Drug poisoning: signs, first aid, treatment

According to doctors, most often they have to deal with drug intoxication - this is the so-called drug poisoning, caused by the incorrect use of medications. Poisoning can be different - both in its manifestations and in its origin. The latter depends on which group of drugs led to intoxication.

A variety of situations can lead to drug poisoning: someone took the wrong dose of a drug, someone takes many medications at once. The possibility of a suicide attempt, as well as accidental drug intake (most often this happens in childhood), is also possible. What to do if this happens, and how dangerous is it?

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Epidemiology

The largest number of drug poisonings are usually associated with easy access to medications - either for self-medication or for a suicide attempt. Today, drug poisonings account for 60% of all household intoxications. Drug intoxication in the form of side effects of medications is not taken into account.

Most often, poisoning is caused by psychotropic drugs - sleeping pills, benzodiazepines, phenothiazines, etc. More recently, tricyclic antidepressants, finlepsin, and leponex have been added to this list.

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Causes drug poisoning

There are many reasons why drug poisoning can occur:

• Incorrect dosage of a medicine – for example, the dosage is often calculated based on the person’s weight and age.
• Inappropriate and incorrect prescription of the drug - for example, it is possible to prescribe a medication without taking into account other health characteristics of the patient. Thus, many drugs lead to intoxication of the body if there are serious problems with the kidneys and/or liver at the same time as another disease.
• Incorrect drug interactions: Some medications are incompatible with each other, as well as with certain foods or alcohol.
• Accidental drug ingestion.

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Risk factors

The greatest risk of drug poisoning occurs in the following situations:

• if the patient self-medicates without first consulting a doctor, or makes his own changes to the treatment regimen proposed by the doctor;
• if, when prescribing treatment, the patient did not inform the doctor that he was taking other medications at the same time;
• if medicines in the house do not have a specific storage place and are freely accessible to both adult family members and children;
• if the expiration date and the tightness of the packaging are not checked before taking medications;
• if a person takes medications chaotically, without adhering to the required treatment schedule.

Another risk factor that should be highlighted is suicidal tendencies. Drug poisoning is sometimes purposeful: a person takes a large dose of medications with the purpose of committing suicide.

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Pathogenesis

There are hundreds of known medications that under certain circumstances can lead to drug poisoning. Moreover, almost all cases of poisoning are associated with the ingestion of medications.

The main reason is considered to be ignoring the rules for storing medicines, as well as attempts at self-treatment without prior consultation with a doctor.

Severe – in most cases fatal – drug poisonings are often intentional, with the intent of suicide.

Fatalities are primarily caused by large doses of oral drugs and their combinations.

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Symptoms drug poisoning

Clinical manifestations of drug poisoning may differ from each other, depending on which particular medication caused the intoxication. However, there is a certain symptom complex inherent in almost any type of toxic drug poisoning.

The first signs are most often:

• severe nausea, vomiting, digestive disorders;
• problems with vision and hearing, impaired motor coordination;
• change in skin tone;
• change in body temperature (in one direction or another);
• disorders of the respiratory system, cardiac activity, and central nervous system.

Acute drug poisoning manifests itself with different symptoms, depending on what medication was taken the day before and in what quantity.

When poisoned with sleeping pills, the central nervous system, urinary system and respiratory centers are most often disrupted. Death usually occurs against the background of acute circulatory failure from paralysis of the respiratory organs. Poisoning with sleeping pills occurs in stages:

1. Drowsiness, apathy, contact with the victim maintained.
2. Loss of consciousness, tongue retraction, fever.
3. State of deep coma, depression of the respiratory center and central nervous system.
4. Fatal outcome, or emergence from a coma with severe psychomotor agitation and instability of the nervous system.

In case of poisoning with antidepressants, the following symptoms are observed:

• hallucinatory visions;
• excited state;
• dilated pupils;
• thirst;
• a sharp decrease in temperature indicators;
• depression of respiratory function and cardiac activity (up to and including cardiac arrest).

In case of poisoning with tranquilizers the following is observed:

• thirst, dry mucous membranes;
• arrhythmia;
• hypotension;
• muscle weakness, tremors.

In the absence of medical assistance, the functioning of the nervous system, heart, blood vessels and respiratory organs is disrupted.

In case of poisoning with drugs that stimulate the central nervous system, the following symptoms are present:

• hyperarousal;
• lack of sleep, hallucinations;
• cardiac dysfunction.

When poisoned with morphine, the work of the heart and respiratory organs is suppressed, the pupils constrict, blood pressure drops, and a state of superficial coma develops.

When poisoned with salicylic acid preparations, heartburn, burning in the stomach, frequent vomiting and bloody diarrhea occur. Victims complain of dizziness, fatigue, deterioration of vision and hearing. The risk of developing internal and external bleeding increases.

