Poisoning with medicines: what to do and first aid

Consider cases of poisoning in adults and children with certain medicines and drugs. What can you do if a person has been poisoned with medicines and how to provide him with the correct first emergency aid for poisoning.

Poisoning by barbiturates: hypnotics

1. Amobarbital. The lethal dose inside is 2-4 g.
2. Barbital. The lethal dose inside is 6-8 g.
3. Heptabarbital. The lethal dose inside is 20 g.
4. Dillylbarbituric acid. The lethal dose inside is 6-8 g.
5. Phenobarbital. The lethal dose inside - 4-6 g.
6. Cyclobarbital. The lethal dose inside - 5-20 g.

All sleeping pills primarily act on the central nervous system, depressing it.

Of the hypnotics, the most common are barbitol, phenobarbital, barbamyl, ethaminal sodium, radedorm. The lethal dose of each of these drugs is usually ten times greater than the therapeutic dosage. Of course, the sensitivity of different people to them is different, and for poisoning one person needs one dose, another one - the other. All barbiturates are rapidly absorbed in the intestines, so washing the bowels with barbiturate poisoning is one of the primary tasks of emergency care.

Symptoms of poisoning

For light poisoning with barbiturates, and during the first hours of severe intoxication, a typical narcotic effect without breathing and circulatory disturbance is observed. But with the further absorption of the poison, even the lungs at first start poisoning gradually into a severe form with the comatose state of the victim. The face, which at first often reddened, later becomes gray and cyanotic. Breathing is usually superficial, at first rare, later, in most cases, rapid. The patient develops drowsiness, apathy, stunnedness, moderate narrowing of the pupils, decrease in the number of cardiac contractions( bradycardia).With more severe poisoning, drowsiness gradually turns into a deep sleep, accompanied by loss of consciousness. The pupils are narrowed, the muscles are relaxed, the pressure drops sharply. There is a delay in stool and urine. Bradycardia is replaced by tachycardia. When poisoning with barbiturates for patients characterized by a tendency to repeat vomiting, so there is always the danger of vomiting in the airway of the patient.

In severe poisoning, even with the most effective treatment, sleep can last 6-7 days.

Death from barbiturate poisoning usually comes from central paralysis of respiration and cardiac arrest.

A few aside from poisoning with other barbiturates is the poisoning of by noxirone. Noxiron is slowly absorbed into the stomach and therefore poisoning symptoms may appear only a few hours after poisoning. The toxic dose of noxiron is 5-20 g.

The clinical picture of noxiron poisoning is characterized by the following symptoms: a coma( with the coma progressing from an easier stage to a more severe stage), a rare pulse, intestinal paresis, atony of the bladder.

Poisoning with sleeping pills requires emergency care.

First emergency aid

First of all, it is necessary to remove the poison from the stomach, reduce its content in the blood, support breathing and cardiovascular system.

1. The poison from the stomach is removed by washing it( the earlier the rinse is started, the more effective it is), consuming 10-13 liters of water, it is advisable to rinse again, best through the probe. If the victim is conscious and there is no probe, rinsing can be done by repeated intake of several glasses of warm water followed by vomiting( irritation of the pharynx).Vomiting can be caused with mustard powder( ½-1 teaspoon per glass of warm water), strongly diluted with potassium permanganate solution( pale pink), or with an emetic, including apomorphine subcutaneously( 1 ml 0.5%).
2. To bind the poison in the stomach use activated charcoal, 20-50 g of which in the form of an aqueous emulsion is injected into the stomach. The reacted coal( after 10 minutes) must be removed from the stomach, since the adsorption of the poison is a reversible process. That part of the poison that has passed into the stomach can be removed with the help of laxatives. Preference is given to sodium sulfate( Glauber's salt), 30-50 g. Magnesium sulphate( bitter salt) in case of impaired renal function may have a depressing effect on the central nervous system. Castor oil is not recommended.
3. For accelerated removal of absorbed barbiturates and their allocation by the kidneys give abundant drink and diuretics. If the patient is conscious, then the liquid( ordinary water) is ingested, in cases of severe poisoning, 5% glucose solution or isotonic sodium chloride solution is injected intravenously( up to 2-3 liters per day).These activities are carried out only in cases where the excretory function of the kidneys is preserved.
4. In severe violation of breathing, intubation, suction of the contents of the bronchi and artificial ventilation of the lungs are performed, with less significant respiratory disorders resorting to the use of respiratory stimulants( analeptics), lobeline( 1 ml of 1% solution) is injected under the skin. For the prevention of pneumonia, antibiotics are prescribed, with a sharp increase in temperature - intramuscularly 10 ml of a 4% solution of amidopyrine.
5. To restore vascular tone, vasoconstrictors are used. To stimulate cardiac activity - fast-acting glycosides, when cardiac arrest is shown, the injection of adrenaline into the cavity of the left ventricle with subsequent massage through the thorax.

