drug poisoning
Introduction
Introduction Poisoning caused by the amount of the drug exceeding the maximum amount. Drug abuse can result from misuse or overdose and drug abuse. Common poisoning drugs are Western medicine, Chinese medicine and pesticides.
Cause
Cause
Causes of drug poisoning
1. Drug management With the development of the chemical pharmaceutical industry, if the management can not keep up with the occurrence of drug poisoning, it will increase.
2. Regional diseases are also an important factor. For example, hexachloro-p-xylene is widely used in the endemic areas of schistosomiasis in China, and the incidence of toxic neuropathy and neurosis is also high.
3. Genetic factors are an important cause of toxicity of certain drugs. Patients with glucose 6-phosphate dehydrogenation (G6PD) deficiency play an important role in the hemolytic anemia that occurs when quinine antimalarials are used. China's G6PD defects are widely distributed. The positive rates in the southwest and coastal provinces are higher. About 23% of patients with chronic acetylated patients have multiple peripheral neuritis. The European whites are 60% slower, and China is about 20%. Patients with deficient cholinesters? After using the same dose of muscle relaxant succinylcholine, prolong the interval between exhalation and inhalation? Severe suffocation. Alcohol metabolism in the body mainly relies on dehydrogenation of acetaldehyde. Dehydrogenation of acetaldehyde is prone to alcoholism. There is almost no shortage of Europeans? Asians lack more acetaldehyde dehydrogenation than Europeans? The Chinese are about 35%.
4. The sensitivity of gender and age differences to drug toxicity varies widely. Chlorine can cause aplastic anemia? The incidence of women is three times higher than that of men. Children should pay more attention to drugs? Because children's drug metabolism is not fully developed, it is highly sensitive to drugs. If chlorotin can cause gray infantile syndrome, the child may die several hours after the onset of symptoms. Children's kidney excretion chain is slow? Long-term application can cause deafness. The heart of the elderly? Liver and kidney function are declining? Prone to allergic reactions or poisoning. The same dose of digoxin? Plasma half-life is prolonged and the incidence of digitalis poisoning is high. Renal excretion function decreased in the elderly. The plasma concentration after intramuscular injection was 13 times higher than that of young people. The dosage of barbiturate hypnotics in the elderly should be adjusted because of the decreased metabolic activity of the liver in the elderly. There are many types of drugs for the elderly. The drug takes a long time. The incidence of toxic and side effects of drugs is also large. Or increase the lumbar muscle strain.
Examine
an examination
Related inspection
ECG neurological examination
Examination and diagnosis of drug poisoning
The characteristic symptoms and signs of poisoning are similar to those of common medical emergencies; the clinical manifestations of different toxic poisons may be similar or overlapping; the performance of the same poison poisoning in different organisms may also be different. Therefore, misdiagnosis or missed diagnosis is easy. The key points of acute poisoning diagnosis are combined with medical history and on-site investigation, clinical and physical examination, poison test and other data to falsify the truth and comprehensive analysis.
According to the comprehensive analysis of medical history, collecting detailed history of poisoning is the primary link of diagnosis. Productive poisoning should ask about occupation history, job types, production processes, types of poisons exposed, quantities, ways of poisoning, and the incidence of others. Non-productive poisoning To understand personal life and mental state, I and my family often take drugs and pesticides, and must investigate the poisoning environment. All drugs or chemicals on the patient's site, as well as pockets and containers. Try to collect information about the patient's usual life, study, work, and recent emotional changes to determine whether or not to take or use a certain drug. For the exact history of poisoning, the type of the drug, the route and time of poisoning should be determined in detail, and the dose of the drug should be roughly estimated. According to the clinical manifestations, the types of poisoning drugs are specifically determined. For sudden appearance of purpura, vomiting, coma, convulsions, dyspnea, shock and unexplained reasons, the possibility of acute poisoning should be considered first; in addition to the possibility of poisoning for unexplained coma, the diagnosis should be wider. Except for diabetic ketoacidosis coma, hyperosmolar coma, hypoglycemia coma, heat stroke, acute cerebrovascular disease, craniocerebral injury, pulmonary encephalopathy, etc.; pay special attention to the main characteristics of toxic poisoning, the so-called "poisoning syndrome" These syndromes not only have diagnostic significance but also help to judge the severity of poisoning.
Diagnosis
Differential diagnosis
Symptoms of drug poisoning
The inquiry and clinical examination of medical history are basically the same as general diseases, but the differential diagnosis of drug poisoning is more complicated. First of all, it should be distinguished whether the patient's symptoms of toxicity are caused by the development of the disease, or caused by medication, such as headache, dizziness, nausea and vomiting. In case of a sudden onset of rash, it should be considered related to drugs or poisons. Doctors should specifically ask about the history of medication, the type of medication, the dose and time, and the familiarity with each drug's adverse reactions. The incubation period of poisoning symptoms is of great significance for diagnosis. Most of them are 1 to 2 days, and the maximum is no more than 10 to 12 days.
The characteristic symptoms and signs of poisoning are similar to those of common medical emergencies; the clinical manifestations of different toxic poisons may be similar or overlapping; the performance of the same poison poisoning in different organisms may also be different. Therefore, misdiagnosis or missed diagnosis is easy. The key points of acute poisoning diagnosis are combined with medical history and on-site investigation, clinical and physical examination, poison test and other data to falsify the truth and comprehensive analysis.
diagnosis
Collecting a detailed history of poisoning is the primary step in diagnosis. Productive poisoning should ask about occupation history, job types, production processes, types of poisons exposed, quantities, ways of poisoning, and the incidence of others. Non-productive poisoning To understand personal life and mental state, I and my family often take drugs and pesticides, and must investigate the poisoning environment. All drugs or chemicals on the patient's site, as well as pockets and containers. Try to collect information about the patient's usual life, study, work, and recent emotional changes to determine whether or not to take or use a certain drug. For the exact history of poisoning, the type of the drug, the route and time of poisoning should be determined in detail, and the dose of the drug should be roughly estimated. According to the clinical manifestations, the types of poisoning drugs are specifically determined. For sudden appearance of purpura, vomiting, coma, convulsions, dyspnea, shock and unexplained reasons, the possibility of acute poisoning should be considered first; in addition to the possibility of poisoning for unexplained coma, the diagnosis should be wider. Except for diabetic ketoacidosis coma, hyperosmolar coma, hypoglycemia coma, heat stroke, acute cerebrovascular disease, craniocerebral injury, pulmonary encephalopathy, etc.; pay special attention to the main characteristics of toxic poisoning, the so-called "poisoning syndrome" These syndromes not only have diagnostic significance but also help to judge the severity of poisoning.
