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.;Approach to the poisoned patient -- Specific considerations -- Specific toxins -- Antidotes -- Envenomings -- Antivenoms.

lgli/Toxicology Handbook, 2nd Edition.pdf

lgrsnf/Toxicology Handbook, 2nd Edition.pdf

zlib/Medicine/Lindsay Murray, Frank Daly, Mark Little, Mike Cadogan, Ovidiu Pascu/Toxicology Handbook_6125957.pdf

Lindsay Murray Mbbs Facem, Mark Little Mbbs Dtm&h(lond) Facem Mph&t Idha, Ovidiu Pascu Md Facem, Kerry Anne Hoggett Mbbs Gcertclintox Facem, Frank Daly Mbbs Facem, Mike Cadogan Ma(oxon) Mbchb Facem

Lindsay Murray; David McCoubrie; Frank Daly; Jessamine Soderstrom; Ovidu Pascu; Jason Armstrong; Mike Cadogan

Murray, Lindsay, Little, Mark, Pascu, Ovidiu, Hoggett, Kerry Anne, Daly, Frank, Cadogan, Mike

Jason Armstrong; Ovidiu Pascu; Lindsay Murray; Frank Daly; Mike Cadogan

Lindsay Murray, Mike Cadogan, Frank Daly, Mark Little, Mark Little

Armstrong, Jason

Elsevier Health Sciences APAC

Elsevier Australia

Elsevier Inc., Health Sciences Division, Sydney [N.S.W.], 2011

Second edition, Chatswood, N.S.W, 2011

2nd ed, Sydney, N.S.W, ©2011

Sydney, Australia, 2010

2nd ed, London, 2010

Australia, Australia

Second, PS, 2011

TRUE PDF

lg2826890

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PREFACE......Page 11
TOXICOLOGY HANDBOOK......Page 4
Copyright
......Page 5
CONTENTS......Page 6
FOREWORD......Page 10
CONTRIBUTORS......Page 12
REVIEWERS......Page 13
Chapter 1 - Approach to the poisoned patient......Page 14
1.1 OVERVIEW......Page 15
1.2 RESUSCITATION......Page 17
1.3 RISK ASSESSMENT......Page 23
1.4 SUPPORTIVE CARE AND MONITORING......Page 26
1.5 INVESTIGATIONS......Page 28
1.6 GASTROINTESTINAL DECONTAMINATION......Page 30
1.7 ENHANCED ELIMINATION......Page 37
1.8 ANTIDOTES......Page 42
1.9 DISPOSITION......Page 43
Chapter 2 - Specific considerations......Page 48
2.1 APPROACH TO SNAKEBITE......Page 49
2.2 APPROACH TO MUSHROOM POISONING......Page 57
2.3 APPROACH TO PLANT POISONING......Page 63
2.4 COMA......Page 68
2.5 HYPOTENSION......Page 72
2.6 APPROACH TO SEIZURES......Page 74
2.7 DELIRIUM AND AGITATION......Page 75
2.8 SEROTONIN SYNDROME......Page 79
2.9 ANTICHOLINERGIC SYNDROME......Page 85
2.10 CHOLINERGIC SYNDROME......Page 89
2.11 NEUROLEPTIC MALIGNANT SYNDROME......Page 93
2.12 ALCOHOL ABUSE, DEPENDENCE AND WITHDRAWAL
......Page 98
2.13 AMPHETAMINE ABUSE, DEPENDENCE AND WITHDRAWAL
......Page 106
2.14 OPIOID DEPENDENCE AND WITHDRAWAL......Page 107
2.15 SEDATIVE-HYPNOTIC DEPENDENCE AND WITHDRAWAL
......Page 110
2.16 SOLVENT ABUSE, DEPENDENCE AND WITHDRAWAL
......Page 113
2.17 BODY PACKERS AND STUFFERS......Page 117
2.18 OSMOLALITY AND THE OSMOLAR GAP......Page 120
2.19 ACID–BASE DISORDERS......Page 122
2.20 THE -LEAD ECG IN TOXICOLOGY......Page 126
2.21 POISONING DURING PREGNANCY AND LACTATION
......Page 132
2.22 POISONING IN CHILDREN......Page 133
2.23 POISONING IN THE ELDERLY......Page 139
Chapter 3 - SPECIFIC TOXINS
......Page 140
3.1 ALCOHOL: ETHANOL......Page 143
3.2 ALCOHOL: ETHYLENE GLYCOL......Page 146
3.3 ALCOHOL: ISOPROPANOL (isopropyl alcohol)......Page 149
3.4 ALCOHOL: METHANOL (methyl alcohol)......Page 151
3.5 ALCOHOL: OTHER TOXIC ALCOHOLS......Page 155
3.6 AMIODARONE......Page 157
3.7 AMISULPRIDE......Page 159
3.8 AMPHETAMINES......Page 161
3.9 ANGIOTENSIN CONVERTING ENZYME INHIBITORS......Page 165
3.10 ANTICOAGULANT RODENTICIDES......Page 167
3.11 ANTICONVULSANTS: NEWER AGENTS......Page 170
3.12 ANTIHISTAMINES (non-sedating)......Page 172
3.13 ANTIHISTAMINES (sedating)......Page 175
3.14 ARSENIC......Page 177
3.15 BETA-BLOCKERS......Page 181
3.16 BACLOFEN......Page 184
3.17 BARBITURATES......Page 186
3.18 BENZODIAZEPINES......Page 190
3.19 BENZTROPINE......Page 192
3.20 BUPROPION......Page 194
3.21 BUTTON BATTERIES......Page 197
3.22 CALCIUM CHANNEL BLOCKERS......Page 199
3.23 CANNABINOIDS (marijuana)......Page 203
3.24 CARBAMAZEPINE......Page 206
3.25 CARBON MONOXIDE......Page 209
3.26 CHLOROQUINE AND HYDROXYCHLOROQUINE......Page 213
3.27 CHLORAL HYDRATE......Page 215
3.28 CLONIDINE......Page 218
3.29 CLOZAPINE......Page 221
3.30 COCAINE......Page 223
3.31 COLCHICINE......Page 227
3.32 CORROSIVES......Page 229
3.33 CYANIDE......Page 232
3.34 DIGOXIN: ACUTE OVERDOSE......Page 235
