Fluoride Poisoning

Discussion in 'Health, Beauty, and Fashion' started by richardleeds, Jan 6, 2011.

  1. richardleeds

    richardleeds New Member

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    does everyone know that there is fluoride in your drinking water? look at your tooth paste, it says do not swallow, if swallowed seek medical attention immediately.
     
  2. maddass98

    maddass98 Member

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    you need a reverse osmosis system

    watt premier makes a really good one for ~$200, only 30 minutes to install. called the RO-PURE. they sell it at costco. it also has quick change cartridges, so very easy to maintain.
     
  3. ab289

    ab289 Well-Known Member

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    Oh yeah ... absolutely. Don't you know your government is trying to kill you, bit by bit each day?

    Go read about what FLUORIDE does to you and why government wants to put it in the water. It's really an eye opener.
     
  4. kontradictions

    kontradictions Well-Known Member

    You dumb ass. Sodium Fluoride is put into drinking water to help prevent cavities. It's been proven to be ineffective but it's not dangerous. A lethal dose for a typical human (70kg or 154lb) is 5-10g. The ratio between Sodium Fluoride is 0.5mg to 1.0 mg per Liter of water.

    Do the math. You would literally drown yourself before you come even remotely close to drinking enough Sodium Fluoride to do any damage.

    Taking Vitamins in large doses is also poisonous. Panic...
     
    #4 kontradictions, Jan 7, 2011
    Last edited: Jan 7, 2011
  5. ao_xxx

    ao_xxx Well-Known Member

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    if you're worried, use a water filter and then boil your water before comsumption.
     
  6. kontradictions

    kontradictions Well-Known Member

    Trying to boil fluoride is like trying to boil a rock...
     
  7. lol @ OP and responses in this thread :facepalm:
     
  8. ^lol was there really much to add after?

    I wanna hear about the one guy who swallowed toothpaste n died..
     
  9. MrCooperS

    MrCooperS Well-Known Member

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    lmao +1
     
  10. bbgirlsum

    bbgirlsum Well-Known Member



    Im pretty much still after swallowing toothpaste... All i rememver i was pretty damn out of it when i done it.... Lol
     
  11. ralphrepo

    ralphrepo Well-Known Member

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    In general Fluoride in toothpaste and drinking water is considered a safe and effective way to mass protect the population against the costs of dental decay. However, it is (like the vaccine debacle) not without controversy and has been source material for conspiracy theorists for years. For those that want to be fearful every time they brush their teeth then go to this site: Fluoride Pollution: An Overview

    For the rest of us who are reasonable, thoughtful and otherwise rational people; then read the following
    (from an article in the New York Times):

    Or, if you want more info (for those that have health care knowledge):

    Geofrey Nochimson, MD, Consulting Staff, Department of Emergency Medicine, Sentara Careplex Hospital
    Updated: Dec 2, 2008

    Introduction

    Background

    Fluoride toxicity is characterized by a variety of signs and symptoms. Poisoning most commonly occurs following ingestion (accidental or intentional) of fluoride-containing products. Symptom onset usually occurs within minutes of exposure. Fluoride is found in many common household products, including toothpaste (eg, sodium monofluorophosphate), vitamins, dietary supplements (eg, sodium fluoride), glass-etching or chrome-cleaning agents (eg, ammonium bifluoride), and insecticides and rodenticides (eg, sodium fluoride). Historically, most cases of fluoride toxicity have followed accidental ingestion of insecticides or rodenticides.

    Pathophysiology


    Fluoride has several mechanisms of toxicity. Ingested fluoride initially acts locally on the intestinal mucosa. It can form hydrofluoric acid in the stomach, which leads to GI irritation or corrosive effects. Following ingestion, the GI tract is the earliest and most commonly affected organ system. Once absorbed, fluoride binds calcium ions and may lead to hypocalcemia. Fluoride has direct cytotoxic effects and interferes with a number of enzyme systems; it disrupts oxidative phosphorylation, glycolysis, coagulation, and neurotransmission (by binding calcium). Fluoride inhibits Na+/K+ -ATPase, which may lead to hyperkalemia by extracellular release of potassium. Fluoride inhibits acetylcholinesterase, which may be partly responsible for hypersalivation, vomiting, and diarrhea (cholinergic signs). Seizures may result from both hypomagnesemia and hypocalcemia. Severe fluoride toxicity will result in multiorgan failure. Central vasomotor depression as well as direct cardiotoxicity also may occur. Death usually results from respiratory paralysis, dysrhythmia, or cardiac failure.

