Copper poisoning

Copper is a metal numbered 29 in the periodic table and is a mineral component necessary for the normal functioning of the human body. Insufficient copper intake leads to disorders of the central and peripheral nervous system, decreased bone density and joint diseases, iron deficiency anemia, depigmentation of the skin and hair, and dysfunction of the immune system. Excessive intake causes copper poisoning.

Copper and its compounds can enter the body's systems through the digestive tract, respiratory tract, and be absorbed through the skin. Poisoning can be acute or chronic. [ 1 ]

Causes copper poisoning

A daily intake of two to three milligrams of copper with food is considered safe for an adult. It is found in many foods: offal, cocoa, cereals, legumes, seeds, nuts, many fruits and vegetables, even in ordinary clean water. Eco-friendly products can be eaten safely without fear of poisoning, while contaminated ones can cause intoxication of any severity. But here we are talking about poisoning with pesticides, and food is just a way to deliver them. For example, copper sulfate or copper sulfate is used by gardeners and in mass agricultural production to feed plants, fight mold and insect pests. Fungicides known to summer residents are Bordeaux and Burgundy mixtures, products with copper oxychloride. If you use them according to the instructions, no trouble will happen. And its violation can have serious consequences, including death. High concentrations of copper can be found in the liver of animals and birds if they drank contaminated water or ate food oversaturated with it. It is impossible to become poisoned by copper simply by eating products containing it; we simply cannot eat that much, for example, 3.5 kg of spinach in one sitting. [ 2 ]

Toxic concentrations of copper and its compounds can form in food if copper cookware is used incorrectly; it quickly oxidizes, especially in a humid environment, forming a patina (greenish coating). Interaction with food acids during heating in such cookware contributes to the fact that the cooked food becomes poisonous. Copper cookware is also not suitable for long-term storage of cooked food.

Copper is used in medicine, both official and folk: as a vital microelement, it is contained in vitamin-mineral complexes and dietary supplements, is part of antiseptics and astringent external agents, copper wire in the composition of the intrauterine device inhibits sperm activity and prevents conception. Medicines containing copper must be used strictly adhering to the recommended doses and duration of treatment. [ 3 ]

Copper tubing is present in hemodialysis machines, so patients who require frequent treatments are at risk of developing intravenous copper toxicity syndrome.

Copper and its compounds are widely used in various industries. Occupational hazards are associated with the production, metalworking and welding of non-ferrous metals, the chemical, paint and varnish, woodworking industries, construction and agricultural work.

Risk factors

The main risk factors for copper poisoning are violations of the rules for using substances containing it and personal safety when working with them:

• overdose of vitamins, dietary supplements and external agents; violation of the duration of the course of treatment, timing of IUD installation, etc.;
• careless attitude to agricultural pesticides based on copper sulfate in everyday life: storing them in unmarked containers, which can lead to accidental ingestion and acute poisoning; neglect of safety measures (processing must be carried out with gloves and a respirator), recommended recipes for preparing the solution and spraying times (at least two weeks before the expected harvest);
• disregard for prescribed safety regulations at work. [ 4 ]

Pathogenesis

The pathogenesis of copper poisoning is associated with its physiological effect on the body. It plays an important role in the metabolic process, since it is a part of most enzymes that catalyze the oxidation of proteins and carbohydrates. When the body is oversaturated with copper and its compounds, there is an excess of free copper ions, which react with the amine nitrogen and the SH group of proteins to form stable insoluble compounds, due to which enzyme formation in the body decreases and important enzymes are inactivated, for example, cytochrome oxidase, a catalyst for the final stage of cellular respiration, which leads to tissue hypoxia; the synthesis of the protein ceruloplasmin decreases, which leads to a disruption in the oxidation of polyamines in blood plasma; the synthesis of collagen and elastin decreases, which affects the strength of the walls of blood vessels, articular cartilage, tendons and the condition of the skin. [ 5 ]

Direct oxidizing action of free copper ions on the erythrocyte membrane in excess leads to their destruction and pathological hemolysis. This is the most common complication of copper compound poisoning. It develops very quickly - first methemoglobinemia (increased content of oxidized hemoglobin, leading to tissue hypoxia), then pathological hemolysis.

