Sedative, tranquillizer, hypnotic poisoning
Introduction
Introduction to sedative, stable, hypnotic poisoning Barbiturates are classified into long-acting, intermediate-acting, short-acting, and ultra-short-acting drugs. The commonly used pediatrics include barbital, phenobarbital, pentobarbital and barbiturate. Barbiturate, thiopental, etc. Acute intoxication can be caused by a hypnotic dose of 5 to 10 times of this type of drug at a time; if the actual absorbed dose exceeds 15 times of its own therapeutic amount, it is fatal. Oral long-acting barbital > 6mg / kg, short-acting barbital > 3mg / kg, can appear toxic reactions. Long-term use of a large number of long-acting barbiturates is more likely to accumulate poisoning, especially in children with liver and kidney dysfunction. The intravenous injection rate is too fast, and serious poisoning reactions can occur. basic knowledge The proportion of illness: 0.0058% Susceptible people: no specific population Mode of infection: non-infectious Complications: jaundice uremia
Cause
The cause of sedative, stable, hypnotic poisoning
A 5 to 10 times hypnotic dose of such a drug can cause acute poisoning; when the actual absorbed dose exceeds 15 times of its own therapeutic amount, it is fatal. Long-term use of a large amount of long-acting barbiturates Drugs are more prone to accumulation of poisoning, especially in children with liver and kidney dysfunction. Intravenous injections are too fast and can cause serious poisoning reactions.
Prevention
Sedative, stable, hypnotic poisoning prevention
Strictly follow the method of use and dosage of this class of drugs. Prevent accidental or suicidal use.
Complication
Sedative, stable, hypnotic poisoning complications Complications, jaundice, uremia
Often due to concurrent hypopnemic pneumonia, the difficulty of breathing is increased. Patients with severe poisoning may have a period of excitement before entering the state of inhibition. At this time, there are arrogance, convulsions, hallucinations, convulsions, etc. Some patients have liver and kidney damage symptoms such as jaundice. Bleeding, uremia, etc., or fever and various types of rash.
Symptom
Symptoms of sedation, stability, and hypnotic poisoning Common symptoms Dizziness and coma on light reflexes, convulsions, convulsions, abnormal color vision, ataxia, sleepiness, auditory hallucinations, circulatory failure
Symptoms of poisoning are headache, dizziness, unclear speech, blurred vision, diplopia, abnormal color vision, ataxia, lethargy, coma, dilated pupils (late enlargement), slow light reflex, lower blood pressure, slower and faster breathing, Even respiratory and circulatory failure, occasional cerebral edema and pulmonary edema, long-term barbiturate poisoning, often due to concomitant hypostatic pneumonia and increased dyspnea, severe poisoning patients may have a period of excitement before entering the inhibition state At this time, there are arrogance, embarrassment, hallucinations, convulsions, etc. Some patients have liver, kidney damage symptoms such as jaundice, hemorrhage, uremia, etc., or fever and various types of rash, slow-acting barbiturates can maintain the drug up to 4 ~ 5 days long; rapid effect can lead to serious consequences within 1 to 2 days.
Examine
Sedation, stability, hypnotic poisoning
1. Toxic detection : Qualitative examination of blood, urine and gastric juice can help diagnosis; and blood concentration measurement is not helpful for clinical reasons, because it is often not parallel with clinical conditions, and it is difficult to judge prognosis.
2, biochemical examination : blood sugar, liver and kidney function should be tested.
3, blood gas analysis : can detect the degree of inhibition of breathing.
4, X-ray examination : chest X-ray can understand pulmonary edema, lung infection, aspiration and tracheal intubation position; abdominal plain film can understand the X-ray pheno-seal tablets in the stomach.
Diagnosis
Diagnosis and identification of sedative, stable and hypnotic poisoning
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
1, cerebrovascular accident: more local local signs, such as hemiplegia, meningeal irritation, head CT examination can help determine the diagnosis.
2, epilepsy: a history of seizures in the past, EEG examination can help diagnose.
3, diabetic ketotoxic coma, hyperosmolar non-ketotic coma: blood sugar, urine sugar, blood ketone, serum electrolyte determination can help diagnose.
4, uremia coma: first irritability, convulsions, and finally into a coma, blood urea nitrogen increased, blood carbon dioxide binding capacity, metabolic acidosis.
5, rickets coma: clinical is not uncommon, according to the accompanying symptoms, signs, history of toxic exposure, and ask the patient's family detailed questions about the spirit of the patient before the onset, emotional state, if necessary, the toxic analysis can help the final diagnosis.