    Frequency


    United States

    In 2006, the American Association of Poison Control Centers reported 22,168 exposures involving toothpaste with fluoride. Only 313 cases were actually treated in the emergency department. Moderate effects were seen in 45 cases. No cases of major adverse effects or death were reported. In 2006, 1802 exposures involving multiple vitamins with fluoride were reported. Only 61 cases were treated in the emergency department with no moderate or major effects noted.

    Mortality/Morbidity

    One death from ingestion of fluoride toothpaste was reported to the American Association of Poison Control Centers in 2002. No deaths were reported in 2006.


    • Death may result from ingesting as little as 2 g of fluoride in an adult and 16 mg/kg in children. Symptoms may appear with 3-5 mg/kg of fluoride.
    • Estimated toxic dose for fluoride ingestion is 5-10 mg/kg.
    • Estimated lethal dose is 5-10 g (32-64 mg/kg) in adults and 500 mg in small children.
    Age

    Children younger than 6 years account for the vast majority of the cases. In 2006, this age group had a total 21,064 exposures, while adults 19 years and older had only 982 exposures.[1 ]



    • Infants and children usually have accidental exposures.
    • Adults usually have intentional exposures.
    Clinical

    History


    • Determine the exact nature and time of exposure or ingestion. Query patient, bystanders, paramedics, and family members regarding specifics of exposure or ingestion.
    Physical


    • Gastrointestinal signs predominate
      • Hypersalivation
      • Nausea
      • Vomiting
      • Diarrhea
      • Abdominal pain
      • Dysphagia
      • Mucosal injury
    • Electrolyte abnormalities
      • Hypocalcemia
      • Hypomagnesemia
      • Hyperkalemia
      • Hypoglycemia
    • Neurologic effects
      • Headache
      • Tremors
      • Muscular spasm
      • Tetanic contractions
      • Hyperactive reflexes
      • Seizures
      • Muscle weakness
    • Cardiovascular
      • Widening of QRS
      • Various arrhythmias
      • Shock
      • Cardiac arrest
    Causes


    • The most common type of exposure is ingestion of products that contain fluoride. To obtain the exact name of the product and how much was ingested is extremely important.
    • Toothpaste contains 1 mg/g of fluoride as sodium monofluorophosphate. This fluoride formulation has low solubility and is generally nontoxic.
    • The toxic effects following large ingestions of the following products usually are limited to GI discomfort.
      • Toothpaste
      • Oral hygiene products
      • Insecticide
      • Rodenticide
      • Dietary supplements
      • Automobile wheel-cleaning products
      • Glass-etching products
    Differential Diagnoses

    Plant Poisoning, Herbs
    Toxicity, Mushroom - Amatoxin
    Plant Poisoning, Licorice
    Toxicity, Mushroom - Disulfiramlike Toxins
    Toxicity, Acetaminophen
    Toxicity, Mushroom - Gyromitra Toxin
    Toxicity, Ammonia
    Toxicity, Mushroom - Hallucinogens
    Toxicity, Antihistamine
    Toxicity, Mushroom - Orellanine
    Toxicity, Arsenic
    Toxicity, Scombroid
    Toxicity, Chlorine Gas
    Toxicity, Heavy Metals

    Workup

    Laboratory Studies

    The following studies may be indicated for suspected fluoride toxicity:

    • Serum electrolytes
      • Hyperkalemia
      • Hypocalcemia
      • Hypomagnesemia
      • Hypoglycemia
    • Electrocardiogram and cardiac monitoring
      • Effects of hyperkalemia (peaked T waves, widened QRS, bradycardia, atrioventricular [AV] nodal blockade)
      • Effects of hypocalcemia (prolonged corrected QT interval [QTc])
    • Serum and urine fluoride levels are not available for ED evaluation.
    • Perform a Dextrostix evaluation (fingerstick) on all patients with seizure and altered mental status because of the risk for hypoglycemia with systemic fluoride toxicity.
    Treatment

    Prehospital Care

    Place patients with a known significant ingestion of fluoride on a cardiac monitor and initiate an IV line. Administer calcium IV to patients who present with cardiac dysrhythmias.

