When poisoning with ANY medicine, you should:

• Give the affected person a drink of 4-5 glasses of warm water (for children - 100 grams per year of life).

• Induce vomiting by pressing on the root of the tongue or tickling the pharynx.

• Rinse the stomach repeatedly until completely cleansed.

• Give the victim 5 tablets crushed activated carbon (washed with water).

• Give abundant drink: alkaline mineral water, 2% solution of baking soda.

• When vomiting unconsciously, turn the victim's head to one side.

Call an ambulance immediately (phone 03)!
This must be done even in cases where, at first glance, the poisoning proceeds easily, because after a while, a sharp deterioration in the condition of the victim may occur.

Sleeping pills (barbiturates ) .

All derivatives of barbituric acid (phenobarbital, barbital, medinal, etaminal-patri, mixture of Sereisky, tardil, bellaspop, bromitale, etc.) are absorbed fairly quickly and almost completely in the gastrointestinal tract. A lethal dose: about 10 medical doses with large individual differences. Acute poisoning with sleeping pills is primarily accompanied by depression of the central nervous system. The leading symptom is a violation of breathing and the progressive development of oxygen starvation . Breathing becomes rare, intermittent. All kinds of reflex activity are suppressed. Pupils first narrow and react to light, and then (due to oxygen starvation) expand and do not react to light. The kidney function sharply suffers: a decrease in diuresis promotes the slow release of barbiturates from the body. Death occurs as a result of paralysis of the respiratory center and acute circulatory disturbance.
There are 4 clinical stages of intoxication:
Stage 1 - "falling asleep": characterized by snotty, apathy, a decrease in reactions to external stimuli, but contact with the patient can be established.
Stage 2 - "superficial coma": loss of consciousness is noted. On painful irritation patients can respond with a weak motor reaction, a short-term enlargement of the pupils. Difficulty swallowing and the cough reflex weakens, breathing disorders are added due to tongue twisting. Characteristic increase in body temperature to 39 ° -40 ° C.
Stage 3 - "deep coma": characterized by the absence of all reflexes, there are signs of a threatening violation of vital body functions. At the forefront are violations of respiration from the surface, arrhythmic to complete paralysis, associated with the inhibition of the central nervous system.
In stage 4 - the "post-comatose state" is gradually restored consciousness. On the first day after awakening, the majority of patients experience tearfulness, sometimes mild psychomotor agitation, sleep disturbance.
The most frequent complications are pneumonia, tracheobronchitis, decubitus.
Treatment. Poisoning with sleeping pills requires emergency care. First of all, it is necessary to remove the poison from the stomach, reduce its content in the blood, maintain breathing and cardiovascular system. The poison from the stomach is removed by washing it (the earlier the rinse is started, the more effective it is), consuming 10-13 liters of water, it is advisable to rinse again, best through the probe. If the victim is conscious and there is no probe, rinsing can be done by repeated intake of several glasses of warm water followed by vomiting (irritation of the pharynx). Vomiting can be caused by powder of mustard (1 / 2-1 teaspoon per glass of warm water), table salt (2 tablespoons per glass of water), warm soapy water (one glass) or emetic, including apomorphine subcutaneously (1 ml 0 ,5%).
To bind the poison in the stomach use activated carbon, 20-50 g of which in the form of an aqueous emulsion is injected into the stomach. The reacted coal (after 10 minutes) must be removed from the stomach, since the adsorption of the poison is a reversible process. That part of the poison that has passed into the stomach can be removed with the help of laxatives. Preference is given to sodium sulfate (Glauber's salt), 30-50 g. Magnesium sulphate (bitter salt) in case of impaired renal function can exert a depressing effect on the central nervous system. Castor oil is not recommended.
To speedily remove the absorbed barbiturates and isolate them by the kidneys give abundant drink and diuretics. If the patient is conscious, then liquid (ordinary water) is taken internally, in cases of severe poisoning, 5% glucose solution or isotonic sodium chloride solution is injected intravenously (up to 2-3 liters per day). These activities are carried out only in cases where the excretory function of the kidneys is preserved.
To accelerate the excretion of venom and excess fluid, a fast acting diuretic is administered intravenously. With severe violation of breathing, intubation, suction of the contents of the bronchi and artificial ventilation of the lungs are performed, with less significant respiratory disorders resorting to the use of respiratory stimulants (analeptics). For the prevention of pneumonia, antibiotics are prescribed, with a sharp increase in temperature - intramuscularly 10 ml of a 4% solution of amidopyrine. To restore vascular tone use vasoconstrictor. For the stimulation of cardiac activity - fast-acting glycosides, when cardiac arrest is shown, the injection of adrenaline into the cavity of the left ventricle followed by massage through the thorax.

