Critical Care Toxicology - Springer978-3-319-17900-1/1.pdf · Jeffrey Brent Senior Editor Keith...
Transcript of Critical Care Toxicology - Springer978-3-319-17900-1/1.pdf · Jeffrey Brent Senior Editor Keith...
Critical Care Toxicology
Jeffrey BrentSenior Editor
Keith Burkhart • Paul DarganBenjamin Hatten • Bruno MegarbaneRobert Palmer • Julian WhiteEditors
Critical Care Toxicology
Diagnosis and Management ofthe Critically Poisoned Patient
Second Edition
With 675 Figures and 487 Tables
Senior EditorJeffrey BrentDepartment of MedicineDivision of Clinical Pharmacologyand ToxicologyUniversity of ColoradoSchool of MedicineAurora, CO, USA
EditorsKeith BurkhartFDA, Office of NewDrugs/Immediate OfficeCenter for Drug Evaluationand ResearchSilver Spring, MD, USA
Paul DarganClinical ToxicologySt Thomas’ HospitalSilver Spring, MD, USA
Benjamin HattenToxicology AssociatesUniversity of ColoradoSchool of MedicineDenver, CO, USA
Bruno MegarbaneMedical Toxicological IntensiveCare UnitLariboisiere HospitalParis-Diderot UniversityParis, France
Robert PalmerToxicology AssociatesUniversity of ColoradoSchool of MedicineDenver, CO, USA
Julian WhiteToxinology DepartmentWomen’s and Children’s HospitalNorth Adelaide, SA, Australia
ISBN 978-3-319-17899-8 ISBN 978-3-319-17900-1 (eBook)ISBN 978-3-319-17901-8 (print and electronic bundle)DOI 10.1007/978-3-319-17900-1
Library of Congress Control Number: 2017930938
1st edition: # Mosby 2005# Springer International Publishing AG 2017, corrected publication 2017This work is subject to copyright. All rights are reserved by the Publisher, whether the whole orpart of the material is concerned, specifically the rights of translation, reprinting, reuse ofillustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way,and transmission or information storage and retrieval, electronic adaptation, computer software, orby similar or dissimilar methodology now known or hereafter developed.The use of general descriptive names, registered names, trademarks, service marks, etc. in thispublication does not imply, even in the absence of a specific statement, that such names are exemptfrom the relevant protective laws and regulations and therefore free for general use.The publisher, the authors and the editors are safe to assume that the advice and information in thisbook are believed to be true and accurate at the date of publication. Neither the publisher nor theauthors or the editors give a warranty, express or implied, with respect to the material containedherein or for any errors or omissions that may have been made. The publisher remains neutral withregard to jurisdictional claims in published maps and institutional affiliations.
Printed on acid-free paper
This Springer imprint is published by Springer NatureThe registered company is Springer International Publishing AGThe registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Foreword
Critical Care Toxicology belongs in every critical care unit, emergency depart-ment, poison center, library, emergency response center, and on the most easilyreached shelf for anyone interested in or who comes in contact with medicaltoxicology. This masterful compilation of information has many attributes,among which are:
• Evidence based well-referenced information• Editors and authors who are experts in their fields• Concise and clear presentation• Tables that convey critical data• Figures and diagrams that are clinically relevant• Paragraph headers that allow focused access to information• Calculations and formulas that are fully explained• Lists of treatment materials to obtain in advance with contact information of
unusual items• Therapeutic dosages that are detailed enough to be utilized without addi-
tional references
In most cases, diagnostic and therapeutic information can be obtained in afew minutes given the book’s careful organization. For those patients pre-senting with complicated or multiple exposures, the structure provides astraightforward method of rapidly developing and working through a differ-ential diagnosis.
The quality of this book should come as no surprise after looking at theimpressive listing of authors. The editors, each of whom I have known, workedwith, and respected for many years, have selected an international group ofexperts whose credibility is unmatched. They represent the best of our profes-sion of medical toxicology and have written a large percentage of the mostimportant and groundbreaking publications in our field. The editors andauthors are the most sought-after educators in our annual toxicology meetingsaround the world and provide clinical expertise as well as leadership andtraining for all of us who work in this wide and varied area.
In the preface to the first edition of Critical Care Toxicology, the word“passion” occurs in the very first sentence. For all of us who have ever written ascientific monograph, paper, chapter, book, or prepared a teaching session, theword passion certainly defines a major requirement for preparation of materials
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that will communicate the knowledge that is intended. It takes time and effortto write something that will stand the test of time, and when written withpassion it means that the author has not skipped over anything and left nothingof importance unaddressed. It requires thorough knowledge of the subject, realworld experience, fully researched literature, and draft after draft until com-munication is assured. When reading this book, it is apparent that the editorsand authors have achieved their goal.
Before writing this foreword, the editors provided me with some chaptersfrom the second edition. In reviewing four of them – “Acid-base,” “Hypoten-sion and Shock,” “Seizures,” and “Acute Respiratory Distress Syndrome” – itwas readily apparent that this second edition is an improvement on an alreadyexcellent book. More current materials are included as expected, but usingthese chapters as examples the authors have dramatically improved this book.Acid-base in the critical care setting is a complicated and often difficult issue.To address that the authors have doubled the length of this chapter andsubstantially added information which will be valuable to all who utilize it.The chapters on hypotension and shock and acute respiratory distress syn-drome have been broken out of their previous locations and addressed com-prehensively to reflect their importance. The chapter on seizures has also beendoubled in length and contains a considerable amount of new information thatis clearly presented.
The authors have also added speed of access to this book through the use ofa table of contents at the beginning of each chapter. This further enhances theability of the reader to get to an answer under emergent circumstances.
The book also has another purpose than just providing critical informationin a clinical setting. It provides a very readable and understandable educationalexperience for all those who are studying this area. This must includeaddressing controversial areas with which the reader may be familiar and ifnot familiar ought to be familiar, and this book engages all of this.
