Drug and poison detoxification

All derivatives of the barbituric acid (phenobarbital, soluble barbital, etaminal-sodium, an admixture Serejsky, etc.) are quickly enough aspirated and practically completely in a gastrointestinal path.

A lethal dose: About 10 medical doses with the big individual distinctions. The heavy poisoning with soporific first of all is accompanied by oppression of functions the central excitatory system. A leading symptom is infringement of breath and progressing development of an air hunger. Breath becomes rare, faltering. All kinds of reflex activity are depressed. Pupils are narrowed in the beginning and react to light, and then (owing to an air hunger) extend and to light do not react any more. Function of nephroses heavyly suffers: diuresis reduction promotes slow allocation poison from an organism. The mors comes as a result of a paralysis of a respiratory centre and heavy infringement of a circulation.

4 clinical stages of an intoxication are observed.

• Stage 1 – “sleep”: it is characterised by drowsiness, apathy, decrease in reactions to choronomic stimuluses, however contact to the patient can be positioned.

• Stage 2 – “a superficial coma”: consciousness loss is marked. Patients can answer pain irritation with a weak motor reaction, short-term dilating of pupils. Swallowing is at a loss and jerk weakens, infringements of breath because of tongue join. Rise in temperature of a body to 39 °-40°С is characteristic.

• Stage 3 – “a penetrating coma”: it is characterised by absence of all jerks, signs of menacing infringement of the vital functions are observed organism. On the foreground infringements of breath from superficial act, arrhythmic to its full paralysis bound to oppression of activity of the central excitatory system.

• In a stage 4 – “postcoma” it is gradually recovered

Consciousness. In the first days after awakening at the majority of patients tearfulness, sometimes moderate psychomotor excitation, sleep infringement are observed.The most frequent complications is a pneumonia.

Treatment. The poisoning with soporific demands first aid. In the first turn it is necessary to remove a poison from a stomach, to reduce its maintenance in blood to sustain breath and cardiovascular system. A poison from a stomach delete by its lavages (the earlier there is begun a lavage, the it is more effective), spending 10-13 l of water, expediently repeated lavage, Is better through a sonde. If the victim is in consciousness and there is no sonde, the lavage can be carried out repeated reception of several beakers of warm water with the subsequent calling of vomiting (irritation Fauces). Vomiting can be invoked warm soap water (one beaker) or emetic means.

For poison linkage in a stomach use absorbent coal, 20-50 g which in the form of an aqueous emulsion introduce into a stomach. The reacted coal (In 10 minutes) it is necessary to remove from a stomach, as poison adsorption represents reversible process. That part of a poison which has passed in a stomach, can be removed by means of laxatives. The preference is given to salt cake. Zinci sulfas of magnesium (epsom salt) at infringement of function of nephroses can have oppressing an effect on the central excitatory system. The castor oil is not recommended.

For the accelerated deducing of the aspirated poisons and allocation by their nephroses yield abundant drink and diuretics. If the patient is in consciousness fluid (usual water) is taken over inside, in cases of a heavy poisoning intravenously introduce 5 % solution of glucose or an isotonic solution of sodium of chloride (to 2-3 l a day). These actions carry out only in those cases if secretory function of nephroses is kept.

For the accelerated deducing of a poison and surplus of fluid appoint intravenously high-speed antibiotic. At the expressed infringement of breath removal by suction of contents of bronchuses and artificial ventilation of lungs is made, at less significant distresses of breath resort to application of stimulants of breath. For preventive maintenance of a pneumonia appoint antibiotics, at heavy rise in temperature – intramuscularly solution of pyramidon. For restoration of a vascular tone use vasohypertonic means. For stimulation of warm activity – glycosides of fast action, at cardiac arrest adrenaline introduction in a lumen of a left ventricle with the subsequent massage through a thorax is shown.