ROUTES, ACTION, ELIMINATION OF POISON By Dr. Sadia.pptx

ROUTES, ACTION, ELIMINATION OF POISON

1. ROUTES, ACTION, ELIMINATION OF POISONS BY. DR. Sadia Memon

2. Routes of Poisoning

3. ROUTES OF ADMINISTERATION Inhalation (mouth or nose to lungs) then into blood. Ingestion (mouth to stomach) then into blood. Injection (cuts, punctures in skin) into blood. Dermal absorption (through skin) into blood .

4. Route of Drug Administration Enteral Parenteral Others Intravenous Route Intra-Muscular Route Intradermal route Oral Sub Lingual Rectal By Inhalation Topical Subcutaneous

5. ACTION OF POISONS Depend upon: Dose  small dose produce therapeutic action and large dose produce toxic effect Form Method of administration General condition of body Physical State Chemical Combination Mechanical Combination

6. Routes of E limination Urine Lungs Stools Saliva Sweat Breast milk

7. ELIMINATION OF POISON Removal of unabsorbed poison Use of antidote Removal of absorbed poison Maintaining general symptoms

8. REMOVAL OF UNABSORBED POISON FROM THE SYSTEM 1. INHAILED POISON  If the patient inhaled the gases poison then patient should taken to fresh air Artificial respiration

9. REMOVAL OF UNABSORBED POISON FROM THE SYSTEM 2. INJECTED POISON  If the poison get injected s/c then TOURNQUET INCISIONS SUCTION

10. REMOVAL OF UNABSORBED POISON FROM THE SYSTEM 3. CONTACT POISON  If the poison is spilled or spread on skin, eyes or wound, the best way to treat 1.Wash warm water. 2.Neutralize it by an antidote.

11. REMOVAL OF UNABSORBED POISON FROM THE SYSTEM 4- INGESTED POISON V omiting (Emesis) Stomach washed out (Gastric lavage)

12. REMOVAL OF UNABSORBED POISON FROM THE SYSTEM SYRUP IPECAC 30 ml dose act as an emetic in about 20 to 30 minutes SALT WATER APOMORPHINE  6 mg by s/c injection CONTRAINDICATIONS:- Corrosives/ Strychnine /kerosene oil/Pregnancy

13. REMOVAL OF UNABSORBED POISON FROM THE SYSTEM Position of patient Removal of dentures Mouth gag Stomach tube Lubrication Test the position of tube

14. STOMACH WASH TUBE

15. RYLE’S TUBE/NG

16. GASTRIC LAVAGE Run 5 Ltr plain water into funnel end Avoid too much water Preserve first washing for chemical analysis 10 Ltr fluid is necessary for complete lavage Antidote Solution should be left in stomach

17. REMOVAL OF UNABSORBED POISON FROM THE SYSTEM COMPLICATIONS OF GASTRIV LAVAGE: Perforation Aspiration Injuries Cardiac arrest Psychological trauma

18. REMOVAL OF ABSORBED POISON FROM THE SYSTEM USE OF ANTIDOTE  Antidotes are agents that negate the effect of a poison or toxin . TYPES OF ANTIDOTES: Mechanical or physical antidote Chemical antidote Universal antidote (myth) Receptor or pharmacological or physiological antidote Chelating agents

19. REMOVAL OF ABSORBED POISON FROM THE SYSTEM MECHANICAL OR PHYSICAL ANTIDOTE  A mechanical or physical antidote is a substance that prevents the absorption of a poison or neutralizes it by mechanical action Examples of mechanical or physical antidotes bulky food, activated charcoal .

20. REMOVAL OF ABSORBED POISON FROM THE SYSTEM Chemical Antidote: These are substances which act chemically with the poisons to form less toxic compounds. Dilute alkalis ( acetic acid or vinegar neutralizes ) Copper(II ) sulfate Tannic Acid forms insoluble compounds with metal poisons potassium permanganate is an oxidizing agent

21. REMOVAL OF ABSORBED POISON FROM THE SYSTEM UNIVERSAL ANTIDOTE Combination of Mechanical + Chemical Antidote, When exact nature of poison is not known When 2 or more poisons taken. COMPOSITION:- Charcoal 2 parts---------Adsorbs/take up Alkaloids Milk of magnesia 1 part-------neutralizes acids Tannic acid 1 part----------precipitates metals

22. REMOVAL OF ABSORBED POISON FROM THE SYSTEM RECEPTOR OR PHARMACOLOGICAL ANTIDOTE: e.g. Atropine for Pilocarpine. Diazepam for strychnine. Naloxone for Morphine.

23. REMOVAL OF UNABSORBED POISON FROM THE SYSTEM CHELATING AGENTS   chelating agents are used to remove toxic metals from the body Example BAL (British anti Lewisite) EDTA ( Ethylene diamine tetraacetic ) PENICILLAMINE DESFEROXAMINE

24. ELIMINATION OF ABSORBED POISONS If more than 6 to 8 hrs. have elapsed Forced Diuresis (Frequently used method to eliminate toxin ) Mannitol & Furosemide 300 – 500 ml / hrs. i.e., 8 – 14 Ltr / day Dialysis(Peritoneal, Hemodialysis ) Exchange Transfusion

25. ELIMINATION OF ABSORBED POISONS DIALYSIS  Dialysis is a procedure to remove waste products and excess fluid from the blood when the kidneys stop working properly.

26. Thank You