For clinical purposes, toxic agents can be divided into two classes: those for which a specific treatment or antidote exists and those for which there is no specific treatment. For the vast majority of drugs and other chemicals, there is no specific treatment; symptomatic medical care that supports vital functions is the only strategy.
Supportive therapy is the mainstay of the treatment of drug poisoning. The adage, "Treat the patient, not the poison," remains the most basic and important principle of clinical toxicology. Maintenance of respiration and circulation takes precedence. Serial measurement and charting of vital signs and important reflexes help to judge the progress of intoxication, response to therapy, and need for additional treatment. This monitoring usually requires hospitalization. The classification in Table 64-3 helps to define the severity of CNS intoxication. Treatment with large doses of stimulants and sedatives often causes more harm than the poison. Chemical antidotes should be used judiciously; heroic measures seldom are necessary.
Treatment of acute poisoning must be prompt. The first goal is to maintain the vital functions if their impairment is imminent. The second goal is to keep the concentration of poison in the crucial tissues as low as possible by preventing absorption and enhancing elimination. The third goal is to combat the pharmacological and toxicological effects at the effector sites.
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