Drug Poisoning

Medicines: poisoning and first aid

Drug poisoning occurs particularly in connection with suicidal intentions. This is often an overdose of sedatives, sleeping pills, antipsychotics or antidepressants, for example. But children who find medication are also often affected by drug poisoning, as well as elderly or demented people who mix up their own medication and use the wrong dose. Depending on the active ingredient, this can have dangerous consequences.

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• Poisoning with sleeping pills and sedatives
• Poisoning with antidepressants
• Poisoning with pain medication
• Cardiovascular drug poisoning
• Overdose of birth control pills
• Overdose of antibiotics

If a drug overdose is suspected, medical advice should always be sought. Contact the poison information center +43 (0) 1 406 43 43 to assess the risk. If the symptoms are severe, dial 144. Also ensure the packaging or the label.

On the phone, state as precisely as possible:

• Which medication was taken (name of the active ingredient and dosage)?
• How much of it?
• Who (child, adult)?
• When (how much time has passed since ingestion)?
• What complaints did you have?
• Why (suicide, accident)?

You don't need to memorize these questions - they are actively asked of you on the phone! Then follow the instructions given by the staff on the phone.

In order to avoid poisoning with medication, households with children in particular should be made “safe for gifts”. More on the topic: Poisoning: Prevention.

The following drugs are an extract and serve as examples of possible drug poisoning.

Danger! The indicated symptoms of poisoning are not to be confused with possible side effects! These can occur even with normal dosages.

Poisoning with sleeping pills and sedatives

Sleeping pills or sedatives are often preparations from the benzodiazepine group of active substances (alprazolam, bromazepam, diazepam, nitrazepam, flunitrazepam, flurazepam, lormetazepam, lorazepam, triazolam etc.). Due to their effects, these drugs have a particularly high potential for addiction. They have an anxiety-relieving, relaxing, calming, sleep-promoting and anti-spasmodic effect (e.g. in epilepsy). Benzodiazepines - often imprecisely referred to as tranquilizers - require a prescription and are used particularly in psychiatry, anesthesia and generally as short-term sedatives. It is not uncommon for the drugs to lie by the bed and are then easily accessible to children. More on the topic: sleeping pills and sedatives

Possible symptoms of overdose:

• Respiratory depression
• coma
• Loss of protective reflexes (attention: aspiration of gastric juice possible!)
• There is also an increased risk of falls and accidents due to tiredness and unsteadiness!

Danger! In children, even taking small amounts can cause symptoms; these include, in particular, severe fatigue, unsteady gait and sleepiness. Larger amounts can be life threatening!

First aid measures:

In the event of poisoning with these drugs, there is an acute danger to life (especially for children!), Therefore carry out the following emergency life-saving measures:

• Remove any tablet residue from your mouth if necessary.
• Contact the Poison Information Center on +43 (0) 1 406 43 43.
• Children should always be monitored in a children's clinic after taking sleeping pills or sedatives.

If unconscious:

Dial emergency number 144

• Keep your airway clear. An unconscious person lying on their back is at risk of suffocation. A simple stable side position can prevent this.
• If you have stopped breathing, perform a resuscitation immediately.
• More on the subject: first aid measures

Danger! Benzodiazepines are particularly dangerous in combination with alcohol and other psychotropic drugs!

Poisoning with antidepressants

Antidepressants (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, etc.) are widespread and are used for a variety of psychiatric diseases, e.g. depression, anxiety and panic attacks, obsessive-compulsive disorder, eating disorders. The modern antidepressants often belong to the group of serotonin reuptake inhibitors. More on the topic: Depression: Medication & Psychotherapy

Symptoms of overdose:

• Drowsiness or loss of consciousness
• Restlessness
• confusion
• increased muscle reflexes
• Muscle tremors
• Muscle spasms
• high blood pressure
• Racing heart
• EKG changes
• Temperature rise

First aid measures:

• Remove any tablet residue from your mouth if necessary.
• Contact the Poison Information Center on +43 (0) 1 406 43 43.
• If unconscious:
  • Dial emergency number 144 !
  • Keep your airway clear. An unconscious person lying on their back is at risk of suffocation. A simple stable side position can prevent this.
  • If you have stopped breathing, perform a resuscitation immediately.

