This document summarizes common types of drug poisonings, including accidental, deliberate self-poisoning, and homicide. It discusses incidence, common drugs involved like paracetamol and aspirin, clinical features, investigations, and general management principles like preventing absorption, enhancing elimination, and specific pharmacological interventions. For some specific drugs, it provides details on mechanisms of toxicity, clinical presentations, and treatment approaches.

1. Poisons & Drug Poisoning Dr Mohamad shaikhani.

2. Accidental?

32. Paracetamol Overdose

37. Do not check a paracetamol level before 4 hours have elapsed; it is uninterpretable. If more than 8 hours since ingestion, start N-acetylcysteine immediately & only stop it if the concentration is below the treatment line

49. Cardiotoxic drugs:

65. Carbon monoxide poisoning. SPECIFIC INDICATIONS FOR HYPERBARIC OXYGEN THERAPY All comatose patients Patients with neurologic impairment by examination or psychometric testing Patients with carboxyhemoglobin levels >40% Cardiovascular involvement (chest pain, ECG changes, arrhythmias) Pregnant patients with carbon monoxide levels >15% Patients who do not respond to 100% oxygen Patients with recurrent symptoms up to 3 weeks after exposure

81. Methanol & ethylene glycol poisoning. POISONING WITH METHANOL OR ETHYLENE GLYCOL Methanol S&ss Altered mental status; coma; seizures; gastrointestinal disturbance with abdominal pain; pancreatitis in some; visual disturbances: blurred vision, diplopia, photophobia, sensation of "being in a snowstorm," blindness (end result). Treat Aggressively prevent methanol conversion by infusing IV ethanol. Correct metabolic acidosis with sodium bicarbonate; Hemodialysis to remove methanol/metabolites—indicated for patients with visual disturbance, serum methanol >50 mg/dL, or with intractable metabolic acidosis.

82. Methanol & ethylene glycol poisoning. Ethylene Glycol Signs and symptoms Early Altered mental status; seizures; hypocalcemic tetany 12 hr after ingestion Congestive heart failure 24 – 72 hr after ingestion Profound renal failure Treatment Treat ethylene glycol with: aggressive gastric lavage; ethanol infusion or 4-methylpyrazole, sodium bicarbonate to correct metabolic acidosis, Correct hypocalcemia with calcium chloride, Hemodialysis

98. Tricyclic OD – Initial ECG

99. Tricyclic OD – Recovery ECG