The largest amount of copper in case of poisoning comes from the digestive tract into the liver, its parenchyma is damaged, jaundice and other manifestations of hepatotoxicity develop. [ 6 ]

Massive intravascular hemolysis can result in renal and respiratory failure. Free copper ions circulating in the body in large quantities can have a direct damaging effect on vascular cells and cardiomyocytes. In the most severe cases, sepsis, arterial hypotension, and shock can occur.

Fatal poisoning with copper and its compounds is rare and is mostly associated with intentional ingestion of, for example, a large amount of copper sulfate solution for the purpose of suicide. Accidental ingestion of even a significant amount of the toxic substance rarely causes fatal poisoning, since, as experts explain, the effect of copper salts on the gastric mucosa immediately causes reflex vomiting, which eliminates most of the absorbed toxic substance. In addition, copper causes thrombosis in the gastrointestinal mucosa, which also prevents the absorption of the poison. Chronic, but not fatal, poisoning most often develops in people whose professions are associated with constant contact with substances containing copper and its compounds. Poisoning statistics indicate that the greatest number of copper intoxications of varying severity are characteristic of regions with developed viticulture. [ 7 ]

Symptoms copper poisoning

In acute poisoning with copper and its compounds, symptoms appear after several hours. The severity and speed of intoxication depend on the amount of toxic substance that has entered the body. Different routes of penetration have their own specific features, but the general symptom indicating poisoning with copper compounds is a complex of the following symptoms: muscle and abdominal pain, nausea (vomiting), loose stools, acidosis, acute inflammation of the pancreas, methemoglobinuria and pathological hemolysis.

The most dangerous is the ingestion of a large amount of copper compounds into the gastrointestinal tract through the mouth. The conventional lethal dose in this case is considered to be the intake of 0.15 to 0.3 g of copper sulfate per kilogram of the victim's weight. The first signs are irritation of the gastric mucosa: pain and vomiting. Poisoning with copper salts, especially copper sulfate, gives the vomit a bluish tint. But this is not a specific symptom, since such a color can occur with poisoning with boric acid, methylene blue, and food colorings.

At high concentrations of the toxic substance, gastrointestinal bleeding and perforation may develop. In addition, patients often complain of chest pain and a sweet metallic taste in the mouth.

From the digestive tract, copper enters the liver, so the next symptoms are signs of liver damage. Externally, jaundice spreads. Simultaneously with liver damage, symptoms of hemolysis appear. [ 8 ]

Not each symptom is assessed separately, but the entire complex. Poisoning with copper preparations, food prepared and/or stored in copper utensils, contaminated agricultural products, accidental or intentional ingestion of copper sulfate manifests itself as irritation of the digestive tract with symptoms of dyspepsia, subsequent increase in liver and kidney failure and damage to other organs.

Clinical manifestations increase rapidly in approximately the following order: simultaneously with nausea and paroxysmal abdominal pain, the patient feels a sweetish metallic taste in the oral cavity, there may be a burning sensation in the mouth and esophagus, especially if their mucous membranes were in direct contact with the powder or solution of copper compounds, thirst and hypersalivation are characteristic, nausea is quickly resolved by vomiting, which has a bluish or greenish tint. When toxic masses reach the intestines, flatulence and diarrhea join in. Feces can also be bluish and with streaks of blood. Signs of hepatotoxic and hemotoxic action appear quite quickly - the sclera of the eyes, skin turn yellow, the tongue is coated, blood pressure drops, nausea and vomiting increase, muscle and joint pain appears, in severe cases a high temperature will rise. All this develops against the background of symptoms of general intoxication: pallor, increasing weakness, dizziness, headache, fever. Renal failure manifests itself as dysuric disorders, and acute urinary retention may develop.

