Dreisbach's Handbook of Poisoning: Prevention, Diagnosis and Treatment, Thirteenth Edition (Dreisbach's Handbook of Poisoning)

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Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagnoses should be independently verified. The reader is strongly urged to consult the drug companies' printed instructions, and their websites, before administering any of the drugs recommended in this book. This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately. The authors and publishers have also attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Front Matter......Page 1 Contents......Page 5 Preface......Page 7 I. General considerations......Page 9 Safe storage and use......Page 10 Education......Page 11 Storage of poisons......Page 13 Other protective measures......Page 14 Environmental controls......Page 15 Instructions for and provision of safety equipment......Page 17 References......Page 18 CANCER......Page 20 References......Page 21 References......Page 23 Symptoms and signs of depression......Page 24 Prevention......Page 25 Drugs especially to be avoided during pregnancy......Page 26 DRUG-INDUCED REACTIONS, FATALITIES, AND INTERACTIONS......Page 27 Medication factors......Page 28 References......Page 30 2. Emergency management of poisoning......Page 32 Precautions......Page 36 Cathartics......Page 37 Activated charcoal......Page 38 SKIN CONTAMINATION......Page 39 RECTALLY ADMINISTERED POISONS......Page 40 References......Page 41 Lethal dose LD and lethal concentration LC......Page 42 Index of this book......Page 43 References......Page 44 Occupational exposure......Page 45 General......Page 48 Skin......Page 49 Central nervous system......Page 50 Eyes......Page 51 Cardiorespiratory system......Page 52 Genitourinary system......Page 53 Laboratory examination of blood......Page 54 Special chemical examinations useful in diagnosis of poisoning......Page 55 References......Page 56 Airway......Page 59 Artificial respiration by direct inflation......Page 60 Equipment......Page 61 General measures......Page 62 Emergency measures......Page 63 Digitalis......Page 65 Treatment......Page 66 CONVULSIONS......Page 67 Emergency treatment......Page 68 Drugs for the control of convulsions......Page 69 Management of coma......Page 70 HYPERACTIVITY, DELIRIUM, AND MANIA......Page 71 Causes of delirium or psychosis or coma......Page 72 ACUTE RENAL FAILURE......Page 73 Treatment......Page 74 URINE RETENTION......Page 75 WATER AND ELECTROLYTE IMBALANCE......Page 76 Treatment......Page 78 Treatment of hyperthermia......Page 79 Treatment of hypothermia......Page 80 Cholestatic without inflammatory change......Page 81 Clinical findings......Page 82 Treatment......Page 83 Clinical findings......Page 84 Treatment......Page 85 References......Page 86 Treatment......Page 87 DERMATITIS DUE TO CONTACT WITH CHEMICALS......Page 88 Evaluation of dermatitis due to contact with chemicals......Page 89 Treatment......Page 90 Benztropine mesylate......Page 91 Charcoal activated charcoal see pp. 31?32......Page 92 Digoxin Immune Fab Digibind......Page 93 Dimercaprol BAL......Page 94 Epinephrine......Page 95 Flumazenil Romazicon......Page 96 Methylene blue......Page 97 Neuromuscular blocking agents......Page 98 Nitrite, sodium and amyl......Page 99 Oxygen, 100%......Page 100 Phentolamine Regitine......Page 101 Phytonadione Vitamin K1......Page 102 Pyridoxine Vitamin B6......Page 103 Succimer or DMSA meso-2,3-dimercaptosuccinic acid......Page 104 HEMODIALYSIS, HEMOPERFUSION, AND PERITONEAL DIALYSIS......Page 105 PHARMACOKINETICS AND TOXIC