Term Glossary

Glossary of Common Terms

Please note the following definitions are specific to the Washington Poison Center. Other poison centers may define terms differently.

General Terms

• Exposure: actual or suspected contact with any substance which has been ingested, inhaled, absorbed, gotten into the eye, nose, ears, or on the skin, injected, or otherwise entered the body. Exposures may or may not be harmful.
• Poison: a broad term encompassing any substance that could be harmful (or someone believes might be harmful) when used the wrong way, in the wrong amount, or by the wrong person. Common poisons include prescription drugs, illicit drugs, household and industrial products, venoms, etc.
• Information calls: questions that are not about an exposure that has occurred. This includes:
  • Food safety, such as “how long can I safely store eggs in my refrigerator?”
  • Medication safety, such as “Can I take an antihistamine and aspirin together?”
  • Product safety, such as “if I’m pregnant can I paint the nursery?”
• Patient: anyone with an exposure described above – see exposure
• Case: a written record, like a medical record when you see the doctor, of what the caller tells the WAPC happened and what the WAPC recommends or tells them to do. Cases may be information questions or exposures. Cases may involve more than one call (the poison center calling patients or healthcare facilities to check in, to provide additional treatment, and/or to answer additional questions; the patient/healthcare facility calling the WAPC with additional questions or symptoms).
• Specialists in Poison Information (SPIs): trained and knowledgeable call center staff available 24/7 who provide information and advice regarding “poisons” (see above). SPIs are trained nurses or pharmacists.
• Toxicology: the branch of medicine concerned with poisons

Exposure Reasons

The following list does not include all possible exposure reasons.

Unintentional exposure reasons

• Therapeutic error: a mistake when taking medication, such as taking the wrong dose, the wrong medication, the wrong person’s medication, taking the medication at the wrong time, or taking a medication the wrong way (e.g., swallowing a medication instead of putting it on your skin; putting ear drops in your eyes). Therapeutic errors can occur by the person taking the medication, or by a person giving someone a medication. Any substances mistaken for medication are also included in this exposure reason, such as accidentally taking a teaspoon of dish soap instead of cough syrup.
• Unintentional Misuse: accidentally using something (that is not a drug) the wrong way or for the wrong purpose. This includes mixing cleaning products; putting bleach in a cup, forgetting about it, and drinking it on accident; not reading the directions on a product, thereby not diluting it sufficiently.
• Withdrawal: physical and mental effects that a person experiences after they stop using or reduce their intake of a substance, such as alcohol, prescription, or recreational drugs. The length and severity of withdrawal varies greatly, depending on the type of drug and how long a person has used it.  Withdrawal can be unpleasant and potentially dangerous in some cases. For this reason, people should always talk to their doctor before stopping or reducing their use of a substance/or drug.
• Accidental/unintentional– general: All unintended or accidental exposures that are not specifically defined elsewhere. Most exposures in young children are coded here. These include:
  • Toddler got into (and swallowed) a grandparent’s prescription medicine, a bottle of drain opener left under the sink, or a container of chewable multivitamins
  • Children eating plants
  • Persons with limited mental capacity (e.g., dementia, Alzheimer’s disease, Down’s Syndrome, etc.) are also coded here

Intentional exposure reasons

• Suicide/self-harm: An exposure resulting from the use of a substance or drug to hurt or injure oneself, for self-destructive reasons, or with the intent to die. Includes ingestions of large quantities of one or more drugs where the only likely explanation is the patient’s intent to harm themselves. For immediate assistance in the event of self-harm, contact 911. For additional resources, see University of Washington Forefront, Crisis Text Line, Teen Link, and the National Suicide Prevention Lifeline.
• Intentional Misuse: Incorrect use of a substance or product on purpose. This includes when a person deliberately mixes or uses a higher amount of a pesticide than recommended, so that it will be more effective, like using more to make it stronger. It includes when a person deliberately increases the dosage of a medication hoping it will work better (such as overuse of caffeine to study for a test).
• Intentional Abuse: Use of a substance to seek intoxication (to get “high” or “drunk,” or attain a euphoric “feel good” effect). This includes:
  • A person who inhales helium to talk funny
  • A person who smokes or consumes cannabis to get high

Clinical Effects

The following list does not include all possible clinical effects.

