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1、AcutetoxicityCapitaluniversityofmedicalscienceXuanwuhospitalEmergencyDepartmentContentsBackgroundGeneralintroductionAcuteOrganophosphatepoisoningAcutecarbonmonoxidepoisoningAcutesedatives-hypnoticspoisoningAlcoholIntoxication/WithdrawalBackgroundThereare
2、about9000000kindsofchemiclaPeoplehavemanyopportunitytotouchwithpoisonBackgroundThereare1751476poisoningpt’sinUSAin1993Poisoncontrolcenter(PCC)isestablishedinChicago1953。Majorduty:componentofpoison;4.informationDangerous5.toxicologyfirstaid6.generalknowle
3、dgeofpreservationBackgroundCountryside>city。Countryside----pesticideintoxication。City---food-poisoning,carbonmonoxidepoisoning,Hypnoticintoxication。EstablishPCCinBeijing,Shanghai,ShenyangWhatispoison?Apoisonisanythingsomeoneeats(ingestion),breathes(inhal
4、ation),getsintheeyes(ocularexposure),orontheskin(dermalexposure),thatcancausesicknessordeathifitgetsintobodyoronthebody.Poisoncanbefoundinfourforms:solid,liquid,sprayandgas.Generalintroductiontoxicsubstance:drug,chemical,badfoodandsoon.Acutepoisoning：sho
5、rttime，largedoseChronicpoisoning：longtime、smalldoseEtiopathogenisisandpathogenesyCauseofapoisoningOccupationalpoisoningLifepoisoningAccidentalpoisoning,SuicidalAbuse，addication,homicdalPathogenesy--AbsorptionBymouth;inhalation（Powderdust、smoke、steam）,ski
6、nmucosa,muscleorintravenousinjectionRectum、urinarycanal、femalesheathvagina、bladder、peritoneum、eyeInsectstingsorbitePathogenesis--metabolismspreadalloverbodybybloodlivermetabolismPoisonousnessPoisonousnessOxidation,deoxidize,hydrolyse,bondingPathogenesis-
7、--Eliminatebreatheoutbyrespiratorytract（gas，volatilematter）DischargebykidneyDischargebyalimentarytractSkinMilk1.Localeffect强酸、强碱吸收组织水分与蛋白质脂肪结合组织细胞变性坏死2.HypoxiaInhibitionrespiratoryfunction：ChangebloodconstituentInhibitioncellsrespiratory：cyanide，hydrogen
8、sulfideDestroyCardiovascularfunction破坏酶蛋白质部分的金属或活性中心——氰化物抑制细胞色素氧化酶Fe++；一氧化碳抑制细胞色素氧化酶Fe+++从而破坏酶蛋白质分子中的金属，使细胞发生窒息毒物与基质竞争同一种酶而产生抑制作用,丙二酸结构与琥珀酸相似，抑制三羟酸循环中琥珀酸脱氢酶3.Inhibitoryenzymeactivity与酶的活性剂作用：——氟化物与Mg++形成复合物，使Mg++失去激活磷酸葡萄糖变