Antidepressants

The group of apoidepressants includes imizine (imipramine), amitriptyline, azafen, fluocyclin, etc. They are well absorbed in the gastrointestinal tract, easily bind to proteins of the sprinkling and organs, quickly distributed throughout the body, producing toxic effects. The prognosis is always serious and the mortality rate when taking more than 1 g exceeds 20%.
Symptoms . Characteristic changes in the central and cardiovascular system. Already from an early period after the poisoning, there is psychomotor agitation, hallucinations appear, the body temperature drops sharply, a coma develops with respiratory depression. Acute cardiopathy and cardiac arrest are the main cause of death in these poisonings. The main manifestations of toxic effects on the myocardium are expressed during the first 12 hours, but can develop during the next 6 days.
The severity of poisoning is manifested by a sharp expansion of the pupils, dryness of the oral mucosa, a violation of the motility of the gastrointestinal tract up to the intestinal paresis.
First aid. Rinsing of the stomach with sodium bicarbonate solution (baking soda), sodium chloride solution or water with activated carbon. Flushing is carried out in the first 2 hours after poisoning, and then repeatedly. At the same time, a saline laxative is introduced, a cleansing enema is put. Apply emetics, artificial respiration in the event of respiratory failure. Contraindicated cardiac glycosides, as the toxicity of tricyclic antidepressants in this case increases dramatically.
Hypertensin is used to correct vascular tone. For the arrest of seizures and psychomotor agitation, it is advisable to use barbiturates and aminazine. The main drug that gives an antidote effect is physostigmine, which is administered intravenously. The criterion of its effectiveness is a decrease in the pulse to 100-120 beats per minute and an increase in blood pressure (100/80 mm Hg).

Tranquilizers .

The drugs of this group include meprotan (andaxin, meprobamate), diazepam (seduxen, relanium, valium), nitrazepam, trioxazine, elenium, librium and other agents with a pronounced tranquilizing or soothing effect. All substances are easily absorbed in the gastrointestinal tract and form strong connections with blood and tissue proteins.
Symptoms. The clinical picture is manifested in the depression of the central nervous system. On the background of muscle weakness, there is tremor (trembling) of the limbs, a violation of the rhythm of the heart, a drop in blood pressure. The motility increases or the peritoneal of the gastrointestinal tract is sharply depressed, combined with a decrease in the secretion of saliva and a feeling of dryness in the mouth.
In severe poisoning, symptoms predominate from the side of the central nervous system: confusion, psychomotor agitation, hallucinations, convulsions. From the side of the cardiovascular system - tachycardia, a tendency to collapse; Respiratory failure, cyanosis.
First aid. Early frequent and repeated lavage of the stomach with activated charcoal, saline laxative, siphon enema. The role of conservative therapy for the purpose of maintaining vital functions is great: the use of vasoconstrictors with severe circulatory failure, the introduction of cardiac agents (strophanthine, cocarboxylase, korglikon), the introduction of alkaline solutions, correction of convulsions and external respiration, including oxygen therapy.

Caffeine and its apologists
(Theophylline, theobromine, euphyllin, aminophylline, theoephedrine, diprofylline, etc.).

Of the whole group, caffeine , the toxic dose of which is at the level of 1 g, has the greatest stimulating effect, and the death dose is about 20 g with large individual differences. With intravenous administration of euphyllin there are deaths from a dose of about 0.1 g, lethal doses in children when administered in candles - 25,100 mg / kg.
Symptoms . The main signs of toxic effects with prolonged use of relatively large doses (for example, in people who abuse coffee and tea) are manifested in irritability, anxiety, excitability, in a persistent headache, which is less amenable to drug therapy, and sleep disorders. The effect on the gastrointestinal tract is manifested by a sensation of burning in the epigastric region, nausea, vomiting, a sharp increase in gastric secretion, which is especially dangerous for ulcer patients, constipation.
Acute caffeine poisoning is expressed in psychomotor reactions, resulting in delusions and hallucinations, there are violations of sensory functions (determination of time and distance) and speed of movement. The initial phase of excitation is quickly replaced by a co-morbid state. The most dangerous complication of caffeine and its analogs is the development of acute cardiovascular insufficiency with the phenomena of collapse. Paralysis of the heart is also possible with the rapid introduction of a vein of euphyllin.
First aid. Gastric lavage with 1-2% solution of tannin or sodium hydrogencarbonate (baking soda), suspension of activated carbon . If the poisoning is caused by candles containing euphyllin, put an enema, take a salt laxative.
To stop psychomotor agitation and seizures, use chloral hydrate in enema (1.5-2 g per 50 ml of water), aminazine (2 ml of a 2.5% solution on novocaine), diphenhydramine (1 ml of 2% solution with novocaine) - intramuscularly.
Correction of cardiovascular failure in case of caffeine poisoning is difficult in the conditions of pre-medical care, since most vasoconstrictors will enhance the toxic effect of caffeine and its analogues. It is advisable to carry out this type of resuscitation in a hospital, where an exchange transfusion of blood (plasma) can be performed, and forced diuresis with alkalinization is used.

