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Pharmacotherapy: A Pathophysiologic Approach, 8e
| Section 1. Foundation Issues > |
Clinical Spectrum of Poisoning
Sections: Acetaminophen, Clinical Presentation, Mechanism of Toxicity, Causative Agents, Sidebar: Clinical Presentation of Acute Acetaminophen Poisoning, Incidence, Risk Assessment, Management of Toxicity, Sidebar: Clinical Controversy, Monitoring and Prevention, Anticholinesterase Insecticides, Clinical Presentation, Mechanism of Toxicity, Causative Agents, Incidence, Sidebar: Clinical Presentation of Anticholinesterase Insecticide Poisoning, Risk Assessment, Management of Toxicity, Sidebar: Clinical Controversy, Monitoring and Prevention, Calcium Channel Blockers, Clinical Presentation, Mechanism of Toxicity, Sidebar: Clinical Presentation of Calcium Channel Blocker Poisoning, Causative Agents, Incidence, Risk Assessment, Management of Toxicity, Sidebar: Clinical Controversy, Monitoring and Prevention, Iron, Clinical Presentation, Mechanism of Toxicity, Causative Agents, Incidence, Sidebar: Clinical Presentation of Acute Iron Poisoning, Risk Assessment, Management of Toxicity, Sidebar: Clinical Controversy, Monitoring and Prevention, Tricyclic Antidepressants, Clinical Presentation, Sidebar: Clinical Presentation of Tricyclic Antidepressant Poisoning, Mechanism of Toxicity, Causative Agents, Incidence, Risk Assessment, Management of Toxicity, Sidebar: Clinical Controversy, Monitoring and Prevention.
Topics Discussed: acetaminophen; acetaminophen overdose; acetylcysteine; amoxapine; antidepressive agents; antidepressive agents, tricyclic; atropine; bupropion; bupropion toxicity; calcium channel blockers; carbamate insecticide; carbamate poisoning; deferoxamine; drugs affecting serotonergic neurotransmission; insecticide poisoning; iron; iron poisoning; management of drug toxicity and overdosage; maprotiline; mechanisms of toxicity; organophosphate insecticide; organophosphate poisoning; overdose of tricyclic antidepressant; parathion; poisoning by anticholinesterase agents; poisoning by calcium-channel blockers; poisoning by tricyclic and tetracyclic antidepressants; pralidoxime compounds; principles of toxicology; selective serotonin re-uptake inhibitors; serotonin syndrome; sodium bicarbonate; ssri overdose; toxic effects of pesticides; toxic responses of the liver; toxicology, clinical.
Excerpt:"Poisoning and drug overdose with acetaminophen, anticholinesterase insecticides, calcium channel blockers, iron, and tricyclic antidepressants are the focus of the remainder of this chapter because they represent commonly encountered poisonings for which pharmacotherapy is indicated. These agents also were chosen because they represent common examples with different mechanisms of toxicity, and they illustrate the application of general treatment approaches as well as some agent-specific interventions. Acute acetaminophen poisoning characteristically results in hepatotoxicity
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and is the leading cause of acute liver failure in the United States.
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Clinical presentation (see below) is dependent on the time since ingestion, presence of risk factors, and the ingestion of other drugs. During the first 12 to 24 hours after ingestion, nausea, vomiting, anorexia, and diaphoresis may be observed; however, many patients are asymptomatic. During the next 1 to 3 days, which is a latent phase of lessened symptoms, patients often have an asymptomatic rise in liver enzymes and bilirubin. Signs and symptoms of hepatic injury become manifest 3 to 5 days after ingestion..."
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