RASHIDA IQBAL FINANCIAL AID ORGANIZATION (RIFAO )
SPECIAL TOXICOLOGY MADE EASY ! (WITH MNEMONICS AND IMPORTANT STUFF) THIS FILE CONTAINS IMPORTANT POISONS
ACIDS:-
METAL POISONING
-Treatment of all..COMMON POINTS (ARSENIC,LEAD,MERCURY)
1)BAL (PLUS EDTA IN LEAD AND PENCILLAMINE IN MERCURY )
2)TREAT DEHYDRATION ( DEXTROSE AND NORMAL SALINE)
3)MORPHINE TO TREAT PAIN
4)ICE TO DECREASE THIRST
5)DEMULCENTS
6)STOMACH WASH
As---- MILK AND WARM WATER
Hg-----NaFORMALDEHYDE-SULFOXYLATE
-CHRONIC POISONING MERCURY (LENSS)
L= LINING OF GUMS
E=ERETHISM
N=NEPHRITIS
S=SKIN IRRITATION
S=SHAKE (HATTER SHAKE) LENS= MERCURIA LENTIS
-GENERAL SYMPTOMS THAT CAN BE WRITTEN IN ALL :
.BURNING SENSATION IN MOUTH,THROAT,ESOPHAGUS,STOMACH
.INTENSE THIRST
.PAIN IN ABDOMEN
.VOMITING ( CONTAINS STOMACH CONTENT FIRST..THEN BILLIOUS.. AND THEN MUCUS )
.COLLAPSE
.CONVULSION
.DEATH
-LEAD CHRONIC POISONING :
REMEMBER TO START FROM BRAIN !!!
LEAD ENCEPHALITIS .. NOW SINCE BRAIN IS IN HEAD REMEMBER FACIAL PALLOR ... FACIAL PALLOR IS DUE TO ANEMIA ... THAT IS DUE TO PUNCTATE BASOPHILIA ... SO LESS BLOOD SUPPLY TO MUSCLES AND KIDNEYS .. SO PARALYSIS OF MUSCLES AND NEPHRITIS IN KIDNEYS .. OTHER THAN THIS REMEMBER REPRODUCTIVE SYSTEM MANIFESTATIONS
Lead; FAnCoBuPERS (Facial pallor,Anemia with punctate basophilaia,Coliky,constipation.Burtonian line(lead line),Paralysis,Encephalopathy,Renal dysfunction,Sexual dysfunction(reproductive)
VEGETABLE POISONS :
-RICINUS R=RICINUS
R=RAW STATE POISONOUS
R=RATS ALSO POISONED BY IT
R=RESIDUE OF SEEDS (PRESS CAKE) HAS ACTIVE PRINCIPLE
R=RICIN IS ACTIVE PRINCIPLE THAT ACTS AS ENDOTOXIN
R=RENAL CONGESTION NOTED
-COMMON TREATMENT OF RICINUS AND CROTON
1)STOMACH WASH WITH WARN WATER
2)DEMULCENTS
3)STIMULANTS
3)DEHYDRATION TREATED
4)ELECTROLYTE IMBALANCE TREATED BY I/V GLUCOSE
-ERGOTISM (BITINCEED)
BURNING (SAINT ANTHONY'S FIRE)
ITCHING
TINGLING
INSECTS CREEPING ON BODY SENSEATIONS (FORMICATION)
NUMBNESS
COMA , CONVULSION
EAR(LOSS OF HEARING)
EYE(VISUAL DIST,DILATED PUPILS)
DEATH
-SIGNS OF POISONING OF RICINUS,ERGOT(ACUTE),CROTON--COMMON TO ALL
.BURNING PAIN IN MOUTH THROAT ESOPHAGUS AND STOMACH .PURGING
.VOMITING
.ABDOMINAL PAIN
-(A)RBUS (A)LL PARTS ARE POISONOUS
-ARBU(S) IS ALSO CALLED (S)UI
Animal poisons (SNAKE BITE)
-
NAMES OF NEUROTOXIC (KC)
KING COBRA
KRAIT
CORAL
COBRA
-COMPOSITION OF VENOM (ToP NACCHH)
THROMBOPLASTIN
PROTEINS (PROTEOLYSINS, FIBRINOLYSINS)
NEUROTOXINS
AGGLUTININS
CHOLINESTERASES
CARDIOTOXIC
HEMOLYSINS HYALURONIDASES
-DIFFERENCE B/W POISONOUS AND NON POISONOUS
IMAGINE A SNAKE WITH VERY SMALL HEAD AND SMALL SCALES ON IT .. WITH LONG GROOVED FANGS ... HAVING SMALL SCALES ON HEAD AND LARGE ON BODY WITH COMPRESSED TAIL TO ESCAPE FAST...... ALL THESE CHARACTERS ARE OF POISONOUS ... IS K OPPOSITE NON POISONOUS
-LAB TESTS TO DIAGNOSE SNAKEBITE
(CTBT)
-CT
-BT
-CHOLINESTERASES
-THROMBOPLASTIN ( MAKES U THINK OF PROTEIN)
-FIBRINOLYSINS
-DIFFERENCE B/W TYPES OF SNAKES ARE EASY JUST KEEP ONE TYPE IN MIND ... I KEPT VASCULOTOXIC IN MIND !
