Toxicologist Answers Poison Questions From Twitter | Tech Support | WIRED

- 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, Drino, 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.