CONCENTRATIONS......Page 107 References......Page 108 PRESERVATION OF EVIDENCE......Page 109 Evidence to be saved in fatal poisoning......Page 110 Homicidal poisoning......Page 111 References......Page 112 II. Agricultural poisons......Page 113 HALOBENZENE DERIVATIVES AND ANALOGS......Page 114 Chronic poisoning......Page 116 Emergency measures......Page 117 BENZENE HEXACHLORIDE Gamma Isomer = Lindane......Page 118 Laboratory findings......Page 119 TOXAPHENE Chlorinated camphenes......Page 120 Prognosis......Page 121 Symptoms and signs from ingestion or skin absorption......Page 122 General measures......Page 123 POLYCYCLIC CHLORINATED INSECTICIDES: CHLORDANE, HEPTACHLOR, ALDRIN, DIELDRIN, ENDRIN, MIREX, THIODAN, AND CHLORDECONE......Page 124 Chronic poisoning from ingestion, inhalation, or skin contamination......Page 125 References......Page 126 7. Cholinesterase inhibitor pesticides......Page 128 Acute poisoning from inhalation, skin absorption, or ingestion......Page 133 Acute poisoning......Page 134 References......Page 136 Laboratory findings......Page 138 General measures......Page 139 Acute poisoning from skin contamination, ingestion, or inhalation......Page 140 General measures......Page 141 Prevention......Page 142 TOBACCO AND NICOTINE......Page 143 Acute poisoning......Page 144 Clinical findings......Page 145 Acute poisoning......Page 146 THIOCYANATE INSECTICIDES: THANITE, LETHANE......Page 147 VACOR......Page 148 Emergency measures......Page 149 PARAQUAT AND DIQUAT......Page 150 Laboratory findings......Page 151 AVERMECTINS: ABAMECTIN, IVERMECTIN......Page 152 References......Page 153 III. Industrial hazards......Page 166 Clinical findings......Page 167 Acute poisoning from inhalation, skin absorption, or ingestion......Page 168 Chronic poisoning from inhalation or skin absorption......Page 172 Prognosis......Page 173 Emergency measures......Page 174 References......Page 175 CARBON TETRACHLORIDE......Page 176 Acute poisoning from inhalation, skin absorption, or ingestion......Page 177 Acute poisoning......Page 178 Prognosis......Page 179 Chronic poisoning from inhalation or skin absorption......Page 180 Chronic poisoning......Page 181 Chronic poisoning from inhalation or skin absorption......Page 182 TRICHLOROETHYLENE......Page 183 Chronic poisoning from inhalation or skin absorption......Page 184 1,1,1-TRICHLOROETHANE......Page 185 TETRACHLOROETHYLENE......Page 186 DICHLOROMETHANE......Page 187 Laboratory findings......Page 188 ETHYLENE DICHLORIDE......Page 189 Prevention......Page 190 Clinical findings......Page 191 POLYCHLORINATED NAPHTHALENE AND POLYCHLORINATED AND POLYBROMINATED BIPHENYLS......Page 192 Prevention......Page 193 Symptoms and signs......Page 194 FLUOROCARBONS......Page 195 Clinical findings......Page 196 Clinical findings......Page 197 References......Page 198 METHANOL......Page 203 Prevention......Page 204 Chronic poisoning......Page 205 ETHANOL......Page 206 Interactions......Page 207 Chronic poisoning from ingestion......Page 208 Laboratory findings......Page 210 Chronic poisoning......Page 211 References......Page 212 ETHYLENE GLYCOL AND DIETHYLENE GLYCOL......Page 213 Laboratory findings......Page 214 Prognosis......Page 215 References......Page 216 Laboratory findings......Page 218 Reference......Page 219 Acute poisoning From ingestion, inhalation, or skin absorption......Page 220 FORMALDEHYDE......Page 221 Skin manifestations......Page 222 ACETALDEHYDE, METALDEHYDE, PARALDEHYDE......Page 223 Acute poisoning......Page 224 Acute poisoning from ingestion......Page 225 Prognosis......Page 226 References......Page 227 