Poisoning and Drug Overdose, Eighth Edition

by Alan H. B. Wu, Kent R. Olson (Editor), Justin C. Lewis, Paul D. Blanc, Neal L. Benowitz

Overview

When every moment counts, count on Poisoning & Drug Overdose

A Doody's Core Title for 2023!

Speed is crucial when dealing with toxicologic and drug-related emergencies. Finding answers quickly is easier than ever with this streamlined eighth edition of Poisoning and Drug Overdose. This instant-answer guide provides the critical information needed to diagnose and manage drug-related emergencies and chemical exposures.

Updated with newly released drugs and new information on existing drugs, the guide covers initial emergency management, including treatment of coma, seizures and hypotension; physical and laboratory diagnosis; and methods of decontamination and enhanced elimination of poisons.

Poisoning and Drug Overdose, Eighth Edition is divided into four sections:

Section I. Provides a stepwise approach to the evaluation and treatment of coma, seizures, shock, and other complications of poisoning and the proper use of gastric decontamination and dialysis procedures.

Section II. Lists specific poisons and drugs, as well as the pathophysiology, toxic dose and level, clinical presentation, diagnosis, and specific treatment associated with each substance.

Section III. Covers descriptions of therapeutic drugs and antidotes, including pharmacology indications, adverse effects, drug interactions, and recommended dosage.

Section IV. Describes the approach to hazardous materials incidents; the evaluation of occupational exposures; and the toxic effects, physical properties, and workplace limits for over 500 common industrial chemicals.

Poisoning and Drug Overdose, Eighth Edition is enhanced by numerous tables and charts, as well as a user-friendly index. This trusted resource has consistently been relied upon by front line professionals responding to drug-related emergencies and chemical exposures.

Product Details

ISBN-13:	9781264259083
Publisher:	McGraw Hill LLC
Publication date:	05/06/2022
Edition description:	8th ed.
Pages:	784
Sales rank:	162,656
Product dimensions:	5.30(w) x 8.30(h) x 1.20(d)

About the Author

Kent R. Olson, MD, FACEP, was the former medical director of California Poison Control System, San Francisco Division; and clinical professor of medicine and pharmacy at the University of California.

Craig Smollin, MD, is professor of emergency medicine and pharmacy at the University of California San Francisco; program director of the UCSF Medical Toxicology Fellowship; medical director of the California Poison Control System, San Francisco Division; and attending emergency physician at San Francisco General Hospital.

Ilene Anderson, PharmD, is clinical professor of pharmacy at the University of California, San Francisco.

Neal L. Benowitz, MD, is professor of medicine emeritus of the Research Program in Clinical Pharmacology, Division of Cardiology at the University of California, San Francisco.

Paul D. Blanc, MD, MSPH, is professor of medicine and chief of the Division of Occupational and Environmental Medicine at the University of California, San Francisco.

Susan Y. Kim-Katz, Pharm D, is clinical professor of pharmacy at the University of California, San Francisco; and senior toxicology management specialist for the San Francisco division of California Poison Control System.

Justin C. Lewis, PharmD, DABAT, is associate clinical professor of pharmacy at the University of California, San Francisco; and managing director of the Sacramento division of California Poison Control System.

Alan H.B. Wu, PhD, is professor of laboratory medicine at the University of California, San Francisco; and chief of the clinical chemistry laboratory at Zuckerberg San Francisco General Hospital.

Table of Contents

Authors xi

Preface and Acknowledgements xvii

Section I Comprehensive Evaluation and Treatment 1-73

This section provides a stepwise approach to the evaluation and treatment of coma, seizures, shock, and other common complications of poisoning and to the proper use of gastric decontamination and dialysis procedures.