Great importance is attached to the care of patients( warming, hygiene of the body and oral cavity, bladder catheterization, treatment of pressure sores, etc.).

Barbiturates( especially luminal and veronal) are among the dialyzing poisons that can penetrate through the semipermeable membrane. Therefore, it is most expedient to use hemodialysis with the help of the apparatus "artificial kidney" when poisoning with these poisons.

If this is not possible, then repeated exchange blood transfusions of 400-500 ml are recommended to reduce the concentration of venom in the blood. For a quicker removal of it, large quantities of liquid are injected - physiological solution of sodium chloride, 5% glucose solution( intravenously, subcutaneously in a drop enema), at least 2-3 liters per day( contraindicated in pulmonary edema).Since barbiturates are excreted mainly by the kidneys, measures are taken to increase diuresis, resorting to daily intramuscular injection of 1-2 ml novurite( or 1 ml intravenously).The maximum increase in daily diuresis is achieved by intravenous injection of a 30% solution of urea, alkaline solutions and electrolytes.

For a very large diuresis( 8-11 liters or more) 10 ml of a 5-10% solution of sodium chloride and 50-75 ml of a 2% solution of potassium chloride are injected intravenously to prevent hyponatremia and hypokalemia( a solution of potassium chloride can be introduced viaprobe into the stomach and drip into the rectum).A small diuresis usually indicates a kidney failure, and the introduction of urea in such cases should be stopped.

To remove from the coma, large doses of analeptics( strychnine, caffeine, cordiamine, bemegrid) are used to stimulate the central nervous system and are physiological antagonists of barbiturates. To use them, absolute certainty in barbiturate poisoning is necessary.

Depending on the severity of coma, 2 to 10 ml of 0.1% solution of nitric acid strichin every hour or every 3-6-8 hours( or 10-12 ml of cordiamine) is injected intravenously until pain sensitivity, pupil and corneal reflexes are restored orbefore the appearance of the first signs of increased muscular excitability( easy muscle twitching).

After emergency and emergency care, the patient needs to be hospitalized in a medical institution.

Atropine poisoning and atropine-containing substances

Atropine and atropine-like substances are rapidly absorbed in the stomach and intestines. The first symptoms of poisoning appear after 20-30 minutes. If atropine got into the body with alcohol, then the period of intoxication will be delayed for several hours.

Atropine and atropine-like poisoning develops accidentally or intentionally when attempting suicide.

In the clinic of poisoning, the main ones are neurological, psychiatric and vegetative disorders. Symptoms of poisoning depend on the dose of poison, the mental and physical condition of the patient, his age and individual sensitivity to the poison.

Poisoning levels: symptoms of

There are 4 degrees of severity of poisoning.

With , , a patient has a state of temporary stunning( talkiness, a desire to joke, a state of euphoria), attention and memory disorders. The speech of the patient is incoherent, incomprehensible. He complains of a feeling of dryness in his mouth. Sometimes he has hallucinations.

