Treatment of nitrate and nitrite poisoning

From the moment of consuming products with nitrates until the first signs of nitrate poisoning appear, it can take from 1 to 6 hours. So if symptoms of stomach upset appear during this period, you can suspect poisoning. But the catch is that the same symptoms can be caused by other intoxications or gastrointestinal diseases, so you should not make a diagnosis in this situation on your own, there is a high risk of making a mistake.

But what can be done to try to remove some of the nitrates from the body is to cleanse the stomach and intestines. If a person has vomiting and diarrhea, then cleansing occurs naturally. If there is no vomiting, it must be induced by stimulating the root of the tongue.

It is even better to wash the stomach with a large amount of water (at least 1 liter). You can add salt or a few grains of potassium permanganate to it so that the solution becomes light pink. Usually, drinking a large amount of warm water at once causes vomiting. If this does not happen, you need to induce vomiting by irritating the receptors located on the root of the tongue.

After the stomach is washed, some relief usually occurs, nausea goes away and you can try to carry out a deeper cleansing with the help of enterosorbents. Any preparations from this group are suitable, starting with "Activated carbon" or "Sorbex" and ending with "Polysorb" or "Carbolong".

If relief does not occur, nausea, vomiting and severe diarrhea remain, you can try to wash out the stomach again. Enterosorbents, which are taken orally, can be used only after vomiting has stopped, otherwise they will be useless.

It is important to understand that gastric lavage in case of poisoning makes sense if no more than 3-4 hours have passed since eating products with nitrates. After that, nitrates can already be looked for in the intestines and blood. In case of mild poisoning, everything will gradually return to normal, in case of severe poisoning, when the symptoms of stomach upset do not go away within 2-3 days, plus neurological manifestations, heart problems, etc. are added to them, you can no longer do without medical help.

If the temperature rises (and this does not always happen), it is necessary to monitor its indicators, and bring it down only if it exceeds 39 degrees, which can cause negative processes in the body. If the temperature has dropped by the time the ambulance arrives, it should still be reported to the doctors.

Nitrate poisoning almost always involves diarrhea. It should never be fought, the body should be given the opportunity to cleanse the intestines. But it is also not worth stimulating this symptom with strong laxatives or enemas until the cause of its occurrence is precisely established. As a last resort, you can try drinking a saline laxative.

To slow down the conversion of nitrates into toxic substances (and some nitrogenous salts, under the influence of enzymes, are converted into nitrosamines, which are considered carcinogens and can contribute to the development of cancer), doctors recommend taking several tablets of vitamin C (“ascorbic acid”) immediately after vomiting stops.

After nausea and vomiting subside and the gastrointestinal tract is cleansed with enterosorbents, it will be necessary to begin taking measures to restore the body. Symptoms such as vomiting and diarrhea contribute to the removal of fluid from the body and disrupt the water-salt balance. Therefore, in order to prevent severe dehydration of the body, it is recommended to drink more clean water. It will help remove the remains of nitrites that did not get into the blood and will replenish the volume of fluid in the body.

If there is no nausea, you can drink not only water, but also tea. It is better if it is strong tea with a slice of lemon and sugar, which also helps to restore strength. With nutrition in the first time after the disappearance of symptoms of intoxication, you need to be careful, gradually introducing into the diet porridge without oil, boiled and stewed vegetables, dietary boiled meat (chicken, turkey, veal). Natural green tea, pickles and cabbage (not marinated, but salted!) will be useful. It is worth giving up on it for now, so is the use of alcoholic beverages, which only aggravate the situation.

If the fight against diarrhea and vomiting is unsuccessful, the patient gets worse, neurological symptoms appear (coordination disorder, speech and vision impairment, convulsive syndrome) and other dangerous manifestations, the help of specialists will be required.

Long-term vomiting and diarrhea will lead to severe dehydration, which will be manifested by a drop in blood pressure, a decrease in the amount of urine and the appearance of a sharp smell, dry mucous membranes. This condition also requires specific treatment - taking drugs for dehydration (Hydrovit, Regidron, etc.). But oral administration of drugs and drinking plenty of fluids are again possible only in the absence of vomiting. If vomiting persists, the situation can only be saved by infusion of fluids and rehydration drugs, which is possible in a hospital setting.