Even those of us who have been in this field for a long time stand to learnsomething from this book. The discussion of the strong anion gap in the acid-base chapter coupled with the very practical explanations of the other factors inthis important area is the clearest I have ever read. An area in which I have littleknowledge is malignant hyperthermia, and this chapter provides a clear expla-nation along with even a phone number and website to get additional updatedinformation in what is apparently a rapidly evolving issue. The editors clearlywant readers to get the right answers to their questions.
Critical Care Toxicology covers all of the areas in medical toxicology in aseries of well-written chapters following the excellent chapters that provide anapproach to the critically poisoned patient and an understanding of toxicsyndromes. Images of various aspects of toxicological encounters providevisual reinforcement of the written materials.
The index is very well done and comprehensive. Unlike the 7th edition in1959 of Nelson’s pediatric text where the editor’s daughter, who hated havingto produce the index, entered under B “Birds, for the” and listed the entirebook, the index of Critical Care Toxicology was obviously prepared bysomeone who had a passion for helping readers get to answers.
vi Foreword
Critical Care Toxicology provides a very valuable contribution to allaspects of medical toxicology from education to, as the title states, criticalcare. It should be readily accessible to everyone who may face this issue fromforming a differential diagnosis to rendering care.
Rocky Mountain Poison and Drug Center Barry H. RumackDenver, Colorado Director EmeritusUSA
Foreword vii
Preface to the Second Edition
Those readers who are familiar with the first edition of Critical Care Toxicol-ogy (CCT) know that it was about passion – our collective passion for caringfor patients with the group of fascinating physiological derangements causedby exogenous chemical exposures. While our passion for the field of clinicaltoxicology remains unabated, an additional theme that characterizes the sec-ond edition of Critical Care Toxicology is scientific evidence.
In the 10 years since the publication of the first edition, a considerable bodyof new scientific evidence has emerged, new antidotes have become available,and systematic reviews andmeta-analyses have becomemore commonplace inthe field of clinical toxicology. Seizing upon the opportunity to provide acompendium of this accumulated evidence-based knowledge, we have workedwith our chapter authors to assure that they have stayed true to the existingbody of empirical data and, in the many places, where data gaps exist identifythem so that the user of this book will understand the basis for the treatmentrecommendations we provide. In order for the user of CCT to quickly discernthe veracity of the evidence supporting the treatment recommendations pro-vided, we have adopted the US Public Health Service’s rating of scientificevidence. These gradings allow the reader to instantly know the level ofscientific support for various treatment recommendations and thus to be ableto rely most heavily on well-supported therapeutic modalities.
We are highly cognizant of the reality that there are many areas where theevidence base relating to treatment decisions is insufficient. Nevertheless, theclinician treating the critically poisoned patient still requires guidance. Giventhat so many of our chapter authors represent the world’s authority on theirtopic, we have also strongly encouraged them to give their highly informedopinions on how to proceed in the many areas where there are clear knowledgegaps. Where they have supplied these opinions they have been identified assuch, and we have worked with them to also explain their thought processesunderlying these opinions.
We are very proud of the group of chapter authors that have been broughttogether in CCT. Where possible we have endeavored to recruit a group ofinternational experts in their respective subject matter who are also experi-enced clinicians, proficient in the intensive care of patients poisoned by thetoxins and toxicants they have addressed. This quest for such a uniquelyqualified group of chapter authors has required us to seek out scholars frommany areas of the world. Being such highly respected individuals, our chapter
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authors are for the most part very busy with their various academic and clinicalpursuits. We are greatly indebted to them for the generous donation of the timethey gave us to not only produce their excellent chapters but also to put up withour compulsively detailed editing and challenges to them for justification ofthe information contained in their chapters. In most instances, they have doneso because they were dedicated to the idea of working with us to achieve thegoals enumerated above.
Critical Care Toxicology is not a static textbook in the traditional sense. Theonline version is a living dynamic document that can, and will, be updated asneeded and new chapters will be provided beyond the date of the originalpublication of the current edition. In this way, we will feel confident that you,the reader of CCT, will have the most up-to-date information available to youin your care of your critically poisoned patients.
Jeffrey BrentKeith Burkhart
Paul DarganBenjamin HattenBruno Megarbane
Robert PalmerJulian White
x Preface to the Second Edition
Preface to the First Edition
To us, this book is about passion. It is the result of the passion we share for theclinical challenges we face every day in caring for critically poisoned patientsand in understanding their unique and enchanting pathophysiology and itstherapeutic implications. This is a passion we hope to elicit in all who ventureinto the world of clinical toxicology as they read this book. To the medicaltoxicologist, the care of the seriously poisoned patients merges the diverseworlds of critical care, emergency medicine, pharmacology, altered drugpharmacokinetics (hence the term “toxicokinetics”), diagnostic challenges,multisystem involvement in often otherwise healthy patients, and the use ofspecific and often esoteric treatment strategies and antidotes.
Before embarking on the extraordinarily labor-intensive activity of gener-ating a book of this depth and complexity, we queried the importance ofproducing another clinical toxicology textbook. We are aware of severalexcellent general clinical toxicology textbooks on the market and appreciatetheir attempts to achieve a far greater breadth than the present work. However,toxicology is such a broad field that general textbooks encompassing all ofclinical toxicology necessarily must limit the extent of their coverage of theintensive care unit management of major poisonings. Thus, the intensivist, andcritically poisoned patients, deserve a reference that specifically addressestheir needs. This need is made all the more important by the life-threateningnature of many of these poisonings. Stark evidence of the complexity of justthese issues is that to cover them adequately required 160 chapters and 1633pages.
Our goal was to have the most knowledgeable and experienced medicaltoxicologists author relevant chapters. In order to achieve this goal we draftedour colleagues with unique experience and expertise worldwide. As witnessedby our contributor list, all continents, except Antarctica, are represented. Weproudly boast that our collective chapter authors represent a significant pro-portion of the most experienced critical care toxicologists in the world. Med-ical toxicologists interested in acute care tend to be domiciled at the bedside, inpoison centers, or both. Because of the highly clinical nature of this book, weselected authors with a predominantly bedside care orientation.