3.35 DIGOXIN: CHRONIC POISONING......Page 239
3.36 DIPHENOXYLATE-ATROPINE......Page 243
3.37 GAMMA-HYDROXYBUTYRATE (GHB)......Page 245
3.38 GLYPHOSATE......Page 248
3.39 HYDROCARBONS......Page 250
3.40 HYDROFLUORIC ACID......Page 253
3.41 HYDROGEN PEROXIDE......Page 257
3.42 INSULIN......Page 260
3.43 IRON......Page 263
3.44 ISONIAZID......Page 267
3.45 LEAD......Page 269
3.46 LITHIUM: ACUTE OVERDOSE......Page 273
3.47 LITHIUM: CHRONIC POISONING......Page 276
3.48 LOCAL ANAESTHETIC AGENTS......Page 278
3.49 MERCURY......Page 282
3.50 METFORMIN......Page 286
3.51 METHOTREXATE......Page 289
3.52 MIRTAZAPINE......Page 292
3.53 MONOAMINE OXIDASE INHIBITORS (MAOIs)
......Page 293
3.54 NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs)......Page 297
3.55 OLANZAPINE......Page 300
3.56 OPIOIDS......Page 303
3.57 ORGANOCHLORINES......Page 308
3.58 ORGANOPHOSPHORUS AGENTS (organophosphates and carbamates)......Page 311
3.59 PARACETAMOL: ACUTE OVERDOSE......Page 315
3.60 PARACETAMOL: REPEATED SUPRATHERAPEUTIC INGESTION......Page 325
3.61 PARAQUAT......Page 329
3.62 PHENOTHIAZINES AND BUTYROPHENONES (antipsychotic agents)......Page 333
3.63 PHENYTOIN......Page 336
3.64 POTASSIUM CHLORIDE......Page 339
3.65 QUETIAPINE......Page 341
3.66 QUININE......Page 344
3.67 RISPERIDONE......Page 347
3.68 SALICYLATES......Page 349
3.69 SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs)
......Page 353
3.70 STRYCHNINE......Page 356
3.71 SULFONYLUREAS......Page 359
3.72 THEOPHYLLINE......Page 361
3.73 THYROXINE......Page 365
3.74 TRAMADOL......Page 367
3.75 TRICYCLIC ANTIDEPRESSANTS (TCAs)......Page 370
3.76 VALPROIC ACID (sodium valproate)......Page 374
3.77 VENLAFAXINE AND DESVENLAFAXINE......Page 377
3.78 WARFARIN......Page 381
Chapter 4 - Antidotes......Page 384
4.1 ATROPINE......Page 385
4.2 CALCIUM......Page 386
4.3 CYPROHEPTADINE......Page 389
4.4 DESFERRIOXAMINE......Page 390
4.5 DICOBALT EDETATE......Page 392
4.6 DIGOXIN IMMUNE FAB......Page 394
4.7 DIMERCAPROL......Page 396
4.8 ETHANOL......Page 398
4.9 FLUMAZENIL......Page 400
4.10 FOLINIC ACID......Page 402
4.11 FOMEPIZOLE......Page 404
4.12 GLUCAGON......Page 405
4.13 GLUCOSE......Page 407
4.14 HYDROXOCOBALAMIN......Page 409
4.15 INSULIN (high-dose)......Page 411
4.16 INTRAVENOUS LIPID EMULSION......Page 413
4.17 METHYLENE BLUE......Page 414
4.18 N-ACETYLCYSTEINE......Page 416
4.19 NALOXONE......Page 419
4.20 OCTREOTIDE......Page 421
4.21 PENICILLAMINE......Page 423
4.22 PHYSOSTIGMINE......Page 424
4.23 PRALIDOXIME......Page 426
4.24 PYRIDOXINE......Page 428
4.25 SODIUM BICARBONATE......Page 430
4.26 SODIUM CALCIUM EDETATE......Page 433
4.27 SODIUM THIOSULFATE......Page 435
4.28 SUCCIMER......Page 437
4.29 VITAMIN K......Page 439
Chapter 5 - Envenomings......Page 442
5.1 BLACK SNAKE......Page 443
5.2 BROWN SNAKE......Page 446
5.3 DEATH ADDER......Page 449
5.4 TIGER SNAKE......Page 452
5.5 TAIPAN......Page 455
5.6 SEA SNAKE......Page 458
5.7 AUSTRALIAN SCORPIONS......Page 460
5.8 BLUEBOTTLE JELLYFISH (Physalia species)......Page 462
5.9 STONEFISH......Page 463
5.10 BOX JELLYFISH (Chironex fleckeri)......Page 465
5.11 IRUKANDJI SYNDROME......Page 467
5.12 BLUE-RINGED OCTOPUS......Page 470
5.13 REDBACK SPIDER......Page 472
5.14 FUNNEL-WEB (BIG BLACK) SPIDER......Page 474
5.15 WHITE-TAILED SPIDER......Page 476
5.16 TICKS......Page 478
Chapter 6 - Antivenoms......Page 482
6.1 CSL BLACK SNAKE ANTIVENOM......Page 483
6.2 CSL BROWN SNAKE ANTIVENOM......Page 484
6.3 CSL DEATH ADDER ANTIVENOM......Page 486
6.4 CSL TIGER SNAKE ANTIVENOM......Page 488
6.5 CSL TAIPAN ANTIVENOM......Page 490
6.6 CSL SEA SNAKE ANTIVENOM......Page 492
6.7 CSL POLYVALENT SNAKE ANTIVENOM......Page 494
6.8 CSL STONEFISH ANTIVENOM......Page 495
6.9 CSL BOX JELLYFISH ANTIVENOM......Page 497
6.10 CSL REDBACK SPIDER ANTIVENOM......Page 499
6.11 CSL FUNNEL-WEB SPIDER ANTIVENOM......Page 501
APPENDICES......Page 504
APPENDIX 1: POISONS INFORMATION TELEPHONE
NUMBERS
......Page 505
APPENDIX 2: EXAMPLE ECGs......Page 506
APPENDIX 3: CONVERSION FACTORS AND
THERAPEUTIC RANGES FOR
IMPORTANT TOXINS......Page 511
APPENDIX 4: ALCOHOL PATHWAYS......Page 512
APPENDIX 5: THERAPEUTIC OVER-WARFARINISATION......Page 513
APPENDIX 6: MANAGEMENT OF ALLERGIC REACTIONS
TO ANTIVENOMS......Page 515
INDEX......Page 516