With the of the second degree of , the patient becomes fussy, long-winded, restless. It seems to him that he has lost something, he is looking for his things, working tools. There are hallucinations: the patient sees small men, small animals, insects, lizards. His memory is severely disturbed. He begins to speak, but immediately loses the thread of his thoughts. With an external examination, there is noticeable hyperemia of the face, dry lips, dilated pupils. Pain and temperature sensitivity is increased. The patient is worried about shortness of breath.

With , the third, severe, degree of poisoning, visual hallucinations that occur in a patient acquire the character of small stage productions. He sees frightening images, can see his own funeral, etc. The patient says a lot, but his speech is an ordinary set of words. Sensitivity is greatly increased and even when touched, he feels pain. There is severe shortness of breath, blood pressure is increased, the pulse is increased to 120 beats per minute.

In the most severe cases of ( fourth degree of poisoning) , the patient develops a coma, from which he may die. Muscle tone is tense, there are noticeable twitchings of individual muscle groups, pupils are dilated and do not respond to light. The skin is dry, the body temperature is increased, the pulse is up to 120 beats per minute.

First aid

1. Gastric lavage is effective only in the first 1,5-2 hours after poisoning;
2. continuous monitoring;
3. during the patient's excitation should be fixed;
4. hospitalization in any medical institution.

Emergency care in the

hospital

1. When taking the poison inside, it is necessary to induce vomiting artificially, resorting to mechanical methods( Apomorphine can be used in a hospital).
2. Rinse the stomach with a large amount of warm water containing 50 g of activated charcoal or a solution of potassium permanganate( 1: 1000), followed by the introduction of activated charcoal with a salt laxative with a suspension. Pre-lubricate the probe well with oil, in view of the large dryness of the mucosa of the esophagus.
3. Immediately put a high enema.
4. For acute motor and mental excitement, Chloral hydrate( 50 ml of a 2% solution) or Barbamyl( 0.3-0.5 g in 25-50 ml of water) is prescribed in an enema or 3-5 ml of a 5% sterile solution of Burbamilsubcutaneously. The use of morphine is dangerous because of the possibility of paralysis of the breath. With caution, you can enter 1 ml of a 1% solution of Promedol subcutaneously.
5. It is necessary to reintroduce 1 ml of 0.05% Prozerin solution subcutaneously or intravenously with saline( since it eliminates the synaptic block caused by Atropine) and 1 ml of 1% solution of Pilocarpin subcutaneously.
6. For severe poisoning, bleeding should be done( 300-400 ml) followed by dropwise transfusion with 250-500 ml of single-group blood or plasma and 500-1000 ml of physiological sodium chloride solution or 5% glucose solution, intravenously or subcutaneously. Cordiamin, Caffeine, Camphor.
7. Conduct oxygen inhalations through a mask or nasal catheters, with respiratory depression - intubation of the trachea or tracheotomy, prolonged artificial respiration and the whole complex of necessary measures.

Poisoning with diphenhydramine, suprastin, tavegil

When these preparations are poisoned, the clinical picture depends on the amount of poison taken, but in general it is similar.

Symptoms of poisoning

When receives a small amount of poison ( 1-2 g), the patient complains of dryness of the mucous membranes, ringing in the ears, muscle weakness, double vision, gait disturbance, signs of stunnedness.

With severe form of poisoning( 4-5 g), the condition of the victim becomes heavier. He has fear, he is fearful, his speech is incoherent, the mucous membranes are dry. There are signs of motor excitation, which is replaced by a state of stunning.

Then the patient falls into a superficial coma. If Dimedrol was adopted against the background of alcoholic intoxication, then the patient's condition becomes much harder. He has a strong palpitation of up to 140 beats per minute( tachycardia) and other irregularities in the heart. Sometimes there is convulsions and shortness of breath. Death can come from paralysis of the respiratory center.