With the ready access to facts and data via the Internet, the very nature ofhard copy books has changed dramatically. No longer is it necessary for booksto be compendia of facts. However, electronic databases cannot convey thereasoned clinical approaches and the synthesis of pathophysiology with
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clinical effects and treatment that characterizes the pages that follow. Certainly,important physiologic and monitoring parameters as well as drug dosages areamply provided. The degree to which they are included represents our view ofthe best balance between those that are important to know and the desire todedicate as much space as necessary to an elucidation of relevant concepts anda critical discussion of therapeutic controversies. We have embraced ratherthan glossed over controversies. The reader will find that this is not simply a“how to” handbook. Our aim is to provide the practitioner with the data neededto care for his or her individual patients. As an aid to those who choose to delvemore deeply into the concepts, approaches, and controversies in this book,chapters are well referenced with primary source citations.
It is our hope and expectation that this book will evoke the same passion inthe reader that the subject does for us.
Jeffrey Brent, M.D., Ph.D.Kevin L. Wallace, M.D.Keith K. Burkhart, M.D.Scott D. Phillips, M.D.J. Ward Donovan, M.D.Robert B. Palmer, Ph.D.
xii Preface to the First Edition
Contents
Volume 1
Part I General Management of the Critically PoisonedPatient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1 The Critically Poisoned Patient . . . . . . . . . . . . . . . . . . . . . . . 3J. Ward Donovan, Keith Burkhart, and Jeffrey Brent
2 The Diagnostic Process in Medical Toxicology . . . . . . . . . . . 29Anthony F. Pizon, Joseph H. Yanta, andGreg S. Swartzentruber
3 Therapeutic Approach to the Critically Poisoned Patient . . . 43Evan S. Schwarz
4 Extracorporeal Membrane Oxygenation andCardiopulmonary Bypass in the Poisoned Patient . . . . . . . . 79William P. Kerns II and Alan C. Heffner
5 Post-Resuscitation Management of the Poisoned Patient . . . 101Michael Lynch and Jon C. Rittenberger
6 Psychiatric Issues in the Critically Poisoned Patient . . . . . . . 117J. J. Rasimas and Gregory L. Carter
7 Poisoning in Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159Kevin F. Maskell Jr., Kirk L. Cumpston,Timothy B. Erickson, and Jerrold B. Leikin
8 Geriatric Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193Janetta L. Iwanicki
9 Intensive Care of Pediatric Poisoning Cases . . . . . . . . . . . . . 205Prashant Joshi and Mitchell P. Ross
10 The Critically Poisoned Worker . . . . . . . . . . . . . . . . . . . . . . . 223Michael G. Holland
11 Complications of Chronic Alcoholism That AffectCritical Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249Alison L. Jones
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12 Extracorporeal Substance Removal . . . . . . . . . . . . . . . . . . . . 267Monique J. Cormier and Marc Ghannoum
13 Poisoning Fatalities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279Philippe E. Hantson
Part II Toxic Syndromes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
14 The Assessment and Management of Hypotensionand Shock in the Poisoned Patient . . . . . . . . . . . . . . . . . . . . . 295Florian Eyer
15 Acid–Base Balance in the Poisoned Patient . . . . . . . . . . . . . . 325Stephen W. Borron
16 Treatment of Acute Respiratory Distress Syndromein the Poisoned Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 359Dylan W. de Lange
17 Toxicant-Induced Hepatic Injury . . . . . . . . . . . . . . . . . . . . . . 385Kim Dalhoff
18 Toxicant-Induced Renal Injury . . . . . . . . . . . . . . . . . . . . . . . 409Joshua D. King
19 Toxicant-Induced Alterations in Consciousness . . . . . . . . . . 425Jerrold B. Leikin and Andrea Carlson
20 Toxicant-Induced Seizures . . . . . . . . . . . . . . . . . . . . . . . . . . . 447Philippe E. Hantson
21 Cardiac Conduction and Rate Disturbances . . . . . . . . . . . . . 475Hallam Gugelmann and Neal Benowitz
22 Toxicant-Induced Torsade de Pointes . . . . . . . . . . . . . . . . . . . 509Jonas Höjer and Donna Seger
23 Anticholinergic Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . 519William J. Boroughf
24 Serotonin Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 539Peter R. Chai and Edward W. Boyer
25 Sympathomimetic Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . 549Andrew M. King, Eric R. Malone, and Cynthia K. Aaron
26 Toxicant-Induced Immunological Reactions . . . . . . . . . . . . . 569Jenny M. Stitt and Stephen C. Dreskin
27 Withdrawal Syndromes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 591Adhi N. Sharma and Robert S. Hoffman
28 Acute Radiation Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 605Ziad N. Kazzi
xiv Contents
29 Malignant Hyperthermia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 619Henry Rosenberg, Dorothea Hall, and Harvey Rosenbaum
30 Toxicant-Induced Hematologic Syndromes . . . . . . . . . . . . . . 643Steven C. Curry and A. Min Kang
31 Neuroleptic Malignant Syndrome . . . . . . . . . . . . . . . . . . . . . . 661Rebecca E. Bruccoleri and Michael J. Burns
32 Toxicant-Induced Rhabdomyolysis . . . . . . . . . . . . . . . . . . . . . 679G. Patrick Daubert
Part III Medication Safety in the Intensive Care Unit . . . . . . . . . 691
33 Adverse Drug Reactions in the Intensive Care Unit . . . . . . . 693Philip Moore and Keith Burkhart
34 Medication Errors and Drug–Drug Interactions in theIntensive Care Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 741Brenna Farmer and Luke Yip
Part IV Medications: Cardiovascular . . . . . . . . . . . . . . . . . . . . . . . . 749
35 Alpha-2 Adrenergic and Imidazoline ReceptorAgonists: Clonidine, Dexmedetomidine, and RelatedAntihypertensives, Decongestants, and Sedatives . . . . . . . . . 751Anthony J. Tomassoni
36 Beta-Receptor Antagonists . . . . . . . . . . . . . . . . . . . . . . . . . . . 771Michael Levine and Jeffrey Brent
37 Calcium Channel-Blocking Agents . . . . . . . . . . . . . . . . . . . . . 787Maude St-Onge and Jeffrey Brent
38 Digitalis Glycosides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 807Bruno Mégarbane
39 Sodium Channel-Blocking Antidysrhythmics . . . . . . . . . . . . 821Silas W. Smith