Danger! Particularly dangerous in combination with alcohol, opioids and other psychotropic drugs!

Poisoning with pain medication

Many popular pain medications are available over the counter. Nevertheless, an overdose can lead to serious clinical pictures; There are big differences in terms of danger. Medicines such as mefenamic acid, paracetamol or salicylates belong to the group of non-steroidal anti-inflammatory drugs (NSAIDs). These work against pain, inflammation and reduce fever.

Paracetamol and mefenamic acid in particular are often used in children. The risk of overdosing or poisoning comes from freely accessible drugs on the one hand, and from wrongly dosed drugs on the other. More on the topic: painkillers

Mefenamic acid

Mefenamic acid can be used in various forms and dosages in both children and adults.

Symptoms of overdose:

• States of confusion
• dizziness
• Hallucinations
• nausea
• Vomit
• Upper abdominal pain
• Rashes
• general tendency to bleed
• Muscle spasms, epileptic fits
• Kidney failure

The initial symptoms are unspecific. It can be completely absent and does not have to be related to the severity. If poisoning is suspected, early therapy in a hospital is necessary, especially in children.

First aid measures:

• Remove any tablet residue from your mouth if necessary.
• Contact the Poison Information Center on +43 (0) 1 406 43 43.
• If unconscious:
  • Dial emergency number 144.
  • Keep your airway clear. An unconscious person lying on their back is at risk of suffocation. A simple stable side position can prevent this.
  • If you have stopped breathing, perform a resuscitation immediately.

Paracetamol

Paracetamol has not only proven itself in adults, but also in pediatrics. However, it is dangerous if overdosed. The toxicity depends on the amount, the body weight and the time interval in which the overdose was taken. Symptoms of poisoning can be caused by a single dose that is too high or too frequent, both in adults and in children. People with chronic liver disease, the elderly and young children are particularly at risk.

Symptoms of overdose:

• Nausea, vomiting
• stomach pain
• sweat
• paleness
• after massive overdoses there is a risk of irreversible liver damage; this can subsequently become life-threatening.

First aid measures:

• Remove any tablet residue from your mouth if necessary.
• Contact the Poison Information Center on +43 (0) 1 406 43 43.

Note Even if paracetamol poisoning is suspected, a medical examination and treatment should be carried out within the first ten hours!

Salicylates

The best-known representative of this active group is acetylsalicylic acid. In principle, drugs in this group are not suitable for children under the age of twelve; Reye's syndrome (life-threatening disease of the brain and liver) can occur.

An overdose can lead to moderate or severe symptoms of intoxication, depending on the amount consumed.

Symptoms of moderate overdose:

• Hearing impairment, tinnitus
• sweat
• Nausea, vomiting
• Headache, dizziness

Additionally in the case of severe poisoning

• fever
• Hyperventilation
• Disorders of the acid-base balance
• Severe hypoglycaemia
• coma
• Respiratory and circulatory failure

Danger! Acetylsalicylic acid poisoning can be life-threatening, especially in small children and the elderly!

First aid measures:

• Remove any tablet residue from your mouth if necessary.
• Contact the Poison Information Center on +43 (0) 1 406 43 43.
• If unconscious:
  • Dial emergency number 144.
  • Keep your airway clear. An unconscious person lying on their back is at risk of suffocation. A simple stable side position can prevent this.
  • If you have stopped breathing, perform a resuscitation immediately.

opiate

Opiates (including opioid analgesics) do not belong to the NSAID group. The active ingredients of this group are derivatives of opium (obtained from the milk sap of the opium poppy), well-known representatives are morphine, codeine, heroin, pethidine and methadone. Opiates or opioids have a variety of effects; morphine is primarily used as a strong pain reliever.

Opiates must not be taken by children (especially small children) (keep them safe!). Opiate poisoning or overdoses also occur mainly in people with drug addiction (heroin).

