The immunization consists of three subcutaneous injections given 2 weeks apart, followed by three additional subcutaneous injections given at 6, 12, and 18 months. Annual booster injections of the vaccine are required to maintain immunity. TOXICOLOGY LEARNING OBJECTIVE: Identify how poisons are introduced into the body and the factors that affect their toxicity. Toxicology is the science of poisons, their actions, their detection, and the treatment of the conditions produced by them. A poison is a substance that, when inhaled, swallowed, absorbed, applied to the skin, or injected into the body in relatively small amounts, may cause damage to structures or disturbances of function. Poisons act by changing the normal metabolism of cells or by actually destroying them. The effects of poisons may be local or remote, and in some instances, poisons can produce both effects. A local effect is produced when a poison only affects the area in which it is applied. A remote effect is produced when a poison affects parts of the body that are remote to the site of application or point of introduction. Poisons sometimes show no effect—or only a slight effect—until several doses have been taken. Then, suddenly, an effect is produced that nearly equals that produced by taking the whole amount at one time. This is known as a cumulative effect. The toxicity of poisons depends upon their method of introduction into the body and how fast they are absorbed by the body. For example, snake venom taken into the mouth or into the stomach during first aid treatment of snakebite is not ordinarily harmful, but snake venom injected parenterally is extremely poisonous. Various conditions affect an individual’s reaction and susceptibility to poisons. For instance, some individuals by nature are unusually sensitive to certain poisons (such as venom from bee stings), while others possess a natural tolerance. Additionally, the age of the victim can affect the severity of the poisoning. Young children, for example, are normally more susceptible to poisons than adults. Habitual use of certain poisons, such as narcotics, may cause individuals to become accustomed to a poison’s effects, even though the amount taken by these individuals would ordinarily be considered lethal. This habitual use of poisons, however, may result in a sudden hypersensitivity that could be deadly. The actions of poisons may also be considerably modified by disease, some diseases increasing and others lessening the action of poisons. Poisons are eliminated from the body by way of the kidneys, liver, gastrointestinal tract, and skin. Poisons are eliminated either unchanged or in the form of other compounds. These compounds are the result of chemical changes made in various body organs and tissues. For a more in-depth understanding of the various types of poisoning and their emergency treatment procedures, see chapter 5, “Poisoning, Drug Abuse, and Hazardous Material Exposure.” PHARMACY LEARNING OBJECTIVE: Recall the v a r i o u s p h a r m a c e u t i c a l w e i g h t a n d measurement systems, and determine medication dosage by using the conversion process or the percentage and ratio calculations. As you progress in your career as a Hospital Corpsman, you will be assigned duties in specialized departments throughout the hospital and especially aboard ship. Not only will your responsibilities increase, but your training will become more and more diversified. One of the departments to which you may be assigned is the pharmacy, where you will assist in preparing and dispensing medicines. This section will give you a basic introduction to the field of pharmacy and help prepare you for these responsibilities. METROLOGY AND CALCULATION Metrology, called the arithmetic of pharmacy, is the science of weights and measures and its application to drugs, their dosage, preparation, compounding, and dispensing. It is absolutely vital for Hospital Corpsmen to thoroughly understand the principles and applications of metrology in pharmacy. Errors in this area endanger the health—even the life—of the patient. 6-10