PETROLEUM DISTILLATES: KEROSENE, SOLVENT DISTILLATE, AND GASOLINE......Page 232 Laboratory findings......Page 233 References......Page 234 Clinical findings......Page 235 Prevention......Page 236 References......Page 237 Acute poisoning from ingestion or inhalation......Page 238 General measures......Page 239 ATMOSPHERIC ORGANIC COMPOUNDS......Page 240 References......Page 241 Acute poisoning from ingestion of oxalic acid......Page 244 Prognosis......Page 245 Acute poisoning......Page 246 Prevention......Page 248 Eye contact......Page 249 References......Page 250 NITROGEN OXIDES......Page 251 Clinical findings......Page 252 Prognosis......Page 253 Symptoms and signs from inhalation, skin absorption, or ingestion......Page 254 General measures......Page 255 Sources......Page 256 Effects on humans and animals......Page 258 SULFUR OXIDES......Page 259 Clinical findings and treatment......Page 260 Acute poisoning......Page 261 Ingestion......Page 263 Prognosis......Page 264 Ingestion......Page 265 Prevention......Page 266 FLUORINE, HYDROGEN FLUORIDE, AND DERIVATIVES......Page 267 Clinical findings......Page 268 Chronic poisoning from inhalation or ingestion......Page 269 Skin or mucous membrane burns......Page 270 Fluorosis......Page 271 References......Page 272 Acute poisoning......Page 273 ARSENIC AND ARSINE......Page 274 Acute poisoning......Page 275 Chronic poisoning from ingestion or inhalation......Page 276 Acute poisoning from arsenic......Page 277 References......Page 278 Acute poisoning......Page 279 Acute pneumonitis......Page 280 Prognosis......Page 281 Acute poisoning......Page 282 Ingestion......Page 283 CHROMIUM......Page 284 Prevention......Page 285 LEAD......Page 286 Clinical findings see Table 15.1......Page 288 Laboratory findings......Page 289 Prevention......Page 291 Antidotes......Page 292 Special problems......Page 293 References......Page 294 Clinical findings......Page 296 Prevention......Page 297 MERCURY......Page 298 Chronic poisoning......Page 300 Prevention......Page 301 References......Page 302 NICKEL CARBONYL......Page 303 Acute poisoning......Page 304 PHOSPHORUS, PHOSPHINE, AND PHOSPHIDES......Page 305 Acute poisoning......Page 306 Prevention......Page 307 ZINC FUMES AND METAL FUME FEVER......Page 308 Other measures......Page 309 References......Page 310 HYDROGEN CYANIDE AND DERIVATIVES: ACRYLONITRILE, CYANAMIDE, CYANOGEN CHLORIDE, CYANIDES, NITROPRUSSIDES, AND CYANOGENETIC GLYCOSIDES see Table 16.1......Page 315 Chronic poisoning......Page 317 Inhaled cyanide......Page 318 Ingested calcium cyanamide......Page 319 HYDROGEN SULFIDE, OTHER SULFIDES, MERCAPTANS, CARBON DISULFIDE, AND PROPANE SULTONE......Page 320 Acute poisoning......Page 321 Chronic poisoning......Page 322 Acute poisoning......Page 323 CARBON MONOXIDE......Page 324 Chronic poisoning......Page 327 General measures......Page 328 References......Page 329 17. Atmospheric particulates......Page 331 SILICA......Page 332 Chronic pneumoconiosis......Page 333 General measures......Page 334 ASBESTOS......Page 335 Cancer......Page 337 Prevention......Page 338 Asbestos......Page 339 Silica......Page 340 Other particulates......Page 341 IV. Household hazards......Page 345 Laboratory findings......Page 346 Prognosis......Page 347 Reference......Page 350 Clinical findings......Page 351 General measures......Page 352 Symptoms and signs......Page 353 General measures......Page 354 Prevention......Page 355 Scombroid poisoning......Page 356 Treatment......Page 357 References......Page 358 Clinical findings......Page 359 SOAPS AND DETERGENTS......Page 360 Cationic detergents see p. 