    Emergency Department Care



    • Provide cardiac monitoring.
    • Hypocalcemia may be detected.
    • Perform gastric aspiration and lavage. Small-bore nasogastric tube aspiration, followed by lavage, is recommended because of the potential severity of this ingestion and the ineffective absorption of fluoride by activated charcoal. Lavage with milk or a solution containing calcium or magnesium hydroxide (eg, milk of magnesia) is theoretically attractive but has not been proven beneficial. Some recommend lavaging with 1-5% calcium chloride solution to bind fluoride in the stomach.
    • Gastric aspiration and lavage are most effective when instituted within 1 hour of ingestion.
    • Administer milk, calcium carbonate, and aluminum- and magnesium-based antacids (eg, hydroxides) to bind fluoride.
    • Activated charcoal is not helpful. Fluoride does not bind to charcoal. Activated charcoal still is recommended for those with intentional ingestions when a polysubstance overdose is possible.
    • Correct calcium deficiencies with IV calcium chloride.
    Consultations


    • Consult a toxicologist or poison control center for acute management recommendations.
    • Psychiatric consultation is necessary after medical clearance.
    Medication

    Goals of therapy are to reduce toxicity and prevent complications.

    Electrolytes


    Calcium chloride is administered to correct hypocalcemia that may result from fluoride poisoning. Calcium chloride provides 3 times more calcium than calcium gluconate on an equal-volume basis and is preferred (despite greater tissue toxicity if extravasation occurs).

    Calcium chloride

    Manages underlying hypocalcemic effects caused by fluoride poisoning.

    Dosing


    Adult

    Initial dose: 1-2 g (1-2 ampules) IV slow push of 10% calcium chloride solution (10 mL each); repeat doses to obtain desired serum calcium level; for severe poisoning, may need to give multiple grams for the first several hours

    Pediatric


    20-25 mg/kg IV push of calcium chloride; repeat as necessary; may need massive doses with severe poisoning

    Interactions


    Coadministration with digoxin may cause arrhythmias; with thiazides, may induce hypercalcemia; may antagonize effects of calcium channel blockers, atenolol, and sodium polystyrene sulfonate

    Contraindications


    Ventricular fibrillation not associated with hyperkalemia; digitalis toxicity, hypercalcemia, renal insufficiency, cardiac disease

    Precautions


    Pregnancy

    B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

    Precautions


    Administer slowly (not to exceed 0.5-1 mL/min) to avoid extravasation; hypercalcemia may occur in renal failure

    Calcium gluconate (Kalcinate)

    Moderates nerve and muscle performance and facilitates normal cardiac function. For systemic hypocalcemia, agent can be given IV initially, and then calcium levels can be maintained with high calcium diet. Some patients will require oral calcium supplementation. For topical pain, agent can be applied as a water-soluble gel mixture.

    Dosing


    Adult

    May apply 2.5-5% calcium gluconate to affected area; repeat as often as required for pain control; if not available commercially, prepare as a simple 3:1 (for 2.5%) or 1:1 (for 5%) dilution of a 10% IV solution in a water-soluble surgical gel or similar sterile base

    Pediatric


    Apply as in adults

    Interactions


    May decrease effects of tetracyclines, atenolol, salicylates, iron salts, and fluoroquinolones; antagonizes effects of verapamil; large intakes of dietary fiber may decrease calcium absorption and levels; interactions likely not significant for calcium administered via topical route

    Contraindications


    Renal calculi, hypercalcemia, hypophosphatemia, renal or cardiac disease, and digitalis toxicity

    Precautions


    Pregnancy

    B - Fetal risk not confirmed in studies in humans but has been shown in some studies in animals