First aid

1. Gastric lavage with a thick probe followed by saline laxative;cleansing enema;oxygen therapy. The doctor prescribes the parenteral fluid and applies forced diuresis. With convulsions, anticonvulsant therapy is performed.
2. Emergency hospitalization in a medical institution. Symptoms of poisoning can appear in 10 minutes - 1,5 hours after taking the drug: lethargy, drowsiness, swaying, incoherent speech. Stunnedness can be replaced by motor and mental arousal with hallucinations;then comes a dream that lasts 10-12 hours. Reddening of the face and trunk, dry skin, visible mucous membranes, breathing and pulse are becoming more frequent. Severe poisoning leads to a coma.

When agitating, it is necessary either to give the patient a sedative( Seduxen), or to limit his movements.

Poisoning by iodine

Poisoning is possible with when administered iodine tincture. The minimum lethal dose for internal use is 5 to 10 ml of iodine tincture. Iodine has a high antiseptic activity. When applied to the skin and mucous membranes, it irritates. Large doses of iodine taken internally are absorbed into the bloodstream and have a general effect.

Iodine is excreted from the body mainly by the kidneys, partly by the gastrointestinal tract, by sweat and by the mammary glands( with lactation).

Clinic: Symptoms and Signs

Odor of iodine from the mouth. Runny nose, shortness of breath. Burning and pain in the mouth, throat, esophagus and in the epigastric region. Burns and brown color of the oral mucosa and tongue. Edema of the larynx. Salivation. Vomiting with dark yellow or blue masses( starch) with blood. Diarrhea, often with blood. Hematuria, oliguria, albuminuria. There are severe disorders of the central nervous system, accompanied by insomnia, delirium, hallucinations, psychoses, acute cardiovascular insufficiency.

Iodine vapors show a sharp irritation of the mucous membranes - lacrimation, sneezing, salivation, vomiting, convulsive cough, spasm of the glottis, severe shortness of breath, dizziness, headache, cyanosis, increasing general weakness, acute tracheobronchitis, inflammatory pulmonary edema.

Inhalation of iodine vapor is accompanied by approximately the same clinical picture as chlorine poisoning. At iodine poisoned around lips and mouth dark brown spots, visible mucous nasopharynx also brown. When you breathe a sick person in the air, you smell iodine.

Death can come from asphyxia( swelling of the larynx and lungs), collapse, shock. If the patient has an allergic reaction to iodine, then he may develop anaphylactic shock. Complications: pneumonia, bronchitis, nephritis.

First and first aid

When poisoning with iodine tincture, sulfuric acid( thiosulphate) sodium is used as antivenom. Rinse the stomach with a warm 5% sodium hydrogen sulfate solution, then with water, the same solution is used as a drink( 1-2 glasses) and for rinsing the mouth. Iodine is converted into non-irritating sodium iodide. Inside give protein water, starch paste, milk, 2-3% solution of soda, burnt magnesia( 20 grams per 120 ml of water, 1 tablespoon every 10 minutes).Assign cardiovascular drugs - Cordiamin, Camphor,

Caffeine, Codeine or Dionin( for coughing), intravenously inject 10 ml of a 10% solution of calcium chloride. With severe cyanosis and dyspnea, it is necessary to make a bleeding( 250-300 ml), followed by a dropwise injection of 300-500 ml of a 5% solution of glucose or saline, to appoint long-term intermittent oxygen inhalations with well-moistened oxygen. Rinse your mouth and throat with a 2% solution of soda. When poisoning with iodine vapor - inhalation of water vapor along with ammonia or soda, rinse mouth, nose, throat with 2% solution of soda.

Chloroform poisoning

The main signs of poisoning are: drowsiness, nausea, vomiting, diarrhea, dizziness, weakness. In severe cases, loss of consciousness, convulsions.

First aid

1. Give the victim strong tea, coffee;
2. to pour the head with cold water, put a wet cloth on the forehead and occiput;
3. give sniffing ammonia;
4. rinse the stomach;
5. call a doctor.

Contraindicated: sulfanilamide preparations, epinephrine and chlorine-containing sleeping pills( Chloralhydrate, etc.).It is unacceptable to drink alcohol and fats!