40 Sodium Nitroprusside . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 843Steven C. Curry and Meghan B. Spyres
41 Sympathomimetic Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . 851Robert J. Hoffman and Lewis S. Nelson
Part V Medications: Decongestant/Antihistaminergic/Bronchodilatory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 867
42 Antihistamines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 869Jerry W. Snow and R. Brent Furbee
Contents xv
43 Theophylline and Other Methylxanthines . . . . . . . . . . . . . . . 883Ann-Jeannette Geib
Part VI Medications: Psychotropic . . . . . . . . . . . . . . . . . . . . . . . . . . 905
44 Antipsychotics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 907Bradley L. Demeter and Michael J. Burns
45 Anxiolytics, Sedatives, and Hypnotics . . . . . . . . . . . . . . . . . . 935C. William Heise and Daniel E. Brooks
46 Barbiturates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 955Steven J. Walsh and Kenneth D. Katz
47 Bupropion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 965Peter Wu and David Juurlink
48 Cyclic Antidepressants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 975Mark K. Su
49 Lithium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 991Eric J. Lavonas and Jeffrey Brent
50 Monoamine Oxidase Inhibitors . . . . . . . . . . . . . . . . . . . . . . . 1009Ayrn D. O’Connor and Kirk C. Mills
51 Serotonergic Antidepressants . . . . . . . . . . . . . . . . . . . . . . . . . 1027Andrew H. Dawson
Volume 2
Part VII Medications: Anticonvulsant . . . . . . . . . . . . . . . . . . . . . . . 1041
52 Hydantoin Anticonvulsants: Phenytoin andFosphenytoin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1043Frank LoVecchio
53 Iminostilbene Anticonvulsants: Carbamazepine andOxcarbazine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1053Hwee Min Lee and Andis Graudins
54 Second Generation Anticonvulsants: Gabapentin,Lamotrigine, Levetiracetam, and Topiramate . . . . . . . . . . . . 1065M. P. Emswiler and Kirk L. Cumpston
55 Valproic Acid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1083Wayne R. Snodgrass and Chia Wei Hsu
xvi Contents
Part VIII Medications: Neuromuscular . . . . . . . . . . . . . . . . . . . . . . 1095
56 Antiparkinsonian Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1097Steven J. Walsh and Kenneth D. Katz
57 Baclofen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1119Erin Stewart and Laura M. Tormoehlen
58 Centrally Acting Muscle Relaxants . . . . . . . . . . . . . . . . . . . . 1133Madeline L. McCarthy and Carl R. Baum
Part IX Medications: Analgesic/Anti-Inflammatory . . . . . . . . . . 1143
59 Acetaminophen/Paracetamol . . . . . . . . . . . . . . . . . . . . . . . . . 1145D. Nicholas Bateman
60 Methotrexate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1171Yedidia Bentur and Yael Lurie
61 Nonsteroidal Anti-Inflammatory Drugs . . . . . . . . . . . . . . . . . 1219Kimberlie A. Graeme
62 Opioids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1237Scott Lucyk and Lewis S. Nelson
63 Salicylates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1251Steven C. Curry and Meghan B. Spyres
Part X Medications: Antimicrobial . . . . . . . . . . . . . . . . . . . . . . . . . . 1269
64 Chloroquine and Quinine . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1271Alison L. Jones
65 Isoniazid and Related Hydrazines . . . . . . . . . . . . . . . . . . . . . 1287Cynthia Koh, Alicia B. Minns, and Richard F. Clark
66 Rifampin, Dapsone, and Vancomycin . . . . . . . . . . . . . . . . . . . 1299Cyrus Rangan and Richard F. Clark
Part XI Medications: Hematologic . . . . . . . . . . . . . . . . . . . . . . . . . . 1311
67 Iron . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1313Sean M. Bryant and Jerrold B. Leikin
68 Oral Anticoagulants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1325George Sam Wang
69 Thrombolytics, Heparin and Derivatives,and Antiplatelet Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1341Robert A. Raschke and Steven C. Curry
Contents xvii
Part XII Medications: Miscellaneous . . . . . . . . . . . . . . . . . . . . . . . . 1361
70 Antidiabetic Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1363Jenna M. LeRoy and Samuel J. Stellpflug
71 Antitubulin Agents: Colchicine, Vinca Alkaloids, andPodophyllin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1387Jerry W. Snow, Louise W. Kao, and R. Brent Furbee
Part XIII Drugs of Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1411
72 Amphetamines and Their Derivatives . . . . . . . . . . . . . . . . . . 1413Nicholas J. Connors and Robert S. Hoffman
73 Arylcyclohexamines: Ketamine, Phencyclidine, andAnalogues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1439James H. Ho and Paul I. Dargan
74 Cathinones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1485Rachelle Abouchedid and David M. Wood
75 Cocaine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1525Ruben Olmedo, Christopher Yates, and Robert S. Hoffman
76 Gamma-Hydroxybutyrate and Its Related AnaloguesGamma-Butyrolactone and 1,4-Butanediol . . . . . . . . . . . . . . 1555David M. Wood
77 Hallucinogens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1587Curtis P. Snook
78 Synthetic Cannabinoid Receptor Agonists . . . . . . . . . . . . . . . 1609Andrew A. Monte
Part XIV Chemical Agents: Metals and Related Substances . . . 1617
79 Antimony and Nickel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1619Matthew D. Sztajnkrycer
80 Arsenic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1639Michael J. Kosnett
81 Cadmium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1669Jan Meulenbelt
82 Lead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1675Michael J. Kosnett
83 Mercury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1705Irma de Vries
xviii Contents
84 Phosphorus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1719Emily B. Austin and Marco L. A. Sivilotti
85 Thallium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1733Sean H. Rhyee
Part XV Chemical Agents: Solvents, Glycols, and Alcohols . . . 1741
86 Ethylene Glycol and Other Glycols . . . . . . . . . . . . . . . . . . . . 1743Knut Erik Hovda, Kenneth McMartin, and Dag Jacobsen
87 Isopropyl Alcohol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1761Heath A. Jolliff
