What to do if you take 2 tablets. Safe dose of paracetamol. Consequences of metamizole sodium poisoning
More than fifty years ago, paracetamol began to be widely used. At first, it was positioned simply as an alternative to aspirin - it lowers the temperature, but does not have an irritating effect on the gastrointestinal tract. Now this drug is an integral part of any home medicine cabinet.
Its main properties are analgesic and antipyretic. Its anti-inflammatory effect is minimal. Therefore, it is taken for symptomatic treatment. Usually used for febrile syndrome caused by an infectious disease, as well as for various pains.
Side effects
In general, if the dose of paracetamol is within the normal range, the drug is slightly toxic. But with prolonged use, side effects develop. Paracetamol has a particularly noticeable effect on the liver and kidneys.
Paracetamol has been used for quite some time. From time to time its safety is called into question and research is carried out. For example, a teacher at the University of Illinois stated that taking paracetamol in children caused a 41% increase in the incidence of asthma. She conducted her research from 1970 to 1990, when America massively switched from aspirin to paracetamol.
The use of paracetamol by pregnant women also has its risks. Analgesics from this series can cause disruption of the development of the genital organs in boys. Therefore, paracetamol is contraindicated in pregnant women in the third trimester and in newborns up to one month old.
Paracetamol dosage by age
Adolescents and adults are usually prescribed paracetamol 500 mg 4 times a day. In this case, the maximum daily dose of paracetamol should not exceed 4 g. Interval between doses: four to six hours.
Pregnant women can use paracetamol with caution, once. Infants up to three months old should not drink it at all.
From 6 to 12 months, the same single dose is 80 mg, but 2 to 3 times a day.
It is necessary to follow certain rules in storing dosage forms. It is not advisable to store blisters without packaging or throw away the instructions before using the tablets. If there are children in the house, medications should be stored in inaccessible places, for example, in the upper sections of closets.
Sometimes, a person, buying a drug in a pharmacy that is sold without a mandatory prescription, considers it practically harmless and abuses its use. The logical result of such actions is drug poisoning. However, poisoning can also occur due to illiteracy of a person who did not bother to read the instructions for the drug. What happens if you take a lot of pills or any other dosage forms?
Drug poisoning is characterized by a number of common symptoms. It is especially important to know the symptoms for parents who carelessly leave first aid kits in accessible places where small children can easily open them. Common symptoms include bouts of nausea, as well as vomiting, diarrhea, abdominal pain and cramps. A person complains of disorientation and dizziness. There is drowsiness, rapid heartbeat, and possible loss of consciousness. In addition, drug poisoning may be accompanied by a lack of response to painful stimuli and light.
Overdosing on medications is extremely dangerous. In the absence of first aid, death cannot be ruled out. Typically, poisoning is diagnosed when taking a 10-fold dose of the drug. However, for young children the dosage threshold is much lower. The most dangerous poisoning is with nootropic drugs, sleeping pills, painkillers, antidepressants, beta blockers, and drugs that affect heart rate and blood pressure.
An overdose of sleeping pills causes deep inhibition of the central nervous system, when sleep gradually turns into unconsciousness. A person's breathing becomes shallow and is often accompanied by wheezing. Drug poisoning can be distinguished by weakness, pale skin, and drowsiness. There is cyanosis of the lips, uneven breathing, and constriction of the pupils. Possible vomiting and loss of consciousness.
Painkillers and antipyretic drugs cause dilation of capillary vessels, excitation and inhibition of the central nervous system, drowsiness, and unconsciousness. With a significant overdose, blood circulation and breathing stop.
The victim urgently needs to perform gastric lavage before profuse vomiting occurs. Mix 2 teaspoons of dry mustard or salt in 3 glasses of water and force the person to drink the solution. Then, you need to give the person activated carbon. Just 10 grams of the drug neutralizes an overdose of sleeping pills or aspirin. It is advisable to first grind the activated carbon to a powder state. If poisoning occurs as a result of taking a sedative, you can give the victim fresh tea, which contains stimulants. When a person is conscious, you should definitely find out what medications he took. This information will significantly help doctors and reduce the time for selecting optimal treatment methods.
To reduce the risk of drug poisoning, you must follow a few simple rules. For example, it is not recommended to take several different medications at the same time, since they may contain the same components. In this case, there is a high probability of overdose. It is strictly forbidden to use drugs with an expired expiration date. Before taking the drug, you must carefully read the instructions and check the prescription prescribed by your doctor. If the dosage recommended by the physician does not correspond to the dosage indicated in the annotation, you should once again consult a specialist.
When prescribing different drugs that need to be taken at the same time, you need to consult with your therapist about their compatibility. If the drugs are incompatible, the doctor will definitely select an analogue.
If you suspect drug poisoning, you must first call an ambulance immediately. Before doctors arrive, you should provide the necessary assistance. Often, a person’s life depends on the actions of the patient’s relatives or friends.
Its high efficiency combined with a low price made it very popular in our country. However, due to serious side effects, extreme caution is recommended when using this medication. Poisoning with analgin can be caused by even a small overdose, which in especially severe cases can be fatal. In most developed countries, the sale of analgin has been prohibited due to its side effects since the 70s of the twentieth century. This drug is used in Russia, but has been excluded from the list of Essential Medicines since 2009.
