injuries poisoning
General Principles of Poisoning
Key Points
Poisoning is distinguished from hypersensitivity and idiosyncratic reactions, which are unpredictable and not dose-related, and from intolerance, which is a toxic reaction to a usually nontoxic dose of a substance. Recognizing a toxidrome (eg, anticholinergic, muscarinic cholinergic, nicotinic cholinergic, opioid, sympathomimetic, withdrawal) can help narrow the differential diagnosis. Toxicity may be immediate, delayed (eg,acetaminophen, iron,Amanita phalloidesmushrooms causing delayed hepatotoxicity), or occur only after repeated exposure. Maximize recognition of poisoning and identification of the specific poison by considering poisoning in all patients with unexplained alterations in consciousness and by searching thoroughly for clues from the history. Consider other causes (eg, Introduction to Brain Infections , Use toxicology testing (eg, drug immunoassays) selectively because it can provide incomplete or incorrect information. Treat all poisoning supportively and use activatedcharcoalfor serious oral poisoning and other methods selectively. 