TABLE OF CONTENTSodin.ces.edu.co/Contenidos_Web/41043049.pdf · THE GENERAL APPROACH TO MEDICAL...
Transcript of TABLE OF CONTENTSodin.ces.edu.co/Contenidos_Web/41043049.pdf · THE GENERAL APPROACH TO MEDICAL...
TABLEOFCONTENTS
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxvii
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xxviii
1 HistoricalPrincipIesand Perspectives 1PaulM. Wax
2 Toxicologic Plagues and Disasters in History . . . .. 18PaulM. Wax
PARTA
THEGENERALAPPROACHTO MEDICALTOXICOLOGY 31
3 Initial Evaluation of the Patient: Vital Signs andToxic Syndromes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
LewisS.Nelson, Neal A. Lewin, Mary Ann Howland, Robert S.Hoffman, LewisR. Goldfrank, and Neal E. Flomenbaum
4 PrincipIesof Managingthe AcutelyPoisoned orOverdosedPatient . . . . . . . . . . . . . . . . . . . . . 37
Lewis S. Nelson, Neal A. Lewin, Mary Ann Howland, Robert S.
Hoffman, Lewis R. Goldfrank, and Neal E. Plomenbaum
5 Diagnostic Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
David T. Schwartz
6 Laboratory PrincipIes. . . . . . . . . . . . . . . . . . . . . . . . . . 70
PetrieM. Rainey
7 Techniques Used to Prevent GastrointestinalAbsorption. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Anne-Bolette Gude and Lotte C. G. Hoegberg
A 1 Syrup of Ipecac . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 104
Mary Ann Howland
A2 ActivatedCharcoal. . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Mary Ann Howland
A3 Whole-Bowel Irrigation and Other IntestinalEvacuants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Mary Ann Howland
8 Pharmacokinetic and Toxicokinetic PrincipIes .119MaryAnn Howland
9 PrincipIes and Techniques Applied to EnhanceElimination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
David S. Goldfarb
10 Use ofThe Intensive Care Unit 148Mark A. Kirk
PARTB
THEFUNDAMENTALPRINClPLESOFMEDICALTOXICOLOGY. . . .. . . . .. . . . . . . . .. . .. .. 155
BiochemicalandMolecularBasis. . . . . . . . ... . . .. . . .. .157
11 ChemicalPrincipIes. . . . . . . . . . . . . . . . . . . . . . . . .. 157
Stephen ,. Traub and Lewis S. Nelson
12 BiochemicaI and Metabolic PrincipIes . . . . . . . . .. 170Kurt C.KleinschmidtandKathleenA. Delaney
13 Neurotransmitters and Neuromodulators . 189
Steven C. Curry, Kirk Charles Milis, Anne-Michelle Ruha,
and Ayrn D. Q'Connor
14 WithdrawaI PrincipIes. . . . . . . . . . . . . . . . . . . . . . . . 221
Richard ,. Hamilton
PathophysiologicBasis:Organ Systems. . . . . . . . . . . . . . . 228
15 Thermoregulatory PrincipIes . . . . . . . . . . . . . . . . . . 228
Susi U. Vassalloand Kathleen A. Delaney
16 Fluid, Electrolyte, and Acid-Base PrincipIes. . . . . 249
Alan N. Charney and Robert S. Hoffman
17 Psychiatric PrincipIes. . . . . . . . . . . . . . . . . . . . . . . . . 265
Kishor Malavade and Mark R. Serper
18 Neurologic PrincipIes. . . . . . . . . . . . . . . . . . . . . . . . . 275Rama B. Rao
19 Ophthalmic PrincipIes. . . . . . . . . . . . . . . . . . . . . . . . 285
Adhi Sharma
20 Otolaryngologic PrincipIes. . . . . . . . . . . . . . . . . . . . 292WilIiam K. Chiang
21 Respiratory PrincipIes . . . . . . . . . . . . . . . . . . . . . . . . 303
