Basic Research Required by Emergency Physicians on the Management of Poisoning

Abstract

We surveyed recent outbreaks of poisoning in Japan and discussed the subjects in response to the request from emergency physicians for their research. Except for carbon monoxide poisoning, agricultural chemicals are the main cause of death by poisoning in Japan. The second most frequent cause is death by pharmaceutical substances. Moreover, there are many cases of multi-chemical poisoning caused by the complication of the above chemicals. It is clear that of the basic studies about toxicological mechanisms and the development of antidotes are both important on the basis of the management of all kinds of poisoning. Especially, the development of low molecular specific antidotes for poisoning by paraquat and organophosphates is required, because of the high mortality rate of these chemicals. The importance should be noted by the simulation studies which clarify the human kinetics of overdose cases by using the kinetic data of therapeutic doses and overdoses in animals along with the data on therapeutic doses in human cases. Furthermore, studies which predicting the effects of multi-chemical poisoning may be important : for example, the study on the changes of levels of toxic substances in the blood caused by the interaction of other chemicals. Endermic drugs expected to reduce the occurrence of pharmaceutical poisoning would be developed. The development of a new nonspecific absorbent which could be handled easily and effective in a small dose. The methods of rapid qualitative analysis for the detection of unknown toxic substances should be promoted.