Everything about Drug Toxicity

When we say “drug toxicity,” we mean the side effects that take place when a medicine is utilized to harm the organism. These reactions range from insignificant to severe, and in some situations, even fatal. Toxicity can arise from several factors, such as incorrect dosage, long-term use, interactions with other substances, or individual sensitivity. Below, we discuss this condition and its treatment in more detail.

What is Drug Toxicity?

Toxicity is the level of poisonousness or harm caused by a compound. In pharmacology, drug toxicity occurs when excessive amounts of a prescription drug or an over-the-counter (OTC) medications build up in the blood, leading to harmful outcomes.

The formal definition describes drug toxicity as a wide range of side effects. They may appear even when a medicine is taken at therapeutic portions, though they can also result from non-therapeutic use.

Many people confuse drug toxicity and overdose. The distinction is that toxicity, as a rule, develops after some time. Simultaneously, an overdose arises when too much of an active ingredient is taken. Drug toxicity often occurs accidentally. An overdose may be both intentional or accidental.

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How Does It Occur?

Drug toxicity takes place when too much of a medication is consumed at once. It means taking a dosage that exceeds the doctor’s prescription. When taking some pills, patients can experience an adverse drug reaction (ADR). In this situation, even when taking a normal amount of medication, undesirable side effects may occur.

Take lithium as an example. The distinction between proper dosage and lithium toxicity is minimal. A dosage that benefits one patient may harm another. Additionally, compounds with a significant half-life accumulate in the bloodstream, resulting in elevated levels within the organism.

Please note that a drug’s half-life is the period required for the concentration of its active substance in the body to decrease by half. The interval depends on the body’s potential to process and eliminate the compound. It ranges from several hours to a couple of weeks. The speed of drug elimination also depends on criteria such as age, hydration level, and kidney condition.

Key Signs of Drug Toxicity

Symptoms of intoxication vary depending on the substance. Let’s look at the key signs of such poisoning.

• Changes in mental state, including confusion, drowsiness, agitation, or fainting.
• Breathing problems, including shallow, slow, or irregular breathing. The person may also make gurgling sounds or stop breathing entirely.
• Changes in vital signs, such as a high or low pulse, or dangerous drops in blood pressure.
• Gastrointestinal problems, including nausea, vomiting, and diarrhea.
• Neurological signs, such as tremors, seizures, and slurred speech.
• Pupil changes. They may become very small or very dilated.
• Skin and temperature changes. The skin might be clammy, sweaty, and cold, and the body temperature may be elevated or very low.

Let’s examine the key symptoms associated with different drug categories.

• Painkillers. Initial symptoms may be mild, e.g., nausea and vomiting. However, such poisoning leads to liver dysfunction.
• Cardiovascular drugs. Incorrect dosage may lead to an excessively low pulse and low blood pressure (hypotension).
• Antidepressants. The most common toxicity leads to serotonin syndrome. It causes agitation, confusion, high pulse, sweating, and tremors.
• Sedatives/hypnotics. Excessive concentration can lead to extreme drowsiness, slurred speech, and slow breathing.
• Opioids. Such intoxication may result in constricted pupils, loss of consciousness, and slow or stopped breathing.
• Antibiotics. The toxic effect of drugs has many negative consequences, including hearing loss or kidney failure.

If you or your loved ones experience any of the above symptoms, you should seek immediate medical attention to start detox.

Basic Methods of Diagnosing Drug Toxicity

Health care professionals diagnose medication toxicity. Acute intoxication is simple to diagnose because signs appear after a single dosage. Below, we will describe the main types of diagnosis.

Clinical examination and anamnesis include the following steps.

• Symptom assessment. Health care professionals monitor the patient’s health to identify the class of substances. For example, opioid poisoning often causes constriction of the pupils, slow breathing, and a lack of response to external stimuli.
• Physical examination. During the examination, doctors will assess the patient’s primary symptoms, including temperature, blood pressure, and pulse. They will also take into account other signs, including skin color and neurological features.
• Anamnesis. The doctor asks patients or their relatives/friends about what medicines, when, and in what dosage they took. It is also essential to clarify any concomitant diseases and allergic reactions.

Another type of diagnosis is laboratory tests. If toxicity is suspected, laboratory tests are performed to confirm the diagnosis and identify the specific medication.