88 Methanol and Formaldehyde . . . . . . . . . . . . . . . . . . . . . . . . . 1769Knut Erik Hovda, Kenneth McMartin, and Dag Jacobsen
Part XVI Chemical Agents: Pesticides . . . . . . . . . . . . . . . . . . . . . . . 1787
89 Chlorophenoxy Herbicides . . . . . . . . . . . . . . . . . . . . . . . . . . . 1789Sally M. Bradberry and J. Allister Vale
90 Fumigants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1797Matthew Zuckerman
91 Fungicides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1811Annette M. Lopez and Daniel Sudakin
92 Organophosphate and Carbamate Insecticide . . . . . . . . . . . . 1829J. Allister Vale and Sally M. Bradberry
93 Paraquat and Diquat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1855Michael Eddleston
94 Phosphate and Phosphine . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1875Ashish Bhalla
95 Rodenticides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1887Ryan Chuang and Jennie A. Buchanan
Part XVII Chemical Agents: Gases and Vapors . . . . . . . . . . . . . . . 1909
96 Carbon Monoxide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1911Christopher Hoyte
97 Cyanide: Hydrogen Cyanide, Inorganic Cyanide Salts, andNitriles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1929Steven C. Curry and Meghan B. Spyres
98 Hydrocarbons and Halogenated Hydrocarbons . . . . . . . . . . 1951Jakub Furmaga, Kurt Kleinschmidt, and Kapil Sharma
Contents xix
99 Hydrogen Sulfide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1963Aaron Skolnik and C. William Heise
100 Irritant and Toxic Pulmonary Injuries . . . . . . . . . . . . . . . . . . 1973Joseph K. Maddry
Part XVIII Chemical Agents: Caustics and Corrosives . . . . . . . . . 2003
101 Caustics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2005Diane P. Calello
102 Hydrofluoric Acid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2021Kennon Heard
Volume 3
Part XIX Natural Toxins: Marine . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2031
103 Ciguatera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2033Shaun Greene
104 Marine Vertebrates, Cnidarians, and Mollusks . . . . . . . . . . . 2045L. Keith French and B. Zane Horowitz
105 Scombroid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2075Mark A. Suguitan and Rama B. Rao
106 Tetrodotoxin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2085Chen-Chang Yang
Part XX Natural Toxins: Mushrooms . . . . . . . . . . . . . . . . . . . . . . . . 2101
107 Overview of Mushroom Poisoning . . . . . . . . . . . . . . . . . . . . . 2103Michael C. Beuhler
108 Cyclopeptide-Containing Mushrooms: The DeadlyAmanitas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2129Thomas Zilker and Heinz Faulstich
109 Gyromitra Mushrooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2149Daniel E. Brooks and Kimberlie A. Graeme
Part XXI Natural Toxins: Plants and Herbals . . . . . . . . . . . . . . . . . 2161
110 Overview of Plant and Herbal Toxicity . . . . . . . . . . . . . . . . . 2163Philip Aplin
111 Anticholinergic Plants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2175Robert N. E. French and Frank G. Walter
xx Contents
112 Cardiotoxic Plants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2187Barbarajean Magnani and Alan D. Woolf
113 Poison Hemlock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2205Frederick W. Fiesseler and Richard D. Shih
114 Toxalbumins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2213Jennifer A. Oakes and Richard Y. Wang
115 Water Hemlock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2225Edward W. Cetaruk
Part XXII Natural Toxins: Scorpions . . . . . . . . . . . . . . . . . . . . . . . . . 2237
116 Overview of Scorpion Envenoming . . . . . . . . . . . . . . . . . . . . 2239Julian White
117 Middle East and North African Scorpions . . . . . . . . . . . . . . . 2255Yona Amitai
118 North American Scorpions . . . . . . . . . . . . . . . . . . . . . . . . . . . 2269Michael Levine and Anne-Michelle Ruha
Part XXIII Natural Toxins: Snakes . . . . . . . . . . . . . . . . . . . . . . . . . . . 2277
119 Overview of Snake Envenoming . . . . . . . . . . . . . . . . . . . . . . . 2279Julian White
120 African Snakes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2319Jean-Philippe Chippaux, Julian White, andAbdulrazaq G. Habib
121 Asian Snakes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2343Aniruddha Ghose and Julian White
122 Australian and Pacific Snakes . . . . . . . . . . . . . . . . . . . . . . . . . 2405Julian White
123 European Snakes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2441Luc de Haro and David Boels
124 Non-Front-Fanged Colubroid Snakes . . . . . . . . . . . . . . . . . . 2453Scott A. Weinstein
125 North American Coral Snakes and Related Elapids . . . . . . . 2493Jeffrey N. Bernstein
126 Rattlesnakes and Other North American Crotalids . . . . . . . 2503Anne-Michelle Ruha
127 South and Central American Snakes . . . . . . . . . . . . . . . . . . . 2527Ceila Maria Sant’Ana Malaque and José María Gutiérrez
Contents xxi
Part XXIV Natural Toxins: Spiders . . . . . . . . . . . . . . . . . . . . . . . . . . 2549
128 Overview of Spider Envenoming . . . . . . . . . . . . . . . . . . . . . . 2551Julian White
129 Australian Funnel Web Spiders . . . . . . . . . . . . . . . . . . . . . . . 2565Julian White
130 Loxosceles Spiders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2577Ceila Maria Sant’Ana Malaque, Richard S. Vetter, andMarlene Entres
131 Widow and Related Lactrodectus Spiders . . . . . . . . . . . . . . . 2595Jeena Jacob and Julian White
Part XXV Natural Toxins: Miscellaneous . . . . . . . . . . . . . . . . . . . . 2607
132 Botulism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2609B. Zane Horowitz
133 Massive Bee Envenomation . . . . . . . . . . . . . . . . . . . . . . . . . . . 2627Hui Wen Fan and Jorge Kalil
Part XXVI Threat Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2637
134 Chemical Terrorism Incidents and Intensive Care . . . . . . . . 2639R. Steven Tharratt and Timothy E. Albertson
135 Nerve Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2655Mahdi Balali-Mood, Beeta Balali-Mood, andKia Balali-Mood
136 Sulfur Mustard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2683Dirk Steinritz and Horst Thiermann
Part XXVII Antidotes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2713
137 Antidigitalis Fab Fragments . . . . . . . . . . . . . . . . . . . . . . . . . . 2715Bruno Mégarbane