    Precautions


    Caution in digitalized patients, respiratory failure, acidosis, or severe hyperphosphatemia; monitor serum calcium when calcium gluconate is administered parenterally

    Follow-up


    Further Inpatient Care

    Further inpatient care for those with fluoride ingestion include the following:

    • Correct electrolyte abnormalities, especially hyperkalemia and hypocalcemia.
    • Hemodialysis is used for critically ill patients that are refractory to all other forms of treatment.
    • Cardiac arrhythmias are difficult to treat because they do not respond to lidocaine, cardioversion, or defibrillation.
    Deterrence/Prevention


    • Keep all dangerous household products out of reach of small children.
    Prognosis


    • Patients may be discharged if asymptomatic and ingestion is less than 3 mg/kg by accurate history.
    • If a patient presents with persistent signs and symptoms, admit to a monitored bed.
    • Monitor and watch patients in the ED for 6 hours before possible discharge.
    • Delayed clinical presentation of significant exposures is quite common.
    Patient Education


    • For excellent patient education resources, visit eMedicine's Poisoning - First Aid and Emergency Center. Also, see eMedicine's patient education articles Poisoning and Poison Proofing Your Home.
    Miscellaneous

    Medicolegal Pitfalls


    • Failure to appreciate potential severity of this exposure
    Source: http://emedicine.medscape.com/article/814774-overview

    And, from a 1942 Article that appeared in Time Magazine:

    [​IMG] Monday, Nov. 30, 1942
    Death by Fluoride


    Assistant Cook A. M. McKillop was short-handed and in a tearing hurry. His supper menu at the Oregon State Hospital for the Insane, in Salem, called for scrambled eggs. He needed powdered milk to make them. Against the rules he dispatched a kitchen-helper inmate to the catacomb-like cellar to bring him a new supply. The eggs were served. At long tables in one dining ward, 467 mental patients clinked their forks and spoons against their tin and enamelware plates. Minutes later they began to drop in anguish to the floor. That night and the next day 47 of them died. In the tiny morgue the bodies had to be piled like cordwood. For three days State police quizzed terrified employes and bewildered patients. At last the truth came out. The kitchen helper seeking the powdered milk had dim-wittedly come back from the wrong storeroom with seven pounds of sodium fluoride roach powder, with which hurried, overworked Cook McKillop had scrambled the eggs. At week's end McKillop and his boss, Mary O'Hare, were booked on charges of involuntary manslaughter.



    The hydrangea hedges, the big round beds of pansies, a fountain tinkling outside the main entrance of the institution "out at the end of Center Street," where Oregon houses 3,000 of its mental patients, make its externals pleasing to the eye. But any Oregonian who knows enough to make comparisons is shocked by the interior of this mid-Victorian (1883) Bedlam. Its 3,000 patients are 1,000 more than facilities properly can care for. Two toilets, seatless and of vintage unknown, must serve 60 men; 62 women share one metal wash basin. Thanks to conscientious Dr. John C. Evans, superintendent, the institution is clean. But thanks to Oregon's legislature and public neglect, the State spends scarcely more than half as much money per month per patient as neighboring California, leaves its institution's superintendent to cope as best he may with too many patients, too small a staff. At a cost of 47 deaths, Oregon may learn to take better care of her insane.


    Source: http://www.time.com/time/magazine/article/0,9171,766637,00.html
     
    #11 ralphrepo, Mar 23, 2011
    Last edited: Mar 23, 2011
  12. lmfao ralph....
     
  13. ralphrepo

    ralphrepo Well-Known Member

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    Why? he wanted info; So, I gave it to him... :p
     
    #13 ralphrepo, Mar 23, 2011
    Last edited: Mar 24, 2011
  14. kontradictions

    kontradictions Well-Known Member

    You raped his brain.
     
  15. MrCooperS

    MrCooperS Well-Known Member

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    +1 I still think "you dumb ass." was the best response.
     
  16. ralphrepo

    ralphrepo Well-Known Member

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    Well, at least he's not running out to buy salt, LOL... -bigsmiles
     
  17. .Cameron

    .Cameron Well-Known Member

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    Hehe.

    [​IMG]