Oxalic acid (acid of sugar, salt of sorrel)
 
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It occurs as colowebsiteess, transparent prismatic crystals and resembles in appearance the crystals of magnesium sulphate and zinc sulphate. On long standing the crystals obtain a dirty grey colour.
Route :
Ingestion, Contact
Fatal Dose :
15 to 20 g.
Fatal Period :
1 to 2 hours
Mechanism of action :
1} Local: Corrosive action {though corrosion is not marked}. Prolonged contact may produce cyanosis and even gangrene. 2} Systemic: a. Shock b. Hypocalcaemia c. Nephrotoxicity
Clinical Picture :
A} Fulminating poisoning: A large concentrated dose produces immediate symptoms and death within minutes. 1} Burning, sour, bitter taste in the mouth with a sense of constriction around the throat and burning pain from the mouth to the stomach. 2} Pain is very severe, begins in the epigastrium` but soon radiates all over the abdomen` there may be tenderness. 3} Nausea and eructations are immediately followed by vomiting which may be persistent. 4} Vomitus usually contains blood and mucus and has a ‘coffee-ground’ appearance. 5} Thirst may be present 6} Death usually occurs before bowels are affected, but if life is prolonged, diarrhoea will occur. B} Acute poisoning: It occurs by a large dose when the patient survives for a few hours and is characterised by symptoms of hypercalcaemia and less by digestive upset. 1} Muscle irritability and tenderness, tetany or usually convulsions. 2} There may be numbness and tingling of the fingertips and legs. 3} Usually signs of cardiovascular collapse occur. 4} In some patients, stupor and coma occur. C} Delayed Poisoning: It is characterised by symptoms of uraemia. 1} The urine may be scanty or suppressed {oliguria} and may contain traces of blood {haematuria}, albumin {albuminuria} and calcium oxalate crystals. This is known as oxaluria. 2} There may be metabolic acidosis and venricular fibrillation.
Treatment :
1} The stomach is washed out carefully using calcium lactate or gluconate, two teaspoonfuls in each lavage. 2} The antidote is any preparation of calcium which converts the poison into insoluble calcium oxalate e.g. lime water, calcium lactate, calcium gluconate, calcium chloride, a suspension of chalk in water or milk. One and a half g. of chalk will neutralise about 1 g. of acid. 3} Calcium gluconate 10 percent, 10 ml i.v. at frequent intervals. 4} Dialysis or exchange transfusion for renal failure. 5} Parathyroid extract 100 units i.m. in severe cases. 6} Demulcent drinks 7} The bowels may be evacuated by an enema or castor oil.
07/14/2019 01:40:49 Oxalic Acid (Acid of sugar, Salt of Sorrel)
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