138 Atropine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2725Robert N. E. French and Frank G. Walter
139 Calcium Edetate (Calcium Disodium EDTA) . . . . . . . . . . . . 2733Michael J. Kosnett
140 Cyanide-Binding Antidotes: Dicobalt Edetate andHydroxocobalamin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2737Vikhyat S. Bebarta
141 Cyproheptadine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2747Karen E. Simone
xxii Contents
142 Dantrolene . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2757Blaine E. Benson
143 Deferoxamine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2771F. Lee Cantrell
144 4-Dimethylamino Phenol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2779Thomas Zilker and Peter Eyer
145 Dimercaprol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2791Michael J. Kosnett
146 Ethanol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2795Tammi H. Schaeffer
147 Euglycemic Insulin Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . 2801Kristin Engebretsen
148 Flumazenil . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2811Allyson Kreshak and Stephen Munday
149 Folic and Folinic Acids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2819Michelle A. Hieger and S. Rutherfoord Rose
150 Fomepizole . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2829Kenneth McMartin, Knut Erik Hovda, and Dag Jacobsen
151 Immunotherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2843Steven A. Seifert and Brandon J. Warrick
152 Lipid Resuscitation Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . 2859Jeffrey Brent and Michael Levine
153 Methylene Blue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2867Jack Clifton II and Jerrold B. Leikin
154 N-Acetylcysteine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2879Eric Villeneuve and Sophie Gosselin
155 Nitrites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2889Bruce D. Anderson
156 Octreotide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2897Bryan D. Hayes
157 Opioid Receptor Antagonists . . . . . . . . . . . . . . . . . . . . . . . . . 2907Scott Lucyk and Lewis S. Nelson
158 Oximes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2913J. Allister Vale
159 D-Penicillamine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2929Cristy Eidelman and Jennifer A. Lowry
160 Pentetic Acid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2937Shikha Kapil and Ziad N. Kazzi
Contents xxiii
161 Physostigmine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2943William J. Boroughf
162 Prussian Blue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2957Pierre-André Dubé and Sophie Gosselin
163 Pyridoxine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2963Ashleigh Kennedy and Tammi H. Schaeffer
164 Sodium Bicarbonate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2967Sara K. Lookabill, Anna Rouse Dulaney,Greene Shepherd, and William P. Kerns II
165 Succimer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2987Michael J. Kosnett
166 Thiamine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2993Alfred Aleguas Jr.
167 Thiosulfate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3001F. Lee Cantrell
168 Unithiol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3005Michael J. Kosnett
Erratum to: Critical Care Toxicology – Diagnosis andManagement of the Critically Poisoned Patient . . . . . . . . . . . . . . . E1
Jeffrey Brent, Keith Burkhart, Paul Dargan, Benjamin Hatten,Bruno Megarbane, Robert Palmer, and Julian White
Appendix: Sympathomimetic Pressors . . . . . . . . . . . . . . . . . . . . . . 3009Jeffrey Brent
Grading System for Levels of Evidence SupportingRecommendations in Critical Care Toxicology, 2nd Edition . . . . . . 3017
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3019
xxiv Contents
About the Editors
Jeffrey Brent holds the rank of Distinguished Clinical Professor of Medicine,in the Division of Clinical Pharmacology and Toxicology, at the University ofColorado, School of Medicine. He holds secondary appointments in theDepartments of Emergency Medicine and Pediatrics and in the ColoradoSchool of Public Health.
Dr. Brent has received numerous awards and honors during his professionalcareer. Among these are multiple career achievement awards, including theLouis Roche Award by the European Association of Poisons Centres andClinical Toxicologists, the Career Achievement Award by the AmericanAcademy of Clinical Toxicology, the Ellenhorn Award by the AmericanCollege of Medical Toxicology, and the Clinical Translational ToxicologyCareer Achievement Award by the Society of Toxicology.
A former President of the American Academy of Clinical Toxicology,Dr. Brent has also served on the board of directors of the American Collegeof Medical Toxicology.
Dr. Brent has served as a consultant to the World Health Organization andto several US government agencies, including the Department of Health andHuman Services, and the National Vaccine Program. Currently, he is an activeconsultant with the US Food and Drug Administration.
Dr. Brent is Director of a large National Institutes of Health and Food andDrug Administration supported multicenter research group in clinical toxicol-ogy known as the Toxicology Investigators Consortium.
xxv
Keith K. Burkhart Dr. Burkhart is the Senior Advisor for Medical Toxicol-ogy and Lead Medical Officer for the Biomedical Informatics Team in theDivision of Applied Regulatory Science in the Office of Clinical Pharmacol-ogy within the Office of Translational Science in the Center for Drug Evalu-ation and Research at the FDA. He is board certified in Emergency Medicineand Medical Toxicology. He is a Clinical Professor of Emergency Medicine atthe Penn State University. He practices critical care toxicology at thePinnacleHealth Hospital System. He is the former Medical Director of thePenn State Poison Center. Dr. Burkhart received his medical toxicologytraining at the Rocky Mountain Poison Center in Denver. He received hisemergency medicine training at the University of Cincinnati. He is a graduateof the former Medical College of Pennsylvania, nowDrexel University. He is apast President of the American College of Medical Toxicology. His FDAworkfocuses upon using bioinformatics and cheminformatics tools to data mine theFDA Adverse Event Reporting System to learn mechanistic insights into drugsafety issues.
