Akalinisation of urine may be done in case of poisoning with
(A) (Barbiturates)* Forced alkaline diuresis is valuable in aspirin and barbiturate poisoning (phenobarbitone).Forced alkaline diuresis* Forced alkaline diuresis implies achieving an alkaline urinary pH of 7.5 to 9* This promotes excretion of drugs that are weak acidsDrugs that can be eliminated by alkaline diuresis include* Salicylates* Barbiturates (Long acting/ phenobarbitone)* Chlorpropamide* Methotrexate**** Lithium, Isoniazid (controversial)* Alkaline dieresis is usually achieved with sodium bicarbonate** and may be forced by using urea, furesamide or mannitol infusions.Elimination of Absorbed bv DiuresisAlkaline DiuresisAcid Diuresis* Salicylates* Barbiturates* Amphetamine* Quinine* Phenylcylidine* Strychnine* Aldrich Mees lines on finger nails seen in poisoning of - Arsenic* Burtonium line seen in Lead (chronic lead poisoning)Classic Triad of chronic mercury ooisonins | |||Excessive salivation&Gingivitis*TremorsNeuropsychialnc changes* Erethism* Other features- Mercuria lends*** - Nephritis (DCT)*** - Acrodynia*** - Abortion is common** - Minimata disease * ** Rain drop pigmentation of skin, hyperkeratosis of palms, lines on nails (Mees line) and paraesthesias are classical signs of chronic arsenic poisoning.Aluminium phosphide poisoning (celphos)(i) Aluminium phosphide produces phosphine gas on coming in contact with moisture which inhibits cytochrome c- oxidase(ii) AP causes wide spread organ damage due to cellular hypoxia as a consequence of non competitive inhibition of the enzyme cytochrome oxidase of the mitochondria(iii) CP- retrosternal burning, epigastric pain and vomiting hypotension, restlessness, tachypnea, oliguria or anuria, jaundice, impaired sensorium and cardiac arrhythmias, focal myocardial necrosis and changes in action membrane potential to result of alteration in permeability of Na+ Mg++ Ca + ionsDiagnosis1. Garlicky (or decaying fish) odour from mouth with highly variable arrhythmias2. Confirmation can be done by Silver Nitrate test.3. Most specific and sensitive method for detecting the pH 3 in blood/air in gas chromatographyTreatment - No specific antidote, Gastric lavage with Pottasium permagnate + supportive
Barbiturates
Amphetamine
Alcohol
Morphine
Toxicology