• Blood test. It allows specialists to accurately identify the concentration of the drug in the body at the time of the test. It will enable them to understand the severity of the poisoning and develop a further algorithm of actions.
• Urine test. It is a popular method to detect toxic drugs. It is a non-invasive procedure that allows specialists to identify the presence of drugs or their metabolites for a longer period than with a blood test.
• Other tests. The doctor may order other tests, including liver and kidney function tests or electrocardiograms.

After collecting the toxicology information, a final diagnosis will be made. A positive screening result does not mean intoxication. The data must be interpreted taking into account the symptoms, the substance’s content in the organism, and other relevant parameters.

Treatment of Drug Toxicity

Treatment of poisoning aims to achieve several goals, including improving the patient’s well-being and reducing the amount of chemicals in the body. You should probably be prepared for residential treatment or to be taken to the emergency room.

A key part of treatment is supportive care. It involves relieving the patient’s symptoms and maintaining basic bodily functions.

• Airway, Breathing, and Circulation (ABC). Healthcare specialists must ensure that patients have an open airway and are breathing normally. This may involve the use of supplemental oxygen or a ventilator. It is also crucial to normalize blood pressure and pulse with intravenous fluids or medications.
• Monitoring. Doctors monitor the patient’s vital signs and mental health disorders.

If the drugs were taken orally, decontamination can reduce the dosage of the compounds the organism absorbs. It is recommended to perform this set of measures as soon as possible after taking the medication.

• Activated charcoal. This is a crushed black powder that is taken orally. It binds to drug molecules in the stomach and intestines, limiting their absorption into the bloodstream. It’s not effective for some substances, such as alcohol or certain metals.
• Gastric lavage. It involves inserting a tube into the stomach to flush out unabsorbed contents. This procedure is used less frequently than activated charcoal, and it is typically reserved for more severe situations.

For some poisonings, some antidotes can reverse the effect of the poison. Below, we will examine several well-known examples.

• Naloxone. This is a chemical compound used to stop the ingestion of opioids. The compound instantly blocks their action, normalizes breathing, and restores consciousness.
• N-N-acetyl cysteine (NAC). It is an antidote for paracetamol. It helps prevent or reduce the negative impact on the liver.
• Flumazenil. This substance is utilized to eliminate the sedative effect in case of benzodiazepine overdose. Flumazenil has many side effects, so it should be used with caution.

In severe situations, when the drug is absorbed into the organism, doctors use methods that ensure its rapid elimination. Thus, hemodialysis is particularly relevant for small volumes of medications, such as lithium and salicylates. The patient’s blood is passed through a special device that filters out the compounds and waste products. This resembles the work of an artificial kidney.

Major Factors in Toxicity

Some factors increase the probability of toxicity and drug overdose. Let’s examine the primary scenarios.

• Incorrect storage of compounds. Children can be harmed by taking too many pills if they are stored incorrectly.
• Ignorance or failure to follow the instructions. Taking more than the recommended dosage or consuming pills more frequently can cause toxicity.
• Tendency to substance abuse and dependence. Intentional abuse of medications or use of illegal substances increases the risk of toxicity or overdose. Risks also increase with a toxic combination, or mixing pills with strong liquors or addictive substances.
• Mental illnesses. Chronic depression and suicidal thoughts can be risk factors for overdosing on pills, especially if the person is not on treatment.

It is critical to track these factors to prevent organ damage and other adverse consequences.

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How to Reduce Risks

Here are some basic tips to help you prevent drug toxicity.

• Follow safety precautions when consuming medications. Always read the instructions for the pills carefully. Take the drug only as directed by your doctor. All substances must be stored in their original box.
• You should store medications, strong liquors, and poisons in a place where children cannot reach.
• Always take your medications as prescribed.
• Be careful when taking various substances simultaneously (including wine or beer). They can react with each other and increase the risk of intoxication.
• Consult your physician if there are any interactions you should know about.
• Contact your medical specialist as soon as possible if you note any signs of toxicity.

It is also essential to understand your aggravating circumstances. Older people are often at greater risk of drug toxicity. They have a slow metabolism and tend to take more pills.

As we can see, drug toxicity is a multifaceted topic that raises many questions in the medical field. It is essential to understand the mechanisms of action and threats to ensure accurate pharmaceutical intervention. Constant monitoring, accurate reporting, and preventive measures enable healthcare professionals to minimize the risks of drug toxicity and enhance patient safety.

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