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Poisoning: general information
Medical expert of the article
Last reviewed: 04.07.2025
Accidental poisonings and intentional self-inflicted (deliberate) poisonings are a common cause of emergency department visits and some deaths.
General information about poisoning
Poisoning is contact with substances that have a toxic effect. Symptoms vary, but some characteristic syndromes may indicate the type of toxic agent. Diagnosis is primarily based on clinical data, but in some poisonings, urine and blood tests may be important. Treatment for most poisonings is symptomatic, with specific antidotes needed only in a few cases.
Prevention of poisoning includes clearly labeling medicine packages and storing poisons out of the reach of children.
Most poisonings are dose-dependent. Poisoning may result from exposure to excessive amounts of a substance that is normally nontoxic. Some substances are toxic in any amount. Poisoning differs from hypersensitivity and idiosyncrasy, which are unpredictable and independent of dose, and from intolerance (a toxic reaction to a normally nontoxic dose of a substance).
Poisoning usually occurs through ingestion, but can also occur through injection, inhalation, or contact with body surfaces (skin, eyes, mucous membranes).
Most commonly ingested non-food substances are non-toxic, but almost any substance can be toxic if taken in excess. Accidental poisoning is common in young children who are inquisitive and swallow objects indiscriminately despite a toxic taste or smell; usually, a single substance is ingested. Poisoning is also common in older children, adolescents, and adults who attempt suicide; in this case, poisoning may involve more than one toxic substance (alcohol, paracetamol, other over-the-counter drugs). Accidental poisoning may occur in the elderly due to forgetfulness, poor eyesight, mental disorders, or prescription of the same medication by different doctors.
Poisoning with the purpose of killing or incapacitating (for example, during robbery or rape) is possible. Medicines used for temporary incapacitation usually have a sedative and amnestic effect (scopolamine, benzodiazepines, hydroxybutyrate derivatives).
Substances that are generally harmless if swallowed
- Astringents
- Barium sulfate
- Floating Bath Toys
- School chalk (calcium carbonate)
- Candles (insecticide/repellent candles can be toxic)
- Carbowax (polyethylene glycol)
- Carboxymethylcellulose (a dehydrating agent used in packaging of medicines, films, etc.)
- Castor oil
- Cetyl alcohol
- Contraceptives
- Pencils (children's, marked A.P., S.R. or CS 130-46)
- Dichloral (herbicide)
- Dry batteries (alkaline)
- Glycerol
- Glyceryl monostearate
- Graphite
- Resins (gum arabic, agar)
- Ink (one pen's worth)
- Iodine salts
- Kaolin
- Lanolin
- Linoleic acid
- Flaxseed oil (non-boiling)
- Lipstick
- Magnesium silicate (antacid)
- Matches
- Methylcellulose
- Mineral oil (if not aspirated)
- Clay and other materials for modeling
- Paraffin, chlorinated
- Pencil lead (graphite)
- Pepper, black (except for massive inhalation)
- Vaseline oil
- Polyethylene glycol
- Polyethylene glycol stearate
- Polysorbitol
- Putty
- Shaving cream
- Quartz (silicon dioxide)
- Spermaceti
- Stearic acid
- Sweeteners
- Talc (except in cases of inhalation)
- Wheel grease
- Liquid from a thermometer (including liquid mercury)
- Titanium oxide
- Triacetin (glyceryl triacetate)
- Children's multivitamins, with or without iron
- Multivitamins without iron
*This is a guideline; the substances listed may combine with phenol, gasoline, or other toxic substances. A poison control center can provide information. Almost all substances can become toxic in certain quantities.
There are cases of poisoning of children by parents with some knowledge of medicine, for unclear psychological reasons, or in order to obtain medical assistance (see Munchausen syndrome).
Most poisons are metabolized, pass through the gastrointestinal tract, or are excreted by the kidneys. In some cases, tablets (acetylsalicylic acid, iron, capsules with a protected shell) form large accumulations (bezoars) in the gastrointestinal tract, get stuck and continue to be absorbed, increasing the poisoning.
Symptoms of poisoning
Symptoms of poisoning depend on the toxic substance. In addition, different patients poisoned by the same agent may have very different symptoms. However, 6 groups of symptoms (toxic syndromes) are considered characteristic and can indicate the class of a specific poison. Patients who have taken several substances are unlikely to develop symptoms characteristic of individual agents.
Where does it hurt?
What's bothering you?
Diagnosis of poisoning
The first stage of diagnosis is an assessment of the patient's general condition. Severe poisoning may require emergency measures to treat acute cardiovascular failure (collapse).
The fact of poisoning may be known on admission. In patients with difficult to explain symptoms, especially with changes in consciousness, poisoning should be suspected. Deliberate self-poisoning in adults suggests the possibility of using several toxic substances. Anamnesis sometimes plays a major role.
[ What do need to examine?
What tests are needed?
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Treatment of poisoning
Patients with severe poisoning may require mechanical ventilation and/or treatment for cardiovascular collapse. If consciousness is impaired, constant monitoring and restraint may be required.
Treatment for poisoning by various substances is presented in tables. In all but the mildest cases, consultation with the Poison Control Center is indicated.
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