All substances are poisons;
There is none which is not a poison.
The right dose differentiates a poison from a remedy.
It is not possible to identify all toxic substances in a single
journal article. However, there are some exposures that in
small doses are potentially fatal. Many of these exposures
are particularly toxic to children. Using data from poison
control centres, it is possible to recognise this group of
This article provides information to assist the general
practitioner to identify potential toxic substance exposures
In this article the authors report the signs and symptoms
of toxic exposures and identify the time of onset. Where
clear recommendations on the period of observation and
known fatal dose are available, these are provided. We do
not discuss management or disposition, and advise readers
to contact the Poison Information Service or a toxicologist
for this advice.
Poisoning is a frequent occurrence with a low fatality rate. In 2008, almost 2.5 million human exposures were reported to the National Poison Data System (NPDS) in the United States, of which only 1315 were thought to contribute to fatality.2 The most common poisons associated with fatalities are shown in Figure 1. Polypharmacy (the ingestion of more than one drug) is far more common.
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