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→Metabolism
===Metabolism===
===Metabolism===
Metabolism has two phases:
*Phase 1 where the substance is broken down into smaller molecules - often mediated by the cytocchrome P450 system
*Phase 2 where molecules are conjucated to increase their solubility by the addition of glucuronide, sulphate, glutathione or acetyl/methyl groups prior to excretion.
Metabolism may create a toxic byproduct - this is the case with paracetamol and aflatoxin poisonings, or may reduce the toxicity of a substance e.g. Ivermectin metabolites demonstrate reduced toxicity. Alternatively, metabolism may make little difference to the toxic affects of a substance so this effect is specific to individual substances and drugs. Commonly, sites that undergo metabolism (usually ones that express cytochrome P450) are the targets of toxic effects - the liver is the main organ of metabolism, but the kidneys, lungs, nasal epithelium, eyes and GI tract are also targeted because of cytochrome P450 activity.
==Specific Poisons==
==Specific Poisons==
==Clinical approach to a suspected poisoning case==
==Clinical approach to a suspected poisoning case==