Calcium Channel Blocker Toxicity
Severe calcium channel blocker toxicity is highly lethal, as a result of cardiovascular collapse. Good outcomes can be achieved through aggressive treatment and provision of circulatory support
Category Toxicology
Theophylline toxicity
Theophylline and caffeine are the most commonly encountered methylxanthines. Theophylline = water soluble aminophylline derivative; cAMP phosphodiesterase inhibitors
Toxic agents and abnormal vital signs
Abnormal vital signs in patient's following toxic exposures can suggest underlying toxidromes. Differential diagnosis of abnormal signs
Toxicological causes of cardiac arrest
The differential diagnosis of toxicological causes of cardiac arrest are many and varied. It is useful to consider the causes in terms of mechanism.
Malignant Hyperthermia
Malignant Hyperthermia = pharmacogenetic disease of skeletal muscle induced by exposure to certain anaesthetic agents; incidence 1:5,000 -> 1:65,000 anaesthetics (suspected); mutation in the gene coding for the ryanodine receptor
Anticholinergic Syndrome
Anticholinergic Syndrome
Evidence-based Toxicology
Much of what we do in toxicology is because we think it works, not because we know it works. Clinical toxicology has traditionally been based on animal studies, case reports and case series based on clinical observation rather than clinical trials
Iron Overdose
Iron overdose can have local gastrointestinal effects as well as characteristic systemic toxicity (metabolic acidosis, liver failure, shock and multi-organ failure). Risk assessment is based on the amount of elemental iron ingested
Plant Toxicity
Severe toxicity from plants is rare in humans; risk assessment is often difficult - plant identification may be difficult; - toxin quantification may be impossible
Lithium Toxicity
Lithium: acute overdose is usually benign if adequate hydration is maintained and renal function is normal; chronic toxicity can be difficult to manage and result in devastating neurotoxicity
Alcohol Withdrawal
Alcohol Withdrawal: common and can be fatal; manifests within 48 hours of stopping drinking
Hyperthermia-associated toxidromes
Toxidromes associated with hyperthermia may be difficult to distinguish: serotonin syndrome; anticholingeric syndrome; sympathomimetic syndrome; neuroleptic malignant syndrome; malignant hyperthermia