452......Page 361 References......Page 366 V. Medicinal poisons......Page 367 SALICYLATES......Page 368 Acute poisoning from ingestion or skin absorption......Page 369 Laboratory findings......Page 370 Prevention......Page 371 General measures......Page 372 References......Page 373 Chronic poisoning......Page 374 Laboratory findings......Page 375 General measures......Page 376 References......Page 377 INTERACTIONS see p. 20......Page 378 PHARMACOKINETICS AND TOXIC CONCENTRATIONS see p. 100......Page 379 Acute poisoning from ingestion, injection, or absorption through mucous membranes or skin abrasions......Page 380 Acute poisoning......Page 381 References......Page 382 PROCAINE AND OTHER LOCAL ANESTHETICS Tables 22.1 and 22.2......Page 383 Laboratory findings......Page 384 Acute poisoning......Page 385 VOLATILE AND GASEOUS ANESTHETICS......Page 386 Chronic poisoning from inhalation......Page 387 General measures......Page 388 INTERACTIONS see p. 20......Page 389 PHARMACOKINETICS AND TOXIC CONCENTRATIONS see p. 100......Page 390 Acute poisoning from ingestion or injection......Page 391 Chronic poisoning from ingestion......Page 392 Treatment......Page 393 Antidote......Page 395 General measures......Page 396 Mild......Page 397 Clinical findings......Page 398 Laboratory findings......Page 400 Acute poisoning......Page 401 ANTIHISTAMINES Table 23.5......Page 402 Acute poisoning from ingestion......Page 403 Chronic poisoning......Page 404 PHENOTHIAZINE DRUGS Table 23.6......Page 405 Chronic poisoning from ingestion......Page 406 Prevention......Page 407 Prognosis......Page 408 Laboratory findings......Page 409 Acute poisoning......Page 410 Acute poisoning......Page 411 Clinical findings......Page 414 Prevention......Page 415 INTERACTIONS See p. 20......Page 416 Anticonvulsants......Page 417 Antihistamines and phenothiazines......Page 418 Selective depressants......Page 419 PHARMACOKINETICS AND TOXIC CONCENTRATIONS see p. 100......Page 421 ATROPINE, HYOSCYAMINE, BELLADONNA, SCOPOLAMINE, AND SYNTHETIC SUBSTITUTES......Page 423 Prevention......Page 424 Prognosis......Page 425 SYMPATHOMIMETIC AGENTS: EPINEPHRINE, EPHEDRINE, AMPHETAMINE, NAPHAZOLINE, AND RELATED DRUGS......Page 426 Chronic poisoning......Page 428 Acute poisoning......Page 429 References......Page 430 Acute poisoning from ingestion, injection, or application to mucous membranes......Page 431 Emergency measures......Page 432 Treatment......Page 433 References......Page 435 Acute poisoning from ingestion......Page 436 Acute poisoning......Page 437 ERGOT, ERGOTAMINE, AND ERGONOVINE......Page 438 Chronic poisoning from ingestion, injection, or application to mucous membranes......Page 439 References......Page 440 INTERACTIONS see p. 20......Page 441 PHARMACOKINETICS AND TOXIC CONCENTRATIONS see p. 100......Page 442 Clinical findings......Page 443 Prevention......Page 444 References......Page 445 Acute poisoning......Page 446 Prevention......Page 447 Chronic poisoning......Page 448 PHENOL AND DERIVATIVES......Page 449 Prevention......Page 451 References......Page 452 Clinical findings......Page 453 CHLORATES......Page 454 Acute poisoning......Page 455 SILVER AND SILVER SALTS: SILVER NITRATE, SILVER PROTEINATES, AND SILVER PICRATE......Page 456 Acute poisoning......Page 457 Reference......Page 458 References......Page 459 Acute poisoning from injection, ingestion, or diuresis in a fully digitalized patient......Page 460 Acute poisoning......Page 461 QUINIDINE......Page 463 Prevention......Page 464 References......Page 465 Laboratory findings......Page 466 References......Page 467 Clinical findings......Page 