Toxicology Handbook, 2nd Edition
Murray, Daly, McCoubrie, Soderstrom, Pascu, Armstrong & Cadogan
Table of Contents
Section 1: Introduction
Who are the authors
Scope of the book
Handbook of acute management of common poisonings.
Hands on and practical approach.
Rationale for drugs included
How to use the book
Universal disclaimer
Clinical: Approach to the poisoned patient
Overview of approach to toxicology/toxinology
Principles of risk assessment-based approach
Resuscitation, Risk assessment, Supportive care, Decontamination, Investigations, Enhanced elimination, Antidotes, Disposition
Section 2: Approach to specialist toxicology problems
Approach to special problems: Approach to snakebite, mushroom poisoning, plant poisoning
Toxidromes: Serotonin syndrome, Neuroleptic Malignant Syndrome, anticholinergic syndrome, cholinergic syndrome
Important poisoning manifestations and management: Seizures, coma, hypotension, delirium and agitation
Drugs of abuse and withdrawal syndromes: Alcohol, amphetamines, opiods, sedative hypnotics, body packers and stuffers
Investigations: Laboratory results: acidosis, anion gap and osmolar gap, recommended baseline investigations with interpretation. Unit conversion table: ECG interpretation in poisoning: Radiology.
Special populations: Paediatric poisoning: 1 tablet can kill (list), special precautions in management (overnight stay, paracetamol, risk of charcoal etc); Pregnancy and lactation and poisoning; and Geriatric poisoning
Section 3: Toxic Drugs (78 chapters)
Approach to diagnosis, investigation and management of the poisoned patient with all of the common drug presentations. Updated with 8 new drug chapters as per readers nominations and feedback
Section 4: Antidotes (29 chapters)
Detailed description of indications, contraindications, clinical administration and therapeutic end-points for all antidotes. New chapter on Intralipid, the latest development in antidote therapy
Section 5: Toxinology (16 chapters)
Approach to snakebite, spider and marine envenoming. New chapter on tick envenoming
Section 6: Antivenom (11 chapters)
Detailed description of indications, contraindications, clinical administration and therapeutic end-points for all antivenoms
Appendices Sample ECGs from poisoned patients; Drug concentrations and unit conversion chart; Guide to the management of allergic reaction to antivenom