In case of poisoning with iodine preparations, a change in the color of the oral mucosa is noticeable, which acquires a yellow-brown tint. There is a desire to vomit, the stool becomes liquid with the release of blue feces. Mucous discharge from the nose, skin rashes, convulsions, and coma are noted.

Poisoning by medicinal plants

Poisoning with plant materials is also not uncommon and occurs:

• when using excessive doses of herbal preparations;
• when ingesting plants that are classified as poisonous;
• when inhaling the essential oils of some plants.

If signs of plant poisoning are detected, the patient is prescribed detoxification treatment.

Poisoning by relatively harmless medicinal plants that were collected incorrectly cannot be ruled out:

• near highways and railways;
• near large enterprises;
• near landfills and settling ponds.

There are known cases of poisoning from berries collected in areas where poisonous plants grow in large numbers, such as wild rosemary or rhododendron.

Poisoning of children with drugs

A child can be poisoned by medicine in the following situations:

• if parents leave any medications (even harmless ones, in their opinion), including vitamins, unattended;
• if parents give their baby the wrong dose of medicine;
• if a child (usually a teenager) makes a suicide attempt.

Often, drug poisoning does not show symptoms immediately, but only a few hours after the use of prohibited medications. Therefore, if parents suspect that their child has taken any medications, they should not wait for the first signs - they should consult a doctor as soon as possible.

Complications and consequences

Drug poisoning is a very common occurrence. To develop intoxication, it is enough to take an excessive amount of drugs or combine them incorrectly. And small children and the elderly can be poisoned, even with a seemingly normal dose of medication.

Some medications can increase the symptoms of other diseases that a person suffers from. However, I call this condition not poisoning, but "drug disease". This happens if the patient does not warn the doctor that he has other serious diseases, or due to the doctor's own mistake.

Drug poisoning is accompanied by the accumulation of toxic components, which are not always easy to remove from the body. It is also impossible to exclude the increased probability of developing side effects, which significantly worsen the patient's already unsatisfactory well-being.

The most severe consequence of drug poisoning is considered to be a fatal outcome. It is known that many cases of poisoning are intentional and are done intentionally with suicidal intent. Unfortunately, suicide attempts often actually result in the death of the patient.

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Diagnostics drug poisoning

In order to correctly navigate the situation of drug poisoning, the doctor needs to determine exactly which group of medications the drug that caused the intoxication belongs to, as well as the amount of it taken. Therefore, if the patient is conscious, a detailed survey is conducted, followed by an examination and clinical examination. Later, information on laboratory tests is also included.

During the examination, the doctor should evaluate the following points:

• are there any disturbances of consciousness;
• how the patient moves, whether coordination is impaired, whether the body is in a forced position;
• what is the condition of the visual organs, is there any asymmetry of the pupils, their narrowing or dilation, yellowness of the sclera;
• what is the condition of the respiratory system, is there a cough, wheezing, or shortness of breath;
• is there any cardiac dysfunction?
• is there any bloating or abdominal pain;
• Is your body temperature elevated?

Based on the listed diagnostics, the doctor can make a preliminary diagnosis. In order to confirm it, it may be necessary to conduct additional laboratory tests.

Tests are carried out only after emergency medical care has been provided, since laboratory tests take time, which in the case of acute poisoning can cost lives.

Thus, traces of drugs can be found in the victim’s blood and urine even several weeks after taking the drugs.

Instrumental diagnostics at the first stage are rarely performed and may include spectrophotometry, spinal puncture, ECG, and fibrogastroscopy.

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Differential diagnosis

Differential diagnostics are carried out with other types of poisoning. For example, it is important to distinguish drug poisoning from food intoxication, from poisoning with chemicals, drugs, alcohol, and heavy metal salts.

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Treatment drug poisoning

The treatment tactics for drug poisoning must be determined taking into account the main necessary stages:

• Urgent delivery of the victim to a medical facility.
• Urgent, rapid detoxification, removal of toxic components from the bloodstream and tissues.
• If possible, specific treatment with the administration of antidotes.
• Use of symptomatic drugs.

What can people around or the victim do in case of drug poisoning?

1. Call an ambulance.
2. Provide first aid: induce vomiting, give an absorbent and a laxative in sufficient quantity.
3. Do not eat or take any medications until your doctor arrives.

The sooner first aid is provided, the better for the health and life of the victim.

