Medical Treatment

Elimination: Get rid of the unabsorbed poison before it can do any harm.

• If the person is unconscious, the doctor will put a flexible, soft, plastic tube into the windpipe to protect the person from suffocating in his or her own vomit and to provide artificial breathing (intubation).

• Once the poison has moved past the stomach, other methods are needed.
  • Activated charcoal acts as a "super" absorber of many poisons. Once the poison is stuck to the charcoal in the intestine, the poison cannot get absorbed into the bloodstream. Activated charcoal has no taste, but the gritty texture sometimes causes the person to vomit. To be effective, activated charcoal needs to be given as soon as possible after the poisoning. It does not work with alcohol, caustics, lithium (Lithobid), or petroleum products.
    
    
  • Whole bowel irrigation requires drinking a large quantity of a fluid called Golytely. This flushes the entire gastrointestinal tract before the poison gets absorbed.

Antidotes: Some poisons have specific antidotes. Antidotes either prevent the poison from working or reverse the effects of the poison.

• Atropine is an antidote for certain nerve gases and insecticides. During Operation Desert Storm, all military personnel were issued atropine injectors when it was feared that the enemy would use nerve gas.
  
  
• A common antidote is N-acetylcysteine (Mucomyst), which is used to neutralize acetaminophen (Tylenol) overdoses. Acetaminophen, in normal doses, is one of the safest medications known, but after a massive overdose, the liver is damaged, and hepatitis and liver failure develop. Mucomyst works as an antidote by bolstering the body's natural detoxification abilities when they are overwhelmed.

• It may also be possible to reverse the harmful effect of a drug even if no antidote exists.
  • If a person with diabetes takes too much insulin, a dangerously low blood sugar (hypoglycemia) will cause weakness, unconsciousness, and eventually death. Sugar given by mouth or IV is an effective treatment until the insulin wears off.
    
    
  • When the poison is a heavy metal, such as lead, special medicines (chelators) bind the poison in the bloodstream and cause it to be eliminated in the urine.
    
    
  • Another "binder" is sodium polystyrene sulfonate (Kayexalate), which can absorb potassium and other electrolytes from the bloodstream.

General supportive measures: When there are no specific treatments, the physician will treat signs and symptoms as needed.

• If the person is agitated or hallucinating, a sedative can be given to calm the person until the drug wears off.
  
  
• A ventilator can be used to breathe for anyone who has stopped breathing from a poisoning.
  
  
• Antiseizure medicines can be used to treat or prevent seizures.