In the context of biology, poisons are substances that can cause damage, illness, or death to organisms,
usually by chemical reaction or other activity on
the molecular scale, when a sufficient quantity is absorbed by an organism. Paracelsus, the father of toxicology, once wrote: "Everything is poison,
there is poison in everything. Only the dose makes a thing not a poison".
In medicine (particularly veterinary) and in zoology, a
poison is often distinguished from a toxin and a venom. Toxins are
poisons produced via some biological function in nature, and venoms are usually defined as biologic toxins that are injected by a
bite or sting to cause their effect, while other poisons are generally defined as substances which are absorbed through
epithelial linings such as the skin or gut.
Terminology
Some poisons are also toxins, usually referring to naturally produced substances, such as the
bacterial proteins that cause tetanus and botulism. A distinction between the two terms is not always
observed, even among scientists.
Animal toxins that are delivered subcutaneously (e.g. by sting or bite) are also called venom. In normal usage, a poisonous organism is one
that is harmful to consume, but a venomous organism uses poison to defend itself while still alive. A single organism can be both
venomous and poisonous.
The derivative forms "toxic" and "poisonous" are synonymous.
Within chemistry and physics, a poison is a substance that
obstructs or inhibits a reaction, for example by binding to a catalyst. For example, see
nuclear poison.
The phrase "poison" is often used colloquially to describe any harmful substance, particularly corrosive substances, carcinogens, mutagens, teratogens and harmful pollutants, and to exaggerate the dangers of chemicals. The legal definition of "poison" is stricter.
Warning symbols
Poisons have been known to be symbolized by the skull and crossbones, indicating
lethal potential. This is the UN standard symbol, used in the European Union and in the
Globally Harmonized System. However, it can be considered a liability for
marketing. In the United States, other symbols such as Mr. Yuk have been suggested to replace
the skull and crossbones. Proponents of the Mr. Yuk argue that the skull-and-crossbones symbols attracts children because of its
association to pirates, and assert that Mr. Yuk does not. However, the Globally Harmonized System will be enforced also in the United States, including the
skull-and-crossbones symbol.
Chemicals with non-lethal hazards, such as corrosivity, mild toxicity and harmfulness, may be informally referred to as
"poisons", but are not usually marked with the skull-and-crossbones symbol. To contrast, see also the definitions of
corrosive, harmful, environmentally hazardous and irritant. The UN standard
symbol for harmful and irritant substances is a St Andrew's cross on an orange background, which
is being replaced by an exclamation mark (or carcinogen symbol when applicable) in the
Globally Harmonized System. This is applied to materials with non-lethal
hazards as well as to potentially lethal materials.
Uses of poison
Poisons are usually not used for their toxicity, but may be used for their other properties. The property of toxicity itself
has limited applications: mainly for controlling pests and weeds, and for preserving building materials and food stuffs. Where
possible, specific agents which are less poisonous to humans have come to be preferred, but exceptions such as phosphine continue in use.
Throughout human history, intentional application of poison has been used as a method of assassination, murder, suicide and
execution. [1][2] As a method of execution,
poison has been ingested, as the ancient Athenians did (see Socrates), inhaled, as with
carbon monoxide or hydrogen cyanide (see
gas chamber), or injected (see lethal injection).
Many languages describe lethal injection with their corresponding words for "poison shot". Poison was also employed in
gunpowder warfare. For example, the 14th century Chinese text of the Huo Long
Jing written by Jiao Yu outlined the use of a poisonous gunpowder mixture to fill
cast iron grenade bombs.[3]
Poisonous materials are often used for their chemical or physical properties other than being poisonous. The most effective,
easiest, safest, or cheapest option for use in a chemical synthesis may be a
poisonous material. Particularly in experimental laboratory syntheses a specific reactivity is used, despite the toxicity of the
reagent. Chromic acid is an example of such a "simple to use" reagent. Many technical
applications call for some specific physical properties; a toxic substance may possess these properties and therefore be
superior. Reactivity, in particular, is important. Hydrogen fluoride, for example, is
poisonous and extremely corrosive. However, it has a high affinity for silicon, which is
exploited by using HF to etch glass or to manufacture silicon semiconductor chips.
Biological poisoning
Acute poisoning is exposure to a poison on one occasion or during a short period of time. Symptoms develop in close relation
to the exposure. Absorption of a poison is necessary for systemic poisoning. In contrast, substances that destroy tissue but do
not absorb, such as lye, are classified as corrosives rather than
poisons.
Chronic poisoning is long-term repeated or continuous exposure to a poison where symptoms do not occur immediately or after
each exposure. The patient gradually becomes ill, or becomes ill after a long latent period. Chronic poisoning most commonly
occurs following exposure to poisons that bioaccumulate such as mercury and lead.
Contact or absorption of poisons can cause rapid death or impairment. Agents that act on the nervous system can paralyze in seconds or less, and include both biologically derived neurotoxins and so-called nerve gases, which may be synthesized for
warfare or industry.
Inhaled or ingested cyanide as used as method of execution on US gas chambers almost instantly starves the body
of energy by inhibiting the enzymes in mitochondria that make ATP. Intravenous injection of an
unnaturally high concentration of potassium chloride, such as in the execution of
prisoners in parts of the United States, quickly stops the heart by eliminating the
cell potential necessary for muscle
contraction.
