Drug poisoning may be the result of deliberate action, but it can also happen accidentally, inadvertently. We are able to poison ourselves with any drug available, so this article will discuss the most common poisonings and poisonings with drugs readily available to everyone.
Drug poisoningcan happen to anyone. Already Paracelsus used to say that "Everything is poison, and nothing is poison. Only dose makes poison." We now know that this is a very accurate statement, because even very large amounts of water can poison the body.
Which drug poisonings are the most common? How to proceed in case of poisoning with popular painkillers?
Opioid poisoning
Opioids are a broad and very diverse group of drugs that have various uses, ranging from antitussives to painkillers to narcotic drugs.
Most opioids are euphoric, therefore all substances belonging to this group, consumed in excess, can quickly and easily lead to the development of addiction.
Opioids include drugs such as: morphine, codeine, fentanyl, tramadol, buprenorphine, heroin, dextromethorphan, oxycodone, methadone, loperamide.
Opioids are most commonly used in the treatment of pain of a different nature, intensity and duration. In addition, they are used in the treatment of coughs, diarrhea and even withdrawal symptoms.
Not all opioids are available on prescription, so there is an even greater risk of poisoning with this group of drugs, as some may wrongly believe that over-the-counter drugs cannot harm us.
The vast majority of opioids act on the central nervous system, which can be magnified by combining them with alcohol, sedatives, or psychotropic drugs, leading to depression of the respiratory center.
The characteristic symptoms of opioid poisoning include:
- pin-shaped pupils - a very common and specific symptom, but its absence does not exclude opioid poisoning
- sleepiness leading to coma
- breathing disorders - shallow, irregular breathing until it disappears
- bradycardia
- hypotension
- intestinal paralysis, obstruction
- vomiting
- pale coating
- convulsions
- dangerous heart arrhythmias
What to do in the event of opioid poisoning?
A specific antidote is naloxone which blocks the action of opioids on their specific receptors. Gastric lavage is not used in the case of opioid poisoning, and the administration of activated charcoal is also ineffective. Symptomatic treatment and maintenance of the basic functions of the body are important in poisoning with this group of drugs.
Benzodiazepine poisoning
Benzodiazepines are a group of drugs that have such effects as: anticonvulsants, sedatives, muscle relaxants and hypnotics. Hence, they are used in the treatment of some types of epilepsy, anxiety, withdrawal syndromes, insomnia, states of increased muscle tension and in premedication before various treatments.
Treatment with this group of drugs should be carried out under the constant and careful supervision of a physician, because benzodiazepines can lead to the development of a strong addiction, and their too abrupt and ill-considered discontinuation may cause dangerous withdrawal syndromes.
Benzodiazepines are quite quickly and easily absorbed from the gastrointestinal tract, and in the elderly their action may be significantly prolonged. Fortunately, for severe poisoning to occur, very large doses of benzodiazepines are needed. The symptoms of poisoning with these drugs include:
- sleepiness up to coma
- slow mental and physical
- slurred speech
- imbalance
- nystagmus
- dyskinesia
- diplopia, or double vision
- weakening of reflexes
- more often tachycardia, but also possible bradycardia and hypotension
Benzodiazepine poisoning can be detected by urine testing for their presence.
How to deal with benzodiazepine poisoning?
Gastric lavage should be performed as soon as possible, preferably within an hour of ingestion. Important in the treatment of poisoning with these drugs is the use of forced diuresis and symptomatic treatment. There is a specific antidote to benzodiazepines, flumazenil, which can reverse their effects even within several dozen seconds.
Paracetamol poisoning
Paracetamol is perhaps the most popular over-the-counter medication. It is a substance with analgesic and antipyretic properties, already used in young children. Paracetamol comes in the form of tablets, syrups, suppositories, and also as a solution for intravenous use. It is quickly absorbed from the digestive tract.
In a relationshipwith the fact that paracetamol is almost completely metabolized by the liver, it is this organ that is most damaged in overdose or poisoning.
In adults, the dose of paracetamol that leads to intoxication is 4 grams ingested within 8 hours, or more than 150 milligrams per kilogram of body weight.
In children, paracetamol poisoning occurs after taking a single dose of more than 150 milligrams per kilogram of body weight.
Chronic poisoning with this drug is also possible. It occurs when paracetamol is taken chronically in increased doses. A greater risk of paracetamol poisoning occurs in such situations as:
- elderly people and children
- People with chronic alcohol consumption or simultaneous alcohol consumption with paracetamol
- dehydration
- "empty stomach"
- malnutrition
- liver disease
- kidney disease
- with the simultaneous use of drugs that affect the metabolism of paracetamol
Symptoms of paracetamol poisoning appear several dozen hours after overdosing the substance, while irreversible liver damage occurs almost immediately. The first symptoms of paracetamol poisoning include:
- weakness
- nausea and vomiting
- stomach pains
- sweating
- pallor
After another several to several dozen hours, symptoms typical of acute liver failure appear, among which we can distinguish, for example:
- jaundice
- pains in the right hypochondrium
- itching
- disturbance of consciousness
- encephalopathy
- coagulation disorders
- hypoglycemia
- metabolic acidosis
- coma
Apart from symptoms of liver failure, there may also be arrhythmias, drops in blood pressure, convulsions, oliguria, respiratory failure.
What to do in case of paracetamol poisoning?
In poisoning with this drug, it is important to monitor the function of the liver, kidneys, coagulation parameters, and gasometry. It is also worth determining the level of paracetamol in the blood in the first hours after poisoning, because then you can achieve the best treatment effects by administering the antidote, which is N-acetylcysteine.
In case of paracetamol poisoning, gastric lavage is recommended, preferably within one hour of poisoning, and the administration of activated charcoal and sodium sulphate. In the event of severe paracetamol poisoning, hemodialysis should be considered.
If conservative treatment failseffects, sometimes the only chance for a patient after paracetamol poisoning is liver transplantation.
Poisoning with non-steroidal anti-inflammatory drugs (ibuprofen)
Non-steroidal anti-inflammatory drugs, or NSAIDs, are a broad group of drugs, probably the most popular of which is ibuprofen.
It is a substance with analgesic, antipyretic and anti-inflammatory properties, therefore its use is even wider than the previously discussed paracetamol.
Intoxication with ibuprofen does not cause any characteristic symptoms, although it is known that high doses of NSAIDs can severely irritate the gastrointestinal mucosa, which is associated with the risk of bleeding in the event of an overdose of these drugs.
What to do in case of ibuprofen poisoning?
There is no specific antidote for poisoning with this drug. Treatment should be symptomatic and gastric lavage as far as possible.