Trends in the therapy of acute poisonings

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Abstract
Attention has been focused on many new and old techniques for preventing and treating poisonings arising from the ingestion of substances against which no specific antidotes are established. Aside from symptomatic and general supportive care, the nonspecific measures of value in clinical toxicology are of two types: those employed to minimize absorption by terminating the toxic exposure and those designed to promote the excretion of poisons already absorbed. In the first category, the induction of emesis, gastric lavage, the ingestion of adsorbents, and the administration of cathartics are recognized. In the second category are techniques for accelerating renal and biliary excretion, as well as extracorporeal hemodialysis, peritoneal dialysis, gastric dialysis, and related procedures. Considerably more information is desirable about each of these measures, how and when it should he used, and what advantages and disadvantages can be anticipated in its adoption. On the basis of recent studies, specific topics of promise for future investigation are suggested. Developments in these areas will probably prove to be more important than new systemic antidotes in terms of improving patient care in clinical toxicology.