Essentials 1 Exotic snakebite is a growing issue worldwide, especially with the growth in illegally held snakes. 2 Symptoms and signs may be different to those seen in Australian snakebites. 3 As many non-Australian snakes, especially the vipers, cause local…
Essentials 1 Australia has a number of medically important venomous snakes. All are elapids (front-fanged). New Zealand has no snakes of medical importance. 2 All patients giving a history of possible snakebite should be assessed and observed for at least…
Essentials 1 In overdose, any of the oral anticoagulants will elevate the international normalized ratio (INR), although not always in a direct dose-dependent manner. 2 Activated charcoal decreases the absorption following the ingestion of apixaban and is probably also effective…
Essentials 1 Opioid toxicity is characterized by respiratory depression, decreased level of consciousness and miosis. 2 The mainstay of treatment of opioid toxicity is naloxone and good supportive care. 3 Many opioid agents can have other toxic effects; for example,…
Essentials 1 In overdose, chloroquine is a highly toxic drug with a high mortality rate. 2 Cardiac toxicity occurs early and may manifest before arrival at hospital. 3 Good supportive care and the use of adrenaline are the principles of…
Essentials Anticholinergic (anti-muscarinic) toxic syndrome Anticholinergic toxic syndrome (ACTS) occurs as a result of the blockade of post-synaptic muscarinic receptors and/or a reduction or inhibition of cholinergic transmission at muscarinic receptor sites by drugs. Serotonin toxicity Clonus (spontaneous, inducible and…
Essentials 1 Hymenoptera strings are responsible for one or two deaths annually in Australia. 2 Hymenoptera venom is a common cause of allergy and anaphylaxis (∼3% of population). 3 Anaphylaxis is an absolute indication for venom immunotherapy. 4 Massive envenomation…
Essentials 1 Anticonvulsant overdose typically causes central nervous system effects, but other effects such as cardiotoxicity may be exhibited after the ingestion of certain agents. 2 Multiple doses of activated charcoal can reduce the duration of toxicity in carbamazepine and…
Essentials 1 Carbon monoxide is the commonest agent used in completed suicides by poisoning in Australia and the United Kingdom. 2 Carbon monoxide is produced by incomplete combustion and is found in car exhaust, faulty heaters, fires and in industrial…
Essentials 1 Ethanol is a major cause of morbidity, mortality and emergency department (ED) presentation in most Western societies. Presentations may result from acute intoxication, withdrawal or medical complications of chronic ethanol ingestion. 2 Ethanol causes central nervous system (CNS)…