Strychnin .

Lethal dose: 0.2-0.3 g. Strychnine is easily absorbed from the gastrointestinal tract and also easily enters the body from all injection sites.
Symptoms: agitation, headaches, dyspnea. An increase in the tone of the occipital muscles, trismus of the masticatory muscles, tetanic convulsions with the slightest irritation . Spasm of the respiratory musculature with the development of a sharp stiff chest. Death occurs when asphyxiation (choking) occurs.
Treatment. When poison is ingested - early gastric lavage, saline laxative, chloral hydrate in the enema again. Sedation therapy: barbamyl (3-5 ml of 10% solution) in the vein, morphine (1 ml of 1% solution), diphenhydramine (2 ml of 1% solution) under the skin. In the case of breathing disorders, intubation anesthesia with the use of muscle relaxants (canine, diplacin). Forced diuresis (alkalinization of urine).

Narcotic drugs.

Indian hemp (hashish, plan) - narcotic intoxicant. Used for chewing, smoking and ingestion for the purpose of a kind of intoxication. The toxic effect is associated with the depression of the central nervous system.
Symptoms. Initially, psychomotor excitation, pupillary dilatation, tinnitus, bright visual hallucinations (vision of flowers, large spaces), rapid change of thoughts, laughter, ease of movement are characteristic. Then comes general weakness, lethargy, tearful mood and a long deep sleep with slowing of the pulse and lowering of body temperature.
Treatment. Gastric lavage when taking the poison inside. With a sharp excitation - aminazine (1-2 ml of a 2.5% solution) intramuscularly, chloral hydrate in enema, cardiovascular funds.
Nicotine is a tobacco alkaloid. The lethal dose is 0.05 g.
Symptoms : when the poison gets inside the mouth, behind the breastbone and in the epigastric region - the sensation of itching, areas of numbness of the skin, dizziness, headache, visual and hearing impairment. Dilation of the pupils, pallor of the face, drooling, repeated vomiting. Shortness of breath with a shortness of breath, palpitations, irregular pulse, fibrillar twitching of certain muscle groups with the development of common clopic-tonic convulsions.
During seizures, there is an increase in blood pressure followed by its fall. Loss of consciousness. Cyanosis of the mucous membranes.
Death occurs when paralysis of the respiratory center and respiratory muscles occurs.

Cardiovascular drugs
(Caffeine, cordiamine).

Novocaine with glucose in the vein is drip, magnesium sulfate intramuscularly, dimedrol under the skin. In convulsions with difficulty breathing - 10% solution of barbamyl (2.5% solution of hexenal or thiopental sodium), 5-10 ml per vein slowly at intervals of 20-30 seconds until the cramping of seizures or 1% solution of chloral hydrate in the enema.
If these measures are unsuccessful, dithiline (or other similar drugs) into a vein with subsequent intubation and artificial breathing apparatus. If cardiac rhythm of the type of tachycardia is violated - cardiac glycosides, with a sharp slowing of the pulse - atropine and a solution of calcium chloride intravenously. Oxygenotherapy.

Group of morphine .

Lethal dose: 0.1-0.2 g inside.
Symptoms . When ingestion or intravenous administration of toxic doses of drugs develops a coma, which is characterized by a significant narrowing of the pupils with a weakened response to light. Characteristic predominant oppression of the respiratory center - paralysis of respiration, even with a shallow coma or with a saved consciousness of the patient (with codeine poisoning). There may also be a significant drop in blood pressure. Death occurs as a result of oppression of the respiratory center.
First aid: washing the stomach with warm solutions of potassium permanganate (since it oxidizes the morphine) with the addition of activated carbon, salt laxative. Do not let the poisoned sleep, hot baths with cold dousings, rubbing. On the head, to the hands and feet warmers.
Treatment. Repeated gastric lavage, even with intravenous morphine. Nalorphine (anthorphin) for 1-3 ml of a 0.5% solution in a vein is repeated. Forced diuresis (alkalinization of urine). Cardiovascular drugs according to indications. Antibiotics. Vitaminotherapy. Artificial ventilation of lungs.