For acute inhalation poisoning - fresh air, rest. Prolonged inhalation of moistened oxygen with the use of nasal catheters( continuous during the first 2-4 hours, then for 30-40 minutes with interruptions of 10-15 minutes).Cardiac funds: Camphor( 20%), Caffeine( 10%).Cordiamine( 25%) 1-2 ml subcutaneously;soothing agents, strong sweet tea. Intravenously enter 20-30 ml of 40% glucose solution with 5 ml of 5% ascorbic acid, 10 ml of 10% solution of calcium chloride. With hiccups, vomiting - intramuscularly 1-2 ml of 2.5% solution of Aminazine with

2 ml of 1% solution of Novocaine. With respiratory depression, inhale the carbogen again for 5-10 minutes, intravenously 10-20 ml of 0.5% solution of Bemegrid, subcutaneously 1 ml of a 10% solution of Corazol. With a sharp weakening( stopping) of breathing - artificial respiration by mouth-to-mouth with the transition to a controlled one. In severe cases, immediate admission to the intensive care center.

When receiving the poison inside - thorough washing of the stomach through the probe, a universal antidote( TUM), 100-200 ml of vaseline oil followed by a salt laxative;purification of the intestine to clean wash water( siphon enema);Bleeding( 150-300 ml) followed by partial blood loss. To increase the diuresis, administering to the vein 50-100 ml of 30% Urea on a 10% solution of glucose or 40 mg of Lasix. With the development of the collapoid state, intravenously, 0.5 ml of a 0.05% solution of Strophantine in 10-20 ml of a 20% solution of glucose or Corligicon( 0.5-1 ml of a 0.06% solution in 20 ml of 40%Glucose solution);according to the indications - mezaton. In the future, to restore the acid-base balance - intravenous drip injection of 300-500 ml of a 4% solution of sodium bicarbonate. Recommended vitamins B6 and C, lipoic acid, unitiol( 5% solution intramuscularly 5 ml 3-4 times a day in the first day, 2-3 times a day for the second and third days).

Poisoning with derivatives of benzene, aniline, pyrazolone

This includes aniline, paracetamol, phenacetin, analgin, amidopyrine, indomethacin, methindol, furadonine, sulfonamides, etc.).

Benzene, aniline, pyrazolone derivatives are part of the group of methhemoglobin-forming poisons.

They are used in the manufacture of paints, rubber, pesticides, fertilizers, explosives, drugs.

The poisoning of these drugs most often occurs after they enter the gastrointestinal tract. These poisons are absorbed very quickly. Their action is that they disrupt the transport of oxygen in the body( acting on the hemoglobin of the blood, they form methemoglobin, i.e. oxidize ferrous iron to trivalent, and the ability of hemoglobin to transport oxygen is lost).

Symptoms of

The clinical picture of poisoning with these compounds, in mild cases, is as follows: burning in the mouth and throat, severe vomiting, gastrointestinal colic( sometimes with blood), fatigue, dizziness, headache.

With moderate poisoning there is a sharp cyanosis of the mucous membranes and skin, headache and dizziness are worse. Poisoned becomes drowsy. His speech is disconnected, the gait is broken, dyspnea and tachycardia appear.

Severe poisoning develops violently. Signs of poisoning appear after 1-2 hours. Patients complain of a sharp headache, nausea, vomiting. Their complexion is grayish-cyanotic, for some very serious patients the skin and visible mucous are almost black and blue. They experience severe shortness of breath, anxiety, an increase in the number of heartbeats, and a drop in blood pressure. If medical assistance is not provided, paralysis occurs, consciousness is lost, deep coma develops, convulsions appear, as epileptic. Poisoners sometimes die already in the first day from stopping breathing or circulatory disorders.