468 Acute poisoning......Page 469 ANTICOAGULANTS: HEPARIN, WARFARIN, ETC.......Page 470 Prevention......Page 471 HYDRALAZINE......Page 472 Prevention......Page 473 CALCIUM CHANNEL BLOCKING AGENTS......Page 474 Laboratory findings......Page 475 References......Page 476 INTERACTIONS see p. 20......Page 482 PHARMACOKINETICS AND TOXIC CONCENTRATIONS see p. 100......Page 483 References......Page 484 SULFONAMIDES......Page 486 Laboratory findings......Page 487 Prognosis......Page 488 Acute poisoning from injection, ingestion, or application to mucous membranes......Page 489 Chronic poisoning from repeated injection, ingestion, or application to mucous membranes......Page 490 Prevention......Page 494 Chronic poisoning......Page 495 IPECAC AND EMETINE......Page 496 Prevention......Page 497 Clinical findings......Page 498 Acute poisoning......Page 499 Reference......Page 500 Acute poisoning from ingestion......Page 504 Prognosis......Page 505 INTERACTIONS see p. 20......Page 506 PHARMACOKINETICS AND TOXIC CONCENTRATIONS see p. 100......Page 507 References......Page 508 Clinical findings......Page 509 Prevention......Page 510 CAFFEINE, THEOPHYLLINE, AND OTHER XANTHINES......Page 511 Chronic poisoning......Page 512 General measures......Page 513 Clinical findings......Page 514 General measures......Page 515 Emergency measures......Page 516 PICROTOXIN, PENTYLENETETRAZOL, AND NIKETHAMIDE......Page 517 Emergency measures......Page 518 POLYCYCLIC ANTIDEPRESSANTS: AMITRIPTYLINE, IMIPRAMINE, AND RELATED DRUGS......Page 519 Chronic poisoning......Page 520 Emergency measures......Page 521 Drug interactions increasing antidepressant toxicity......Page 522 References......Page 523 Clinical findings......Page 524 Prognosis......Page 525 ANTIMANIC AGENTS ? LITHIUM......Page 526 Emergency measures......Page 527 Acute poisoning......Page 528 General measures......Page 529 PSYCHOTOMIMETIC AGENTS......Page 530 PHARMACOKINETICS AND TOXIC CONCENTRATIONS see p. 100......Page 531 References......Page 532 Laboratory findings......Page 533 METAL SALTS: ALUMINUM, COPPER, TIN, NICKEL, AND ZINC SALTS......Page 534 Chronic poisoning......Page 535 Special problems......Page 536 Clinical findings......Page 537 General measures......Page 538 Acute poisoning from ingestion or absorption through the skin......Page 539 Emergency measures......Page 540 References......Page 541 Acute poisoning......Page 542 General measures......Page 543 Symptoms and signs from ingestion or application to the skin......Page 544 Prognosis......Page 545 Symptoms and signs from ingestion......Page 547 CORTICOSTEROIDS: ADRENAL CORTEX HORMONES AND SUBSTITUTES......Page 548 Chronic poisoning......Page 549 Prognosis......Page 550 Chronic poisoning......Page 551 References......Page 552 PHARMACOKINETICS see p. 100......Page 553 References......Page 556 DISULFIRAM AND THIOCARBAMATES......Page 557 Acute poisoning......Page 558 Acute poisoning......Page 559 Acute poisoning from ingestion......Page 560 Emergency measures......Page 561 General measures......Page 562 Laboratory findings......Page 563 References......Page 564 Clinical findings......Page 573 Retrolental fibroplasia......Page 574 References......Page 575 ANTICANCER AGENTS......Page 576 Clinical findings......Page 580 Emergency measures......Page 581 INTERACTIONS see p. 20......Page 582 Iron salts......Page 583 Dietary additives, vitamins, natural medicines......Page 584 Miscellaneous......Page 585 VI. Animal and plant hazards......Page 586 Pathology......Page 587 Envenomization by sea snakes......Page 594 Emergency measures......Page 595 Antidote check