First aid for drug poisoning

• In case of drug poisoning with sleeping pills, the following steps must be taken:
  • rinse the victim's stomach with plenty of water;
  • give the patient an absorbent (activated carbon, enterosgel, etc.);
  • give a saline laxative;
  • ensure sufficient fluid intake into the body with the simultaneous administration of diuretics;
  • In case of breathing and heart problems, use analeptics, cardiac glycosides, and, if necessary, adrenaline.
• In case of drug poisoning with antidepressants or tranquilizers, the patient's stomach is washed with a weak solution of baking soda, a saline laxative is given or a siphon-type enema is given, and sorbents are given. Physostigmine is considered an antidote when taking antidepressants - it is administered intravenously, which causes stabilization of blood pressure and cardiac activity.
• In case of drug poisoning with CNS stimulants, gastric lavage with a solution of baking soda should be performed as soon as possible, the patient should be given activated carbon, and a siphon enema should be done. If convulsions occur, aminazine or diphenhydramine with novocaine should be administered by injection. In severe cases, cardiovascular resuscitation measures may be required.
• In case of drug poisoning with morphine, the stomach is washed with a weak solution of potassium permanganate, the victim is given a sorbent and a saline laxative. Sometimes there may be a need to repeat the gastric lavage. Then, infusion treatment is carried out with forced diuresis and intravenous infusion of 0.5% nalorphine.
• In case of drug poisoning with salicylic acid preparations, alkaline gastric lavage is performed, and the victim is given a large amount of alkaline drink. Infusion of alkaline solutions is also possible. To neutralize salicylic acid, 1 g of vitamin C per day is used, or ascorbic acid is administered intravenously in combination with a glucose solution.
• In case of drug poisoning with iodine preparations, the victim is offered to take starch or flour paste, or another slimy drink, or fresh milk. In addition, an antidote should be taken - up to 300 ml of sodium thiosulfate. Then, if there are indications, symptomatic treatment is carried out.

Medicines common to all types of drug poisoning:

Activated carbon	Take as a suspension of 30 g per dose. Long-term use may cause constipation.
Enterosgel	Take one full tablespoon per dose with water. Constipation may develop with prolonged use.
Sorbex	Take 4-8 capsules per dose. With prolonged use - more than 15 days in a row, constipation may develop.
Carlsbad salt	Dissolve 1 tbsp. of salt in 100 ml of water, take 2-4 times a day if necessary. The drug is considered completely safe and does not cause side effects.
Regidron	Dilute a packet of the drug in 1 liter of clean warm water, take in the amount of 10 ml per kg of weight per hour, in case of dehydration. No side effects were observed.

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Vitamins

In most cases of drug poisoning, vomiting, diarrhea, and general intoxication are observed. In such conditions, many useful substances – vitamins, minerals – are rapidly eliminated from the body. Their level must be restored – but only after the digestive tract has stabilized.

First of all, it is necessary to provide the body with the following vitamins:

• Vitamin A – helps to quickly restore damaged tissues and the functions of many organs (the vitamin is found in bread, cereals, oils);
• B vitamins – improve bowel function, stabilize digestion, strengthen the nervous system and immunity (these vitamins can be found in liver, milk, cabbage, sprouted wheat, carrots);
• ascorbic acid – strengthens blood vessels, maintains immune defense (found in berries, citrus fruits, kiwi, bell peppers, tomatoes);
• Vitamin E – helps to quickly restore damaged tissues in the body (the vitamin can be obtained from vegetable oils, rowan, sea buckthorn, nuts).

At the recovery stage, it is necessary to include plant products with a high pectin content in the menu - these can be apples, carrots, tomatoes. Pectin will help to thoroughly cleanse the digestive system and protect mucous tissues from damage.

Physiotherapy treatment

Physiotherapy is rarely used for drug poisoning. As a rule, this type of treatment is appropriate at the recovery stage after severe intoxications. Coniferous baths, electrophoresis of the collar area according to Shcherbak, and full quartz irradiation may be indicated.

In addition, mud applications, manual therapy, exercise therapy, and, if paresis develops, electrical stimulation are sometimes used. In some cases, the doctor may recommend spa treatment.

Folk remedies

To speed up the removal of toxic substances and metabolic products from the body, use dry kelp: eat 3 g of ground dry seaweed every three hours, washing it down with a glass of water.

In case of severe vomiting attacks, you can use a saline solution, which will provide detoxification and prevent dehydration. The simplest recipe for a saline solution: dissolve 1 tbsp. granulated sugar, 1 tsp. salt and ½ tsp. baking soda in 1 liter of warm drinking water. This solution should be drunk 0.5 liters every 30-40 minutes.

Tincture of Eleutherococcus helps to stabilize the function of vital organs during intoxication. Usually, in case of drug poisoning, 10 drops of tincture are taken in 50 ml of liquid. The medicine can be taken several times a day, but not more often than once an hour.

Dill has a good antitoxic effect: experts recommend preparing an infusion of 1 tbsp. dried dill and 300 ml of boiling water. You can add 1 tsp. honey to the warm infusion.