V=VASCULOTOXIC
VIPERS
V SHAPED TRIANGULAR HEAD
VERTICAL PUPILS
AND THEY HAVE LMC (LONG MOBILE CANALIZED FANGS)
Animal poisons (SNAKE BITE)
-NAMES OF NEUROTOXIC (KC) KING COBRA
KRAIT
CORAL
COBRA
-COMPOSITION OF VENOM (ToP NACCHH)
THROMBOPLASTIN
PROTEINS (PROTEOLYSINS, FIBRINOLYSINS)
NEUROTOXINS
AGGLUTININS
CHOLINESTERASES
CARDIOTOXIC
HEMOLYSINS
HYALURONIDASES
-DIFFERENCE B/W POISONOUS AND NON POISONOUS
IMAGINE A SNAKE WITH VERY SMALL HEAD AND SMALL SCALES ON IT .. WITH LONG GROOVED FANGS ... HAVING SMALL SCALES ON HEAD AND LARGE ON BODY WITH COMPRESSED TAIL TO ESCAPE FAST...... ALL THESE CHARACTERS ARE OF POISONOUS ... IS K OPPOSITE NON POISONOUS
-LAB TESTS TO DIAGNOSE SNAKEBITE
(CTBT)
-CT
-BT
-CHOLINESTERASES
-THROMBOPLASTIN ( MAKES U THINK OF PROTEIN)
-FIBRINOLYSINS
-DIFFERENCE B/W TYPES OF SNAKES ARE EASY JUST KEEP ONE TYPE IN MIND ... I KEPT VASCULOTOXIC IN MIND !
V=VASCULOTOXIC
VIPERS
V SHAPED TRIANGULAR HEAD
VERTICAL PUPILS
AND THEY HAVE LMC (LONG MOBILE CANALIZED FANGS)
USE THIS TO FIND OUT NEUROTOXIC I-E
ROUND HEAD (SAME WIDTH AS OF NECK)
ROUND PUPILS
SHORT FIXED GROOVED FANGS
VASCULOTOXIC
SMALL HEAD
SHORT FIXED (SAME AS ELAPIDS) FANGS
NEUROTICS (MNEMONICS)
-DHATURA
10 D's (FROM HEAD TO FOOT)
DROWSINESS,DREADFUL HALLUCINATIONS,DELIRIUM (HEAD)
DIPLOPIA,DILATED PUPILS (EYE)
DYSPHAGIA,DYSARTHRIA,DRY MOUTH (MOUTH)
DRY SKIN DRUNKEN GAIT (FOOT)
TREATMENT (PAPES)
ANTIDOTE: PHYSOSTIGMINE OR PYRIDOSTIGMINE --> REMEMBER DP
ARTIFICIAL RESPO
P:PURGATIVE
E:EMETICS
STOMACH WASH WITH WARM WATER ,KMn04,ZnSO4
-COCAINE
.TREATMENT (REMEMBER COCAINE)
Charcoal left in stomach stOmach wash with kmno4 and tannic acid
Caffeine and Ammonia that are stimulants
Amyl nitrite(antidote)
INE= Coramine i/v
.2 satges (early and late)
Early .. imagine a person who is euphoric and excited .. so he is restless and confused .. talks too much (talkative) and while talking moves his hands fast(tremors) to catch his vomit (vomiting and nausea).. he cant eat (dysphagia) ...so has rapid pulse ... he only breaths fast i-e rapid respiration and Rapid BP late...now in early stage person is dysphagic so in late phase he has stomach cramps .. this leads to emmaciation weakness.. leading to conciousness and giddiness .. remember now we need to kill the person so ... breathing becomes shallow gasping.. bp decreases fall... person dies of respo failure or cardiac failure