Side effects of analgin
Analgin has a negative effect on the hematopoietic organs and kidneys. It can also cause allergic reactions, including anaphylactic shock.
The most dangerous is the effect of analgin on the composition of the blood. When taking it, the level of white blood cells - leukocytes, which perform a protective function, neutralizing pathogens that have entered the body, decreases. There is also a decrease in the number of platelets responsible for blood clotting.
A drop in the level of leukocytes leads to a weakening of the immune system, which becomes unable to control the microflora that lives on the mucous membranes. As a result, the mucous membranes of the mouth, gastrointestinal tract, genitals, liver, lungs, and bladder become inflamed and then affected by ulcers and necrosis. Agranulocytosis develops, a dangerous disease that often results in death. It is precisely because of the danger of developing agranulocytosis that the sale of metamizole sodium was banned in the USA, Japan, Australia, and most European countries.
Complications of agranulocytosis can include:
- pneumonia;
- liver damage – toxic hepatitis;
- necrotizing enteropathy is an intestinal lesion in which there is a high risk of intestinal perforation, leading to peritonitis and sepsis.
A decrease in platelet levels - thrombocytopenia - creates a risk of internal bleeding and cerebral hemorrhage.
The negative effect of this drug on the kidneys is manifested by such violations of their functions as the appearance of protein in the urine, a reduction in the amount of urine, up to the complete cessation of its production. Inflammation of the kidneys – nephritis – may develop.
These side effects more often occur with an overdose of analgin, but in cases of individual intolerance, even after a single dose of this medication, drug agranulocytosis may develop, or allergic reactions such as angioedema, bronchospastic syndrome, anaphylactic shock, which in 10-20% of cases ends in death, may occur. outcome.
Causes of intoxication with analgin
Is it possible to get poisoned with analgin? Of course, the consequences of this poisoning can be very severe, even death. The cause of poisoning with analgin is most often its overdose - systematic or one-time, but other factors may also occur:
- individual intolerance;
- overdose of analgin due to its excessive use for prolonged pain;
- simultaneous use with drugs that increase the toxicity of analgin: oral contraceptives, tricyclic antidepressants, allopurinol, cytostatics, thiamazole, other non-steroidal analgesics;
- disorders of the liver and kidneys. In this case, the drug cannot be eliminated from the body in a timely manner, and its concentration increases above the permissible values;
- An overdose of analgin in children can occur when medications are stored in places accessible to children.
Clinical picture of intoxication
In acute poisoning with analgin, the following symptoms are usually observed:
- nausea, vomiting;
- abdominal pain;
- decreased body temperature and blood pressure;
- rapid heartbeat (tachycardia);
- drowsiness;
- dyspnea;
- the appearance of disorders of consciousness, delirium;
- convulsions, difficulty breathing;
- bleeding of mucous membranes;
- decreased urine production;
- there may be signs of liver and kidney failure;
- Symptoms of acute agranulocytosis may appear: sore throat, weakness, fever up to 39-40 ° C, stomatitis, putrid odor from the mouth, laryngeal spasm.
First aid
If symptoms of analgin overdose appear, you should immediately call an ambulance. Before her arrival, the patient needs to induce vomiting, then give him activated carbon in the amount of 1 tablet for every 10 kg of weight. Since one of the possible complications of analgin overdose is necrotizing enteropathy, an enema cannot be given due to the risk of intestinal perforation. To cleanse the intestines, it is recommended to use a saline laxative.
If the patient has lost consciousness, it is necessary to lay him on his side to avoid retraction of the tongue, and try to return him to a conscious state by allowing him to inhale ammonia vapor.
Treatment
Analgin overdose is treated in a hospital. The patient is shown:
- gastric lavage;
- bowel cleansing with saline laxatives;
- taking activated carbon;
- use of forced diuresis;
- in case of impaired renal function - hemodialysis;
- for convulsive syndrome - therapy with anticonvulsants (barbiturates, diazepam).
After the symptoms of acute poisoning are relieved, the patient is examined and additional treatment is prescribed for identified diseases caused by an overdose of analgin.
Prevention
Analgin is one of the most effective painkillers and antipyretics among non-steroidal anti-inflammatory drugs. This drug is easily soluble in water and has rapid absorption, which is a valuable quality when it is necessary to quickly achieve the required concentration of its active substance in the blood.
However, despite all the advantages, taking into account the side effects and consequences of an overdose of analgin, it is better to reduce its use to a minimum, replacing it, if possible, with other, less dangerous drugs.
Permissible doses
Analgin is available in tablets and ampoules and can be administered intramuscularly or intravenously. It is taken orally after meals. Adults are allowed to take 0.25-0.5 g three times a day; for severe pain, the maximum daily dose is no more than 3 g.
Dosage for children – no more than 10 mg/kg three times a day. In infancy, only intramuscular administration is permissible to relieve febrile syndrome.
In the form of injections (intramuscular or intravenous) (for severe pain), the dose for adults is 1-2 ml 2-3 times a day of a solution of 50% or 25% concentration. The total daily dose is no more than 2 g. For children, the norm is calculated based on the proportion of 0.1-0.2 ml of a solution of 50% concentration or 0.2-0.4 ml of a 25% solution per 10 kg of weight.