More on the topic: Alcohol & Drugs: Poisoning

Symptoms of overdose:

• Constriction of the pupil
• Confusion, disorientation
• Nausea, vomiting
• Drop in blood pressure
• Slowing your heart rate
• unconsciousness
• Slowing of breathing, there is a risk of breathing arrest
• Circulatory failure through to deep coma

Danger! An overdose of opiates is always life-threatening due to the risk of respiratory failure. Children in particular must be closely monitored and given medical care if they are suspected of taking opiates.

First aid:

• Remove any tablet residue from your mouth if necessary.
• Even a conscious person must be monitored after excessive opiate use. Don't leave it alone!
• Dial emergency number 144.

• In addition, if unconscious:
  • Keep your airway clear. An unconscious person lying on their back is at risk of suffocation. A simple stable side position can prevent this.
  • If you have stopped breathing, perform a resuscitation immediately.

Cardiovascular drug poisoning

Examples of active ingredients that are used to treat cardiovascular diseases are cardiac glycosides, antiarrhythmic drugs and drugs that lower blood pressure. In these cases, overdose or poisoning can lead to threatening symptoms; Older people or people with dementia are often affected.

Cardiac glycosides

Cardiac glycosides are drugs that are widely used in cardiology and that reduce the heartbeat and increase the strength of the heart. Active ingredients in this group include digoxin, digitoxin and acetyldigoxin. They are used to treat heart failure. In nature, glycosides are found in many plant species (e.g. foxgloves, lily of the valley, oleander), but also in some vertebrates.

Symptoms of overdose:

• Loss of appetite
• nausea
• Vomit
• fatigue
• Visual disturbances
• a headache

Symptoms delayed up to six hours include:

• very slow heartbeat
• Cardiac arrhythmias
• Cardiac arrest

First aid measures:

• Remove any tablet residue from your mouth if necessary.
• Contact the Poison Information Center on +43 (0) 1 406 43 43.
• If you experience symptoms, dial 144 immediately.
• If unconscious:
  • Dial emergency number 144.
  • Keep your airway clear. An unconscious person lying on their back is at risk of suffocation. A simple stable side position can prevent this.
  • If you have stopped breathing, perform a resuscitation immediately.

Note Children should always be monitored by a doctor after accidental ingestion.

Antiarrhythmics

Antiarrhythmics are used to treat abnormal heart rhythms. There is a large number of active ingredients that differ in their main mechanism of action. What they all have in common is that they are dangerous if taken incorrectly or excessively, as they affect the heart rhythm. The risk increases with the amount ingested.

More on the topic: cardiac arrhythmias

Symptoms of overdose:

Depending on the drug, different symptoms can occur:

• Racing heart
• slow heartbeat
• sleepiness
• paleness
• nausea
• unconsciousness

Most of the time, the amount consumed is small, but you should always contact the Poison Control Center: +43 (0) 1 406 43 43, especially with children!

First aid measures:

• Remove any tablet residue from your mouth if necessary.
• Contact the Poison Information Center on +43 (0) 1 406 43 43.
• If you experience symptoms, dial 144 immediately.
• If unconscious:
  • Dial emergency number 144.
  • Keep your airway clear. An unconscious person lying on their back is at risk of suffocation. A simple stable side position can prevent this.
  • If you have stopped breathing, perform a resuscitation immediately.

Antihypertensive drugs

Certain antihypertensive drugs, like heart rhythm drugs, can also be dangerous. In addition, low blood pressure, breathing problems, drowsiness and lower blood sugar can occur. The procedure in the event of an overdose is the same as with cardiac rhythm medication.

Overdose of birth control pills

Birth control pills contain female sex hormones. Excessive intake may lead to nausea, vomiting or loss of appetite, and in young girls it may lead to slight vaginal bleeding. There are no known serious harmful effects from a single overdose. The same applies if children accidentally take a tablet; in these cases, too, no further measures are necessary.

More on the topic: The pill

Overdose of antibiotics

To make it easier for children to take, antibiotics are often prescribed as juices. These liquids should be swallowed using a measuring spoon or a measuring cup. This increases the risk of incorrect or overdosing. Fortunately, most of the time this only leads to gastrointestinal symptoms with diarrhea and abdominal pain. Dietary measures are often enough.