The patient's condition may further worsen with respiratory failure, heart failure, hypotension, sepsis, and even toxic shock. If timely assistance is provided, the patient's clinical picture may not include all the symptoms.

Inhalation poisoning is usually milder. Since the mucous membranes of the respiratory organs come into contact with the powder or aerosol form of copper compounds, the patient feels the first signs as a burning and dryness of the mucous membranes of the nose and throat, they turn red, there is a burning sensation under the eyelids, hyperemia, lacrimation, visual impairment). The throat is constantly tickling, the nose is "twisting", there is a desire to sneeze and cough. The victim "does not have enough air" to the point of suffocation, he has severe shortness of breath, a hoarse voice, problems with swallowing. Symptoms develop against the background of increasing weakness, high fever, sweating, headache, joint and muscle pain. A variant of inhalation poisoning is the development of so-called foundry fever. The symptoms are the same, but more pronounced: suffocation, hacking cough, fever to hyperpyretic values, accompanied by chills and heavy sweating. Against the background of intoxication, clouding of consciousness with delusional-hallucinatory syndrome up to fainting develops. After the temperature drops, respiratory and sometimes psychotic symptoms still persist. Foundry fever usually goes away on its own within a few days.

Copper oxychloride is considered to be an easier-to-use and less toxic pesticide than other compounds of this metal. Inhalation or gastrointestinal poisoning with copper oxychloride is clinically manifested as copper intoxication, and usually occurs in a milder form. If the substance gets on unprotected skin, inflammation and eczematous lesions may occur.
Copper poisoning through the skin is more typical for copper sulfate, since it can penetrate the body from intact skin due to the reabsorption of sweat. In addition, copper is an antiseptic and astringent, and is used to treat, for example, burns. Absorption is more intense through damaged skin. After repeated application of an ointment containing copper, patients experienced symptoms of chronic intoxication and local darkening of the skin.

Chronic copper poisoning occurs when small excess doses enter the body over a long period of time. In this case, the symptoms increase slowly and gradually. Chronic fatigue, periodic attacks of nausea and dizziness appear, appetite is disturbed, vomiting and loose stools may occasionally occur. The sclera of the eyes, skin and mucous membranes acquire a yellowish tint, the hair of blondes acquires a greenish tint (by the way, this effect is also observed in swimmers, since the water in swimming pools is disinfected with copper-containing agents). A red border may appear on the mucous membrane of the gums, teeth begin to deteriorate more rapidly, and areas of irritation from hyperemia and rash to eczematous spots appear on the skin. Symptoms of gastrointestinal disorders, liver and kidney dysfunction, endocrinological disorders may appear, the body's defenses are reduced, the psychological state changes, neurological problems appear, hematopoiesis is disrupted - laboratory tests show deviations from the norm of almost all blood parameters (pancytopenia). [ 9 ]

According to the degree of severity, the following are distinguished:

• mild poisoning - manifested by digestive disorders that resolve on their own within the next few hours, symptoms of burns of the mucous membranes of the mouth and throat if ingested, nose, eyes and upper respiratory tract - if inhaled, minor nephropathy;
• moderate poisoning - characterized by more pronounced gastrointestinal tract disorders, possible development of bleeding from the esophagus and/or stomach, the duration of which is approximately 24 hours, complicated by the development of moderate nephro- and hepatopathy;
• severe - pronounced symptoms of gastrointestinal disorders persist for several days and are complicated by bleeding, which can end fatally, as well as decompensated exotoxic shock; hemolysis is characterized by a high (up to 600 g / l) serum content of free hemoglobin and a duration of two to six days; in addition, the development of anemia, hepatopathy and nephropathy (early stage of the toxicogenic phase) and severe acute combined renal and hepatic failure are observed, the appearance of which indicates the onset of the late stage of the toxicogenic phase of poisoning.

