Iodine poisoning
Iodine belongs to the chemical group of halogens, is an active non-metal, and is present as a trace element in all living organisms.
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Iodine is an indispensable substrate for thyroid hormones (thyroid hormones), triiodothyronine and thyroxine, which regulate basal metabolism, the process of growth and development. With a lack of iodine in the body, a small amount of hormones is synthesized, and with an excess, on the contrary, excessive. The daily requirement is individual and varies depending on physiological characteristics, but on average is approximately 150-200 mcg.
In adults, a decrease in the level of thyroid hormones entails a slowdown in metabolic processes, an increase in their intensification. Iodine deficiency in a pregnant woman can lead to the development of a number of serious pathologies in a child, for example, cretinism, dwarfism, congenital hypothyroidism, etc.
As a simple substance, iodine is represented by black-violet crystals with a faint metallic luster and a characteristic pungent odor. At normal pressure, heating iodine leads to its sublimation, a transition to a gaseous state. To obtain a liquid substance, it must be heated under pressure. We will dissolve very little in water (1: 5000), we will dissolve in anhydrous alcohol (1:10) and in aqueous solutions of iodides (potassium and sodium).
Iodine is widely used:
- alcohol solution as an antiseptic for treating the wound surface, operating field;
- as part of a radiopaque substance during instrumental studies;
- for fingerprinting in forensic science (iodine vapor);
- as a component of the gaseous medium in the production of halogen lighting elements;
- as part of an electrode in the manufacture of batteries;
- in the nuclear industry.
Iodine is toxic. The lethal dose is 2-3 g, the maximum permissible concentration in the air is 1 mg / m 3.
How does iodine poisoning happen?
The toxic effect of iodine is based on its ability to denature cellular proteins, which causes local reactions. Systemic action is characterized by signs of damage to the central nervous system, cardiovascular system and the development of hepatorenal syndrome.
Poisoning occurs most often:
- by inhalation of iodine vapor;
- when iodine enters the body in a critical amount;
- with prolonged use of iodine-containing drugs;
- with individual hypersensitivity to iodine and its compounds.
The most dangerous, from the point of view of the development of acute intoxication when taken orally, are preparations containing elemental iodine (5 and 10% tincture, Lugol's solution) and organic substances that split off elemental iodine, for example, iodoform.
In addition to acute poisoning, poisoning can also be chronic. Chronic poisoning develops, as a rule, with prolonged unjustified intake of iodine-containing drugs, in the case of a systematic excess of the recommended dose or an increase in the frequency of administration.
Poisoning symptoms
The main symptoms of acute poisoning with vapors of iodine and its compounds:
- coughing, sneezing;
- lacrimation, profuse discharge from the nose;
- burning and scratching in the nasal cavity;
- difficulty breathing;
- hoarseness of voice;
- tickling in the nasopharynx;
- dizziness, headache.
When iodine is consumed inside, the lesion clinic will largely be due to the cauterizing effect of iodine on the mucous membranes of the digestive tract:
- burning pain in the oropharynx and along the esophagus;
- difficulty swallowing;
- metallic taste in the mouth;
- staining of the oral mucosa in an intense brown color;
- smell of iodine from the mouth;
- nausea;
- vomiting and diarrhea, possibly mixed with blood;
- intense pain in the abdomen.
In addition to specific gastroenterological complaints, there are a number of symptoms indicating systemic exposure to iodine:
- depression of consciousness (stupor or stupor, possibly coma);
- hallucinations, delusions;
- headache, dizziness;
- intense thirst;
- fever;
- convulsions of a clonic or tonic nature;
- cyanosis of the skin and visible mucous membranes;
- tachycardia;
- threadlike pulse;
- hypotension;
- disorders of urination.
Chronic iodine intoxication, as a rule, is manifested by the phenomenon of iodism - aseptic inflammation of the skin and mucous membranes in the places where iodine is excreted (respiratory tract, salivary glands, paranasal sinuses). In this case, the following are diagnosed:
- swelling of the mucous membranes;
- hypersalivation, rhinorrhea, lacrimation;
- sore teeth and gums;
- iodine acne (papulopustular rash on the face and body);
- iododerma (toxicoderma, manifested by a variety of skin elements);
- fever;
- deterioration in general health;
- metallic taste in the mouth.
Being powerful allergens, iodine and its compounds are capable of provoking the debut of allergic reactions or the addition of an allergic component to the clinical picture of poisoning.
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First aid for iodine poisoning
In case of acute poisoning with iodine vapors, it is necessary:
- Evacuate the victim from the lesion, interrupt contact with the toxin.
- Provide oxygen access by opening a window, unbuttoning tight clothing.
- Provide physical and psycho-emotional peace.
- Alkaline drink (alkaline mineral water without gas, milk, starch or flour, diluted in water, 2% baking soda solution (dissolve 1 teaspoon of soda in 200 ml of water)).
- Take a saline laxative (magnesium sulfate).
- Take enterosorbent (Enterosgel, Polyphepan, Laktofiltrum, Polysorb).
- Rinse eyes, rinse mouth, inhale with 2% baking soda solution.
- Rinse the stomach (for this, you need to drink 1-1.5 liters of warm water or 2% sodium bicarbonate solution and induce an emetic urge by pressing on the root of the tongue). The exception is cases of poisoning with 5 and 10% iodine solutions, Lugol's solution - repeated contact of damaged mucous membranes with these substances can lead to increased symptoms of chemical burns, gastric lavage is prohibited.
When is medical attention required?
Seek medical attention if:
- in the provision of emergency care, there is no positive dynamics or the victim's condition has worsened;
- vomit and feces contain blood impurities;
- intense neurological symptoms (delirium, impaired coordination, orientation, hearing and vision);
- a child, a pregnant woman, an elderly person was injured;
- the victim is in a soporous or comatose state and is inaccessible to contact.
In the clinic, the victim is injected with Sodium thiosulfate, an antidote to iodine. Prescribe treatment aimed at maintaining the basic life support systems and eliminating the symptoms of intoxication.
Possible consequences
The consequences of iodine poisoning are very serious:
- strictures of the esophagus;
- ulcerative defects and erosion of the mucous membrane of the stomach and duodenum;
- stomach and intestinal bleeding;
- pneumonia;
- pulmonary edema;
- acute heart failure;
- coma;
- hepatorenal syndrome;
- damage to the central nervous system (delirium, hallucinations, depression of consciousness, hearing impairment, vision);
- allergic reactions up to angioedema.
Prevention
To prevent iodine intoxication, you must:
- when using iodine-containing drugs, strictly adhere to the doctor's recommendations, do not exceed the dosage and do not change the treatment regimen;
- do not contact with iodine and its compounds in production conditions without personal protective equipment;
- observe safety precautions at the workplace when working with iodine and its compounds in production conditions;
- store medicinal iodine solutions out of the reach of children.
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Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