Most (but not all) biocides, including pesticides, are created to act as poisons to
target organisms, although acute or less observable chronic poisoning can also occur in
non-target organism, including the humans who apply the biocides and other beneficial organisms. For example, the herbicide 2,4-D imitates the action of a plant hormone, to the effect that the lethal toxicity is
specific to plants. Indeed, 2,4-D is not a poison, but classified as "harmful" (EU).
Many substances regarded as poisons are toxic only indirectly, by toxication. An example
is "wood alcohol" or methanol, which is not poisonous itself, but is chemically converted to
toxic formaldehyde and formic acid in the
liver. Many drug molecules are made toxic in the liver, and
the genetic variability of certain liver enzymes makes the toxicity of many compounds differ
between individuals.
The study of the symptoms, mechanisms, treatment and diagnosis of biological poisoning is known as toxicology.
Exposure to radioactive substances can produce radiation poisoning, an unrelated
phenomenon.
Poisoning management
- Poison Control Centers (In the US reachable at 1-800-222-1222 at all hours)
provide immediate, free, and expert treatment advice and assistance over the telephone in case of suspected exposure to poisons
or toxic substances.
General first aid
- If the poison is an inhalant, remove the patient from the area and to fresh air.
- If the poisoning is affecting the skin, remove the clothing and wash the skin thoroughly unless a dry powder is the cause of
the poisoning.
- If the poison is in the eye, flush the eye thoroughly with water for at least 15 minutes.
- Following ingestion, do not induce vomiting or administer anything without medical advice.
- Contact a poison control center for advice on what to do next.
Initial medical management
Decontamination
- If the toxin was recently ingested, absorption of the substance may be able to be decreased through gastric decontamination.
This may be achieved using activated charcoal, gastric
lavage, whole bowel irrigation, or nasogastric aspiration. Routine use of emetics (syrup of Ipecac) and cathartics are no longer
recommended.
- Activated charcoal is the treatment of choice to prevent absorption of the poison.
It is usually administered when the patient is in the emergency room. However, charcoal is ineffective against metals, Na, K, alcohols, glycols, acids, and alkalis.
- Whole bowel irrigation cleanses the bowel, this is achieved by giving the
patient large amounts of a polyethylene glycol solution. The osmotically balanced
polyethylene glycol solution is not absorbed into the body, having the effect of flushing out the entire gastrointestinal tract. Its major uses are following ingestion of sustained release drugs, toxins
that are not absorbed by activated charcoal (i.e. lithium, iron), and for the removal of ingested packets of drugs (body packing/smuggling).[4]
- Gastric lavage, commonly known as a stomach pump, is the insertion of a tube into the
stomach, followed by administration of water or saline down the tube. The liquid is then removed along with the contents of the
stomach. Lavage has been used for many years as a common treatment for poisoned patients. However, a recent review of the
procedure in poisonings suggests no benefit.[5] It is still
sometimes used if it can be performed within 1 h of ingestion and the exposure is potentially life threatening.
- Nasogastric aspiration involves the placement of a tube via the nose down
into the stomach, the stomach contents are then removed via suction. This procedure is mainly used for liquid ingestions where
activated charcoal is ineffective, i.e. ethylene glycol.
- Emesis (i.e. induced by ipecac) is no longer recommended in poisoning situations.[6]
- Cathartics were postulated to decrease absorption by increasing the expulsion of the
poison from the gastrointestinal tract. There are two types of cathartics used in
poisoned patients; saline cathartics (sodium sulfate, magnesium citrate, magnesium sulfate) and saccharide
cathartics (sorbitol). They do not appear to improve patient outcome and are no longer
recommended.[7]
Antidotes
Some poisons have specific antidotes:
Enhanced excretion
Further treatment
- In the majority of poisonings the mainstay of management is providing supportive care for the patient, i.e. treating the
symptoms rather than the poison.
Types of poisons
The majority of this section is sorted by ICD-10 code, which classifies poisons based upon the
nature of the poison itself. However, it is also possible to classify poisons based upon the effect the poison has (for example,
"Metabolic poisons" such as Antimycin, Malonate, and
2,4-Dinitrophenol act by adversely disrupting the normal metabolism of an organism.)
(T36-T50) Poisoning by drugs, medicaments and
biological substances
(T36.) Poisoning
by systemic antibiotics
(T37.) Poisoning
by other systemic anti-infectives and antiparasitics
(T38.) Poisoning
by hormones and their synthetic substitutes and antagonists,
not elsewhere classified
(T39.) Poisoning
by nonopiod analgesics, antipyretics and antirheumatics
(T40.) Poisoning
by narcotics and psychodysleptics (hallucinogens)
(T41.) Poisoning
by anaesthetics and therapeutic gases
(T42.) Poisoning
by antiepileptic, sedative-hypnotic and antiparkinsonism drugs
(T43.) Poisoning
by psychotropic drugs, not elsewhere classified
(T44.) Poisoning
by drugs primarily affecting the autonomic nervous system Neurotoxins interfere with nervous system functions and often lead to
near-instant paralysis followed by rapid death. They
include most spider and snake venoms, as well as many modern
chemical weapons. One class of toxins of interest to neurochemical researchers are the
various cone snail toxins known as conotoxins.
Anticholinesterases (T44.0)
Acetylcholine antagonists
Cell membrane disrupters Others
- Nicotine - not strictly a neurotoxin, but capable in large doses of causing heart
attack
(T45.) Poisoning
by primarily systemic and haematological agents, not elsewhere
classified