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Mercury exists in three oxidation states, elemental, mercuric and mercurous and can form both organic and inorganic compounds. The central nervous system is the most susceptible target organ, though mercury is also a potent renal toxin. Chelation therapy with DMPS can enhance mercury elimination and there are case reports demonstrating that chelation therapy can reverse mercury-induced neurological...
Salicylate poisoning is potentially serious, particularly if the diagnosis or presentation is delayed, the patient is elderly (>70 years of age), is comatose, has a fever, or if they develop non-cardiogenic pulmonary oedema or acidaemia. Urine alkalinization and haemodialysis increase salicylate elimination and should be employed respectively in patients with moderate or severe poisoning.
Evaporation of liquid nitrogen from the eye or skin may cause cold burns. It may displace oxygen, causing hypoxic asphyxia. Of the nitrogen oxides NO 2 is most toxic. Following exposure, effects in the peripheral airways and alveoli can be expected; clinical symptoms are usually absent during the first hours after exposure. Consequently, physical examination of the patient immediately after...
Features of severe theophylline poisoning include vomiting, hypokalaemia, sinus tachycardia, supraventricular and ventricular arrhythmias, seizures, rhabdomyolysis and metabolic acidosis. Treatment is supportive, with correction of hypokalaemia being the most important measure. The administration of multiple-dose activated charcoal will enhance elimination.
Paracetamol poisoning is common. If untreated, liver and/or renal failure may develop. The administration of N-acetylcysteine within 8–10 hours of overdose will minimize or prevent hepatic damage and ensure survival irrespective of the magnitude of the ingestion. Important prognostic factors are the international normalized ratio (INR), pH and plasma creatinine concentration.
Iron poisoning causes its metabolic effects in proportion to the concentrations of free iron. Toxicity is therefore related to dose ingested. The amount of iron in different salts varies, and iron concentrations may rise and fall, making plasma concentrations difficult to interpret in acute poisoning. Clinical features include severe gastrointestinal irritation, cardiovascular collapse and direct...
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