If the patient has frequent vomiting and diarrhea with signs of increasing dehydration, and especially when blood is visible in the vomit and/or feces, it is necessary to immediately call an ambulance. Emergency medical care is necessary if the victim has a high fever (body temperature reaches pyretic values and above), symptoms of "acute abdomen", and respiratory, excretory and swallowing functions are impaired. [ 10 ]

Complications and consequences

Acute copper poisoning can end in different ways: from a fairly successful recovery in mild cases in a one-time situation to a fatal outcome. The consequences directly depend on the dose of the toxic substance received, oral administration of 10 to 20 g of copper sulfate usually ends in the death of the victim, even if timely assistance is provided. It occurs by the end of the week directly during hemodialysis. But, nevertheless, not in everyone. A high concentration of copper does not always determine the outcome of poisoning. Much depends on the age of the patient, his general health, and individual characteristics of the body. It is necessary to fight for survival in any case, since it is difficult to predict the outcome of poisoning, even severe, as practice shows. But in any case, timely assistance increases the likelihood of a successful outcome.

Complications of acute poisoning may include:

• DIC syndrome;

• perforation and bleeding from the gastrointestinal tract;
• water-electrolyte imbalance, dehydration;
• toxic nephropathy, acute renal failure;
• toxic hepatopathy with subsequent encephalopathy;
• violation of hematopoiesis, blood circulation, tissue hypoxia, necrotic changes in organs;
• disorders of the respiratory, cardiovascular and nervous systems;
• sepsis, toxic shock;
• fatal outcome due to severe complications in the vital systems of the body.

Chronic poisoning does not have a pronounced clinical picture. Its consequences increase slowly and lead to the development of degenerative-dystrophic changes in various organs, developing into life-threatening diseases. The liver and kidneys are most often affected. Cases of childhood liver cirrhosis are quite common in developing countries. It is observed as a result of chronic poisoning with water stored in copper utensils previously used to store milk. [ 11 ]

In countries with developed viticulture, pneumosclerosis (vineyard sprayer's disease) is common among those working in this industry. Also, chronic poisoning with copper compounds results in small-nodular liver cirrhosis, liver hemangiosarcoma, and lung adenocarcinoma, which suggests the oncogenicity of long-term exposure to copper compounds. Renal failure, central nervous system lesions, which vary greatly from tremors of the extremities to epileptiform seizures, vascular disorders, ulcers, and erosions on the mucous membranes of organs that come into contact with dust and fumes, in particular, lesions of the cornea, conjunctiva, and other structures of the eye are known. Long-term exposure to excessive amounts of copper and its compounds inhibits hematopoiesis processes, and pancytopenia develops. And the quality of the blood affects the functioning of all body systems.

Against the background of chronic poisoning with small doses of copper and its compounds, a paradoxical metabolic disorder may occur: free ions begin to be deposited in the tissues of various organs - the liver, kidneys, iris, causing local intoxication in them, while in the body as a whole there is a deficiency of this element and associated disorders.

Diagnostics copper poisoning

Copper and copper compound poisoning is diagnosed based on the patient's condition and evidence that he or she has been in contact with the chemicals in question. [ 12 ]

The assumption can be confirmed by tests for copper concentration in plasma or whole blood. Laboratory tests of serum levels of direct and indirect bilirubin, free hemoglobin levels (using photoelectrocolorimetry), plasma electrolytes, liver enzyme activity, prothrombin time, and water balance are mandatory. Clinical urine and blood tests are performed to assess the general health status. [ 13 ]

If necessary, instrumental diagnostics are prescribed: ultrasound of the liver and kidneys, fibrogastroscopy, X-ray and other studies.

Differential diagnosis

Differential diagnostics are carried out with poisoning by other substances, acute gastrointestinal diseases, liver and kidney pathologies of non-toxic origin. [ 14 ]

Treatment copper poisoning

At home, you can provide assistance to the victim, which will reduce the strength of the irritant. In case of inhalation of dust or vapors of copper and its compounds, wash the affected mucous membranes of the eyes under running water, rinse the nose, gargle. It is recommended to drink plenty of fluids in combination with taking diuretics. Such tactics accelerate detoxification of the body.