Paul Dargan Professor Paul I Dargan is a Consultant Physician and ClinicalToxicologist and Clinical Director at Guy’s and St Thomas’ NHS FoundationTrust, London, UK. He is also a Professor of Clinical Toxicology at King’sCollege London. He has an active research program with a focus on recrea-tional drug toxicity, new psychoactive substances, prescription medicine mis-use, self-poisoning (in particular, paracetamol/acetaminophen), and heavy
xxvi About the Editors
metal toxicity (in particular, lead). He has published over 250 peer-reviewedpapers and numerous book chapters. He is active in postgraduate training inclinical toxicology and in undergraduate education of medical students atKing’s College London Medical School. He is a board member of theEuropean Association of Poisons Control Centres and Clinical Toxicologists,and the Asia Pacific Association of Clinical Toxicology. He sits on the UKAdvisory Council on the Misuse of Drugs (ACMD) and the Scientific Com-mittee of the European Monitoring Centre for Drugs and Drugs Addiction(EMCDDA). He is an expert adviser to a number of other bodies, including theUS Food and Drug Administration (FDA) and the World Health Organization(WHO).
Benjamin Hatten Dr. Hatten received his M.D. in 2006 at the University ofTexas – Southwestern Medical Center in Dallas, TX. After completion of thisdegree, he entered residency in emergency medicine at Denver Health MedicalCenter in Denver, CO. Subsequently, he entered the medical toxicologyfellowship training at Oregon Health and Science University in Portland,OR. During his fellowship, he simultaneously obtained a Masters in PublicHealth in epidemiology and biostatistics. Upon completion of his fellowshipand M.P.H. degree, he returned to Denver in 2013 and joined the faculty at theUniversity of Colorado School of Medicine, the Rocky Mountain Poison andDrug Center, and Toxicology Associates. He is currently an Assistant Profes-sor at the University of Colorado School of Medicine with a primary appoint-ment in the Section of Medical Toxicology, Department of EmergencyMedicine. In addition, he is an attending physician at the Rocky MountainPoison and Drug Center as well as a member of Toxicology Associates, Prof.LLC – a hospital based, single specialty medical group dedicated solely tomedical toxicology. Dr. Hatten is board certified in both emergency medicineand medical toxicology.
About the Editors xxvii
Bruno Mégarbane is Professor of Critical Care Medicine at Paris DiderotUniversity and directs a research team at INSERM UMRS-1144. He is theHead of the Department of Medical and Toxicological Critical Care atLariboisière Hospital, Assistance Publique – Hôpitaux de Paris, in Paris,France. He is the current President of the European Association of PoisonsCentres and Clinical Toxicologists (EAPCCT). He conducted several clinicaland experimental studies in clinical toxicology, mainly regarding mechanismsof opioid-related respiratory toxicity, prognostic factors of life-threateningpoisonings, and management of refractory cardiotoxicant poisonings usingECMO. He is a member of the EXTRIP group and an Associate Editor forClinical Toxicology.
Robert Palmer Clinical Assistant Professor, Medical Toxicology, EmergencyMedicine, School of Medicine, University of Colorado, Aurora, CO, USA.Attending Toxicologist and Faculty, Medical Toxicology Fellowship Program,Rocky Mountain Poison and Drug Center, Denver Health and HospitalsAuthority, Denver, CO, USA.
Dr. Robert Palmer received his undergraduate degree in chemistry from theUniversity of Idaho. His M.S. and Ph.D. degrees were obtained in organic-medicinal chemistry from the University of Washington in Seattle. He com-pleted a postdoctoral appointment at the University of Washington HealthSciences Center, followed by joining the faculty at the University of NewMexico in Albuquerque. Dr. Palmer then relocated to Colorado and completeda fellowship in clinical toxicology at the Rocky Mountain Poison and DrugCenter (RMPDC) in Denver, CO. He is board certified in clinical toxicology
xxviii About the Editors
and an elected Fellow of the American Academy of Clinical Toxicology.Dr. Palmer maintains a faculty position at RMPDC teaching in the medicaltoxicology fellowship program, as well as serving as an attending toxicologiston the medical toxicology clinical service. He is a member of multiple medicaland scientific associations and lectures locally, nationally, and internationally.He has authored over 50 scientific papers and more than 30 book chapters.Among his clinical and research interests are postmortem toxicology andopioid abuse.
Julian White is Professor and Head of Toxinology at the Women’s andChildren’s Hospital, Adelaide, Australia. He has been treating cases ofenvenoming since he graduated from the University of Adelaide MedicalSchool over 40 years ago and in 1990 was invited to found the ToxinologyDept., WCH. Author of hundreds of papers, monographs, book chapters, andbooks, mostly on aspects of toxinology, he is internationally known for hiswork as a clinical toxinologist and has presented at many international meet-ings, mostly by invitation. In 1997, he co-founded the Clinical ToxinologyShort Course, through the University of Adelaide, and this internationallyrecognized course, the only one of its type, is run every 2 years, plus mini-versions at selected medical meetings, and attracts both an international expertfaculty and doctors attending from many nations. Julian has been involved inaspects of venom research and clinical research throughout most of his career.Since 1994, he has been the national consultant on envenoming for the soleAustralian antivenom producer, CSL Ltd (now Seqirus), via his hospital(WCH; he is not paid by CSL/Seqirus). He has been an occasional consultanton clinical toxinology to WHO since about 1988 and to Australian PoisonsInformation Centres since the 1990s. A current focus of his activity is theMyanmar Snakebite Project, a large foreign aid project, funded by theAustralian Government, aiming to improve outcomes for snakebite patientsin that country. He is also developing a higher-level training program forclinical toxinology at the international level, through his role as Chair of theBoard of Clinical Toxinology of the International Society on Toxinology
About the Editors xxix
(IST); he is also Secretary of IST and is on the editorial board of Toxicon.He founded the Clinical Toxinology Resources Website (www.toxinology.com) in 2002. In 2015, he was presented with an award for “OutstandingContribution to Medicine” by the Australian Medical Association and in 2016was made a Member of the Order of Australia (AM) for his work in clinicaltoxinology. Julian is married, has two adult children, and lives with his wife inthe Adelaide Hills, when not traveling overseas to meetings.
