Key Concepts Asymptomatic patients seeking emergency department (ED) care for an abnormal metal test need follow-up evaluation arranged with a medical toxicologist. Metal testing in the ED should be ordered in consultation with a medical toxicologist or regional poison center.…
Key Concepts Hallucinogens include many types of drugs and chemicals with different associated effects, including action at serotonin receptors, dopamine receptors, and glutamate N -methyl- d -aspartate receptors. Diagnosis and management are based primarily on the history and physical examination,…
Key Concepts Excessive use of stimulants can lead to sympathomimetic toxicity , manifesting as tachycardia, hypertension, mydriasis, diaphoresis, hyperthermia, hyperreflexia, and agitation. If untreated, sympathomimetic toxicity can lead to seizures, coma, and death. Administration of benzodiazepines is the key therapeutic…
Key Concepts Health care workers caring for patients with caustic exposures should adhere to universal precautions to prevent additional exposure. All symptomatic patients should undergo endoscopy and be should be observed for at least 24 hours. Asymptomatic patients can undergo…
Cardioactive Steroids (Digoxin) Key Concepts Digoxin toxicity is often occult and should be considered in any patient who is on digoxin and presents with gastrointestinal or visual disturbance and a new dysrhythmia, conduction disturbance or hemodynamic instability, particularly in the…
Key Concepts Although rarely used for depression, MAOIs are used in the treatment of Parkinson disease. Because serious symptoms can occur after a lengthy latent period, patients with reported MAOI overdose should be admitted for 24 hours, regardless of symptoms.…
Key Concepts Anticholinergic (antimuscarinic) intoxication is common and can occur as a result of ingestion of a variety of plants and drugs, both prescription and over-the-counter. Most patients with antimuscarinic toxicity do well with supportive care and observation. Antimuscarinic syndrome…
Key Concepts In the overdose setting, salicylates are profoundly toxic and can be fatal. Salicylate overdose requires vigilant assessment and treatment. The other nonsteroidal antiinflammatory drugs (NSAIDs) generally have self-limited toxicity and respond to supportive measures. There is no specific…
Key Concepts Acetaminophen concentration should be measured in patients with intentional oral overdoses. Acetaminophen poisoning is relatively silent clinically until serious hepatotoxicity ensues. Repeated supratherapeutic dosing of acetaminophen can lead to life-threatening toxicity. Use the acetaminophen concentration on the nomogram…
As eloquently stated by Paracelsus in the 16th century, “all substances are poisons; there is none which is not a poison. The right dose differentiates a poison from a remedy.” Key Concepts Moderate alcohol consumption is defined as one or…