If the substance comes into contact with the skin, wash the area of contact several times with clean water.

At the first signs of poisoning by swallowing a toxic substance - digestive disorders, the usual help for cases of poisoning is provided. If copper and its compounds are ingested orally, the stomach is washed until the wash water is clean and enterosorbents are given. Although in most cases the patient already has severe vomiting, so he is given a lot of water to drink to replenish fluid loss. Milk, sour and fat-containing drinks should not be given. [ 15 ]

The victim is provided with rest: put to bed in a well-ventilated room, covered warmly if he is shivering, put a cool wet napkin on the forehead in case of fever. If there are traces of blood in the vomit, an ice pack can be placed on the stomach. [ 16 ]

Further actions are carried out under the supervision of medical personnel. In cases of mild poisoning, the patient may be left at home, in other cases he is hospitalized. The need for hospitalization should be decided by a doctor.

In a medical institution, the patient is prescribed detoxification and maintenance therapy individually based on the prevailing symptoms and examination. Removal of copper compounds from the digestive tract - probe lavage is rarely performed, since uncontrollable vomiting develops in the vast majority of patients poisoned by this substance. But if necessary, lavage with a probe can be used with the introduction of the complexing agent unithiol (from 50 to 100 mg) through it at the beginning and end of the procedures. [ 17 ]

To cleanse the intestines, a laxative is prescribed; in case of poisoning with copper and its compounds, fat-based preparations such as castor oil or vaseline oil are avoided.

But more often, before prescribing complexing agents, the victim’s vomiting is stopped, the main physiological indicators are corrected, and the water-electrolyte balance is normalized.

Complexing agents (substances that bind toxic substances) are prescribed for severe symptoms of hepatoxicity, hematopoiesis disorders, and severe poisoning. Their effects have not been sufficiently studied, so agents effective in Wilson-Konovalov disease are chosen. If the patient no longer has uncontrollable vomiting, an established allergy to penicillin, and is able to swallow, then penicillamine is preferred as a more effective agent. The drug is taken orally, with an average recommended daily dose of 1 to 1.5 g. It is also used for chronic copper poisoning, in particular, for childhood cirrhosis. The purpose of taking penicillamine is to prevent the development of hemolysis. However, the drug is taken in a short course, since it can also cause adverse effects: anemia, pancytopenia, impaired respiratory function and urine excretion. [ 18 ]

However, dimercaprol is used much more often. Its effectiveness is lower than that of the previous drug, but most victims vomit heavily, so dimercaprol, which can be administered parenterally (intramuscularly), has an undeniable advantage. In cases of severe poisoning, dimercaprol and penicillamine are prescribed simultaneously or one after the other.

There is mixed information about extracorporeal detoxification methods, but hemodialysis and peritoneal dialysis are used in the early period of the toxicogenic phase (on the first to third day). Hemodialysis is especially effective in the first 12 hours after poisoning. The procedure lasts from six to eight hours, and is repeated if necessary.

Peritoneal dialysis is less effective. It is used in cases where hemodialysis is contraindicated for the victim or when there is prolonged circulation of a toxic substance in the patient's blood. In the second case, hemodialysis alone is not enough and is combined with peritoneal dialysis.

The patient is brought out of the state of exotoxic shock according to the standard protocol. Narcotic analgesics, glucocorticosteroids and antispasmodic drugs are used against the background of massive infusion treatment.

Signs of acute hemolysis are well stopped by plasmapheresis, which is started immediately after the patient is brought out of the state of shock. Symptomatic treatment of complications is also carried out: burns of mucous membranes, toxic nephropathy (in severe cases, renal replacement therapy is carried out until the symptoms of hemolysis in plasma and urine completely disappear) and toxic liver dystrophy.

