no more than three times);
8. give 2-3 egg whites per liter of water;
9. to send the victim to any medical institution;
10. before the doctor's arrival warm the patient's body.

Emergency medical assistance

1. The most effective antidote is physiological morphine antagonists: Nalorfin( N-allyl-normorphine, antorfin) and Lavallorfan.1-2 ml of 0.5% solution of Nalorfin is administered intravenously( in 20 ml of physiological solution slowly), intramuscularly or subcutaneously. Lavallorfan is administered 1 mg parenterally( 1 ml 0.1% solution).
2. To prevent further absorption of the poison from the gastrointestinal tract, the patient is subjected to repeated gastric lavage( even after subcutaneous administration of morphine) with water mixed with activated carbon or potassium permanganate solution( 1: 100) or tannin( 5: 1000);give a solution of potassium permanganate potassium in tea spoons every 10 minutes for an hour;prescribe salt laxative( 20-30 grams of sodium sulfate with a suspension of 50 g of activated carbon).
3. Long-term inhalation with carbogen or oxygen through nasal catheters or mask, subcutaneous repeated administration of Atropine, Caffeine, Camphora, Cordiamine, intravenous repeated injections of 0.5-1 ml of 1% solution of Lobelin or Cititon is recommended to stimulate respiration.
4. When Cheyne-Stokes breathing and stopping breathing, urgent intubation of the trachea or tracheotomy, prolonged artificial respiration with oxygen, intravenous administration of 4 ml of Cordiamine( slowly) and 4 ml of subcutaneously.
5. In severe cases of poisoning, bleeding 250-300 ml of blood is done( contraindicated in hypotension) followed by transfusion with 250 ml of canned blood or drip by intravenous injection of 500 ml of physiological sodium chloride solution or 5% glucose solution.
6. When a person is poisoned with opium, morphine or heroin, the patient needs to be warmed. Emetics should not be given.

Source: Iligov GN Official and traditional medicine. The most detailed encyclopedia.- Moscow: Izd-vo Eksmo, 2012.