An alarming symptom of nitrate poisoning is the appearance of blood in the feces, which indicates severe irritation of the gastrointestinal mucosa with the formation of microdamage on it. In this case, you should also immediately consult a doctor.

Regardless of how long the symptoms of stomach upset last, you should call an ambulance if the poisoning was received by a child, an elderly person or an expectant mother. Treatment of such patients should be carried out under the supervision of a doctor, i.e. in a hospital setting.

The measures we use at home are universal help for any food poisoning, regardless of what caused it. But medical specialists know better how to treat poisoning from melon, watermelon and other products with nitrates, using not only universal means, but also specific ones, because they know what substances can neutralize nitrites and what dosages of drugs are needed.

Nitrites are a kind of poison for hemoglobin. And they, like many other poisons, have an antidote, i.e. a substance that neutralizes their effect. This is a solution of methylene blue, which is administered to patients intravenously immediately after the diagnosis of nitrate poisoning. This is necessary to restore normal hemoglobin, which is capable of carrying oxygen to the body's tissues.

Additionally, oxygen therapy is prescribed, ascorbic acid and glucose solutions are administered intravenously, and detoxification therapy is performed. These measures help reduce the negative effects of oxygen starvation and promote the rapid elimination of nitrites and nitrosamines from the body, since they are slow to leave the body on their own (they tend to accumulate there).

If the consequences of nitrate poisoning have begun to affect the functioning of the heart, specific treatment will be required to improve the tissue respiration of this vital organ: the introduction of drugs containing coenzymes (vitamin derivatives) "Cocarboxylase", B vitamins, which will help to eliminate neurological symptoms, since they have a positive effect on the functioning of the central nervous system, insulin, which helps the metabolism of glucose and its conversion into energy.

Medicines for poisoning with nitrites and nitrates

Nitrate poisoning is not just food poisoning, but poisoning of the body with chemicals hidden in food and water. But the symptoms of such poisoning do not appear immediately, when nitrate derivatives nitrites pass from the gastrointestinal tract into the blood. In this case, cleansing the stomach and intestines as first aid is still carried out using enterosorbents, but their choice must be approached thoughtfully.

Smectites, which we are accustomed to using for diarrhea due to food poisoning, will be ineffective in this case, but the time-tested " Activated carbon " and its analogue with prolonged action "Sorbex" will come in handy, because they have a wider application and are effective in poisoning with chemicals. The drugs "Polysorb", "Enterosgel" and "Carbolong" have a good effect in this situation.

"Sorbex" is a capsule preparation based on activated carbon. It has a long-term effect (up to 2 days), which makes it possible to reduce the number of times the medicine is taken. In the process of removing harmful substances, it makes them less toxic.

The drug should be taken between meals 3 times a day. For adults and adolescents over 14 years old, a single dose, depending on the severity of poisoning, can be from 2 to 4 capsules (no more than 8), for children over 7 years old, 1-2 capsules per dose is enough.

The drug can be taken for two weeks, which will not have a negative effect on intestinal motility. If you take the medicine for 15 days or more, constipation or resumption of diarrhea is possible, but of a different nature. Violations of the absorption of nutrients in the intestine are possible, which subsequently results in vitamin deficiency and other deficiency conditions.

The drug should not be taken in case of hypersensitivity to its components, ulcerative or erosive process in the gastrointestinal tract in the relapse stage of the disease, bleeding in the stomach or intestines, or intestinal obstruction.

If a child is injured, then drugs in the form of capsules or tablets are unlikely to suit him. In this case, it is better to resort to the help of such drugs as "Polysorb", which is produced in the form of a powder, or "Enterosgel" in the form of a paste, which is allowed for use from the neonatal period.

"Enterosgel" is a preparation in the form of a silicon-containing paste, which is quite often used as a detoxification therapy for various types of poisoning. The convenient form of the preparation, which is suitable for patients of any age, and the ability to improve the functionality of the liver and kidneys, as well as normalize blood counts will be very useful for nitrate poisoning, which is often diagnosed among young children, more sensitive to the negative effects of these chemical compounds.

The drug is also taken between meals 3 times a day. The paste should be washed down with plenty of water, and for children under 2 years of age it is immediately diluted in water (in a volume that the child can drink in 1 dose).

The youngest patients are given 1 teaspoon of paste per dose, for children aged 5 to 14 the dose is doubled (2 teaspoons). Patients over 14 years of age can be given 3 teaspoons (1 tablespoon) of the preparation at a time.