The treatment is symptomatic, various medications and vitamins are used, depending on the complications of poisoning, and physiotherapy is also prescribed to restore impaired functions.

Folk remedies

Mild copper poisoning can be treated with folk remedies only if the doctor, after examining the patient, finds it possible to leave him at home. Providing first aid: gastric lavage with a solution of potassium permanganate or saline solution, using activated carbon to prepare an absorbent suspension (one tablet per 10 kg of the victim's weight), cold compresses on the head, wrapping can also be attributed to folk treatment.

Ginger or green tea (you can drink green tea with ginger and lemon) has detoxifying properties. You can stop vomiting and diarrhea with rice broth, for which washed round rice is boiled for 10-15 minutes in a large amount of water (approximately 1:5), filtered and the resulting liquid is taken three times a day, half a glass. Or prepare a decoction of calamus root and ginger: pour half a teaspoon of chopped roots with a glass of boiling water and boil for a couple of minutes, strain. Drink half a glass three to four times a day. It is useful to add honey to tea as a sweetener. It is itself a storehouse of mineral components, its presence helps to normalize the electrolyte balance, in particular, optimize the concentration of sodium and potassium, which is necessary to restore the ability of the kidneys to remove fluid and cleanse the blood of toxic substances.

Folk recipes can be used during the recovery period to normalize the disturbed functions of the body's systems.

Laminaria or seaweed helps normalize kidney function. You need to eat 100g of this seaweed daily for therapeutic purposes. It contains alginates - natural sorbents that bind and eliminate toxins from the body, sterols - preventing thrombus formation, pectins, normalizing the functions of the digestive system, antioxidants, B vitamins, necessary for normal hematopoiesis. Seaweed contains a lot of iodine, which is the reason for its main contraindication - hyperthyroidism, people with thrombocytopenia and acute nephritis should not abuse it.

You can improve the functioning of the gastrointestinal tract, restore the mucous membranes and skin, relieve inflammatory processes in the oral cavity and, in general, increase the body's resistance with the help of a decoction of bird cherry berries. It is prepared as follows: throw 20 berries into 200 ml of boiling water and boil for 20 minutes, let cool to about warm, strain and take half a glass three times a day. Before use, bird cherry berries must be freed from stones, they contain hydrocyanic acid, so it is necessary to strictly adhere to the recommended doses. You should not resort to taking a decoction of bird cherry berries in case of severe anemia, people suffering from migraines and / or constipation, as well as diabetes.

Sea buckthorn berries are considered to be one of the most useful for the human body. You can eat them raw or mashed with honey or sugar, drink sea buckthorn juice, make an infusion and decoction. In the recovery period, you can also use sea buckthorn oil, externally and internally. It heals damaged mucous membranes and skin well, treats gastritis and ulcers. Simply eating a few sea buckthorn berries a day, a person saturates his body with a complex of essential vitamins, stabilizes the state of the central nervous system, respiratory function, and gets rid of constipation.

A decoction of sea buckthorn with honey can remove hoarseness of the voice. To do this, 120 g of berries must be boiled in a liter of water for several minutes, allowed to cool, strained, 130 g of liquid honey and 35 g of quality cognac added to the decoction. Mix well, let it brew and in an hour the medicine is ready. Take 30 ml every 1.5 hours.

In case of chronic renal failure, it is recommended to drink whole pomegranate juice, which also changes the blood composition for the better. You can also make an infusion from pomegranate peel. To do this, pour a glass of boiling water over a teaspoon of washed, dried and crushed peel for two hours. Take the strained infusion three times a day, one tablespoon at a time.

Damaged hepatocytes can be restored with turmeric. A drink is prepared with this spice: a teaspoon of honey and about a quarter of the same measure of turmeric are dissolved in a glass of warm water, stirred and drunk.

