Essentials 1 The mortality from acute paraquat poisoning is high owing to rapid multi-organ failure or delayed progressive pulmonary fibrosis. Ingestion of as little as one mouthful of 20% w/v solution is sufficient to cause death. No satisfactory treatment exists.…
Essentials 1 Acute pesticide poisoning is an important cause of morbidity and mortality worldwide, in particular in the Asia-Pacific region. 2 Existing systems for classifying the toxicity of pesticides are imperfect, whereby the toxicity of even ‘slightly hazardous’ pesticides is…
Essentials 1 Patients and medical staff are often unaware of the presence of hydrofluoric acid (HF) in household cleaning products. 2 Topical HF exposures may result in the gradual onset of severe local pain out of proportion to objective clinical…
Essentials 1 Cyanide is a metabolic poison associated with a high mortality. 2 Cyanide toxicity is characterized by rapid onset of central nervous, respiratory and cardiovascular effects and by metabolic acidosis. 3 Cyanide exposure correlates well with serum lactate levels.…
Essentials 1 The diagnosis of intoxication with drugs of abuse is clinical. Good supportive care ensures optimal outcome in the majority of cases. 2 Predisposing factors for opioid-related deaths include co-ingestion of Central nervous system (CNS) depressant drugs, poor tolerance,…
Essentials 1 Acute iron poisoning is a potentially life-threatening condition. 2 The risk of severe toxicity is determined by the dose of elemental iron ingested, not the weight of the iron salt. 3 Iron poisoning has both local (gastrointestinal) and…
Essentials 1 Methylxanthine toxicity can be associated with life-threatening seizures and cardiac arrhythmias. 2 Predictors of toxicity include hypokalaemia, lactic acidosis and serum theophylline concentration. 3 Early identification of high-risk patients allows the institution of enhanced elimination techniques before life-threatening…
Essentials 1 All deliberate self-poisonings with colchicine should be regarded as potentially life threatening. 2 Poisoning may present asymptomatically or with gastrointestinal symptoms only. 3 Consider the diagnosis in patients presenting with gastrointestinal symptoms followed by the development of multi-organ…
Essentials 1 Deliberate self-poisoning with insulin or sulphonylureas may lead to life-threatening hypoglycaemia requiring prolonged observation and treatment over several days. 2 Octreotide blocks endogenous insulin secretion and is indicated in the management of symptomatic sulphonylurea toxicity. 3 Central venous…
Essentials 1 Salicylate pharmacokinetics become complex and alter markedly following overdose. 2 Treatment and disposition decisions are made on clinical signs, biochemistry and serum salicylate level trends. 3 The aim of therapy is to minimize metabolic and central nervous system…