Drug Poisoning and Misuse

Question 1

what is a poison?

Answer 1

a poison is any substance, including medications, that is harmful to your body if too much is eaten, inhaled, injected, or absorbed through the skin. (CDC,2015)

Question 2

what is an acute poisoning?

Answer 2

single contact with a toxin

Question 3

what is a chronic poisoning?

Answer 3

repeated contacts with a toxin which is not or is poorly excreted from the body, thus permitting accumulation

Question 4

what are the three types of poisoning?

Answer 4

• accidental
• intentional
• iatrogenic

Question 5

when does accidental poisoning usually occur?

Answer 5

• mostly in children
• high risk age 12-36 months
• most common poison is household bleach

Question 6

when does intentional poisoning usually occur?

Answer 6

• most common in adults with suicidal/parasuicidal intention
• number of occurrence is higher in accidental but fatality rate is higher in intentional poisoning

Question 7

what percent of poisonings does unintentional account for?

Answer 7

84%

Question 8

what is iatrogenic poisoning?

Answer 8

includes the vast array of adverse drug reactions, many of which are preventable
accounting for 3% of reported poisonings

Question 9

what are the most common drugs enquired about?

Answer 9

paracetamol and ibuprofen

Question 10

what is the most common household item enquired about?

Answer 10

laundry products/detergents

Question 11

what are the signs and symptoms of poisoning?

Answer 11

• burns or redness around the mouth
• chemical smelling breath
• burns, stains and odors on the person or surrounding area
• empty medication bottles or scattered pills
• vomiting, difficulty breathing, sleepiness, seizures, confusion

Question 12

what are some non-specific treatments?

Answer 12

• maintenance of ventilation
• reduce absorption of poison
• maintenance of BP
• increasing elimination
• nutrition, hydration and electrolyte disturbance

Question 13

what are the signs of aspirin poisoning?

Answer 13

• tinnitus and impaired hearing
• hyperventilation
• vomiting
• dehydration
• fever
• double vision

Question 14

what is given as treatment in a significant aspirin overdose?

Answer 14

sodium bicarbonate given until urine pH is between 7.5-8

Question 15

what is classified as a significant aspirin overdose?

Answer 15

salicylate levels greater than 35mg/dl after 6 hours of injestion

Question 16

what are the goals in poison control treatments?

Answer 16

• hemodynamically stabilize the patient
• identify the toxic substance
• minimize further absorption

Question 17

how would you treat inhaled poison substances?

Answer 17

treat with high oxygen administration

Question 18

how would you treat ingested poison substances?

Answer 18

treat with administration of activated charcoal and a cathartic orally or by nasogastric route

Question 19

how would you treat injected poison substances?

Answer 19

treat with the administration of specific antagonistic medications if available

Question 20

how would you treat poisoning by skin absorption?

Answer 20

removal of the toxic substance through irrigation

Question 21

what does supportive care involve?

Answer 21

• maintenance of vital body function in a physiological state until the intoxicant is eliminated
• management of CNS depression
• management of seizures
• management arrhythmias
• management pH & electrolyte imbalance

Question 22

when does a drug become medicine?

Answer 22

when it is used in a prescribed way by the advise of a doctor or pharmacist with a specifically controlled dosage

Question 23

what are the most commonly used substances among young people?

Answer 23

alcohol and tobacco

Question 24

what is the most common drug of misuse in the west?

Answer 24

cannabis

Question 25

what are the risk factors in drug addiction?

Answer 25

- personality (predisposition) - social environment (early use/lack of family involvement) - anxiety, depression and loneliness - genetics/family history - type of drug

Question 26

what would you assess for in a drug use emergency?

Answer 26

- head injury - hypoglycemia (mimics intoxication) - ineffective breathing patterns - risk of violence

Question 27

what is treatment drug use emergency?

Answer 27

- blood specimen for blood alcohol level - sleep off intoxication - observe for central system depression - if sedation is required, observe for hypotension and reduce consciousness - non-judgement attitude

Question 28

what are the aims of drug use treatment?

Answer 28

- to decrease level of drug use - decease offending - decrease overdose risk - prevent spread of blood borne viruses - improve health of individual - improve health of family

Question 29

discuss replacement therapy?

Answer 29

opioid replacement therapy is a medical procedure of replacing illegal opioid drug such as heroin with a longer acting ,less euphoric opioid (like methadone or buprenorphine) taken under medicine supervsion

Question 30

what is the aim of screening and brief interventions?

Answer 30

identify current or potential problems with substance use and motivate those at risk to change their substance use behaviour

Question 31

what are some strategies to prevent spread of blood borne?

Answer 31

- not sharing needles (needle exchange program) - safe sex - screening for blood borne viruses - opportunistic vaccination

Question 32

what are the principles of drug treatment? (1-6)

Answer 32

1. addiction is complex but treatable disease that affect brain function and behaviour 2. no single treatment is appropriate for everyone 3. treatment needs to be readily 4. effective treatment is holistic not just surrounding the drug abuse 5. remaining in treatment for an adequate amount of time is critical 6. behavioral therapies - including family or group - are the most commonly used forms of treatment

Answer 33

7. medications are important elements of treatment with therapies 8. treatment plans must be assessment continually 9. many drug-addicted people suffer from mental illness which must be address 10. medically assisted detoxification is only the first stage of treatment 11. treatment does not need to be voluntary to be effective 12. drug use monitoring during treatment is essential 13. treatment programs should test patients for infectious such HIV/AIDS