The lethal dose of analgin, depending on body weight, can be 5-8 g. To find out how many tablets contain a lethal dose, you need to divide this amount by the mass of the active substance in one tablet. After entering the body of analgin in such quantities, preventing death is possible only by providing emergency medical care. It must be remembered that even if the recommended dosage is observed, it is not recommended to take analgin for a long time.
Contraindications
An important condition for preventing poisoning with analgin is strict adherence to contraindications to the use of this medicine. These include:
- individual intolerance, as well as a tendency to allergic reactions, hay fever, atopic bronchial asthma;
- diseases of the hematopoietic system, leukopenia, anemia;
- kidney disease, including a history of it;
- liver/renal failure;
- asthma;
- pregnancy (especially the first 3 and last 1.5 months);
- breast-feeding;
- the first 3 months of a child’s life;
- alcoholism.
Contraindications also include treatment with medications that are poorly compatible with analgin. These include indirect anticoagulants, hormonal contraceptives, tricyclic antidepressants and many other drugs.
Precautionary measures
Individual intolerance to analgin is rare, but such individuals are highly likely to develop anaphylactic shock, especially with intravenous administration, so people prone to allergic reactions are advised to avoid injections of analgin.
When treating with analgin for a long period of time, it is necessary to periodically do a clinical blood test to monitor the level of leukocytes and platelets.
When taking analgin, you should remember the danger of developing agranulocytosis and carefully monitor changes in your health. You should be alert to the appearance of symptoms such as difficulty swallowing and sore throat, a rise in temperature for no apparent reason, the appearance of bleeding and inflammation of the mucous membranes, signs of stomatitis, vaginitis, and proctitis. All of these conditions require evaluation and immediate discontinuation of this drug.
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Consequences of analgin overdose
Analgin, or metamizole sodium, is used as an antipyretic and analgesic agent. It is produced as a single drug under various trade names, as well as as part of complex products. And a consumer who does not have a medical or pharmaceutical education often does not know about this and can increase the daily dose of metamizole sodium, resulting in an overdose of analgin, which will cause death.
Causes of metamizole sodium poisoning
Analgin poisoning is possible in the following cases:
- if you drink a lot of analgin accidentally or deliberately, for example, the tablets can be found and eaten by a child or a mentally ill person, you can confuse the medicine or dosage, take several full or partial analogs of metamizole sodium at the same time, or deliberately take the drug for the purpose of committing suicide or staging it;
- excessive use of an analgesic to relieve chronic pain; analgin poisoning can occur when taken in large doses for more than a week;
- taking the drug for severe pathologies of the liver and kidneys, since the active substance is destroyed when passing the hepatic barrier and is excreted from the body in the urine; in case of diseases of these organs, they do not cope with their function and, as a result, the amount of metamizole sodium in the blood increases;
- simultaneous use with certain medications, so the toxicity of analgin increases if it is taken together with other non-narcotic analgesics, sedatives and tranquilizers, tricyclic antidepressants, hormonal oral contraceptives, allopurinol, radiocontrast agents, plasma-substituting fluids and penicillin antibiotics.
Lethal dose of analgin
Analgin taken in a therapeutic dose can cause the death of the patient. Death can occur as a result of an allergic reaction (especially when the drug is administered intravenously), development of renal and liver dysfunction, and bronchospasm.
The lethal dose of analgin for a person can be 5-20 g. This dosage depends on body weight, concomitant diseases of the liver and urinary system, method of administration of the drug, concurrent use of other medications and other factors.
Analgin is available in dosages of 0.5 g, and for some, 10 tablets can already cause death. It is especially dangerous to drink a pack of analgin for children of preschool or early school age, since they have low body weight and overdose symptoms develop faster.
If you poison yourself with analgin, you can die from infectious complications, which occur atypically and are difficult to respond to therapy. Less commonly, the cause of death of the patient may be acute renal or liver failure, or paralysis of the respiratory muscles. The cause of death may be internal hemorrhages.
Clinical picture of analgin intoxication
Signs of acute and chronic poisoning with metamizole sodium will be different. If an overdose of analgin is observed, then the hematopoietic organs, liver, kidneys and sometimes lungs are primarily affected. When the drug is abused, the level of leukocytes and platelets in the blood drops.
Leukocytes are responsible for the state of the immune system; when their level decreases, pathogenic bacteria begin to multiply, which provokes the development of inflammation of the mucous membranes. On the mucous membranes of the oral cavity, stomatitis, gingivitis, periodontitis, and frequent sore throats can be observed; when it spreads to the digestive organs, ulcerations of the mucous membrane of various gastrointestinal organs develop, starting from the stomach and ending with the lower intestines.
In addition, the bronchopulmonary system may suffer from inflammation.
When platelet levels decrease, increased bleeding is observed; in severe cases, bleeding may occur, including internal bleeding.
The first signs of chronic intoxication will be the formation of long-term, non-healing ulcers in the mouth. Then the respiratory organs may suffer; a person experiences constant inflammation of the mucous membrane of the pharynx, bronchi and trachea, which are difficult to treat.
In the presence of concomitant lung diseases, long-term poisoning with metamizole sodium can provoke bronchospasm, which is characterized by coughing attacks and dyspnea, even in the absence of physical activity.