Andrew Stolbach and Robert S. Hoffman
22 Electrophysiologic and ElectrocardiographicPrincipIes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 314
Cathleen Clancy
23 Hemodynamic PrincipIes . . . . . . . . . . . . . . . . . . . . . 330Robert A. Hessler
24 Hematologic PrincipIes. . . . . . . . . . . . . . . . . . . . . . . 340Marco 1. A. Sivilotti
ix
Contents
- -- -
25 GastrointestinaI PrincipIes . . . . . . . . . . . . . . . . . . . . 359
Richard G. Church and Kavita M. Babu
26 Hepatic PrincipIes. . . . . . . . . . . . . . . . . . . . . . . . . . . . 367
Kathleen A. Delaney
27 RenalPrincipIes 381Donald A. Feinfeldand Nikolas B. Harbord
28 Genitourinary PrincipIes. . . . . . . . . . . . . . . . . . . . . . 396
JasonChu
29 DermatologicPrincipIes . . . . . . .. . 410Neal A. Lewin and Lewis S. Nelson
SpecialPopulations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 423
30 Reproductive and PerinataI PrincipIes . . . . . . . . . . 423JeffreyS. Fine
31 Pediatric PrincipIes. . . . . . . . . . . . . . . . . . . . . . . . . . . 447
JeffreyS. Fine
32 Geriatric PrincipIes. . . . . . . . . . . . . . . . . . . . . . . . . . . 461
Judith C. Ahronheim and Mary Ann Howland
33 Postmortem Toxicology . .. .. .. .. . .. . . . . . . . . . . 471Rama B. Rao and Mark A. F/omenbaum
se1 Organ Procurement from Poisoned Patients 479Rama B. Rao
PARTe
THECLlNICALBASISOF MEDICALTOXICOLOGY.. . . . . .481
A. AnalgesicsandAntiinflammatoryMedications.. . .483
34 Acetaminophen 483Robert G. Hendrickson
A4 N-Acetylcysteine 500Mary Ann Howland and Robert G. Hendrickson
35 Salicylates 508Neal E. Flomenbaum
AS Sodium Bicarbonate. . . . . . . . . . . . . . . . . . . . . . . . . . 520
Paul M. Wax
36 NonsteroidaI Antiinflammatory Drugs 528
William J. Holubek
--
J
37 Colchicine, PodophyIlin, and the Vinca Alkaloids... 537Joshua G. Schier
Se2 IntrathecaI Administration of Xenobiotics. . . . . . . 548Rama B. Rao
38 Opioids 559Lewis S. Nelson and Dean Olsen
A6 Opioid Antagonists 579Mary Ann Howland and Lewis S. Nelson
B. Foods,DietaryandNutritionalXenobiotics.. . . . . . 586
39 Dieting Agents and Regimens . . . . . . . . . . . . . . . . . 586Jeanna M. Marraffa
40 Iron 596Jeanmarie Perrone
A7 Deferoxamine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 604
Mary Ann Howland
41 Vitamins 609
Beth Y. Ginsburg
42 EssentiaI Oils . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 624
Sarah Eliza Halcomb
43 HerbaI Preparations . . . . . . . . . . . . . . . . . . . . . . . . . . 631
Oliver L. Hung
44 Athletic Performance Enhancers . . . . . . . . . . . . . . . 654
Susi U. Vassallo
45 Food Poisoning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 668
Michael G. Tunik
46 Botulism 682
Howard L. Geyer
A8 Botulinum Antitoxin . . . . . . . . . . . . . . . . . . . . . . . . . 695
Lewis R. Goldfrank and Howard L. Geyer
C. Pharmaceuticals . . . . . . . . . . . . . . . . . . . . . . . . 698
47 AnticonvuIsants . . . . . . . . . .. 698
Suzanne Doyon
A9 L-Carnitine 711
MaryAnn Howland
48 Antidiabetics and Hypoglycemics . . . . . . . . . . 714George M. Bosse
A 1O Dextrose 728
Larissa 1. Velez and Kathleen A. Delaney
A11 Octreotide 734
Mary Ann Howland