Herbal treatment has been used for a long time and can really help restore impaired organ functions. Medicinal plants contain a whole complex of vitamins, minerals, phytohormones, organic acids and other essential components, affecting almost the entire body. It is necessary to adhere to the recipes for preparation, the recommended duration of the course of treatment, and familiarize yourself with the contraindications. Do not forget that any folk remedy can cause an allergic reaction.

Homeopathy

Homeopathic treatment of poisoning begins with standard first aid: removing the toxic substance from the body, neutralizing the absorbed toxins and treating complications after poisoning. Poisons are removed from the gastrointestinal tract using the same methods - inducing vomiting, giving a laxative, giving an enema. Symptomatic remedies are used to support the activity of basic vital functions.

Considering that acute poisoning mainly requires emergency detoxification and resuscitation measures using modern equipment, it is worth entrusting your life to official medicine. In the rehabilitation period, homeopathy can help restore organ function. But the treatment should be prescribed by a doctor familiar with the principles of action of homeopathic drugs.

In case of copper poisoning, the digestive organs, liver and kidneys suffer first, the blood composition changes, and the strength of blood vessels is impaired. Complex detoxification of the body can be carried out by including multicomponent homeopathic preparations in the treatment regimen:

• tissue metabolism regulator Coenzyme Compositum, which influences the course of oxidation-reduction reactions and activates detoxification processes, stops retoxic disorders in all organs and systems;
• tissue respiration stabilizer Ubiquinone Compositum, which eliminates the preconditions for the development of hypoxia and stops its consequences;
• Leptandra Compositum, Hepel, restoring normal functioning of the digestive system;
• Berberis Gommacord, which normalizes the functions of the liver, kidneys and blood vessels, impaired due to metabolic disorders;
• Gepar Compositum is a multicomponent preparation that stimulates the restoration of the detoxifying function of the hepatobiliary system, normalizes the functioning of the digestive (elimination of diarrhea, vomiting, dyskinesia) and urinary organs, the lymphatic system, a catalyst for oxidation-reduction reactions, due to which the skin and mucous membranes are cleansed, blood circulation is activated and the general condition of the body is stabilized;
• Populus compositum, the indication for which is nephropathy, urinary tract disorders. Other drugs of this series may also be prescribed.

Classical homeopathy most often uses the following for the treatment of hepatopathy: Carduus marianus (Milk thistle), Chelidonium (Greater celandine), Sepia (the contents of the black cuttlefish bursa), Sulfur (Sulfur), Taraxacum (Dandelion).

For the treatment of toxic nephropathy, Aurum muriaticum (Gold chloride), Lachesis (snake venom), Opium (Poppy), Plumbum (Lead) can be prescribed symptomatically.

Lycopodium (club moss) is also used as one of the main drainage agents, normalizing the functioning of the gastrointestinal tract, kidneys and liver.

Depending on the predominant symptoms and the patient's constitution, other drugs may be prescribed.

Prevention

Copper poisoning in most cases occurs due to carelessness or ignorance of the rules for handling hazardous substances. To avoid it, you need to follow simple recommendations:

• use personal protective equipment (gloves, respirator, glasses) when working with substances containing copper at home and in production;
• do not work with them near food products;
• do not touch your face and mucous membranes with contaminated hands, do not rub your eyes;
• carefully clean the workplace from spilled particles, dust and shavings;
• Do not store substances containing copper in containers without identification marks, or in publicly accessible places;
• adhere to the timing and dosage specified in the instructions when treating plants with copper-containing chemicals;
• During spraying it is not recommended to drink, eat or smoke;
• follow the rules for cooking in copper cookware, do not store cooked food in it, and take proper care of it.

Forecast

Copper poisoning, depending on the absorbed dose of the toxic substance, can end in different ways: from a completely successful recovery to the death of the victim. The outcome also depends on the patient's age, general health, and individual characteristics of the body. Timely assistance in acute poisoning is of great prognostic importance, as well as the elimination of the source and detoxification measures at the first signs of chronic poisoning.