T: Toxins

Toxins-

Sometimes when I think of toxins I only think of pollutiants and posions, like gasoline fumes or a snakebite, but substances that are normally thought to be helpful (like many therapeutic drugs) can also cause toxicity in high doses. It is importiant to get an accurate patient history; including therapeutic and non therapeutic drug use, circumstances surrounding the admitting complaint.

Each toxins mechanism of action is going to vary, but it's still importiant to be familiar with the most common types in case you have a patient who looks like they might code and evidence of the other"H's & T's" are not present. Some toxins disrupt metabolism, others cause cells to break apart, but many of the most common toxic reactions originated from a therapeutic drugs pharmacological reaction accentuated by other factors: Liver failure, kidney failure, accidential or intentional overdose (or a combination of the three).

I've found several PDF's and other graphs that are wonderful educational material to communicate toxin mechanism of action and antidote, once I get back on PC I will update thene here.

Luckily, many pollutants, posions, and drug toxins have antidotes and the effect can be reverse if its cought early enough:

Acetamenophen (Acetylcystine AKA "Mucomyst")
Digoxin (Digoxin immune FAB)
The Blood Thinners
-coumadin (vitamin K)
-heparin (Protamine Sulfate)
Narcotics: Dilaudid, Morphine etc (Narcan)  
Arsonic (Dimercaprol)
(In some instances, dialysis is appropriate)

Drug-toxins may have specific effects on vital organs that, when outside of therapeutic range, cause a characteristic disfunction. I spoke about two of them in "Matters Of The Heart: Drug and Elecrolyte Imballance"