In case of chronic intoxication, urine analysis will show proteinuria and bacteriuria. If the liver suffers during an overdose, then bilirubinemia is observed in the blood. In this case, the skin and sclera turn yellow, and itchy skin appears.
An acute overdose of analgin may have symptoms:
- dyspeptic disorders (nausea, vomiting);
- stomach pain;
- decreased amount of urine excreted;
- decrease in body temperature and blood pressure;
- cardiopalmus;
- dyspnea;
- noise in ears;
- hypersomnia;
- a sharp decrease in the level of leukocytes and, as a result, weakening of the immune system;
- delirium, disorder of consciousness;
- internal bleeding;
- severe pathologies of the liver and kidneys;
- spasms;
- paralysis of the respiratory muscles.
Providing first aid and treatment methods
It must be remembered that there is no specific antidote for analgin overdose. Treatment is symptomatic. The victim must call an ambulance and be taken to the hospital. Before the arrival of doctors, it is necessary to induce artificial vomiting. To do this, the patient is given clean boiled water to drink and pressed on the root of the tongue.
It must be remembered that vomiting should not be provoked in infants, pregnant women, elderly citizens and unconscious patients.
If a small child is vomiting, to reduce the risk of vomit entering the respiratory tract, he or she should be placed face down on your lap. It is also worth taking adsorbents, for example, smecta, polysorb. You can give the victim a laxative or give an enema.
Under no circumstances should you give antiemetic drugs, such as cerucal. Vomiting helps remove the drug from the body, and when it stops, the level of the active substance in the blood increases and, consequently, its toxicity.
When admitted to the hospital, they may prescribe:
- gastric lavage through a tube;
- siphon enema;
- forced diuresis, the essence of which is to accelerate the excretion of urine from the body, and therefore the drug;
- hemodialysis;
- when a bacterial infection occurs, the latest generation antibiotics or reserve drugs are prescribed;
- if convulsions occur, diazepam or barbiturates are injected into a vein;
- carry out symptomatic therapy.
Consequences of metamizole sodium poisoning
An overdose of analgin can have different consequences, depending on the duration and severity of intoxication, the speed of first aid, the presence of concomitant pathologies, and the age of the victim.
The following consequences may occur:
- death from an overdose of sodium metamizole;
- development of liver and kidney disorders;
- hemorrhages in internal organs with subsequent disruption of their function, the severity of which depends on the severity of the damage;
- due to disturbances in the functioning of the immune system, private infectious diseases.
Features of an overdose of metamizole sodium and first aid for children
The development of drug intoxication in children is most often observed when the dosage is calculated incorrectly. As a rule, acute drug overdoses are observed in pediatrics; cases of chronic poisoning are rare.
Signs of intoxication in children are the same as in adults, but the danger is that they can increase too quickly. The younger the child, the faster spasms appear and loss of consciousness occurs. Therefore, in case of overdose, you need to call an ambulance as quickly as possible.
Before her arrival, if the child did not have time to swallow all the tablets, then take them out of his mouth. Give the adsorbent to drink. It can be activated carbon, neosmectin. In a child over 5 years old, if he is conscious, induce vomiting. Before the doctors arrive, give a child under 5 years old water, giving it in small portions. You can give your baby milk. It will help reduce the rate of adsorption of the drug. It is prohibited to feed a child who is poisoned with metamizole sodium.
Without giving in to panic, pack your things for hospitalization, which you cannot refuse. Any pharmaceutical drug can become poisonous. Knowledge of the clinical picture of intoxication will help to timely notice a threat to health, and possibly life. Timely assistance provided to the victim can prevent the development of severe consequences, and it is also possible to prevent the death of the patient from an overdose of any medication, including those based on metamizole sodium.
To prevent poisoning in a child, medications should be stored in an inaccessible place, or even better, locked up. Explain to older children that medications should not be touched. It is also unacceptable to take medications without a doctor’s prescription. Following these rules will help preserve your health and life.
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Analgin poisoning - symptoms, treatment and consequences of overdose
Analgin (metamizole sodium) is a white crystalline powder with a yellowish tint, belonging to the group of non-steroidal anti-inflammatory drugs. Its action is based on blocking the synthesis of prostaglandins, which attenuates the inflammatory process and reduces the intensity of pain.
The main pharmacological effects of metamizole sodium include:
- anesthesia;
- antipyretic effect;
- anti-inflammatory effect.
Metamizole sodium is the basis of such drugs as Baralgin, Pentalgin, Anapirin. The drug is available in tablet and injection form (ampouled solution with a concentration of 50% or 25%). The injection form is often used to prepare a lytic mixture:
- Analgin 2 ml 50% solution;
- Papaverine 2 ml of 2% solution;
- Diphenhydramine 1 ml 1% solution.
When used correctly, Analgin is an effective and highly effective drug. It is prescribed for elevated body temperature, pain of any origin and location, and inflammatory processes. However, the toxicity of the drug is quite high, so violation of the rules of administration leads to the development of a clinic of acute poisoning.
Mechanism of poisoning and therapeutic dosages
There may be several reasons for an overdose of Analgin. The most common is taking medication in doses significantly higher than therapeutic in cases of:
- Suicide attempts;
- Illiterate attempts at self-medication;
- Repeated repeated use in the absence of effect after taking a therapeutic dosage;
Problems also arise when Analgin is used in combination with other drugs that have a similar effect. You cannot take the drug in combination with drugs such as:
In rare cases, problems arise when taking Analgin in a general therapeutic dosage in case of impaired renal function. This happens:
- Slow elimination of the drug;
- Accumulation of increased doses of metamizole sodium in the body;
- Poisoning with Analgin.