.COCAINISM
MANIA , MELANCHOLY,HALLUCINATION AND DELUSION (HEAD)
MELANCHOLY--->IMPOTENCE
FACE PALE...EYES SUNKEN.. DIGESTIVE DERANGEMENTS SO THERE IS EMACIATION AND WASTING
-BARBITURATES
FOR CLASSIFICATION REMEMBER (PACT) .. FATAL DOSE (4-3-2-1mg)
LONG ACTING---PHENOBARBITONE
INT. ACTING ----AMYLOBARBITONE
SHORT ACTING ---- CYCLOBARBITONE
ULTRA SHORT -----THIOPENTONE
TREATMENT (PPRMC)
POISON REMOVAL THAT IS ABSORBED
POISON REMOVAL THAT IS UNABSORBED
RESPIRATION MAINTAINANCE
MEASURES (ANTIBIOTICS GIVEN )
CIRCULATION MAINTAINANCE
-STRYCHNINE
TREATMENT (SSAAAD)
SILENCE --DARK ROOM
STOMACH WASH WITH TANNIC ACID
ANTIDOTE:BARBITURATE
ARTIFICIAL RESPO
ANIMAL CHARCOAL
DIAZEPAM
SYMPTOMS (PEO)
PLEUROSTHOTONUS
EMPROSTHOTONUS
OPHISTHOTONUS
OPIUM
-->TREATMENT (TTEKAA)
TEA AND TANNIC ACID
STOMACH WASH WITH(T AND K )
TANNIC ACID Kmno4
EMETICS AND ENEMA (DONOT USE PURGATIVES)
ANTIDOTES: NALOXONE OR NALORPHINE
ARTIFICIAL RESPO
--> OPIUM IS ALSO CALLED AFFIM
CARDIAC POISONS (ONLY DIGITALIS)
-SIGNS (NMC)
NAUSEA, VOMITING, DIARRHEA
MENTAL CONFUSION, VISUAL DIST
CARDIAC ABNORMALITIES (ARRHYTHMIA, SYSTOLE, CONDUCTION DEFECTS)
-AiR
Acute---hypeRkalemia
Chronic---hypokalemia
-Treatment (seacs)
Stomach wash TANNIC ACID
ECG Monitoring Abnormalities of heart treat by lidocaine and phenytoin
Correct electrolyte imbalance (trisodium EDTA)
SURVIVAL for 24 hrs ---- recovery is usual
ASPHYXIANTS
-CARBONMONOXIDE
.Symptoms (Look at the table attached)
.Treatment (M.I.C.R.O)
MONITOR RESPO AND CIRC
ICP INCREASED--THEN USE CORTICOSTEROIDS AND MANNITOL
CONVULSIONS TREATED BY DIAZEPAM
REMOVAL FROM SOURCE
OXYGEN THERAPY (100 %)
.DIAGNOSIS (DTSS)
1) DILUTE--NAOH--STRAW YELLOW
2) DILUTE--TANNIC ACID--PINK WHITE
3) DILUTE----CAUSTIC SODA---GREEN (SEYLER'S)
4) SPECTROSCOPIC ( 2 LINES B/W D AND E)
-H2S
ALL SYMPTOMS ETC SAME AS THAT OF CO JUST REMEMBER IT INHIBITS CYT OXIDASE..BLACKENS COINS...ROTTEN EGG SMELL
REGARDS, AHMAD HASSAN
RAWALPINDI MEDICAL COLLEGE (BATCH 39 ) PUBLICATION INCHARGE RIFAO
PLEASE DONATE GENEROUSLY ! JAZZAKALLAH UL KHAIR ! DO REMEMBER IN YOUR PRAYERS !