In case of mild drug poisoning, ginger tea will be helpful. To prepare, use 2 teaspoons of grated root and 0.6 liters of boiling water, drink a little throughout the day.

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Herbal treatment

Herbs are usually used for mild drug poisoning with minor intoxication symptoms, or at the recovery stage after moderate or severe intoxication. Most experts recommend using the following medicinal plants:

• Chamomile flowers, which relieve inflammation and have antimicrobial properties.
• Mint leaves stabilize the digestive tract, soothe and relieve nausea.
• St. John's wort herb, which has astringent and antimicrobial properties.
• Plantain leaves normalize blood composition and improve well-being in cases of intestinal dysfunction.
• Chicory, which accelerates the elimination of toxins and improves kidney function.
• Yarrow herb improves liver function and restores the digestive system.
• Elecampane rhizome, which helps remove toxic substances from the body and purifies the blood.
• The mallow plant eliminates the effects of inflammation.

It is allowed to use both individual plant species and their combinations. There is no need to prepare herbal decoctions: they are poured with water brought to a boil and left to infuse for about half an hour. The average proportions for preparing an infusion are 1 tbsp. of raw material per 400 ml of water.

Homeopathy

A competent selection of classic homeopathic preparations will help eliminate the signs of drug poisoning in a short time without any side effects. In addition, homeopathic remedies will have a positive effect on immunity and stimulate regeneration processes.

The main drugs used for drug poisoning are:

• Quinine is prescribed for severe dehydration due to repeated vomiting and diarrhea.
• Carbo vegetabilis is used for poisoning, which is accompanied by severe flatulence, fever, and abdominal cramps.
• Nux vomica – will help if signs of poisoning appeared on the second day. Symptoms may include muscle cramps, abdominal pain, nausea to vomiting, diarrhea, loss of strength, cold extremities.
• Arsenicum album is prescribed for poisoning accompanied by vomiting and diarrhea: the patient cannot drink water due to an increased gag reflex and stomach cramps.

The above homeopathic remedies can be used, including in cases of poisoning of children. They are given to children in a 30C dilution every hour.

Diet for drug poisoning

The main principles of therapeutic nutrition after drug poisoning should be the following rules:

• The first day after drug poisoning is the hardest for the body. Therefore, it is advisable to abstain from food altogether.
• In case of drug poisoning, you should drink liquids, often, but little by little (so as not to provoke a gag reflex). The most optimal drink is considered to be non-carbonated mineral table water, rehydron.
• If you feel an overwhelming desire to eat, you are allowed to eat a small piece of dried bread or a rusk.
• If possible, it is also better to spend the second day without food. Drinking clean water is encouraged.

Starting from the third day, you are allowed to drink rice groats broth, eat rice porridge, and dried bread. Fermented milk products are gradually introduced into the diet, but this is done carefully: if loose stools or nausea appear, then do not rush to introduce such products.

Starting from the fourth day, begin to gradually expand the diet, adhering to the following principles:

• You should eat frequently, approximately every 2.5 hours, but portions should not exceed 100 g;
• When choosing food, preference should be given to light, liquid or semi-liquid dishes;
• you can’t “pounce” on food abruptly: returning to your previous diet should be gradual;
• Drinking sufficient amounts of fluid should be continued for as long as possible;
• At first and until the patient’s condition is completely normalized, it is necessary to exclude from the menu foods that impede the functioning of the digestive tract (cabbage, beans, lard, fried and smoked foods).

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Prevention

To prevent drug poisoning, the main point is to follow basic rules for storing and taking medications:

• It is correct to store medicines in a specially designated place, inaccessible to children and mentally unstable people. The home medicine cabinet should be reviewed periodically, removing expired and unused medicines, and adding fresh ones as needed. You should pay attention not only to the production date of the medicines, but also to the integrity of their packaging, as well as the presence of a clear name of the drug on the packaging.
• Taking certain medications is only permitted when they are prescribed by a doctor, in strictly recommended dosages.
• Before taking any drug, you need to read the instructions for it. Special attention is paid to contraindications and side effects during treatment with the drug. Information about drug interactions is also important.
• Any medication should not be combined with alcoholic beverages.
• If adults decide to throw away any medication, they must make sure that the child does not find this medication in the trash.

Forecast

The effectiveness and duration of treatment, as well as the prognosis for drug poisoning, depend on many factors. First of all, it is important how promptly the victim received first aid. Rapid neutralization and removal of the toxic component from the body increases the chances of a speedy recovery.

In most patients, drug poisoning occurs due to their own fault. The absence of a correct and clear treatment regimen, self-administration of drugs, unauthorized dosage adjustments - such factors can lead to the most unfavorable consequences. If a person has suspicious symptoms of drug poisoning, then it is necessary to immediately contact a doctor - sometimes only timely treatment can save the patient's life.

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