Airway 1

Breathing 4

Ventilatory Failure 4

Hypoxia 5

Bronchospasm 7

Circulation 8

Bradycardia and Atrioventricular Block 8

QRS Interval Prolongation 9

Tachycardia 12

Ventricular Dysrhythmias 13

Hypotension 15

Hypertension 17

Altered Mental Status 19

Coma and Stupor 19

Hypothermia 20

Hyperthermia 21

Seizures 23

Agitation, Delirium, or Psychosis 25

Other complications 26

Dystonia, Dyskinesia, and Rigidity 26

Rhabdomyolysis 28

Anaphylactic and Anaphylactoid Reactions 29

Diagnosis of Poisoning 30

History 30

Physical Examination 30

Essential Clinical Laboratory Tests 34

Serum Osmolality and Osmol gap 34

Anion Gap Metabolic Acidosis 36

Hyperglycemia and Hypoglycemia 37

Hypernatremia and Hyponatremia 38

Hyperkalemia and Hypokalemia 41

Renal Failure 42

Hepatic Failure 43

Toxicology Screening 44

Imaging Studies 50

Decontamination 51

Skin decontamination 51

Decontamination of the Eyes 51

Decontamination after Inhalation 52

Gastrointestinal Decontamination 52

Gastric Lavage 53

Activated Charcoal 54

Whole-bowel Irrigation 55

Enhanced Elimination 56

Urinary pH Manipulation 59

Hemodialysis 59

Hemoperfusion 59

Peritoneal Dialysis 59

Continuous Renal Replacement Therapy 59

Repeat-dose Activated Charcoal 59

Disposition of the Patient 60

Special Considerations in Pediatric Patients 62

Pregnancy and Breastfeeding 65

Forensic Issues/Postmortem Toxicology 70

Evaluation of Drug-Facilitated Crimes 71

Section II Specific Poisons and Drugs: Diagnosis and Treatment 74-479

Organized alphabetically, this section lists specific drugs and poisons, as well as the pathophysiology, toxic dose and level, clinical presentation, diagnosis, and specific treatment associated with each substance. A table of pharmacokinetic values is provided at the end.

