Dreisbach's Handbook of Poisoning: Prevention, Diagnosis and Treatment

696 Pages·2001·18.12 MB·English

by  Bev-Lorraine True

Dreisbach titles.qxd 17/6/08 10:26 am Page 1
D r e i s b a c h’ s
HANDBOOK
of
POISONING
P R E V E N T I O N , D I A G N O S I S
and TREATMENT
THIRTEENTH EDITION

Dreisbach titles.qxd 17/6/08 10:26 am Page 2
D r e i s b a c h’ s
HANDBOOK
of
POISONING
P R E V E N T I O N , D I A G N O S I S
and TREATMENT
THIRTEENTH EDITION
Bev-Lorraine True
and
Robert H. Dreisbach
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2001 by Taylor & Francis Group, LLC
CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
Version Date: 20130415
International Standard Book Number-13: 978-1-4398-0614-2 (eBook - PDF)
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the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on
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Contents
Preface vii
I. General considerations
1. Prevention of poisoning 3
2. Emergency management of poisoning 25
3. Diagnosis and evaluation of poisoning 35
4. Management of poisoning 52
5. Legal and medical responsibility in poisoning 102
II. Agricultural poisons
6. Halogenated insecticides 109
7. Cholinesterase inhibitor pesticides 123
8. Miscellaneous pesticides 133
III. Industrial hazards
9. Nitrogen compounds 163
10. Halogenated hydrocarbons 172
11. Alcohols and glycols 199
12. Esters, aldehydes, ketones, and ethers 216
13. Hydrocarbons 228
14. Corrosives 240
15. Metallic poisons 269
16. Cyanides, sulfides, and carbon monoxide 311
17. Atmospheric particulates 327
IV. Household hazards
18. Cosmetics 343
19. Food poisoning 348
v
vi DREISBACH’S HANDBOOK OF POISONING
20. Miscellaneous chemicals 356
V. Medicinal poisons
21. Analgesics, antipyretics, and anti-inflammatory agents 367
22. Anesthetics 379
23. Depressants 390
24. Drugs affecting the autonomic nervous system 422
25. Antiseptics 442
26. Cardiovascular drugs 459
27. Anti-infective drugs 485
28. Stimulants, antidepressants, antimanics, anticonvulsants, 508
and psychotomimetic agents
29. Irritants and rubefacients 532
30. Cathartics 541
31. Endocrine drugs 546
32. Miscellaneous therapeutic and diagnostic agents 556
VI. Animal and plant hazards
33. Reptiles 587
34. Arachnids and insects 601
35. Marine animals 610
36. Plants 615
Index 639
Preface
Dreisbach’sHandbookofPoisoningprovidesaconcisesummaryofthediag-
nosisandtreatmentofpoisoningformedicalstudents,residents,nursesand
practicingphysicians.Thisbookisintendedtobeareadilyavailablereference
andquickguidetomoredetailedsourcesofpoisoninginformation.Asspeed
is critical in the initial management of poison cases, this book is a quick
source of practical information. Listings of more detailed references,
websites,antidotes,antivenins,etc.areincluded.Becausethisbookhasbeen
inusethroughouttheworldformanydecades,chemicalsandsubstancesthat
arenowbannedintheUnitedStatesarestillincludedsincetheymaystillbe
availableelsewhere.Inaddition,whiletheUShasmandatedthatemployers
adheretodetailedoccupationalexposurerequirementsfortheuseofprotec-
tion,therearemanysmallbusinessesthatarenotawareofsuchsafetyrequire-
ments.Workersmaypresentwithchronicpoisoningssuchasleadinradiator
repair,orcentralnervoussystemdamagefromchronicorganicsolventexpo-
sures.
Organization of the book
Chapters1–4providegeneralinformationaboutprevention,diagnosis,and
treatment of poisoning. Chapter 5 considers the important medicolegal
aspectsofpoisoning.Specificpoisonsarediscussedintheremainderofthe
book and are organized into agricultural, industrial, household, medicinal,
and natural hazards. This organizational system facilitates correlation of
poisons with types of exposure. Insofar as is possible, chemically- and, in
some cases, pharmacologically-related agents have been grouped together.
Toenablethephysiciantoidentifythetoxicprincipleinagivenpropri-
etarypreparation,brand-namedproductslikelytobeencounteredclinicallyor
whosecompositionisnotobviousarelistedintheindex.Thisgroupincludes
many insecticides and medicinal agents.
vii
viii DREISBACH’S HANDBOOK OF POISONING
New features
The thirteenth edition of Dreisbach’s Handbook of Poisoning has been
substantially revised and includes the following new features:
•
Sections on diagnosis and treatment have been revised and updated to
reflect the latest procedures in emergency rooms and poison centers.
(cid:127)
Sectionsonmanagementofpoisoninghavebeensimplifiedforeasieruse
in emergencies.
(cid:127)
New sections added in the medicinal chapters to include the enormous
expansion of drugs since the last edition.
(cid:127)
Reference lists restricted to useful recent articles.
With the thirteenth edition, Dr Bev-Lorraine True joins Dr Robert H.
Dreisbach as co-author of the book. Both authors thank Dr William O.
Robertson,co-authorofthetwelftheditionandMedicalDirectoroftheWash-
ingtonPoisonCenterandallofthosewhohavetakenthetimetoofferhelpful
criticisms and suggestions for improvement of Dreisbach’s Handbook of
Poisoning.
Bev-Lorraine True
Robert H. Dreisbach
I. General considerations
1 Prevention of poisoning
Morethan12000deathsduetopoisoningoccurintheUSAeachyear.Manyof
thesedeathsareavoidableregardlessofwhetherthepoisoningispurposefulor
accidental, occupational or environmental. Prevention of poisoning requires
adequateknowledgeofthehazardouspropertiesofsubstancesbyusers.
IntheUSAovertwomillionexposurestodrugsandchemicalsoccurredin
1997.Over90%ofexposuresoccurredinthehomeand40%ofexposures
occurred to children. The majority of cases of exposure involved cleaning
substances, analgesics, cosmetics and personal care products, plants, and
cough and cold substances. However, children comprised less than 4% of
fatalities.Thus,rapidandeffectivetreatmentofpoisoningsbylaypersons,
withtheadvicebypoisoncontrolcentersandhealthpersonnel,reducesfatal
outcomes. The majority of fatalities occur in adolescents and adults and
are the result of exposures to analgesics, sedatives, antidepressants, anti-
psychotics, anticonvulsants, cardiac drugs, theophylline, amphetamines,
cocaine,hydrocarbons,cleaningproducts,andpesticides/rodenticides.Fatal-
itiesinchildrenaremostoftenfromacetaminophen,aspirin,irontablets,and
cleaningproducts.Drugsshouldnotbeusedduringpregnancyunlessbenefit
overrides the risk to the fetus. Use available resources for evaluating the
safety of drug use in pregnancy (see p. 19).
Whenprescribingdrugs,alwaysbealerttotheirpotentialtoxicitiessothat
thefirstsignswillberecognizedandproperactiontaken.Becautiouswhen
prescribingdrugswithanarrowtherapeuticindex(thedifferencebetweenthe
effectiveandtoxicdose).Manyresourcesalerttheprescribertopotentialdrug
interactions that increase likelihood of a toxic reaction.
HOUSEHOLD POISONING
Safe storage and use
(1) Allcontainersshouldhavesafetyclosures.Medicines,insecticides,and
rodenticidesshouldbestoredinlockedcabinets.Ifalockedcabinetisnot
available, a suitcase with a lock is satisfactory.
3