Toxicologist Answers Poison Questions From Twitter

If you've been bitten by a brown recluse spider,

the first thing I can tell you, keep the spider.

Hi, I'm Anne Chappelle.

I'm a board certified toxicologist,

and this is Poison Support.

[gentle music]

Jehovah's witness, Jehovah's Thickness asks,

so can you really poison people by putting eye drops

in their food?

I'm asking for a friend.

Actually you can.

There have been several high profile cases where a spouse

has been accused of murder for putting Visine drops

into their partner's beverages and food.

The active ingredient in Visine

causes your blood vessels to constrict.

It works great on your eyes getting the red out.

The problem is that when you ingest it

and you ingest enough of it,

it can cause your other blood vessels to also constrict.

And when those constrict you can cut off blood supply

to different parts of your body

and have some overt toxicity.

It's been shown that only a quarter teaspoon

ingested by a child can actually cause significant toxicity.

So you need to be very careful in where you keep your Visine

or other similar eyedrops.

Next up, we have a question from Benjamin Sano.

Poison gas, how does that work?

Well, first you go to Taco Bell.

Just kidding.

Certain poison gases when you breathe them in,

they immediately destroy the lining of your lung.

And so if you don't have a good lung lining,

well then you really can't oxygenate your blood

and then you can die.

Poison gases can also work by interacting with the cells

within your body and stop them from being able

to produce energy.

That's a really big deal when it comes to

your heart and your brain.

One of the most common poisonous gases

is actually carbon monoxide.

Carbon monoxide poisoning often manifests as sleepiness,

and unfortunately carbon monoxide is tasteless, odorless.

And so you often won't be able to tell

if you've been exposed to carbon monoxide.

That's why those carbon monoxide detectors that you can get

at your local big box store are so important.

From Tatum Flynn.

Can you get lead poisoning from stabbing yourself really

hard with a sharp pencil?

Asking for an idiot.

No, no you can't.

No way.

Never, no how.

You know why?

Pencils don't contain lead.

Pencils actually contain a mix of graphite and clay,

which is considered non-toxic.

We have a question now from Brendon FlyEaglesFly.

Did you know that toothpaste can kill you

because it's a poison if you eat the whole bottle at once?

It even says use more for brushing than eating.

Yes.

Why yes I did.

Fluoride when brushed on the teeth helps protect the enamel.

And so it's very good for your teeth, but again,

it's not very good to ingest

because the fluoride is a lot like calcium.

So if you have too much fluoride in your body,

it displaces the calcium.

Why is that important?

Calcium is in your bones.

So your bones aren't as strong

as well as calcium is important in a number of different

metabolic reactions that keep your body healthy.

If you did eat an entire thing of toothpaste,

that's something you really should call

poison control about.

That fluoride in your body could escalate to the point where

you have seizures, convulsions, death.

So please take it seriously.

Don't eat your toothpaste.

Please spit.

We have a question from Emily.

Can you die of food poisoning?

Absolutely you can die of food poisoning.

Food poisoning is actually one of the most common poisonings

that happens in the United States.

According to the Centers for Disease Control

one in six Americans suffer from some form

of food poisoning every year,

128,000 Americans end up going to the hospital

for food poisoning.

And about 3,000 people die every year of food poisoning.

The biggest problem with food poisoning is dehydration.

If you have several days of diarrhea,

you really need to make sure that you stay hydrated.

Sometimes food poisoning can be very difficult to diagnose

because you end up getting a delay between when you actually

ate the food and actually when you became ill.

Usually it is a delay of six to 12 hours for that toxin

to start acting on your intestines

and in your body to produce adverse health effects.

Wife of Chadwick asks can you overdose on vitamins?

Because those gummies are yummy and I keep popping them.

Yes, you can.

However, there is not always an adverse effect.

Many of the gummy vitamins are water-soluble vitamins,

which means that they don't get built up in your system.

So if you've ever taken too many gummies or vitamins

and you've got kind of bright colored pee well,

you've overdosed just a bit.

The problem is when you end up overdosing

on some of these fat-soluble vitamins,

such as vitamin D, vitamin E, some of the Bs as well.

Those like to sequester into your fat.

And so they're harder to get rid of out of your body.

Iron supplements can be also formulated into gummy vitamins.

And those are actually very dangerous,

especially for children to have an iron overdose.

And so in all of these cases if you suspect that there is

unintended ingestion of these kinds of vitamins,

it's important to run it by your poison control center,

especially if it's a child.

So this one is from David Acosta.

Yo, I never had to call poison control at this point

in my life.

How does it work?

Is there like a code system, press one for rat poison,

press two for cyanide?

Do I need a subscription?

Is there a free trial?

You know what, nevermind.

Well, it's really important that you know

that the first step in suspected poisoning

is actually calling poison control.

That's 1-800-222-1222.

It's a national toll free number staffed 24/7.

Now you may think that there are some times

when you need to call 911, or should I call poison control?

Well, if the person is having an extreme medical emergency

right in front of you dial 911.

If you're not sure, still call 911,

especially if they're a child

and then call poison control to follow up.

Leonel asks a very important question.

Wait, wait, wait, how do poison antidotes work?

So there's a number of different kinds of antidotes.

First of all there's the kind that actually just trap

or absorb the chemical.

There are some that actually go after

and neutralize the chemical itself.

Those are things like the antivenoms.

Another one is that it actually inhibits the chemical

at the site of the organ or toxicity.

Here's a good example of an antidote

for a chemical overdose, opiates.

