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Harrison's Principles of Internal Medicine, 18e
| Part 18. Poisoning, Drug Overdose, and Envenomation > |
Chapter e50. Poisoning and Drug Overdosage
Sections: Poisoning and Drug Overdosage: Introduction, Epidemiology, Diagnosis, Specific Toxic Syndromes and Poisonings, Acknowledgment, Further Readings.
Topics Discussed: overdose; poisoning.
Excerpt:"Poisoning refers to the development of dose-related adverse effects following exposure to chemicals, drugs, or other xenobiotics. To paraphrase Paracelsus, the dose makes the poison. In excessive amounts, substances that are usually innocuous, such as oxygen and water, can cause toxicity. Conversely, in small doses, substances commonly regarded as poisons, such as arsenic and cyanide, can be consumed without ill effect. Although most poisons have predictable dose-related effects, individual variability in the response to a given dose may occur because of genetic polymorphism, enzymatic induction or inhibition in the presence of other xenobiotics, or acquired tolerance. Poisoning may be local (e.g., skin, eyes, or lungs) or systemic depending on the route of exposure, the chemical and physical properties of the poison, and its mechanism of action. The severity and reversibility of poisoning also depend on the functional reserve of the individual or target organ, which is influenced by age and preexisting disease...."
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