·
SPOT TESTS FOR METAL POISONING
1. Reinsch Test:
Copper wire turns. . .
a. Shiny
silver: Mercury (see
your BP Instrument...!)
b. Dull
black: Arsenic or Silver.
c. Shiny black: Bismuth
d. Dark
purple
sheen: Antimony &
Tin
2. Gutzeit test
for arsenic
a. Acidification
produces arsine gas, which discolors silver nitrate paper
3. Iron
reacts with potassium ferricyanide and ferrous sulfate to produce Prussian Blue
·
METAL POISONING:
Cadmium, which can be found in
tobacco smoke, has been implicated in producing not only an acute form of pneumonia,
but, with chronic exposure to small concentrations of cadmium vapors, diffuse
interstitial pulmonary fibrosis and an increased incidence of emphysema as
well.
Nickel can cause contact
dermatitis, which is a type IV hypersensitivity reaction,
Mercury toxicity damages the
kidneys and the brain. The neurologic symptoms include a tremor due to
cerebellar abnormalities, and mental changes. Historically the use of mercury
in the hatmaking industry caused these symptoms and resulted in the expression
“mad as a hatter.” A famous widespread outbreak of mercury poisoning occurred
in the Minamata coastal region of Japan (and led to the term Minamata disease).
Cobalt poisoning can produce a dilated
cardiomyopathy.
·
Best body fluid to screen for drugs? (except EtOH)
Urine (Blood is best to screen for EtOH)
·
Cosmetics generally safe (exceptions are wave
neutralizer [boric acid] and nail products [acetonitrile,
methacrylic acid, nitromethane)
·
Cleaning substances toxic when
concentrated (Drano contains
54% NaOH)
·
Plants are variable (Philodendrons contain calcium oxylate crystals causing pain,
Foxglove contains digoxin
causing side effects)
·
Pharmaceuticals, most frequent are
analgesics and cold/cough medicines, Pediatric fatalities often due to
excessive iron intake.
·
Tricyclic antidepressants interfere with
myocardial conduction and can precipitate ventricular tachycardias or complete
heart block. A QRS interval >0.1 second
is predictive of poor outcome in these patients. The presence of a large R wave
in lead accelerated ventricular rhythm (AVR) is also associated with
tricyclics. If these findings are noted, treatment with sodium bicarbonate
should be initiated. Sodium bicarbonate helps prevent the sodium-channel
blockade that is caused by these medications.
·
Chinese restaurant syndrome: Several hours
after the ingestion of Chinese food, a patient may complain of burning and
numbness of the face and neck, headache, and, occasionally, severe chest pain.
Symptoms can persist for up to 1-2 days. The pathophysiology remains unclear,
but monosodium glutamate, a food additive,
may be involved, with the glutamate acting as a neurotransmitter. Other studies
suggest that the fermentation of typical ingredients in Chinese cooking (e.g.,
soy sauce, black beans, shrimp paste) may release histamines that account for
the symptoms.
·
LSD:
Only a small amount of ergotamine
tartrate is required to produce LSD in large batches.
At higher doses it can produce Synaesthesia.
Adverse health consequences of LSD
are comparatively rare, with "bad trips" being the most common adverse
reaction.
LSD affects all receptor sites
including dopaminergic, adrenergic, serotonin, nicotinic, and histamine
receptors.
LSD may trigger a Dissociative
fugue state in individuals who are taking certain classes of
antidepressants such as lithium salts and tricyclics. In such a state, the user
has an impulse to wander, and may not be aware of his or her actions, which can
lead to physical injury.
Flashbacks, a psychological phenomenon in which an individual experiences
an episode of some of the subjective effects of LSD
Remember, STAY SAFE.
·
Cannabinoids
are derived from the resin of Cannabis sativa and
9-tetrahydrocannabinol(9-THC)is its most important pharmacologically active
constituent. It's bioavailability after oral ingestion is about 6%. Naloxone and other opioid receptor
antagonists block the analgesic actions of cannabinoids. Synthetic cannabinoids reduce arachidonic acid-induced
inflammation by inhibiting eicosanoid production.
·
MERCURY
POISONING:
Symptoms: Acid metallic
taste, hoarse voice, greyish white coating of tongue, blood-stained stool,
circulatory collapse, necrosis of jaw, membranous, colitis, proximal renal
tubular necrosis.*
Acrodynia*(Acro-Limbs Odynia-Pain) is seen in mercury poisoning (Pink’s Disease),It is Pain,swelling and parasthesia of Limbs
Mimimata disease—Contamination of fish with mercury, at a place called Minimate Bay in Japan.
Acrodynia*(Acro-Limbs Odynia-Pain) is seen in mercury poisoning (Pink’s Disease),It is Pain,swelling and parasthesia of Limbs
Mimimata disease—Contamination of fish with mercury, at a place called Minimate Bay in Japan.
Chronic Poisoning: (Hydrar gyrism)
• The symptoms are salivation, sore mouth and throat, fine tremors of the
tongue, hands, arms, anemia.
• Shaking palsy is associated with Hg poisoning.
Mercurial tremors are also called hatter’s shakes or glass blower’s
shake.(Danbury
Tremors)
• Mercurial erethism** is seen in persons working with mercury in
mirror manufacturing firms. Erethism is characterized by shyness, timidity,
irritability, loss of confidence, mental depression, loss of memory and
insomnia. (Psychological symptoms).
• Mercurialentis is a peculiar eye change due to brownish deposit of
mercury through the cornea on the anterior lens capsule (Brown-Malt
Reflex*). It is bilateral and has no effect on visual acuity
·
Cyanide intoxication is treated by use of a Lilly kit, which contains amyl nitrate gas
ampules (one 0.3-mL ampule each minute until sodium nitrate infusion
begins) for inhalation. This treatment is followed by intravenous
administration of sodium nitrite (300 mg), which acts by converting
hemoglobin to methemoglobin. Finally, patients are treated with intravenous sodium
thiosulfate (12.5 g), which converts cyanide to less harmful thiocyanate
ions. If carboxyhemoglobinemia is present, sodium thiosulfate should be used
alone because of the additive toxicity of this condition with methemoglobinemia.
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