Acute chemical poisoning, including that with drugs, occurs rather often. Poisonings can be accidental, intentional (suicidal4) and associated with occupational hazards. Most common are poisonings with ethyl alcohol, hypnotic drugs, psychotropic drugs, opioid and non-opioid analgesics, organophosphorous insecticides and other compounds.
Special toxicological centers and departments are established to treat chemical poisonings. The main task of the treatment of acute poisoning is to eliminate the drug causing intoxication from the body. In severe patients' conditions this should be preceded by general therapeutic and resuscitation measures aimed at the maintenance of vital systems' function, respiration and blood circulation.
Detoxification principles are as follows. First of all it is necessary to block the drug's absorption at the routes of introduction. If the drug is already partially or fully absorbed, its elimination from the body should be accelerated and its antidotes should be used to neutralize it and eliminate toxic effects.
A) Delay of the absorption of the toxic substances into the blood
Most often acute poisonings are caused by drug intake. That is why one of the most important methods of detoxification is catharsis. Vomiting is induced and gastric lavage is performed. Vomiting is caused mechanically (irritation of the posterior wall of pharynx), by concentrated solutions of sodium chloride or sodium sulphate or admini-
stration of emetic drug - apomorphine. In poisoning with drugs causing damage to the mucous membranes (acids and alkali), vomiting should not be induced otherwise additional lesions of the esophageal mucous membrane will occur. Besides, drug aspiration and inhalation damage of respiratory tract can occur. Gastric lavage with a stomach pump is the most effective and safe. First, gastric contents are removed, then the stomach is washed out with warm water, an isotonic solution of sodium chloride or permanganate potassium solution with the addition of activated charcoal and other antidotes, if necessary. The stomach is lavaged several times (every 3-4 h) until it is completely drug-free.