In severe cases of poisoning, a double dose of the medicine is allowed for the first 3 days. The treatment can last from 1 to 2 weeks in total.

The most common side effects during the intake of enterosorbent are considered to be dyspeptic phenomena (bloating, gas formation, nausea). In the first days of taking the medicine, diarrhea may be replaced by constipation. In this case, it is advisable to do a cleansing enema at night and use laxatives.

The drug should not be used in case of hypersensitivity to its components or intestinal obstruction.

Any poisoning that is accompanied by vomiting and diarrhea carries the risk of dehydration. Therefore, as soon as you have managed to overcome vomiting, you should immediately begin taking rehydration medications (if vomiting continues for a long time, such medications are administered intravenously).

"Hydrovit" is an oral preparation in powder form that helps restore water-electrolyte balance in case of dehydration of the body. Contains all the necessary minerals and salts that are most often removed from the body as a result of diarrhea (Na+, K+, Cl-, HCO3-).

A solution is prepared from the powder immediately before use using purified or boiled water at room temperature. You can also use black or green tea. For 1 packet of medicine, take 1 incomplete glass of liquid (200 ml).

Adult patients should drink a single dose in one go, but children can divide it into several doses and give it in small portions.

Children under 3 years of age should use 3 to 5 sachets of the drug per day, diluting it in water. Children under 10-12 years of age should be given the solution after each bowel movement, using 1 sachet. Older children are given a solution of 1-2 sachets of the drug after each bowel movement. The same dosage is used to treat adults.

In case of severe dehydration, the dosage may be increased.

Treatment is usually carried out for 1-2 days.

The drug is usually well tolerated by patients. There are isolated cases of nausea and vomiting, and symptoms of allergy to the drug are rare. In patients with diabetes, the drug containing glucose may cause an increase in blood sugar levels.

The medicine has some contraindications for use. These are intolerance to the components of the medicine, excess potassium in the body (hyperkalemia), depressed state of the central nervous system, acid-base imbalance, carbohydrate metabolism disorder (a congenital pathology called glucose-galactose malabsorption), severe renal dysfunction.

The drug can be taken, but caution is required in patients with heart failure, hypertension, and diabetes.

To eliminate the effects of dehydration in cases of severe nitrate poisoning, saline solution, glucose, and drugs that restore water-electrolyte balance are administered intravenously.

In hospital conditions, a 1% aqueous solution of "Methylene blue" is administered intravenously as an antidote to nitrates (it can be diluted with a glucose solution). The powder of this drug has a disinfectant effect, normalizes oxidation-reduction processes in the body, and is a supplier of hydrogen ions.

In cases of poisoning with nitrites, aniline and other substances that form methemoglobin, the drug acts as an antidote. In these cases, the amount of solution corresponding to the patient's weight is administered intravenously, which is calculated using the formula: 0.1-0.15 ml for each kilogram of the victim's weight.

The introduction of the drug may be accompanied by nausea, damage to the tissues of the kidneys and bladder, anemia. Allergic reactions may also occur.

The detoxifying agent is not used in case of hypersensitivity to its components. It is not used to treat infants. However, during pregnancy and lactation, the use of the medicine as emergency aid with the permission of a doctor is possible.

Since nitrate poisoning can cause severe dehydration of the body and, as a result, its acidification (acidosis), and also leads to disruption of the cardiovascular system, specific therapy using vitamins and their derivatives is required to restore the normal functioning of important organs and systems.

"Cocarboxylase" is a vitamin derivative (thiamine coenzyme) that reduces the symptoms of acidosis and restores normal cardiac function.

The drug can be administered intravenously and intramuscularly in a single dose of 50 to 100 mg (no more than 200 mg per day). If hypoxia has caused cardiac dysfunction, treatment can last from 2 weeks to 1 month.

If the drug is administered intramuscularly, the ampoule with the medicine is dissolved in 2 ml of water for injection. For intravenous injections, the medicine is mixed with saline to a volume of 10-20 ml. Intravenous infusions are carried out with the drug diluted in 200-400 ml of saline or glucose solution.

The drug can even be used to treat newborns if nitrate poisoning has led to hypoxia and acidosis. Once a day, the drug is administered to babies intravenously slowly, calculating the dose as 10 mg per kilogram of the child's weight.

