Moving beyond the dose makes the poison

Colalillo, James M; Govindasamy, Laksmi Sakura; Greaves, Robbie Ley

doi:10.1111/1742-6723.14192

Cited by 1 publication

(1 citation statement)

References 23 publications

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“…[3] Furthermore, there is no definitive boundary for poisons or drugs; the distinction lies in the dosage magnitude, where substances surpassing the appropriate dosage are categorized as poisons. [4] Due to the wide range and similarities of clinical manifestations among patients affected by poisoning, a thorough history of exposure, whether provided by the patient or by others (including relatives, friends, healthcare workers, or other bystanders), is an essential part of the diagnostic process for poisoning. [5][6][7] Nonetheless, clinicians may encounter challenges in obtaining precise exposure histories from certain patients.…”

Section: Introductionmentioning

confidence: 99%

The value of toxicological analysis in acute poisoning patients with uncertain exposure histories: a retrospective and descriptive study from an institute of poisoning

Shi,

Ba,

Xia

et al. 2024

World Journal of Emergency Medicine

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BACKGROUND:In clinical practice, some patients might not be able or unwilling to provide a thorough history of medication and poison exposure. The aim of this study was to use toxicological analysis to examine the clinical characteristics of patients with acute poisoning whose exposure history was uncertain from a toxicological analysis perspective.METHODS: This was a retrospective and descriptive study from an institute of poisoning. Patient registration information and test reports spanning the period from April 1, 2020 to March 31, 2022, were obtained. Patients with uncertain exposure histories and who underwent toxicological analysis were included. Clinical manifestations and categories of toxics were analyzed.RESULTS: Among the 195 patients with positive toxicological analysis results, the main causes of uncertain exposure history was disturbance of consciousness (62.6%), unawareness (23.6%) and unwillingness or lack of cooperation (13.8%). The predominant clinical manifestations were disturbed consciousness (62.6%), followed by vomiting and nausea (14.4%) and liver function abnormalities (8.7%). A comparison of clinical manifestations between patients with positive and negative (n=99) toxicological analyses results revealed significantly different proportions of disturbances in consciousness (63% vs. 21%), dizziness (1.5% vs. 5.1%), multi-organ failure (1.5% vs. 7.1%), and local pain (0 vs 4%). The main categories of substances involved were psychiatric medications (23.1%), sedatives (20.5%), insecticides (13.8%), and herbicides (12.8%). CONCLUSION:The clinical manifestations of acute poisoning in patients with an uncertain exposure history are diverse and nonspecific, and toxicological analysis plays a pivotal role in the diagnosis and differential diagnosis of such patients.

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