49 Thyroid and Antithyroid Medications . . . . . . . . . . 738Nicole C. Bouchard
50 Antihistaminesand Decongestants. . 748Anthony J. Tomassoni and Richard S. Weisman
A 12 Physostigmine Salicylate . . . . . . . . . . . . . . . . . . . . . . 759
Mary Ann Howland
51 Antimigraine Medications 763Jason Chu
52 Antineoplastics Overview . . . . . . . . . . . . . . . . . . . . . 770
RichardY. Wang
53 Antineoplastics: Methotrexate . . . . . . . . . . . . . . . . . 778
RichardY. Wang
A 13 Leucovorin (Folinic Acid) and Folic Acid . . . . . . . 783
Mary Ann Howland
A 14 Glucarpidase (Carboxypeptidase GJ . . . . . . . . . . . 787Si/as W. Smith
SC3 Extravasation of Xenobiotics . . . . . . . . . . . 793
Richard Y. Wang
54 Miscellaneous Antineoplastics . . . . . . . . . . . . . . . . . 796
Richard Y. Wang
55 Pharmaceutical Additives . . . . . . . . . . . . . . . . . . . . . 803
Sean P. Nordt and Lisa E. Vivero
D. Antimicrobials 817
56 Antibacterials,Antifungals,and Antivirals 817Christine M. Stork
57 Antituberculous Medications . . . . . . . . . . . . . . . . . . 834
Christina H. Hernon and Edward W. Boyer
A15 Pyridoxine 845Mary Ann Howland
58 Antimalarials. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 849
/. Dave Barry
E. Cardiopulmonary Medieations . . . . . . . . . ..861
59 Anticoagulants ... . . . . . . . . . . . . . . . . . . . . . . . . . . . 861
MarkSu
A 16 Vitamin K. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 876
Mary Ann Howland
A17 Protamine 880
Mary Ann Howland
60 Calcium Channel Blockers . . . . . . . . . . . . . . . . . . . . 884
PrancisJeromeDeRoos
Contents
A 18 Insulin-EuglycemiaTherapy 893William Kerns
61 ~-Adrenergic Antagonists. . . . . . . . . . . . . . . . . . . . . 896JeffreyR. Brubacher
A 19 Glucagon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 910
Mary Ann Howland
62 Other Antihypertensives 914Prancis Jerome DeRoos
63 Antidysrhythmics 925Lewis S. Nelson and Neal A. Lewin
64 Cardioactive Steroids . . . . . . . . . . . . . . . . . . . . . . . . . 936
Jason B. Hack
A20 Digoxin-SpecificAntibody Fragments . . . . . . . . . . 946Mary Ann Howland
65 Methylxanthines and Selective ~2AdrenergicAgonists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 952
Robert J. Hoffman
F. Anestheties and Related Medieations. . . . . . . . . . . . 965
66 Local Anesthetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 965
David R. Schwartz and Brian Kaufman
A21 Intravenous Fat Emulsions . . . . . . . . . . . . . . . . . . . . 976
Theodore C. Bania
67 Inhalational Anesthetics . . . . . . . . . . . . . . . . . . . . . . 982
Brian Kaufman and Martin Griffel
68 Neuromuscular Blockers . . . . . . . . . . . . . . . . . . . . . . 989
Kenneth M. Sutin
A22 Dantrolene Sodium . . . . . . . . . . . . . . . . . . . . . . . . . 1001
Kenneth M. Sutin
G. PsyehotropieMedieations... . . . . 1003
69 Antipsychotics 1003David N. Juurlink
70 Lithium 1016Howard A. Greller
71 Monoamine Oxidase Inhibitors. .. .. 1027Alex P. Manini
72 Serotonin Reuptake Inhibitors and AtypicalAntidepressants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1037
Christine M. Stork
73 Cyclic Antidepressants. . . . . . . . . . . . . . . . . . . . . . . 1049Erica 1. Liebelt