xxx About the Editors
Contributors
Cynthia K. Aaron Michigan Regional Poison Control Center, Children’sHospital Michigan, Detroit, MI, USA
Rachelle Abouchedid Clinical Toxicology and Emergency Medicine, Guy’sand St Thomas’ NHS Foundation Trust and King’s Health Partners, London,UK
Timothy E. Albertson Internal Medicine, UC Davis School of Medicine,Davis, CA, USA
Alfred Aleguas Jr. Florida Poison Information Center – Tampa, Tampa, FL,USA
Yona Amitai Department of Management, Bar Ilan University, Jerusalem,Israel
Bruce D. Anderson School of Pharmacy, University of Maryland-Baltimore,Baltimore, MD, USA
Philip Aplin Emergency Medicine, Flinders Medical Centre, Adelaide,South Australia, Australia
Emily B. Austin Division of Emergency Medicine, University of Toronto,Toronto, ON, Canada
Beeta Balali-Mood MoodBioPharm, London, UK
Kia Balali-Mood Workstream Lead, Medical Business Intelligence atBoehringer Ingelheim Pharma, London, UK
Mahdi Balali-Mood Medical Toxicology Research Centre, Faculty of Med-icine, Mashhad University of Medical Sciences, Mashhad, Iran
D. Nicholas Bateman Pharmacology, Toxicology and Therapeutics, TheUniversity of Edinburgh-College of Medicine and Veterinary Science, Edin-burgh, UK
Carl R. Baum Pediatrics and Department to Pediatric Emergency Medicineand Medical Toxicology, Yale University, New Haven, CT, USA
Vikhyat S. Bebarta Department of Emergency Medicine, University ofColorado Denver – Anschutz Medical Campus, Aurora, CO, USA
xxxi
Neal Benowitz Department of Medicine, University of California SanFrancisco School of Pharmacy, San Francisco, CA, USA
Blaine E. Benson National Capital Poison Center, Washington, DC, USA
Yedidia Bentur Israel Poison Information Center, Clinical Pharmacologyand Toxicology Section, Rambam Health Care Campus, The RappaportFaculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
Jeffrey N. Bernstein Miller School of Medicine, University of Miami,Miami, FL, USA
Michael C. Beuhler Carolinas Poison Center, Department of EmergencyMedicine, Carolinas Medical Center, Charlotte, NC, USA
Ashish Bhalla Department of Internal Medicine, Post Graduate Institute ofMedical Education and Research, Chandigarh, India
David Boels Toxicovigilance Unit, Poison Centre of Angers, Angers, France
William J. Boroughf Emergency Medicine, University of Colorado Schoolof Medicine, Denver, CO, USA
Stephen W. Borron Medical Toxicology, Texas Tech University, El Paso,TX, USA
Edward W. Boyer Department of Emergency Medicine, University of Mas-sachusetts Medical School, Worcester, MA, USA
Sally M. Bradberry National Poisons Information Service (BirminghamUnit), City Hospital, Birmingham, UK
School of Biosciences, University of Birmingham, Birmingham, UK
Jeffrey Brent Department of Medicine, Division of Clinical Pharmacologyand Toxicology, University of Colorado, School of Medicine, Aurora, CO,USA
Daniel E. Brooks Department of Medical Toxicology, Banner - UniversityMedical Center, Phoenix, AZ, USA
Rebecca E. Bruccoleri Program in Medical Toxicology, Division of Emer-gency Medicine, Children’s Hospital Boston, Boston, MA, USA
Sean M. Bryant Cook County Hospital (Stroger), Chicago, IL, USA
Jennie A. Buchanan Staff Physician Denver Health and Hospital AuthorityDepartment of Emergency Medicine, Rocky Mountain Poison and DrugCenter, Denver, CO, USA
Division of Medical Toxicology/Department of Emergency Medicine, Uni-versity of Colorado, Boulder, CO, USA
Keith Burkhart FDA, Office of New Drugs/Immediate Office, Center forDrug Evaluation and Research, Silver Spring, MD, USA
Michael J. Burns Division of Toxicology, Department of Emergency Med-icine, Beth Israel Deaconess Medical Center, Boston, MA, USA
xxxii Contributors
Diane P. Calello New Jersey Poison Information and Education System,Department of Emergency Medicine, New Jersey Medical School, RutgersBiomedical and Health Sciences, Newark, NJ, USA
F. Lee Cantrell School of Pharmacy, University of California, San Francisco,San Francisco, CA, USA
Andrea Carlson Advocate Christ Medical Center, Oak Lawn, IL, USA
Gregory L. Carter School of Medicine and Public Health, The University ofNewcastle Australia, Callaghan, Newcastle, Australia
Edward W. Cetaruk School of Medicine, Division of Clinical Pharmacol-ogy and Toxicology, University of Colorado - Denver, Aurora, CO, USA
Peter R. Chai Department of Emergency Medicine, University of Massa-chusetts Medical School, Worcester, MA, USA
Jean-Philippe Chippaux UMR MERIT, Institut de Recherche pour leDéveloppement, Cotonou, Benin
Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes, Paris,France
Ryan Chuang Poison and Drug Information Service (PADIS), AlbertaHealth Services, Calgary, Alberta, USA
Department of Emergency Medicine, University of Calgary, Calgary, Alberta,USA
Richard F. Clark University of California San Diego, School of Medicine,San Diego, CA, USA
Jack Clifton II ACPRU and Clinical Pharmacology Medical Department,AbbVie Clinical Pharmacology Research Unit, Grayslake, IL, USA
Nicholas J. Connors Division of Emergency Medicine, Medical Universityof South Carolina, Charleston, SC, USA
Monique J. Cormier Department of Nephrology, University of Montreal,Verdun Hospital, