Are kinetic investigations feasible in human poisoning?

Kinetics in human poisoning have gained more importance because of the development of specific and quantitative analytical methods. Despite many pitfalls related to unprecise data in acute poisonings, several studies showed that kinetic parameters, determined by a simple approach, may be helpful for the management. Parameters include plasma elimination half-life, total, renal and hepatic clearances, amounts eliminated by normal routes or by specific treatments. For numerous drugs, spontaneous toxicokinetics and factors of variation could be assessed. These include the dose ingested, the type of poisoning, the age; the symptoms and organ failures; the associated drugs. Kinetic studies have been a major step for the evaluation of treatments such as gastric lavage, oral activated charcoal, haemodialysis, antidotes and have contributed to the understanding of kinetics-dynamics relationships and to the assessment of severity and prognosis criteria. In clinical practice, it is possible by kinetic investigations to select the patients which will really benefit from a treatment such as haemodialysis in lithium poisoning.