You get too much oxycodone in your body

and they give you the Naloxone spray.

That actually gets into your body

and that displaces the oxycodone from the sites

where it activates.

That's why you see such an immediate reversal

after a Naloxone dose.

Poison control and regional trauma centers often have

antivenoms for the things that are local

to that particular area.

But if you happen to be in Northern Ontario,

where there are no rattlesnakes,

there's probably no antivenom.

So be careful where you decide to get bit.

Ivves asks, how do we measure toxicity?

One of the most common ways to measure toxicity

is a test called an LD50 test, lethal dose 50.

It means you give a dose to an animal and you find out what

the dose is that kills 50% of those animals.

I know that sounds pretty barbaric,

but it is a way to analyze and figure out what the inherent

toxicity of that substance happens to be.

OneRaisedBrow asks did you know that activated charcoal

can absorb poison?

It's actually been used for hundreds and hundreds of years

to absorb different toxicants.

Activated charcoal works by actually physically binding

that substance to itself in the digestive tract

and traps it so that it is eliminated

through either the feces or if it is flushed out

of the stomach.

One of the things they like about activated charcoal is that

it acts on all kinds of different poisons and toxicants.

So you don't necessarily have to know what the person

was exposed to to be able to use it and potentially help

eliminate any of these adverse reactions.

If you've already got something in your body,

activated charcoal isn't gonna pull that toxicant out

of your cells and out of your body.

The activated charcoal is really gonna focus on something

that is in your intestinal tract, your GI tract,

but it's really not meant to cleanse any other part

of your body.

Angwin, anyone know what to do if you feel like

you've been poisoned 24/7?

Go to the doctor.

If you feel awful for several days or several weeks,

keep a diary of some of your symptoms.

What have you been eating?

Where have you been going?

What is your work environment like?

That way you're able to give the doctor

or nurse practitioner something to go on.

Here's a question from Kerry Syndram.

If you ever accidentally swallow a poison,

don't make yourself throw up,

drink as much water or milk as you can.

I just saved your life.

Not necessarily Kerry.

Chemical agents have different hazardous properties.

For example, bleach is a very caustic agent,

which means it can burn you.

If you drank milk or water,

you would think that that might dilute what you're having,

but not necessarily.

Sometimes the water or the milk can make it worse.

In addition, if that makes you feel worse

and you accidentally throw up,

there's a condition called aspiration pneumonitis,

which is essentially you inhale your vomit.

Imagine how much worse it is if you inhaled vomit

that was full of bleach,

that would also damage your lungs.

So don't just assume that water or milk is the appropriate

treatment for an overdose or exposure to any kind of poison.

Shoulda Retired says hey toxicology Twitter,

@ScreamingMD, @RyanMarino,

what's the Dapsone dose for a brown recluse bite?

A brown recluse spider is a kind of spider that causes

in some cases a necrotizing wound.

That means all of the skin cells are dying.

If you've been bitten by a brown recluse spider,

the first thing I can tell you keep the spider.

Even if you smash it, put it into a little jar so that if

you get some kind of necrotizing wound,

it's like a gross pussy painful spot,

you can tell the doctor so that they can

treat you appropriately.

The question was for this one is Dapsone treatment.

Dapsone is an antibiotic often given to leprosy patients.

So you might think is that really appropriate

for a brown recluse spider bite?

There's a number of research papers that have compared

treatment for brown recluse spider bites,

between the different standard of care,

the antibiotics and such with adding Dapsone.

And the evidence is mixed.

I have a question here from Anna7,

what the [bleep] is syrup of ipecac?

Syrup of ipecac is a syrup that is made from

the dried root of a South American plant.

It is used in the emergency room to make you vomit.

That's what it does.

If you're going to use syrup of ipecac,

you really should call poison control first

to make sure that you should be up chucking

what you ingested.

Because sometimes if things are really caustic, corrosive,

things like battery acid, Draino, bleach,

that can cause more damage on the way back up.

The problem with syrup of ipecac also is that it has been

abused for many years by people that didn't know how to make

themselves throw up, but they wanted to lose weight.

One of the most famous deaths related to syrup of ipecac

was actually Karen Carpenter in 1983.

She had severe anorexia and kept taking syrup of ipecac

to make her vomit.

Over time syrup of ipecac damaged her heart.

So it caused her to have a heart attack and die.

A question from Andrew King.

Poinsettia cupcakes but no Yule logs,

wait aren't poinsettias poisonous?

That is actually a bit of a myth.

If you eat a significant number of poinsettia leaves,

you might become a little nauseous

or you might be able to reach a potentially toxic dose.

A child weighing 50 pounds has to eat 500 poinsettia leaves

to actually reach a dose that would result

in significant toxicity.

Zoe is just kitten around.

I want to at the very least learn how to tell

a poison mushroom apart from an edible one.

Here is a really easy way to tell them apart.

If it's at a grocery store, you can eat it.

You need to be very careful about foraging

for your own mushrooms,

because it is very difficult to tell a poisonous mushroom

apart from an edible mushroom.

Because there's only about 100 poisonous mushrooms out of

all the mushrooms that are out there

what are the chances that you actually picked

a poisonous one?

Do you really want to find out?

Every year there are about 6,000 mushroom poisonings

reported to the CDC.

Half of those are from ingestions from children.

So please help educate your children

not eat random mushrooms in your backyard.

Alright, that's all the questions.

I had a really good time today

and I hope we can do it again sometime.