In case of an overdose, Analgin has a neurotoxic effect, which disrupts the functioning of the vestibular apparatus, the mechanism of neuromuscular transmission, and higher nervous functions. It is also possible to disrupt hematopoietic processes, malfunction of the liver, kidneys and other internal organs.
The following dosages of Analgin are considered safe (that is, you can drink it per day) in various dosage forms:
By weight, but no more than 2-3 times a day
In pediatrics, an enema with Analgin solution can also be used. The dose of the medicine is 0.25 g (1/4 tablet).
When prescribing metamizole sodium to elderly patients, as well as people suffering from renal failure, therapeutic dosages are reduced - the doctor decides on this based on a clinical examination and data on the rate of excretion of drugs by the kidneys.
Symptoms of an overdose of Analgin
The consequences of an acute overdose appear in the form of:
- Dizziness;
- General weakness;
- Nausea;
- Vomiting;
- Tinnitus;
- Heaviness in the head;
- Psychomotor agitation;
- Tachycardia;
- Pale skin;
- Hypothermia.
In severe cases, the patient may experience convulsions that involve the respiratory muscles, and the urine becomes pink or red. Cyanosis is noted, the patient plunges into a coma, which can reach 4-5 points on the Glasgow scale.
Long-term use of increased doses of Analgin is also harmful to the body - inhibition of hematopoiesis occurs, which results in agranulocytosis and granulocytopenia. In addition, the drug has a negative effect on the gastrointestinal tract, possibly developing gastritis, stomach and intestinal ulcers, and disrupting the production of hydrochloric acid in the stomach.
Diagnosis of hematopoietic disorders is carried out using a laboratory method. Gastrointestinal pathology manifests itself in the form of:
- Heartburn;
- Pain in the epigastric region;
- Belching;
- Bloating;
- Hunger pain due to ulcers;
- Digestive disorders;
- Signs of gastrointestinal bleeding.
Both the acute form of an overdose of Analgin and long-term chronic intoxication with it can lead to the development of allergic reactions occurring in various forms:
- Urticaria - small rashes accompanied by itching;
- Allergic edema is severe swelling of one or another part of the body, developing due to hypersensitization;
- Anaphylactic shock is the most severe form of an allergic reaction, occurring with a sharp drop in blood pressure, centralization of blood circulation, and impaired cardiac and respiratory activity.
Allergic reactions are not always associated with taking large doses of the drug. If hypersensitivity exists, 1 tablet is enough to develop an allergy.
First aid
An acute overdose of Analgin requires immediate qualified assistance.
- The patient is given water to drink (up to 0.5 liters);
- Induce vomiting by pressing fingers on the root of the tongue;
- The vomit is assessed for the presence of tablets that have not had time to dissolve;
- Repeat the procedure several times;
- Washing can be considered complete after the patient begins to vomit with clean water.
The above-described method of detoxification is unacceptable in case of confused or absent consciousness, psychomotor agitation of the patient, or impaired swallowing. If there is no consciousness, the victim is placed on his side and left in this position until paramedics arrive.
Medical care provided by the emergency medical team consists of gastric lavage with a thick gastric tube, administration of enterosorbents at the rate of 1 tablet of crushed activated carbon per 10 kg of body weight. There is often a need to prescribe Relanium (convulsive syndrome), drugs that increase blood pressure (hypotension), and antiemetics (incessant vomiting). Further, urgent hospitalization in the intensive care unit is required.
Continuous vomiting usually occurs if the patient took analgin and alcohol at the same time. This phenomenon often becomes life-saving for the patient, since alcohol, provoking vomiting, helps remove the pills from the stomach even before the ambulance arrives. The clinic of severe poisoning does not develop.
Treatment
The main principle of treatment of acute poisoning is the rapid removal of the xenobiotic from the patient’s body. In modern clinical practice, the following types of detoxification are most actively used.
Forced diuresis
The patient is given a large amount, up to 4-5 liters, of saline solutions and plasma substitutes, which increases the volume of circulating blood. After this, a loop diuretic (furosemide) is injected into the vein. The toxic substance is actively excreted by the kidneys, which requires strict control of diuresis and regular testing of hematocrit, acid-base balance, and electrolytes.
Stool stimulation
Almost any dangerous toxicant, after absorption, is re-released into the intestinal lumen. This makes the method of active detoxification by stool stimulation relevant. Castor oil (up to 400 ml per dose), magnesium sulfate solution 25% (take one ml at a time), and intestinal lavage are used as a laxative. The latter is the introduction into the stomach of a large amount (up to 8-10 liters per procedure) of saline enteral solution, which fully flushes the intestines and “pulls” fluid from the internal environments of the body.
Antidote therapy
There is no specific antidote to analgin. As an antidote, a universal adsorbent is used - activated carbon in a dose of up to 1 kg for the entire course of treatment. For methemoglobinemia, 400 ml of sodium hypochlorite is administered intravenously.
