First aid for poisoning with antihistamines, antipsychotics and antidepressants.

Antihistamines (chloropyramine, promethazine, clemastine and others) are used mainly for the treatment of allergic diseases. Many of them affect the central nervous system, both excitatory and inhibitory.. 

Symptoms of antihistamine poisoning.

Disorders of the central nervous system – mental and motor agitation or, conversely, lethargy, drowsiness, muscle hypotension, inhibition of tendon reflexes. And in the first and second case, convulsions, loss of orientation, delirium, hallucinations can occur. Redness and dryness of the skin and mucous membranes, an increase in body temperature develop. Examination of the patient reveals dilated pupils, rapid pulse, increased blood pressure, there may be heart rhythm disturbances. In severe poisoning with antihistamines, a coma develops.

(15-30 g of sodium sulfate). As a drug with the opposite effect, aminostigmine is used (0.01-0.02 mg / kg body weight, used in a 5% glucose solution), which is administered twice with an interval of 15-20 minutes.

Galantamine and proserin are also used. In convulsions, diazepam (0.2-0.5 mg / kg body weight) or sodium oxybutyrate (100-150 mg / kg body weight) is intramuscularly administered. It is mandatory to carry out infusion therapy in the regime of forced diuresis (intravenous administration of glucose-salt solutions in combination with a diuretic – furosemide). In severe poisoning with antihistamines, hemodialysis is indicated (hardware clarification of the blood).

Poisoning with antipsychotics and antidepressants.

Neuroleptic drugs (chlorpromazine, levomepromazine and others) and antidepressants (amitriptyline and others) affect the central nervous system, many of them have a side effect on the cardiovascular system, which is even more pronounced in case of poisoning.

Symptoms of poisoning with antipsychotics and antidepressants.

A feeling of heaviness in the epigastric region, nausea, vomiting in the initial stages of poisoning. Then there is a suppression of the gag reflex. The victim develops indifference to the environment, lethargy, decreased muscle tone, gait disturbances occur. This condition can be replaced by excitement, hypersensitivity to various external stimuli. Gradually, deep sleep develops. Dry skin and mucous membranes are noted..

Moderate poisoning is also characterized by dilated pupils, heart palpitations, decreased urine output and retention. Heart rhythm disturbances may be detected. Intestinal motility is absent. In severe poisoning, a coma develops, breathing is disturbed, a significant decrease in blood pressure is noted. Marked pallor of the skin, cold clammy sweat are observed. Possible tonic or clonic convulsions, cardiac arrest and breathing.

First aid for poisoning with antipsychotics and antidepressants.

Rinse the affected stomach with a probe or artificially induce a vomiting reflex; use a suspension of activated carbon to complete the wash. Then introduce a salt laxative (15-30 g of sodium sulfate) – give a drink or through a tube. Aminostigmine (0.01-0.02 mg / kg body weight, used in a 5% glucose solution) is used as a drug with the opposite effect, which is administered twice with an interval of 15-20 minutes. Riboxin is administered intravenously at the rate of 20 mg / kg body weight twice with an interval of 1 hour.

For seizures, diazepam (0.2-0.5 mg / kg body weight) or sodium oxybutyrate (100-150 mg / kg body weight) are used. With a significant decrease in blood pressure, dopamine is administered (10-15 μg / kg body weight per minute). To accelerate the conversion of an antipsychotic to an inactive form, injections of a solution of vitamin B12 are used, which are administered 2-3 times a day. It is mandatory to carry out infusion therapy with glucose-salt solutions. In severe cases, hemosorption (hardware purification of blood) is indicated.

Based on the book “Quick help in emergency situations”.
Kashin S.P..

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