74 Sedative-Hypnotics 1060David C. Lee and Kathy Lynn Ferguson
A23 Flumazenil 1072
Mary Ann How/and
H. Substances of Abuse. . . . . . . . . . . . . . . . . . . . . . . . 1078
75 Amphetamines . . . . . . . . . . . . . . . .. . . . . . . .. .. . . 1078
William K. Chiang
76 Cocaine 1091
Jane M. Prosser and Robert S. Hoffman
SC4 Internal Concealment ofXenobiotics 1103
Jane M. Prosser
A24 Benzodiazepines 1109Robert S. Hoffman, Lewis S. Ne/son, and Mary Ann How/and
77 Ethanol 1115
LukeYip
A25 Thiamine Hydrochloride 1129Robert S. Hoffman
78 EthanolWithdrawal. . . . . . . . . . . . . . . . . . . . . . . . . 1134
Jeffrey A. Go/d and Lewis S. Ne/son
79 Disulfiramand Disulfiram-LikeReactions.. . . . . 1143
Edwin K. Kuffner
80 y-HydroxybutyricAcid .. .. .. .. .. .. .. .. .. .. .. 1151Brenna M. Farmer
81 Inhalants 1157
Heather Long
82 Hallucinogens 1166Kavita M. Babu
83 Cannabinoids 1177
Michae/ A. McGuigan
84 Nicotine ... . . 1185
Sari Soghoian
85 Phencyclidine and Ketamine .. . . 1191Ruben E. O/medo
1. Metals 1202
86 Aluminum 1202Brenna M. Farmer
87 Antimony 1207Asim F. Tarabar
88 Arsenic 1214
Stephen W. Munday and Marsha D. Ford
A26 Dimercaprol (British Anti-Lewisite or BAL) 1229
Mary Ann How/and
89 Bismuth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1233
Rama B. Rao
90 Cadmium 1237
Stephen J. Traub and Robert S. Hoffman
91 Chromium 1243Steven B. Bird
92 Cobalt 1248
Gar Ming Chan, MD
93 Copper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1256
Lewis S. Ne/son
94 Lead 1266
Fred M. Henretig
A27 Succimer (2,3-Dimercaptosuccinic Acid) 1284MaryAnn How/and
A28 Edetate Calcium Disodium (CaNazEDTA) 1290MaryAnn How/and
95 Manganese 1294Sari Soghoian
96 Mercury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1299
Young-Jin Sue
97 Nickel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1308
John A. Curtis and David A. Haggerty
98 Selenium 1316Diane P. Ca/ello
99 Silver 1321Melisa W. Lai Becker and Miche/e Burns Ewa/d
100 Thallium 1326
Maria Mercurio-Zappa/a and Robert S. Hoffman
A29 Prussian Blue . ... . . ... .. 1334
Robert S. Hoffman
1O1 Zinc 1339
Nima Maj/esi
J. HouseholdProducts. . . . . . . . . . . . . . . . . . . . . . . . 1345
102 Antiseptics, Disinfectants, and Sterilants . . . . . . . 1345Pau/M. Wax
103 Camphor and Moth Repellents . . . . . . . . . . . . . . . 1358Edwin K. Kuffner
104 Caustics . . . . . . . . . . . . . 1364Jessica A. Fu/ton
105 Hydrofluoric Acid and Fluorides 1374Mark Su
A30 Calcium .. . . . . . . . . . . . . . . .. .. .. .. . .. .. .. .. .. 1381
Mary Ann Howland
106 Hydrocarbons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1386
David D. Gummin
107 ToxicAlcohols..... .. . . . . . . . . . . . . ... 1400
Sage W. Wiener
SC5 Diethylene Glycol. . . . . . . . . . . . . . . . . . . . . . . . . . . 1411foshua G. Schier
A31 Fomepizole 1414Mary Ann Howland
A32 Ethanol 1419
Mary Ann Howland
K. Pesticides 1423
108 Pesticides: An Overview of Rodenticides
and a Focus on Principies. . . . . . . . . . . . . . . . . . . . 1423Neal E. Flomenbaum
109 Barium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1434
Andrew Dawson
110 Sodium Monofluoroacetate andFluoroacetamide. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1437
Fermin Barrueto, fr.