Hemodialysis
The severe consequences of metamizole sodium poisoning require hemodialysis, a procedure based on filtering blood through a semi-permeable membrane. In this case, a double-lumen venous catheter is installed in the patient's femoral vein. Blood is taken through one outlet and returned through the second. In parallel with the procedure, the patient is given a massive infusion of saline solutions (Accusol, Duosol).
Resuscitation aid
The harm of Analgin is often so great that the patient requires resuscitation measures. Indications for transferring a patient to intensive care are:
- Lack of consciousness and coma;
- Convulsive syndrome;
- Urinary disturbances up to anuria;
- Signs of disruption of blood formation processes;
- Severe psychosomatic disorders;
- Allergy to Analgin, some symptoms of which can be life-threatening.
Patients in serious condition are intubated and put on artificial respiration, on which they can remain for a long time. An indwelling urinary catheter is installed to monitor diuresis, and the patient is connected to a monitor that displays basic vital signs.
Forecasts
In the absence of qualified medical care, an acute overdose of Analgin in most cases ends in death. Timely and competent detoxification can save the patient’s life, but it is not always possible to prevent the delayed consequences of intoxication. They may appear several years after the patient is discharged.
A dose of more than 5 grams of metamizole sodium taken at one time is considered lethal. In this case, resuscitation aid is often ineffective and the patient dies. The exception is patients with high body weight - in this case the lethal dose increases.
When used correctly, metamizole sodium causes virtually no harm to the body. However, if errors are made in calculating the dose and number of doses, Analgin can cause irreparable harm to human health.
Symptoms of analgin overdose and first aid for poisoning
Analgin or metamizole sodium is a classic analgesic with pronounced antipyretic properties, actively used to this day mainly in the CIS countries and the Russian Federation.
The non-steroidal anti-inflammatory drug non-selectively blocks cyclooxygenase and reduces the production of prostaglandins; in addition, it is low cost and is available in free pharmacies.
Excessive use of analgin can cause a number of problems, pathologies and acute conditions. Let's look at what happens if you take a lot of analgin (painkiller) tablets and how to determine an overdose.
How does analgin affect the body?
As mentioned above, metamizole sodium systemically blocks COX, and also slows down the production of arachidonic acid and prostaglandins, at the same time preventing the conduction of pain impulses and increasing heat transfer.
Analgin practically does not irritate the mucous membrane of the gastrointestinal tract, has little effect on water and salt metabolism, but at the same time, in addition to analgesic and antipyretic, it also has an antispasmodic effect of moderate intensity, mainly on the biliary and urinary tract. The therapeutic effect begins to appear 30 minutes after oral administration of the drug and reaches its absolute maximum after 4 hours, after which it is excreted by the kidneys, having previously been metabolized in the liver.
Symptoms of analgin overdose
Let's consider what will happen if you take a lot of analgin (pain reliever) tablets. An overdose of analgin can be either acute (develops 3-5 hours after administration) or delayed chronic (negative manifestations develop after 3 days).
Primary manifestations include:
- Nausea and vomiting;
- Dizziness, tinnitus and confusion;
- General weakness of the whole body;
- Tachycardia, sometimes bradycardia;
- Paleness of the skin;
- Psychomotor agitation;
- Hypothermia.
In severe forms of overdose of metamizole sodium, there is a change in the color of the urine (bloody discharge appears in it), systemic convulsions, including the respiratory muscles, cyanosis, and in some cases, coma.
The chronic type of overdose is characterized by a smooth increase in negative symptoms with multiple disturbances in the gastrointestinal tract (heartburn, bloating, pain, digestive problems, gastrointestinal bleeding), failure of hematopoietic processes (granulocytopenia and agranulocytosis), allergic reactions (edema, urticaria, anaphylactic shock), kidney or liver failure.
First aid for adults and children
In case of an overdose of analgin, the victim should be provided with comprehensive pre-medical care. Classic activities for adults and children include:
- Induce vomiting immediately. This is carried out if no more than a minute has passed since consuming the drug. The best option is to drink 1-2 liters of liquid and apply pressure to the root of the tongue to induce the reflex;
- Use of sorbents. After the maximum possible emptying of the stomach, it is necessary to use direct sorbents (for example, activated carbon) per gram of the substance once (for children, the dosage is reduced by 2 times) and 10 grams every 4-5 hours for 1 day;
- Call an ambulance. If acute poisoning with analgin is suspected, before all measures it is necessary to promptly call a medical team to your home;
- Enema. As an addition to the main measures, after 2-3 hours after an overdose and in the absence of emergency medical help, you can use a salt enema (1 teaspoon of salt per 1 liter of boiled water at room temperature) to remove toxins formed in the intestines;
- Monitoring the patient's condition. The victim is placed on his side (to reduce the likelihood of suffocation or choking on vomit) and is under observation until the medical team arrives. In case of loss of consciousness, cotton wool with ammonia is used. If there is no breathing or heartbeat, basic resuscitation measures (chest compressions and artificial respiration) are carried out.