For older children, depending on the severity of the condition, the drug is administered intravenously or intramuscularly. The daily dose can range from 25 to 50 mg of the drug. The course of treatment usually does not exceed 7 days, but there may be exceptions.

Side effects of the drug include redness and swelling at the injection site and various allergic reactions.

When administered simultaneously with cardiac glycosides, it improves their effect.

The drug is not prescribed for hypersensitivity to the coenzyme. During pregnancy and breastfeeding, a doctor's consultation is required.

No matter how effective the described drugs may be, it is important to remember that at home, only mild poisoning can be treated, which is not accompanied by serious disruption of the central nervous system and cardiovascular system. Severe cases of nitrate poisoning are already the competence of medical specialists. They require a completely different approach to treatment, which can be provided in a hospital setting.

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Alternative treatment

Nitrate poisoning is a severe test for the body. Depending on the dose of nitrogen salts that have entered the body, it can be mild with symptoms of stomach upset or severe, when neurological, respiratory and cardiovascular disorders join these symptoms. In mild poisoning, the body copes on its own after taking basic measures to eliminate intoxication. The disappearance of symptoms of diarrhea, nausea and vomiting indicates that the danger has passed.

In case of mild poisoning, you can resort to some folk remedies, which, of course, will not remove nitrites from the body, but will help reduce the toxic effect of nitrosamines on the body and restore normal gastrointestinal function.

Folk remedies should not be used during the acute period of poisoning, but when the main symptoms are on the decline and the patient's condition is stabilized. Any means that are intended for internal use make sense to use when there is no longer vomiting.

For example, as an antitoxic substance to reduce the effects of poisoning, you can take a decoction of chicory. It is better to take chicory in powder. For 1 glass of boiling water, 1 tablespoon of chicory is enough. The composition is infused in a warm place (it is better to use a thermos) for several hours, after which it is divided into four parts, each of which should be drunk half an hour before meals.

If the symptoms of poisoning have subsided, but debilitating vomiting remains despite the fact that the stomach has already been sufficiently washed out, it can be calmed down with the help of the following composition: for 1 liter of warm boiled water, take 1.5 tablespoons of sugar and 1 teaspoon each of salt and soda. This composition should be drunk in 3 doses.

Reduces useless vomiting and lemon. You can eat a little of it in its pure form or add it to tea. As a tea, it is better to take mint infusion, which will soothe an irritated stomach.

When a person can already eat, preference should be given to porridges. They cleanse the intestines well and are suppliers of useful vitamins and minerals. To restore digestion, you can drink kefir and natural yogurt without additives. You can add flax seeds, apple slices or lemon juice to fermented milk products.

Herbal treatment is very helpful in restoring bowel function. For this purpose, you can use fruit and plant infusions:

• Blueberries (berries), mint (leaves), snakeweed (rhizomes) – 2 parts each, chamomile (flowers) – 3 parts.
• Cinquefoil (rhizomes), caraway (seeds) – 1 part each, immortelle (flowers), blueberry (berries) – 2 parts each, sage (leaves) – 3 parts.
• Centaury – 2 parts, mint – 8 parts.
• Bird cherry (fruit) – 6 parts, blueberry (berries) – 4 parts.
• Horse sorrel and knotweed, taken in equal parts.

Herbal infusions are taken ¼-1/2 cup half an hour before meals 2 to 4 times a day.

If we are talking about a severe form of the disease, then you can’t really count on folk medicine recipes and herbal treatment. Don’t waste precious time looking for potions that will help remove nitrates from the body at home. Such remedies do not exist, but in the hospital, doctors can always offer an antidote that will prevent nitrites from further destroying hemoglobin molecules.

Any folk remedies for restoring normal functioning of the body can be used with the permission of the attending physician after the patient's condition has been stabilized by traditional methods.

As for homeopathy, the principle of identity is used in the treatment of poisoning using potentiated chemical toxin preparations. That is, homeopathy suggests accelerating the elimination of nitrates with the same nitrates contained in the preparations Acidum nitricum, Argentum nitricum (silver nitrate), Kalium nitricum (potassium nitrate). It is not so easy to explain how such treatment works, but there is an opinion that almost any poisons in small doses with regular intake gradually reduce the body's sensitivity to them. Plus the influence of such a factor as self-hypnosis, i.e. confidence in the effectiveness of relatively safe homeopathic treatment, which activates the body's defenses.