Toxicology in Intensive Care Unit

Abstract

Severe clinical illness can occur following overdose or exposure to certain chemicals and illicit substances. Many agents produce toxidromes, which allows the physician to identify a probable poisoning syndrome and empirically determine the most appropriate management. Those toxidromes discussed include: 1. Classic opioid toxidrome 2. Sedative-hypnotic toxidrome. 3. Sympathomimetic toxidrome. 4. Anticholinergic toxidrome. 5. Cholinergic toxidrome. Knowledge of the various routes of decontamination, emerging antidotal therapies, and opportunities for enhanced elimination allow for provision of optimal care in the critical care setting. Many cases of poisoning present diagnostic and therapeutic challenges. In chapter 2 in this essay we focus on most common drug overdoses and toxins: 1. Acetaminophen toxicity: Its clinical manifestations was divided into 4 stages starting with nausea, vomiting, pallor and diaphoresis reaching to hepatic encephalopathy and maybe death from multiorgan system failure in stage 3. For patients who survive stage 3