Restoring the body after an overdose
After first aid has been provided and a medical team has arrived, in the case of acute analgin poisoning, a decision may be made to hospitalize the victim in a hospital. Doctors at the intensive care unit perform the following treatment and recovery procedures:
- Systemic gastric lavage. This is carried out if less than 4-6 hours have passed after taking the drug. Repeat several times if necessary;
- Connect to condition monitoring tools. In the event of a severe overdose, the victim requires constant monitoring of vital signs;
- Diuresis. Forcing urination allows you to quickly remove metamizole sodium metabolic products from the body in general and the kidneys in particular;
- Hemodialysis. Aimed at removing toxic breakdown products of analgin from the bloodstream using an extrarenal method;
- Drugs. Medications that support the basic functions of the body can be used - anticonvulsants (Relanium), “fast” barbiturates, antihypotonics, antiemetics, and so on. As a supplement, laxatives that activate the elimination of toxins through bowel movements;
- Additional therapy. It is used at a late stage of treatment - hepatoprotectors, antibiotics (for the manifestation of secondary bacterial infections), glucocorticosteroids (neutralization of too strong an inflammatory process), antihistamines (combat allergic manifestations), probiotics and prebiotics (restoration of gastrointestinal microflora), droppers with saline and glucose are used, as well as physical therapy.
Consequences of analgin overdose and complications
An overdose of analgin tablets can cause a number of both acute and chronic complications, as well as long-term consequences for the body, requiring additional complex therapy and recovery. Possible consequences:
- Urinary system. Diagnosed are oliguria, anuria, interstitial type nephritis, as well as impaired functioning of the kidneys and liver, up to their complete failure in the stage of decompensation;
- Allergic and autoimmune reactions. The most common manifestations are urticaria and angioedema. Less commonly - Lyell's syndrome, exudative erythrema of the malignant type, bronchospastic syndrome and anaphylactic shock;
- The cardiovascular system. Persistent decrease in blood pressure, thrombocytopenia, leukopenia, agranulocytosis, hemorrhages in the heart and other organs (brain, intestines, kidneys, etc.);
- Chronic infectious lesions of the secondary type;
- Fatal outcome after an overdose of analgin;
- Other obvious and implicit complications caused by systemic intoxication, disruption of basic functions in the acute period (for example, breathing) and malfunction of metabolic processes.
Analgin dosage for adults and children
Let's consider how many analgin tablets you can take at a time. Classic recommended dosages of the drug depending on the age group:
- From 10 to 14 years with a weight of one kilogram. A single dose of 500 milligrams of metamizole sodium (or 1 tablet). Daily dose – up to 2 thousand milligrams of analgin (or 4 tablets);
- From 15 years and older with a body weight over 53 kilograms. A single dose is from 500 to 1 thousand milligrams (1-2 tablets). Daily dose – up to 4 thousand milligrams (8 tablets);
- Over 60 years old. The dosage for adults is reduced by 2 times.
Is it possible to die from analgin? The lethal dose of analgin in tablets varies widely and depends on the characteristics of a person’s metabolism, the presence of a number of diseases, the current state of organs (in particular the kidneys and liver), the presence of concurrent use of other medications, the method of administration of the drug and other factors.
As modern medical practice shows, a high probability of death in the absence of prompt, correct first aid and complex intensive care in a hospital setting occurs with a single use of 5-20 grams of metamizole sodium.
Is it possible to take expired analgin?
Generally accepted medical standards prohibit the use of any medications after their expiration date - they must be disposed of in the prescribed manner. Considering the low cost of the medicine, it is better to throw away tablets or ampoules that have expired, replacing them with new ones purchased from an official pharmacy chain.
However, in some cases (for example, the need to introduce the drug into the body as urgently as possible or a person is in a hard-to-reach place without the opportunity to purchase the drug), the use of expired analgin may be justified.
As clinical practice shows, with careful observance of storage conditions (dark place, completely isolated and sealed packaging, correct storage temperature), metamizole sodium, after the expiration of the period of use recommended by GOSTs, retains its therapeutic properties for another 6-8 years. Moreover, during the process of oxidation and destruction of the substance during very long storage, no obvious toxic compounds are formed.
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Health
Despite repeated warnings about the dangers of energy drinks, many continue to drink them, especially young and middle-aged people.
Millions of students and workaholics around the world consume energy drinks or caffeine mixed with an alcoholic drink every day to increase their performance.
But what actually happens to our body when we drink such a drink?
Here is a step-by-step guide explaining the changes in our body, starting from the first 10 minutes and ending with 12 days after drinking just one can of this drink.
It is worth noting that studies have proven that energy drinks, as well as alcoholic drinks, have the same effect on the adolescent brain as the most powerful drugs.
The harm of energy drinks
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The first 10 minutes after drinking one can of energy drink
Caffeine begins to penetrate the blood.
Heart rate and blood pressure begin to increase.
In 15-45 minutes
If you drink the drink quickly, after 15 minutes you will feel more alert and more concentrated. But if you drink the drink slowly, this effect will occur in about 40 minutes.
In 30-50 minutes
Caffeine absorption is complete. Your pupils dilate, your blood pressure rises, and as a result, your liver releases large amounts of sugar into your blood. The adenosine receptors in your brain are now blocked and you no longer feel sleepy.
Blood sugar levels spike, causing a spike in insulin. The liver responds to this by converting sugar into fat.
After 1 hour
Your body begins to feel a sudden drop in blood sugar (hypoglycemia). You quickly run out of energy and you begin to feel very tired.