• Cardiovascular: effects on blood pressure, heart rate, or rhythm. Also describes chest pain with possible heart-related cause.
• Gastrointestinal: describes symptoms involving the mouth, stomach, intestines, bowel and rectum. Includes vomiting, diarrhea, and constipation. Also includes irritation, bleeding, or any abnormalities occurring in these parts of the body as a result of an exposure.
• Respiratory: symptoms that impact the lungs or the patient’s ability to breathe, including abnormalities detected on X-ray. Common examples include coughing, shortness of breath, hyperventilating, and slowing or stopping of breathing.
• Neurological: symptoms related to nervous system function that are not included in cardiovascular, gastrointestinal, and respiratory categories. Examples include seizures, confusion or behavioral changes, unintentional muscle movements, sensations of numbness/tingling, and headache.

Medical Outcomes

• Minor effect: the patient had mild, minimally bothersome symptoms as a result of the exposure, such as drowsiness, stomach upset, skin irritation, and nausea. These symptoms or problems resolved quickly. Additional case examples include:
  • mild vomiting after drinking bleach
  • an insect bite or sting with pain and redness
  • coughing after mixing cleaning chemicals
• Moderate effect: serious but not life-threatening symptoms experienced as a result of an exposure, such as changes to heart rate and blood pressure, decreased organ function, changes to blood components, and confusion. Some form of treatment is typically necessary, and most patients are seen in a hospital. These cases are followed by WAPC until the majority of symptoms have resolved. Additional case examples include:
  • a high fever that causes the patient to be confused or disoriented
  • when liver or kidney issues are seen with a drug or chemical
  • when medication or drugs affect the heart
• Major effect: life-threatening and/or severe long-term effects experienced as a result of an exposure. Examples include decreased ability or inability to breathe, coma, seizures, abnormal heart rhythms, and organ failure.
• Death: the patient died as a result of the exposure or as a direct complication of the exposure.
• Other/not followed outcome:
  • Not followed, judged as nontoxic exposure: The patient was not followed as the exposure was likely to be nontoxic. WAPC call center staff determine this when:
    • The substance involved was nontoxic
    • The amount implicated in the exposure was insignificant (nontoxic).
  • Not followed, minimal clinical effects possible: The patient was not followed because the exposure was likely to result in only minimal toxicity of a trivial nature
  • Other: any outcomes not included in the above. Includes when an effect is judged as not being related to the exposure.  Sometimes includes cases with effects that are expected to be permanent or long-term, and may not be followed further once the effects are no longer expected to worsen.

Substances

General Terms

• Overdose: the ingestion, injection, or application of a drug or other substance in too large of an amount (“too large of an amount” depends on many factors, including the substance, its potency, the amount taken, an individual’s use history, and more). Overdose can occur with prescriptions, over-the-counter medications, legal substances, and illicit substances. In a fatal overdose, the person dies. A non-fatal overdose does not result in death, but may result in short- or long-term injury to the body.
• (Physical) dependence: when the body/brain relies on an external substance to maintain normal function. Can be used to describe when drugs are used to control chronic medical conditions such as diabetes. Also applies in settings of substance use disorders or addiction.
  • Tolerance: needing ever-increasing doses to maintain normal function
  • Withdrawal: when reducing/quitting the substance leads to a range of uncomfortable or painful symptoms
  • Addiction: when dependence becomes disruptive to other aspects of life (dependence is a symptom of addiction)
  • Substance use disorder: the term now used by the Diagnostic and Statistical Manual of Mental Disorder (DSM-5) to replace “substance abuse” and “addiction.” Patients are diagnosed with substance use disorders when they meet certain criteria or symptoms. The diagnosis includes severity of the disorder, ranging from mild to moderate to severe.
• Safe storage: storage practices that limit the risk of unintentional and intentional exposures. Includes child-resistant caps for medications, keeping household products in locked cabinets/cupboards, storing potentially harmful products out of sight and out of reach of kids, etc.

Substance Categories (this is not a comprehensive list)

• Opiates: any drug that is made from the naturally occurring opium, found in the poppy plant. Types of opiate drugs include opium, codeine, and morphine.
• Opioids: any drugs made or synthesized from an opiate such as hydrocodone (Vicodin), oxycodone (Percocet), and methadone. Opioids are made completely in a lab, but still produce similar effects to opiates. Examples of opioid drugs include heroin, hydrocodone (Vicodin), oxycodone (Percocet), and methadone. The term “opioids” is also commonly use to encompass opioids and opiates.