First aid

1. Rinse the stomach, give activated charcoal;
2. if poisoning occurs after taking aniline or nitrobenzene, give the patient a drink of vaseline, sunflower or castor oil( 100 ml);
3. provide fresh air or oxygen inhalation;
4. of all poisoned need to be urgently hospitalized in a medical institution.

Do not give alcohol, milk, salt laxatives.

First aid in the hospital

In acute intoxication:

1. rinsing of mucous membranes and skin with water. Peace, warmth.
2. when the poison is ingested - gastric lavage.
3. inside 200 ml of Vaseline oil.
4. intravenously 20 ml of a 30% solution of sodium thiosulfate.
5. inhalation of oxygen.
6. intramuscularly vitamins B1, B6, B12, ascorbic acid.
7. if necessary - cardiovascular funds.

In chronic intoxication, the treatment of hypoplastic or aplastic anemia is performed in full.

Cardiac glycoside poisoning

This includes poisoning caused by the following drugs: digoxin, digitoxin, digitalis preparations, lily of the valley, etc.

The lethal dose of glycosides is usually 10 times the therapeutic dose. Weakened people are more susceptible to poisoning, patients with heart diseases, old people, children.

Symptoms of poisoning do not depend on the pathway of poison. Usually, the victims complain of nausea, vomiting, abdominal pain, diarrhea, headache, dizziness, and visual disturbances. Often, glycosides poisoned with insomnia, excitement, delirium. There may be hallucinations.

Death occurs as a result of cardiac arrest.

First aid for

1. for gastrointestinal poisoning is good and repeatedly rinse the stomach;
2. give the affected salt laxative, activated charcoal;
3. take inside the paraffin oil( 200 ml);
4. to ensure the influx of fresh air or, if possible, inhalation of oxygen;
5. Call a physician as soon as possible.

Medical care

The toxic agent from the gastrointestinal tract should be removed as soon as possible. It is better to prescribe activated charcoal, since vomiting and gastric lavage can lead to an increase in parasympathetic tone and thereby aggravate cardiac conduction abnormalities. Multiple introduction of activated carbon allows not only to adsorb the cardiac glycosides contained in the digestive tract, but also to accelerate their removal from the blood. Forced diuresis, hemodialysis and hemosorption are ineffective.

If necessary, correct the levels of potassium, magnesium and calcium in the blood. If sinus bradycardia or atrioventricular blockade of 2 nd and 3 rd degree are accompanied by arterial hypotension and persist after administration of atropine, isoprenaline and antidigoxine, an EKS is shown. With ventricular tachycardia prescribe magnesium sulfate( as with anti-arrhythmic agents), phenytoin and lidocaine.

If these agents are ineffective with digoxin poisoning, and arrhythmias threaten life, antidiogoxin ( Fab fragments of antibodies to digoxin) is injected intravenously for 30 minutes( with circulatory arrest, antidigoxin is injected).As a rule, this within an hour leads to the restoration of the heart rhythm and correction of hyperkalemia. With normal kidney function, the antidygoxin-digoxin complex is excreted in the urine and its T1 is 16-20 hours. In case of kidney failure, this complex is gradually( within a few days or even weeks) metabolized. The serum concentration of free digoxin after administration of the antidigoxin rapidly drops to zero. However, usually the concentration of both free and bound digoxin is measured, and in such cases, the serum concentration can not be judged on the effectiveness of treatment. Antidigoxin binds other cardiac glycosides, but for this it must be administered at higher doses.

One bottle contains 40 mg of Antidigoxin;this dose neutralizes 0.6 mg of digoxin. The manufacturer's instructions contain equations and tables for calculating the dose of Antidioksin, based on body weight and serum concentration of Digoxin( after the distribution stage) or the amount of the drug taken.

Unfortunately, the symptoms of poisoning may appear already at the stage of distribution of Digoxin( or until the results of measurement of serum concentration), and the amount of the drug taken is not always known. In such cases, with chronic poisoning, in which the total content of digoxin in the body is only slightly higher than the therapeutic level, and cancellation can exacerbate heart failure, 1-2 vials of antidioksin are administered.