An hour after drinking the drink, you will want to go to the toilet, and you will get rid of the water that was in the drink. This water was enriched with valuable nutrients, but instead of using them for their intended purpose, these substances came out along with the water.
Impact of Energy Drinks
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In 5-6 hours
During this time, the amount of caffeine in the body decreased by half. For women taking birth control pills, this period can be up to 10 hours.
In 12 hours
During this time, the human body completely gets rid of caffeine in the blood. Still, the speed of caffeine cleansing depends on many factors, from age to physical activity.
After 12-24 hours
Withdrawal begins. About a day after drinking the energy drink, an unpleasant surprise awaits you. If a person often drinks such a drink, then during this period he begins to feel lethargic, exhausted, headaches and constipation appear.
In 7-12 days
Studies have shown that by this time the body becomes more resistant to regular consumption of a certain dose of caffeine. This means that you will no longer experience the same unpleasant feelings to the same extent.
Read also:
Non-alcoholic energy drinks
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Today, anyone can buy a sweet non-alcoholic energy drink, even a schoolchild. While teenagers and older people continue to drink energy drinks and end up in the hospital, advertising continues to talk about how this or that drink invigorates and inspires.
Doctors in many countries, including Russia, have long been warning about the dangers of such drinks, that energy drinks cause problems with the cardiovascular system, potency, can cause insomnia and quickly deplete the body’s energy reserves.
Well, if you mix such a drink with alcohol, the situation gets even worse. This mixture can cause heart rhythm disturbances, seizures, and even kidney failure. It is worth noting that deaths have been repeatedly recorded after consuming energy drinks with alcohol.
Relative benefits of energy drinks
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1. For a short period of time, a person receives a boost of vigor and energy.
2. It is possible to choose a drink with a high concentration of caffeine or with a large amount of vitamins and carbohydrates. The former help cope with drowsiness, and the latter increase the level of endurance during physical activity.
3. The vitamins in such drinks can stimulate vital processes in the human body, and glucose can quickly enter the bloodstream and provide energy to the muscles and brain.
4. Thanks to its convenient packaging, energy drinks can be taken with you anywhere and consumed almost anywhere. For some, they can replace a cup of coffee.
5. Most 8-ounce cans of the energy drink contain 80 milligrams of caffeine, which is less than the 400 milligram limit recommended by doctors. Coffee may contain more caffeine than an energy drink (about 300 milligrams on average).
Why are energy drinks harmful?
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1. Drinking more than 2 cans of energy drink per day can significantly increase your blood pressure and may also increase your blood sugar levels. The result is hypertension and diabetes.
2. Since deaths after consuming energy drinks have been officially recorded in Europe, in some countries they can only be purchased in pharmacies.
3. The vitamins contained in energy drinks do not form a balanced complex.
4. If a person suffers from a disease of the heart, blood vessels, nervous system, pancreas or liver, then consuming energy drinks will only worsen the situation. The same applies to those who are predisposed to the above diseases.
5. The energy drink itself does not provide energy, but opens the channels of the body where internal resources are contained. As a result of using energy reserves, the body is depleted, a person may experience nervous overexcitation, and with frequent use, fatigue increases, insomnia, irritability appear, a person is more prone to nervous breakdowns and depression.
6. With regular consumption of energy drinks, the body gets used to caffeine and over time asks for a larger dose, and a large dose of caffeine depletes the body and encourages frequent urination, and this in turn removes salts from the body (in a fairly large volume).
7. A large concentration of B vitamins can lead to disruption of the nervous system, increase heart rate, lead to tremors in the limbs and greatly weaken the body.
8. The dose of amino acids taurine and glucuronolactone in one can of energy drink exceeds the daily norm by 500 times. And if you consider that they are consumed together with caffeine, then such a mixture can lead to severe exhaustion of the human nervous system.
9. Caffeine and other ingredients in energy drinks irritate the stomach lining, which means your risk of developing stomach ulcers and gastritis increases.
10. Energy drinks are high in sugar, which means high in calories. Caffeine, as a stimulant, can cause anxiety, nausea, dehydration and increased heart rate.
11. Between 2007 and 2014, in the US alone, the number of people hospitalized due to energy drink use doubled. These data were shared by the Substance Abuse and Mental Health Services Administration (SAMHSA), which is part of the US Department of Health and Human Services.
Composition of energy drinks
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There are also extracts of guarana, tea or mate, which also contain caffeine.
Sometimes the manufacturer calls caffeine differently: mateine or theine, but in fact it is the same caffeine.
Other stimulants, such as theobromine and theophylline, which are homologues of the same caffeine.
* Carnitine.
This component promotes the rapid oxidation of fatty acids. This means that it enhances the overall metabolism in our body. As a result, a person’s level of muscle fatigue decreases.
* Taurine.
Some believe that this component of energy drinks, as it accumulates in muscle tissue, leads to improved muscle (and heart) function. However, medical experts claim that taurine has absolutely no effect on muscles. Despite this, in one can of energy drink its volume can range from 400 to 1000 mg. This begs the question: why is it needed then?
* There are also vitamins (in particular B vitamins), such as carbohydrates (glucose, sucrose).
It is worth noting that the body needs B vitamins, and if you are deficient in them, your body will tell you about it. But an excess of these vitamins (which an energy drink can provide) can hardly be considered beneficial for a person.
