Poisonings (Intoxications): Causes

Pathogenesis (development of disease)

The following poisonings are common:

• Alcohols (esp. ethanol (ethanol); T51.-).
• Inorganic substances (T57.-).
• Gases, vapors, fumes, unspecified (T59.-)
• Poisons ingested with food (plants (esp. aconite/aconitine), fungi (orellanus, tuberous leaf fungus), etc.; T61.-, T62.-).
• Carbon monoxide (T58)
• Contact with poisonous animals (esp. insect bites; T63.-).
• Food (especially alcoholic beverages)
• Medications (T36.-T50.-):
  • Drugs* and biologically active substances:
    • T39: analgesics (approximately 40% 4-aminophenol derivatives such as acetaminophen; acetylsalicylic acid; opioids).
    • T40 narcotics, methadone, hallucinogens (especially codeine, morphine).
    • T42 Hypnotics (about 50% benzodiazepines), antiepileptic drugs.
    • T42.1 Iminostilbene (carbamazepine).
    • T42.6Other antiepileptic, sedative, and hypnotic drugs (valproic acid).
    • T43 Antidepressants, antipsychotics (neuroleptics), psychotropic substances (unclassified).
    • T44.7 Beta-receptor blockers, not elsewhere classified
    • T46.0 Cardiac glycosides and drugs having a similar effect (digitalis glycosides).
    • T46.1 Calcium antagonists
    • T50.9 Other and unspecified medicinal products, drugs and biologically active substances – “teething aids” and other OTC preparations containing benzocaine → methemoglobinemia
  • Mental and behavioral disorders resulting from acute intoxications with:
    • F10.0 Alcohol (ethanol)
    • F11.0 Opioids
    • F13.0 Hypnotics, sedatives
    • F15.0 Stimulants
    • F19.0 multiple substance use
• Metals (T56.-)
• Nicotine (T65.2)
• Pesticides (T60.-)
• Cosmetics

* Drugs in the sense of intoxicants are divided into:

• “Upper”; these lead to a sympathomimetic (“mimicking the action of the sympathetic nervous system” ) activation and serve to stimulate, euphoria and performance enhancement. Typical representatives are: Cocaine, amphetamines and amphetamine derivatives such as ecstasy.
• “Downer; these lead to a central attenuation and have a sedative (calming) and euphoric effect. Typical representatives are: Cannabis (hashish and marijuana), opiates / opioids, γ-hydroxybutyric acid (eg “liquid ecstasy“) or substitute drugs (γ-hydroxybutyrolactone or 1,4-butanediol).
• Hallucinogens. “Upper” (stimulants); these often have a psychedelic effect with expansion of consciousness. Typical representatives are: LSD (lysergic acid diethylamide/lysergide) and phencyclidine (e.g. “Angel Dust”). Furthermore, serve as hallucinogens psilocybin-containing fungi such as Psilocybe semilanceata or nightshade plants such as Brugmansia and Datura spp.

The exact pathogenesis depends on the type of poisoning.

Etiology (causes)

Behavioral causes

• Pleasure food consumption
  • Alcohol intoxication
  • Shisha consumption (→ carbon monoxide poisoning; ingested amount of carbon monoxide can be ten times the dose compared to cigarette smoking)
• Drug use
  • Drugs, unspecified

Disease-related causes.

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

• Suicidality (suicidal tendencies).

Injuries, poisonings, and other consequences of external causes (S00-T98).

• Poisoning by medicines, drugs, biologically active substances.
• Poisoning by substances used primarily for non-medical purposes.

Environmental pollution – intoxications (poisonings).

• Carbon monoxide poisoning (synonyms: CO poisoning, CO intoxication, carbon monoxide poisoning or carbon monoxide poisoning).