In case of acute poisoning, the digoxin content in the body is much higher, and usually 5-10 vials are administered. If necessary, these doses are repeated.

Poisoning with pachycarpine

When ingesting large doses of pachycarpine, a serious and life-threatening condition arises with a clinical picture of progressive respiratory distress and asphyxia.

Pachycarpine is easily absorbed from the intestine, quickly fixed in the autonomic ganglia and neuromuscular synapses, inhibiting( blocking) the passage through them of nerve impulses. Calling the neuromuscular block, pachycarpine dramatically reduces the muscle tone of the respiratory musculature. The amplitude and frequency of respiratory movements decreases, ventilation of lungs and gas exchange is disrupted, hypoxia and asphyxia are increasing. Blockage of vasoconstrictor pulses leads to the widening of the vessels, mainly the abdominal cavity. In relation to the musculature of the uterus, pachycarpine exerts a stimulating effect that strengthens its muscular tone. The highest therapeutic single dose of pachycarpin - 0.2 g, daily - 0.6 g.

Clinic: symptoms and signs

The first symptoms of poisoning appear most often in 2-3 hours after taking pahikarpine. Sometimes this period may be shorter. There is dizziness, weakness, nausea, vomiting, coldness and numbness of the limbs, pallor, acrocyanosis, a feeling of lack of air, a sharp dilatation of the pupils, disruption of accommodation, impaired vision, pain in the lower abdomen, women often have bloody discharge from the vagina. Later, there is a confusion and loss of consciousness, coma.

Breathing shallow, sparse. Cyanosis increases noticeably. Coma is sometimes preceded by a short period of clonic-tonic convulsions. Changes in the cardiovascular system are different: at first bradycardia can be noted, then with increased hypoxia - severe tachycardia, hypotension, collapse. As a result of impaired capillary permeability, hemorrhages in the conjunctiva, trachea, pleura, lungs, and kidneys occur. There is paresis of the intestine, stool and urination delay. There are albuminuria, hematuria and cylinderuria. Later, there may be changes in the nervous system: loss of vision due to retrobulbar neuritis of the optic nerve, persistent memory impairment, polyneuritis( consequences of hypoxia).

Emergency care

Removal of poison from the body, detoxification, restoration of synaptic transmission of nerve impulses, maintenance of vital respiratory and circulatory functions. The patient is placed in bed, re-washed the stomach( preferably a suspension of activated carbon with water), inside give activated charcoal, 30 g of sulphate magnesia( with coma injected through the probe), put a high siphon enema.

In cases of severe poisoning and severe breathing, intubate the trachea as soon as possible and transfer to controlled breathing( oxygen or air using a DP-1 apparatus);not stopping artificial respiration, the patient is transported to a hospital. Artificial respiration is continued for several hours( usually 6-10) until recovery of muscle tone and self-breathing.

In some cases, a tracheotomy is used.

For rapid elimination of the ganglionic and neuromuscular block, A. Kissin recommends intravenous injection of Prozerin( 1 ml of a 0.05% solution in 500 ml of an isotonic solution of sodium chloride).Prozerin reduces the activity of the cholinesterase enzyme and prevents the destruction of acetylcholine. Accumulation of acetylcholine in synapses quickly eliminates the ganglionic and neuromuscular block.

Intramuscularly injected 4 ml of a 1% solution of the sodium salt of ATP( adenosine triphosphate), which also reduces or temporarily eliminates the ganglionic block.

Bleeding due to pahicarpin poisoning and exchange blood transfusions for detoxification are inexpedient. You can inject intravenously 0.5-2l of a 5% solution of glucose or saline.

If necessary, introduce cardiovascular-tonic drugs( Cordiamin, Camphor, Caffeine), with the collapse - Mesaton or Noradrenaline, and in terminal states carry out resuscitation.

Source: Allega G.N. Official and traditional medicine. The most detailed encyclopedia.- Moscow: Izd-vo Eksmo, 2012.