Poison and Antidote: Sodium thiosulphate, Activated charcoal, Sodium nitrite

Poison

Any chemical that is detrimental to your body is considered a poison. Besides swallowing, inhaling, and absorbing through the skin, it can also be injected. It is possible to be toxic if you consume too much of something. Any substance that poses a health risk to humans is considered poisonous. It is ingested, breathed, injected, or absorbed via the skin. It's possible that taking too much of anything is poisonous or harmful.

Poisons might be anything including,

• Medicines used in excessively high amounts, whether prescribed or over-the-counter
• Pesticides
• Lead and mercury are two toxic metals.
• Illegal drug overdoses are on the rise.
• Carbon monoxide (CO) is a poisonous gas produced by gas appliances.
• Laundry powder and furniture polish are examples of household items.
• Plants can be used indoors or outdoors.

Antidote

An antidote is a therapeutic agent that counteracts the hazardous effects of a medicine or toxin, according to the International Programme of Chemical Safety. Antidotes are agents that "alter the kinetics of the poisonous chemical or interfere with its impact at receptor sites," according to the definition. This might be due to the poison being prevented from being absorbed, bound, and neutralized immediately, antagonizing its end-organ impact, or inhibiting conversion to more hazardous metabolites.

Sodium thiosulphate

The body's natural cyanide detoxifying capability is strengthened by sodium thiosulfate. It can be used alone to treat mild to moderately severe cyanide poisoning, but it should be combined with additional antidotes such as hydroxocobalamin in situations of severe cyanide poisoning. Even though sodium thiosulfate is an inadequate antidote for acute cyanide poisoning due to weak intracellular penetration, a sluggish start of the effect, a short half-life, and a small distribution volume, it is frequently employed in combination with other rapid-acting antidotes. It is no longer recommended or supported as a single antidote for acute cyanide poisoning.

Its pharmacology - Toxicity of cyanide: It acts as a sulfur donor in the thiocyanate synthesis catalyzed by rhodanese (much less toxic than cyanide)

Extravasation control: neutralizes mechlorethamine's reactive species and decreases the generation of hydroxyl radicals, which cause tissue damage.

In addition, potassium thiosulfate or potassium thirst is an anti-cyanide medicine that is used to treat pityriasis Versicolor, cyanide poisoning, and cisplatin-related side effects. It's commonly used after sodium nitrite for cyanide poisoning, and it's normally only given in extreme cases. It can be given as a venous injection or as a topical treatment to the skin.

Side effects - Vomiting, joint discomfort, mood swings, psychosis, and ringing in the ears are all possible side effects.

Excretion – sodium thiosulphate is generally excreted from urine.

For cyanide poisoning

• Cyanide poisoning is traditionally treated with sodium thiocyanate. After sodium nitrite therapy, sodium thiosulfate is given for severe cases only. It is administered by a venous injection.
• Sodium nitrite causes methemoglobinemia, which eliminates cyanide from mitochondria in this application.
• The enzyme rhodanese catalyzes the conversion of cyanide to the harmless thiocyanate, which uses sodium thiosulfate as a sulfur donor. The thiocyanate is subsequently eliminated harmlessly in the urine.
• The use of sodium thiosulfate in this application is not recommended without the use of additional drugs because sodium thiosulfate may not have a quick enough start of the action.

Activated charcoal

A drug overdose or poisoning can occasionally be treated with activated charcoal. Drugs and poisons can bond to activated charcoal when you ingest it. This aids in the removal of undesirable chemicals from the body. Coal, wood, and other materials are used to make charcoal. Activated charcoal is charcoal that has been subjected to high temperatures along with a gas or activator to increase the surface area. Children are rarely given activated charcoal. It should only be used in conditions of potentially severe poisonings wherein the supportive care and antidote therapy alone would result in a terrible outcome, i.e., when the benefits outweigh the hazards. If numerous doses of activated charcoal are administered, it reduces further absorption from the gastrointestinal system and increases the excretion of certain medicines ('gastrointestinal dialysis').

In the treatment of pediatric poisoning, activated charcoal has a relatively little function. Without consulting a toxicologist, it should not be utilized. Activated charcoal inhalation can result in serious morbidity and fatality. Before using activated charcoal, check the location of the nasogastric tube using a chest X-ray. It is very important to give activated charcoal as soon as possible after exposure, generally within one to two hours.

Sodium nitrite

Sodium nitrite has been used in combination with sodium thiosulfate to treat acute cyanide poisoning that is regarded as life-threatening. When the identification of poisoning is unsure, the possibly serious risks related to nitrite ought to be fastidiously weighed against the potential advantages, particularly if the patient isn't in extremis. Sodium nitrite should be given in conjunction with decontamination and supporting measures. Official recommendations for the management of cyanide toxicity should be considered.

Sodium nitrite is employed as a drug alongside a fixer to treat the toxic condition. it's solely suggested in severe cases of toxic condition. In those that have each toxic condition and monoxide poisoning fixer by itself is typically suggested. Slow injections into veins are given. Side effects will embody low-pressure levels, headache, shortness of breath, loss of consciousness, and regurgitation. bigger care ought to be taken in folks with underlying cardiovascular disease. People's levels of methemoglobin ought to be often checked throughout treatment. whereas not well studied throughout the physiological state, there's some proof of potential hurt to the baby. Nitrite is believed to figure by making methemoglobin that then binds with cyanide and therefore removes it from the mitochondria.