Acetaminophen 74

Aconite and Other Sodium Channel Openers 78

Amantadine 79

Ammonia 80

Amphetamines 82

Anesthetics, Local 86

Angiotensin Blockers and ACE Inhibitors 88

Antiarrhythmic Drugs 90

Antibacterial Agents 93

Antichoiinergics 98

Anticoagulants, Direct Oral 99

Anticonvulsants, Newer 102

Antidepressants, General (Noncyclic) 104

Antidepressants, Tricyclic 107

Antihistamines 110

Antimony and Stibine 113

Antineoplastic Agents 115

Antipsychotic Drugs 130

Antiseptics and Disinfectants 132

Antiviral and Antiretroviral Agents 134

Arsenic 138

Arsine 142

Asbestos 145

Azide, Sodium 146

Barbiturates 147

Barium 149

Benzene 151

Benzodiazepines 153

Beta-adrenergic Blockers 155

Beta₂-adrenergic Stimulants 157

Boric acid, Borates, and Boron 159

Botulism 160

Bromates 163

Bromides 164

Cadmium 165

Caffeine 167

Calcium Channel Antagonists 169

Camphor and Other Essential Oils 172

Carbamazepine and Oxcarbazepine 174

Carbon Disulfide 177

Carbon Monoxide 178

Carbon Tetrachloride and Chloroform 181

Caustic and Corrosive Agents 182

Chlorates 185

Chlorinated Hydrocarbon Pesticides 186

Chlorine 187

Chlorophenoxy Herbicides (2,4-D) 189

Chloroquine and Other Aminoquinolines 190

Chromium 192

Clonidine and Related Drugs 194

Cobalt 196

Cocaine 198

Colchicine 201

Copper 203

Cyanide 205

Dapsone 207

Detergents 210

Dextromethorphan 212

Diabetic Drugs 214

Digoxin and Other Cardiac Glycosides 218

Dioxins 221

Disulfiram 222

Diuretics 224

Ergot Derivatives 226

Ethanol 228

Ethylene Glycol and Other Glycols 231

Ethylene Oxide 235

Fluoride 236

Fluoroacetate 238

Food Poisoning: Bacterial 240

Food Poisoning: Fish and Shellfish 242

Formaldehyde 246

Freons and Halons 247

Gamma-hydroxybutyrate (GHB) 249

Gases, Irritant 251

Glyphosate 253

Heparins 255

Herbal and Alternative Products 257

Hydrocarbons 263

Hydrogen Fluoride and Hydrofluoric Acid 266

Hydrogen Sulfide 269

Hymenoptera 270

Iodine 271

Iron 273

Isocyanates 275

Isoniazid (INH) 276

Isopropyl Alcohol 278

Jellyfish and Other Cnidaria 280

Lead 282

Lionfish and Other Scorpaenidae 287

Lithium 289

Lomotil and Other Antidiarrheals 291

Lysergic Acid Diethylamide (LSD) and Other Hallucinogens 293

Magnesium 297

Manganese 299

Marijuana and Cannabinoids 300

Mercury 303

Metat Fume Fever 308

Metaldehyde 309

Metformin 310

Methanol 312

Methemoglobinemia 314

Methotrexate 316

Methyl Bromide 318

Methylene Chloride 320

Molds 322

Monoamine Oxidase Inhibitors 324

Mushrooms 327

Mushroom, Amatoxin-Type 330

Naphthalene and Paradichlorobenzene 332

Nicotine 334

Nitrates and Nitrites 336

Nitrogen Oxides 338

Nitroprusside 339

Nitrous Oxide 340

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) 342

Nontoxic or Minimally Toxic Household Products 344

Opiates and Opioids 346

Organophosphorus and Carbamate Insecticides 349

Oxalic Acid 358

Paraquat and Diquat 359

Pentachlorophenol and Dinitrophenol 361

Phencyclidine (PCP) and Ketamine 362

Phenol and Related Compounds 365

Phenytoin 366

Phosgene 368

Phosphine and Phosphides 369

Phosphorus 371

Plants 372

Polychlorinated Biphenyls (PCBs) 391

Pseudoephedrine, Phenylephrine, and Other Decongestants 393

Pyrethrins and Pyrethroids 395

Quinidine and Other Type la Antiarrhythmic Drugs 397

Quinine 398

Radiation (Ionizing) 400

Rodenticides, Miscellaneous 404

Salicylates 409

Scorpions 411

Sedative-Hypnotic Agents 413

Selenium 415

Skeletal Muscle Relaxants 417

Smoke Inhalation 419

Snakebite 421

Spiders 425

Strychnine 428

Sulfur Dioxide 429

Tetanus 430

Thallium 432

Theophylline 433

Thyroid Hormone 435

Toluene and Xylene 436

Trichloroethane, Trichlomethylene, and Tetrachloroethylene 438

Valproic Acid 440

Vasodilators 443

Vitamins 444

Warfare Agents - Biological 446

Warfare Agents - Chemical 451

Warfarin and Superwarfarins 458

Pharmacokinetic Data 461

Section III Therapeutic Drugs and Antidotes 480-597

This section provides descriptions of therapeutic drugs and antidotes discussed in Sections I and II, including their pharmacology, indications, adverse effects, drug interactions, and recommended dosage.

Acetylcysteine (NAC) 481

Andexanet Alpha 484

Antipsychotic Drugs (Haloperidol, Droperidol, Olanzapine, and Ziprasidone) 486

Antivenom, Centruroides (Scorpion) 488

Antivenom, Crotalidae (Rattlesnake) 489

Antivenom, Latrodectus Mactans (Black Widow Spider) 491

Antivenom, Micrurus Fulvius (Coral Snake) and Exotic Antivenoms 492

Atropine and Glycopyrrolate 494

BAL (Dimercaprol) 495

Benzodiazepines (Diazepam, Lorazepam, and Midazolam) 497

Benztropine 500

Bicarbonate, Sodium 501

Botulism Antitoxin 503

Bromocriptine 504

Calcium 506

Carnitine (Levocarnitine) 508

Charcoal, Activated 509

Cimetidine and Other H₂ Blockers 511

Clotting Factor Replacement Products 512

Cyproheptadine 515

Dantrolene 515

Deferoxamine 517

Dexmedetomidine 518

Digoxin-Specific Antibodies 519

Diphenhydramine 521

Dopamine 522

DTPA (Diethylenetriaminepentaacetate) 524

EDTA, Calcium (Calcium Disodium Edetate, Calcium Disodium Versenate) 525

Epinephrine 527

Esmolol 529

Ethanol 530

Flumazenil 532

Folic Acid 533

Fomepizole (4-Methylpyrazoie, 4-MP) 534

Glucagon 536

Glucarpidase 537

Glucose (Dextrose) 538

Hydroxocobalamin 539

Idarucizumab 540

Insulin 541

Iodide (Potassium Iodide, Kl) 542

Isoproterenol 544

Ketamine 545

Labetalol 547

Leucovorin Calcium 548

Lidocaine 549

Lipid Emulsion 550

Magnesium 552

Mannitol 553

Methylene Blue 554

Metociopramide 555

Naloxone 557

Neuromuscular Blockers 559

Nitrite, Sodium and Amyl 563

Nitroprusside 564

Norepinephrine 565

Octreotide 567

Ondansetron 568

Oxygen and Hyperbaric Oxygen 569

Penicillamine 571

Pentobarbital 572

Phenobarbital 573

Phentoiamine 575

Phenylephrine 575

Physostigmine and Neostigmine 576

Potassium 578

Pralidoxime (2-PAM) and Other Oximes 579

Propofol 581

Propranolol 583

Protamine 585

Prussian Blue 586

Pyridoxine (Vitamin B₆) 587

Silibinin 588

Succimer (DMSA) 589

Thiamine (Vitamin B₁) 591

Thiosuifate, Sodium 592

Unithiol (DMPS) 593

Vasopressin 595

Vitamin K₁ (Phytonadione) 596

Section IV Environmental and Occupational Toxicology 598-721

This section describes the approach to hazardous materials incidents; the evaluation of occupational exposures; and the toxic effects, physical properties, and workplace exposure limits for over 500 common industrial chemicals.

Emergency Medical Response to Hazardous Materials Incidents 598

Evaluation of the Patient with Occupational Chemical Exposure 606

The Toxic Hazards of Industrial and Occupational Chemicals 615

Health Hazard Summaries for Industrial and Occupational Chemicals 621

Index 723