Anti-inflammatory and antipyretic agents :

The most common of them belong to three different chemical groups: salicylates (agents containing acetylsalicylic acid), pyrazolones (amidopyrine, analgin, butadione) and anilines (paracetamol and phenacetin). Each of the groups has its own side effects, but the picture of poisoning has quite a lot of similar features.
Aspirin, ascaphene and other salicylates. Lethal dose: 30-50 g, for children - 10 g.
Symptoms. When ingestion of salicylic acid, especially alcohol solution, there is burning and pain along the esophagus, in the stomach, repeated vomiting, often with blood, sometimes a loose stool with an admixture of blood. Characterized by noise in the ears, hearing impairment, visual impairment. The patients are excited, euphoric. Breathing noisy, rapid, may come comatose. Salicylates reduce blood clotting, so a constant sign of poisoning of hemorrhages on the skin, profuse (massive) nasal and uterine bleeding. The prognosis is usually favorable for life.
Treatment. After washing the stomach through the probe is injected inside the vaseline oil (glass), give a laxative - 20-30 grams of sodium sulfate (Glauber's salt). Increased alkaline sodium bicarbonate (baking soda) or in enema (at the rate of 0.4 g / kg body weight) every hour until normal respiration rate is restored and alkaline urine reaction occurs.
The appointment of large doses of ascorbic acid (up to 0.5-1 g) per day inside or in injections speeds up the neutralization of salicylic acid. When bleeding - vikasol, calcium chloride, blood transfusion. Treatment of renal and hepatic insufficiency, burns of the digestive tract.
Analgin, amidopyrine and other pyrazolium derivatives . The lethal dose: 10-15 g.
Symptoms: noises in the ears, nausea, vomiting, general weakness, fever, shortness of breath, palpitations. With severe poisoning - cramps, drowsiness, nonsense, loss of consciousness and coma. Perhaps the development of peripheral edema, gastric bleeding, hemorrhagic rash.
Treatment. The main measures are the same as for salicylate poisoning: gastric lavage, laxative, plentiful brush drink, diuretics. Additionally, anticonvulsant treatment is possible - chloral hydrate 1 g in enema with starch mucus, barbamyl intramuscularly, diazepam intravenously. At seizures of analeptics it is better to avoid, using for stimulation of heart strofantinom or similar agents. It is mandatory to prescribe chloride or potassium acetate inside by 0.5-1 g for 1-2 doses.
Paracetamol and other aniline derivatives. The phenomena of irritation of the digestive tract during poisoning are less pronounced, but the signs of methhemoglobin formation in the blood - pallor, cyanosis, brownish-brown skin, are more significant. In severe cases - dilated pupils, dyspnea, convulsions, vomiting with the smell of aniline. In later terms, anemia and toxic nephritis develop. The outlook is usually favorable.
Treatment is the same as in previous cases. However, expressed methaemoglobinemia often causes resort to exchange blood transfusions.
More attention should be paid to the fight against impaired renal function (osmotic diuresis or furosemide with copious fluid and mineral salts).

Antiseptics :

Iodine. Lethal dose: 2-3 g. Symptoms: brown staining of the tongue and oral mucosa, vomiting of brown and blue masses (if there is starch in the contents of the stomach), diarrhea. Headache, runny nose, skin rashes. Irritation of the mucous membrane of the respiratory tract. In severe cases - pulmonary edema, convulsions, small rapid pulse, coma.
First aid: gastric lavage, inside - liquid starch or flour paste in large quantities, milk, mucous drink, laxative-burnt magnesia (magnesium oxide).
Treatment: inside 1% of the sodium thiosulfate solution in an amount of 250-300 ml.
Symptomatic therapy, treatment of digestive tract burns.
Potassium permanganate (potassium permanganate ). Lethal dose: 0.5-1 g.
Symptoms: sharp pain in the mouth, along the esophagus, in the abdomen. Diarrhea, vomiting. The mucous membrane of the oral cavity is dark brown in color. Laryngeal edema, burn shock, convulsions.
Hydrogen peroxide . Symptoms: on contact with the skin - its whitening, burn, blisters. When ingestion - burns the digestive tract.