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. • All Chapters And References Reviewed And Updated • A Major Review Of Snake Bite Management And Snake Antivenoms In Light Of New Evidence • New Chapters On Mushroom Poisoning, Plant Poisoning, Amphetamine Abuse And Solvent Abuse • New Chapters On Poisoning With Newer Anticonvulsant Drugs, Barbiturates, Button Batteries, Chloral Hydrate, Local Anaesthetic Agents, Quinine And Tramadol • A New Antidote Chapter On Intravenous Lipid Emulsion • Book Chapters Have Been Reorganised For Enhanced Clinical Usability – For Example, Consolidation Of Drugs Of Abuse • Now Available In An Enhanced Electronic Format

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.
all chapters and references reviewed and updated; major review of snake bite management and snake antivenoms in the light of new evidence new chapters on mushroom poisoning, plant poisoning, amphetamine abuse and solvent abuse new chapters on poisoning with newer anticonvulsant drugs, barbiturates, button batteries, chloral hydrate, local anaesthetic agents, quinine and tramadol new antidote chapter on intravenous lipid emulsion chapters reorganised for enhanced clinical usability – for example, consolidation of drugs of abuse enhanced electronic format

The Toxicology Handbook is a practical, didactic guide to the approach, assessment and management of poisoned patients. It has been written for hospital-based doctors at all levels and describes the risk assessment-based approach pioneered by the principal authors. The concise layout enables the reader to quickly locate information on a poisoning emergency. The book also features locally relevant information on bites, stings and envenoming. This book will also be useful for ambulance service paramedics and pharmacists. It is established as a primary reference in the Australian Poisons Information Centres.--COVER

2020-11-01