antiserum availability at local poison center......Page 596 General measures......Page 597 Emergency measures......Page 598 References......Page 599 Clinical findings......Page 601 General measures......Page 602 Clinical findings......Page 603 References......Page 604 Prevention......Page 605 References......Page 606 References......Page 609 Treatment......Page 610 FISH......Page 611 Prevention......Page 612 References......Page 613 Laboratory findings......Page 615 CASTOR BEAN AND JEQUIRITY BEAN......Page 616 Laboratory findings......Page 617 References......Page 618 General measures......Page 619 Reference......Page 620 HEMLOCK......Page 622 Prognosis......Page 623 Symptoms and signs from ingestion......Page 624 Laboratory findings......Page 625 General measures......Page 626 References......Page 627 Laboratory findings......Page 628 Special problems......Page 629 Acute poisoning from ingestion......Page 630 Prognosis......Page 631 References......Page 638 Index......Page 639 Now in its thirteenth edition, Dreisbach's Handbook of Poisoning is long established as the definitive handbook of poisoning for all physicians, nurses, crisis and hotline workers, paramedics, and students. Rapid response is critical during the initial management of poison cases. This ready-reference guide provides antidotes, antivenins, and more for a vast number of substances. It covers medical toxicology - including prevention and management of exposures, poisonings, adverse effects, abuse and withdrawal from pharmaceuticals - and household, environmental, and natural hazards. The book begins by providing general information about the prevention, diagnosis, and treatment of poisoning. Then it considers the important medicolegal aspects of poisoning. The remainder of the book focuses on specific poisons, organized into agricultural, industrial, household, medicinal, and natural hazards. Chemically- and pharmacologically-related agents have been grouped together wherever possible. For optimal care of critical or unusual poisonings, the book also contains guidelines for consultations with medical toxicologists and regional poison information centers. A concise summary of the diagnosis and treatment of poisoning, Dreisbach's Handbook of Poisoning provides an extraordinary amount of practical information in a compact format. PrefaceGENERAL CONSIDERATIONSPrevention of PoisoningEmergency Management of PoisoningDiagnosis and Evaluation of PoisoningManagement of PoisoningLegal and Medical Responsibility in PoisoningAGRICULTURAL POISONSHalogenated InsecticidesCholinesterase Inhibitor PesticidesMiscellaneous PesticidesINDUSTRIAL HAZARDSNitrogen CompoundsHalogenated HydrocarbonsAlcohols and GlycolsEsters, Aldehydes, Ketone and EthersHydrocarbonsCorrosivesMetallic PoisonsCyanides, Sulfides, and Carbon MonoxideAtmospheric ParticulatesHOUSEHOLD HAZARDSCosmeticsFood PoisoningMiscellaneous ChemicalsMEDICINAL POISONSAnalgesics, Antipyretics, and Anti-inflammatory AgentsAnestheticsDepressantsDrugs Affecting the Autonomic Nervous SystemAntisepticsCardiovascular DrugsAnti-infective DrugsStimulants, Antidepressants, and Psychotomimetic AgentsIrritants and RubefacientsCathartics, Endocrine Drugs, Miscellaneous Therapeutic and Diagnostic AgentsANIMAL AND PLANT HAZARDSReptilesArachnids and InsectsMarine AnimalsPlantsIndex A handbook on poisoning. Designed as a ready-reference guide, it provides a concise summary of medical toxicology, including prevention and management of exposures, poisonings, adverse effects, abuse and withdrawal from pharmaceuticals, and household, environmental and natural hazards.