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Henry Mishin
Henry Mishin

Poisoning And Toxicology Handbook BEST



The present volume provides locations and phone numbers of poison control centers throughout the country, organizations offering information on toxicology, and teratology information services. It presents diagnostic testing and analytical procedures, evaluates the effectiveness of antidotes, and features an extensive symptoms listing. The section on special topics provides detailed treatment protocols, hospital preparedness guidelines, position statements, and practice guidelines focused on the treatment of toxicities. This fourth edition keeps you up to date in one of the most exciting and expanding fields in medical science.




Poisoning and Toxicology Handbook



This text is a comprehensive third edition of a reference handbook that contains current and detailed information for those interested in the medical and medicinal aspects of poisoning and toxicology. Using the standard approach of the Lexi-Comp clinical reference library, this 1553-page handbook serves as a unique and quick-to-use reference tool. This resource is specifically designed to be used by physicians, toxicologists, pharmacologists, emergency medical personnel, medical review officers, nurses, laboratory professionals, and a wide variety of other health care and toxicology specialists. In the fields of laboratory medicine and emergency toxicology, both authors are well-known experts and lecturers. The listings of the contributing participants and the editorial advisory panel constitute an array of equally impressive experts in their fields.


In the introduction, information presented includes general references, contact information for poison information centers, and sources for general poison information and teratology information services. The handbook also gives an overview of important information on the following topics in toxicology: approach to toxicology, antidotes, and drugs used in toxicology; biological agents; diagnostic tests and procedures; drugs of abuse; herbal agents; medicinal agents; and nonmedicinal agents. There is also a comprehensive set of appendices that are too numerous (in excess of 200 pages) to completely describe herein. Selected appendices provide information on averages and conversions, chemical warfare agents, cardiopulmonary resuscitation, adult and pediatric drug dosage information, emergency adult and pediatric drug dosage information, management of occupational exposures to bloodborne pathogens, postmortem blood-drug concentrations, and safe handling of hazardous drugs.


This handbook is an excellent and voluminous body of information that, primarily, should prove useful to any health care professional or scientific investigator who needs to quickly access the latest and most relevant knowledge on poisoning and toxicology information for antidotes and drugs used in toxicology; biological agents; drugs of abuse; herbal agents; medicinal agents; and nonmedicinal agents. With the recognition that this publication is a quick-reference handbook and not a textbook, it is a valuable tool and resource for numerous clinical, scientific, and toxicologic applications.


An updated guide to the approach, assessment and management of poisoned patients Poisoning is a common emergency department presentation, and is the third major cause of hospital admission in Australia. The new edition of this all-encompassing toxicology reference describes the risk assessment-based approach pioneered by its principal authors. The Toxicology Handbook is written for hospital-based doctors at all levels and is divided into six sections, including an approach to the poisoned patient, specific toxins, antidotes, toxinology and antivenom. It also deals with specific toxicology considerations like alcohol abuse, dependence and withdrawal, and poisoning in children and the elderly. Important locally relevant information on bites, stings and envenoming is also included. The concise layout of this didactic medical guide enables readers to quickly locate required information - essential in a poisoning emergency. Established as a primary reference in Australian Poisons Information Centres, the Toxicology Handbook is useful for doctors, nurses, ambulance service paramedics and pharmacists alike.


The book has been streamlined and fully updated to provide a comprehensive yet concise guide for all medical practitioners and health-care professionals who deal with poisonings. It contains quickly accessible information on poisons, toxins, antidotes, envenomings and antivenoms, and uses a structured and rigorous risk assessment-based approach to guide appropriate treatment decisions.


Each year the American Association of Poison Control Centers records more than 1.2 million childhood poisoning exposures. Of these exposures, 76% occur in children younger than the age of 6 years. Exposures in young children are often unintentional, whereas adolescents are more likely to have intentional ingestions.1


See Table 3.2 . A. Decontamination1. Activated charcoal5a. Most effective when used within first hour after ingestion but can be given after first hour, especially for sustained-release preparations. Should be given PO to an awake and alert patient. Nasogastric (NG)tube should be used only if a patient is intubated. b. Substances not absorbed by charcoal: Iron, alcohols, lithium c. Contraindications: Unprotected airway, caustic ingestion, disrupted gastrointestinal tract, concern for aspiration 2. Whole bowel irrigationa. Indicated for evacuation of substances not bound to activated charcoal such as iron, lead-containing foreign bodies, fatal sustained release products, drug packing. b. Use a polyethylene glycol electrolyte solution preparation to irrigate the bowel. Recommended rates: 9 months to 6 years (500 mL/hr), 6 to 12 years (1000 mL/hr), more than 12 years (1500 to 2000 mL/hr). B. Enhanced Removal1. Hemodialysis or exchange transfusions may be indicated to remove a drug/toxin. 2. Ingestions that may require enhanced removal therapies: Salicylate, lithium, methanol, ethylene glycol, metformin-associated lactic acidosis, valproate, theophylline C. Other Considerations1. Many ingestions managed primarily with supportive care of any associated toxic effects, such as hypotension or hyperpyrexia. 2. Seizures: First line agents are benzodiazepines. Barbiturates or propofol should be considered as second line agents. Phenytoin has no role in the treatment of toxin-induced seizures.63. Patients with severe poisoning and refractory cardiorespiratory failure after ingestion are potential extracorporeal membrane oxygenation (ECMO) candidates because the toxic effects are transient.


In response, scientists increased their efforts to capture alkaloids in human tissue. Finally, in 1860, a reclusive and single-minded French chemist, Jean Servais Stas, figured out how to isolate nicotine, an alkaloid of the tobacco plant, from a corpse. Other plant poisons soon became more accessible and chemists were able to offer new assistance to criminal investigations. The field of toxicology was becoming something to be reckoned with, especially in Europe.


The knowledge, and the scientific determination, spread across the Atlantic to the United States. The 1896 book Medical Jurisprudence, Forensic Medicine and Toxicology, cowritten by a New York research chemist and a law professor, documented the still-fierce competition between scientists and killers. In one remarkable case in New York, a physician had killed his wife with morphine and then put belladonna drops into her eyes to counter the telltale contraction of her pupils. He was convicted only after Columbia University chemist Rudolph Witthaus, one of the authors of the 1896 text, demonstrated the process to the jury by killing a cat in the courtroom using the same gruesome technique. There was as much showmanship as science, Witthaus admitted; toxicology remained a primitive field of research filled with "questions still unanswerable."


Jeffrey Brent, M.D., Ph.D (biochemistry), is a Distinguished Clinical Professor of Medicine, University of Colorado School of Medicine and Colorado School of Public Health. He completed his medical toxicology Fellowship training at the Rocky Mountain Poison and Drug Center and has a long career of active research in medical toxicology. His Curriculum vitae lists nearly 300 publications of various kinds, including original research papers, abstracts, chapters, and reviews. Currently, Dr. Brent is Principal Investigator and Director of the Toxicology Investigators Consortium (ToxIC), an NIH supported national multi-center study group in medical toxicology.Dr. Brent is a former President of the American Academy of Clinical Toxicology (AACT), a former member of the Board of Directors of the American College of Medical Toxicology (ACMT), a recipient of the Louis Roche award from the European Association of Poisons Centres and Clinical Toxicologists, the Career Achievement Award from the AACT, and the Ellenhorn Award from the ACMT, and the Clinical Translational Sciences Career Achievement Award from the Society of Toxicology. 041b061a72


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