Opioid poisoning
Introduction
Introduction to opioid poisoning The opium in this category, morphine, codeine, paregoric, and papaverine are effective drugs for analgesia, cough, diarrhea, anesthesia, and spasm. , clinical application is very wide. One time misuse of large or frequent application of morphine can cause poisoning. The morphine poisoning rate is 0.06g in adults and the lethal dose is 0.25g. The lethal dose of dry opioid is 10 times that of morphine. The oral lethal dose is 2~5g. The codeine toxicity is A quarter of morphine, the toxic dose is 0.2g, the lethal dose is 0.8g, barbiturates and other hypnotic drugs have synergistic effects with this class of drugs, and should be used with caution. basic knowledge The proportion of illness: 0.0002%-0.0005% (the prevalence of opium, heroin, k powder smokers is about 5-10%, related to overdose) Susceptible people: good for young men and women Mode of infection: non-infectious Complications: pulmonary edema shock
Cause
Opioid poisoning cause
The main active ingredient of opioid is morphine (about 10%), most of which is metabolized in the liver. It is excreted in the kidney within 24 hours. There is only a trace amount of urine in 48 hours. Morphine is excited to the central nervous system, and then inhibited, but inhibited. Mainly, morphine first inhibits the high-level center of the cerebral cortex, and later involves cerebral ventricle, inhibits the respiratory center and excites the chemosensory area, and morphine enhances the excitation of the spinal cord, improves the gastrointestinal smooth muscle and its sphincter tone, and reduces intestinal peristalsis. Bronchial, bile duct and ureteral smooth muscle have similar effects.
Large doses of morphine can inhibit the medullary vasomotor center and release histamine, causing peripheral blood vessels to dilate and lead to hypotension and bradycardia. A large or frequent application of morphine can cause poisoning, and the amount of morphine poisoning is 0.06g in adults. It is 0.25g; the lethal dose of dry opioid is 10 times that of morphine, the oral lethal dose is 2-5g, the codeine toxicity is 1/4 of morphine, the toxic dose is 0.2g, the lethal dose is 0.8g, long-term application of morphine Causes euphoria and addiction, the original chronic diseases such as liver disease, emphysema, bronchial asthma, anemia, thyroid or chronic adrenal insufficiency and other patients are more prone to poisoning, with alcohol drinks, even if the treatment dose of morphine, There is also the possibility of poisoning. Barbiturates and other hypnotic drugs have synergistic effects with this class of drugs, so be careful when using them together.
Prevention
Opioid poisoning prevention
Long-term application of this product can cause euphoria and addiction, which can lead to physical aging and sexual dysfunction, destroy the body, and cause bankruptcy, and also lead to social disorder. Therefore, strictly strengthen the management system of this product, prohibit this The product is smuggled and sold, the addiction of this product can be completely eliminated. When oral poisoning, it should induce vomiting or gastric lavage as soon as possible, and disable servant morphine to induce vomiting. Because opioids can cause pyloric palsy, gastric emptying is delayed, so even if maintenance is maintained Function, keeping the airway open, medical, public security and other departments and families to cooperate to make addicts detoxification as soon as possible is also very important.
Opioid poisoning is rare, but a small amount of opium poppy is planted in remote rural tree gardens. The pulp is extracted from the fruit and dried for future use. Therefore, clinicians should be familiar with the mechanism, symptoms and rescue points of opioid poisoning to prevent the diagnosis and treatment of poisoned patients.
Strictly strengthen the management system of this product, prohibiting the smuggling of this product, the addiction of this product can be completely eliminated. It is also important for medical and public security departments and families to cooperate to make addicts take drugs as soon as possible.
Complication
Opioid poisoning complications Complications pulmonary edema shock
Accompanied by acute pulmonary edema, and even shock, dilated pupils, respiratory paralysis and death.
Symptom
Opioid poisoning symptoms Common symptoms Respiratory depression, loss of appetite, angulation, nausea, convulsions, coma
Patients with mild acute poisoning have headache, dizziness, nausea, vomiting, excitement or depression. Patients have illusions, loss of time and space, and may have constipation, urinary retention and increased blood sugar. Severe poisoning, coma, needle-like pupil And three characteristics of high respiratory depression, when the spinal cord reflex is enhanced, often convulsions, closed jaws and angulation, the breathing becomes shallow and slow, and later sigh-like or tidal breathing, and often complicated with pulmonary edema In the event of shock, the pupils are dilated, and more than 12 hours of acute poisoning, they may die from respiratory paralysis, or may have pulmonary infections. Survivors over 48 hours have a good prognosis. Urine or stomach contents are toxic. .
Chronic poisoning (opioid or morphine addiction) manifests as loss of appetite, constipation, weight loss, aging and sexual dysfunction. When you quit smoking, you have mental wilting, yawning, tearing, cold sweat, insomnia, and even collapse.
Examine
Opioid poisoning check
1. The mild poisoning inspection project is based on the inspection box "A";
2. Severe poisoning inspection projects may include checking the limits "A", "B" or "C".
Diagnosis
Diabetes diagnosis and identification
It can be diagnosed according to the following diagnosis.
1. There is a history of applying excessive opioids.
2. Clinical manifestations: mild poisoning is headache, dizziness, nausea, vomiting, excitement or inhibition, coma in severe poisoning, dilated pupils such as needle tip size and difficulty breathing, chronic poisoning mainly manifests as loss of appetite, constipation, weight loss, aging and Sexual function decline.
3. Urine and stomach contents are detected in the presence of opioids.