111 Phosphorus 1440Michael C. Beuhler
112 Strychnine . . . . . . . . . . . .. .. .. .. .. .. .. .. . . . . . . 1445Yiu-cheung Chan
113 Insecticides: Organic PhosphorusCompounds and Carbamates . .. . . . 1450Michael Eddleston and Richard Franklin Clark
A33 Pralidoxime 1467
MaryAnn Howland
A34 Atropine 1473MaryAnn Howland
114 Insecticides: Organic Chlorines,Pyrethrins/Pyrethroids, and Insect Repellents. . . 1477Michael G. Holland
115 Herbicides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1494
DarrenM. Roberts
116 MethylBromideand Other Fumigants .. 1516Keith K. Burkhart
Contents xiii
L. NaturalToxinsandEnvenomations.. . . . . . . . . . . 1522
117 Mushrooms 1522
Lewis R. Goldfrank
118 Plants . . . . . . . . . . . . . . . . . . . . . 1537
Mary Emery Palmer and foseph M. Betz
119 Arthropods 1561In-Hei Hahn
A35 Antivenom (Scorpionand Spider). . 1582Richard Franklin Clark
120 Marine Envenomations . . . . . . . . . . . . . . . . . . . . .. 1587D. Eric Brush
121 Snakes and Other Reptiles. . . . . . . . . . . . . . . . . . . . 1601
Bradley D. Ri/ey,Anthony F. Pizon, andAnne-Michelle Ruha
A36 Antivenom (Crotaline) 1611
AnthonyF.Pizon,BradleyD.Ri/ey,andAnne-MichelleRuha
M. OccupationalandEnvironmentalToxins.. . . . . . . 1615
122 Industrial Poisoning:Information andControl. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1615
Peter H. Wald
123 Nanotoxicology 1625Si/asW.Smith
124 Simple Asphyxiants and Pulmonary Irritants . . . 1643Lewis S. Nelson and Oladapo A. Odujebe
125 Carbon Monoxide. . . . . . . . . . . . . . . . . . . . . . . . . . . 1658Christian Tomaszewski
A37 HyperbaricOxygen .. .. .. . 1671Stephen R. Thom
126 Cyanideand Hydrogen Sulfide.. . . . . . . . . . . . . . . 1678
ChristopherP. Holstege,Gary E. 150m,and Mark A. Kirk
A38 Sodium and Amyl Nitrite . . . . . . . . . . . . . . . . . . . . 1689Mary Ann Howland
A39 SodiumThiosulfate ... 1692
Mary Ann Howland
A40 Hydroxocobalamin 1695MaryAnn Howland
127 Methemoglobin Inducers . . . . . . .. . . . . . . . . . . . . 1698Dennis P. Price
XIV Contents
------- --- -----
A41 Methylene Blue . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1708
Mary Ann Howland
128 Smoke Inhalation . . . . . . . . . . . . . . . . . . . . . . . . . . . 1711
Nathan Phillip Charlton and Mark A. Kirk
N. Disaster Preparedness . . .. .. . . . .. . . . . . .. .. .. 1721
129 Risk Assessment and Risk Communication. . . . . 1721
Charles A. McKay
130 Hazmat Incident Response . . . . . . . . . . . . . . . . . . . 1727
Bradley J. Kaufman
131 Chemical Weapons 1735Jeffrey R. Suchard
132 BiologicaI Weapons . . . . . . . . . . . . . . . . . . . . . . . . . 1750
Jeffrey R. Suchard
133 Radiation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1759
Joseph G. Rella
A42 Potassium lodide ... . .. . . . . . . . . . . . . . . . . . . . . . 1775
Joseph G. Rella
A43 DTP A [Pentetic Acid or Pentetate(Zinc or Calcium) Trisodium] . . . . . . . . . . . . . . . . 1779
JosephG. Rella
n
PoisonCentersand Epidemiology. . . . . . . . . . . . . . . . . . 1782
134 Poison Prevention and Education . . . . . . . . . . . . . 1782
Lauren Schwartz
135 Poison Centers and Poison Epidemiology . . . . . . 1789
Robert S. Hoffman
136 International Perspectiveson MedicalToxicology . . . . . . ... .. 1796Michael Eddleston
137 PrincipIesof EpidemiologyandResearch Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1803
Kevin C. Osterhoudt
138 Adverse Drug Events and PostmarketingSurveillance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1811
Louis R. Cantilena
139 Medication Safety and Adverse Drug Events. . . . 1820Brenna M. Farmer
140 RiskManagement and LegalPrincipIes. . . . 1831Barbara M. Kirrane and Dainius A. Drukteinis
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1839