1. 23/04/1437Dr Abdel Moniem Goda Madbouly1 Household products poisoning د / عبد المنعم جودة مدبولى دكتوراة الطب الشرعى و السموم الأكلينيكية, مدرس الطب الشرعى و السموم الأكلينيكية, استشاري علاج التسمم بمستشفى بنها الجامعى

2. CategoryMost common substances Cleaners Corrosives (Bleaches) Cosmetics products Perfumes, cologne, after-shave Plants GlT irritants Hydrocarbons Kerosene, Gasoline Rodenticides Anticoagulants Insecticides OP and Carbamates Arts and crafts Magic markers, ink Paints/ varnishes Latex paint Deodorizes Air fresheners Miscellaneous Desiccants, Toys 23/04/14372

3. Caustics (corrosives) poisoning 23/04/1437Dr Abdel Moniem Goda Madbouly3

4. 23/04/1437Dr Abdel Moniem Goda Madbouly4 Definition: A substance having a pH less than or equal to 3 (caustic acid) or greater than or equal to 11 (caustic alkali). immediate Induces immediate destructive effect on tissues come in contact with it.

5. 23/04/1437Dr Abdel Moniem Goda Madbouly5 Types: Acids (PH<7): Inorganic: H 2 SO4. ماء النار. Inorganic: H 2 SO4. ماء النار. Organic acids: carbolic الفنيك, acetic الخل, oxalic ملح الليمون Organic acids: carbolic الفنيك, acetic الخل, oxalic ملح الليمون Alkalis (PH>7):  Na Hypochlorite الكلوركس  K Carbonate البوتاسا الكاويه Salts:  Heavy metals, cyanide salts.

6. 23/04/1437Dr Abdel Moniem Goda Madbouly6 Circumstances: children household products Caustic exposures are more frequent in children, from household products. Adults may be intentionally or unintentionally exposed to household or industrial products. adults comprise 81% Although children comprise majority of caustic ingestions, adults comprise 81% of patients requiring treatment.

7. 23/04/1437Dr Abdel Moniem Goda Madbouly7 Toxic dose: There is no specific toxic dose. There is no specific toxic dose. The extent of injury is determined by: The extent of injury is determined by: 1. Duration of contact. 2. Volume. 3. pH. 4. Concentration of the caustic, which is more important than pH, as zinc chloride and phenol are capable of producing severe burns even though they have near physiologic pH.

8. 23/04/1437Dr Abdel Moniem Goda Madbouly8 Mechanism of action (Pathophysiology): 1- Local actions: 1- Local actions: Immediate destructive injury. Immediate destructive injury. –Alkalis, penetrate tissue surfaces producing liquefactive necrosis. –Acid, desiccate epithelial cells, producing an eschar, resulting in coagulation necrosis. 2- Systemic actions: 2- Systemic actions: Some types may produce systemic toxicity, after their absorption (organic acids, salts of heavy metals … ). Some types may produce systemic toxicity, after their absorption (organic acids, salts of heavy metals … ).

9. 23/04/1437Dr Abdel Moniem Goda Madbouly9 AlkaliAcidsDD Household bleaches (Clorox, Potash) Phenol, H 2 SO4, Oxalic A, Acetic A Example Liquefactive necrosis Coagulative necrosis Mechanism DiarrheaConstipationC/P Oropharynx and Esophagus Stomach Stomach Injury Location +++++++Pain ++++++++ Perforation & Stricture +++++------------------------OrganicOrganicSteroid Systemic effects G lavage