Saturday, December 6, 2014

Which of the following is the most common cause of death from poisoning?

Which of the following is the most common cause of death from poisoning?

A. Acetaminophen
B. Carbon monoxide
C. Chlorine gas
D. Insecticide
E. Tricyclic antidepressants

The answer is B. Most are acute, accidental (unintentional), involve a single agent, occur
in the home, result in minor or no toxicity, and involve children younger than 6 years of
age. Pharmaceuticals are involved in 47% of exposures and 84% of serious or fatal poisonings.
Unintentional exposures can result from the improper use of chemicals at work or
play; label misreading; product mislabeling; mistaken identification of unlabeled chemicals;
uninformed self-medication; and dosing errors by nurses, pharmacists, physicians,
parents, and elderly adults. Excluding the recreational use of ethanol, attempted suicide
(deliberate self-harm) is the most common reported reason for intentional poisoning.
Recreational use of prescribed and over-the-counter drugs for psychotropic or euphoric
effects (abuse) or excessive self-dosing (misuse) are increasingly common and may also
result in unintentional self-poisoning. About 20–25% of exposures require bedside health
professional evaluation, and 5% of all exposures require hospitalization. Poisonings
account for 5–10% of all ambulance transports, emergency department visits, and intensive
care unit admissions. Up to 30% of psychiatric admissions are prompted by attempted
suicide via overdosage. Overall, the mortality rate is low: fewer than 1% of all exposures.
It is much higher (1–2%) in hospitalized patients with intentional (suicidal) overdose,
who account for the majority of serious poisonings. Acetaminophen is the pharmaceutical
agent most often implicated in fatal poisoning. Overall, carbon monoxide is the leading
cause of death from poisoning, but this is not reflected in hospital or poison center statistics
because patients with such poisoning are typically dead when discovered and are
referred directly to medical examiners.

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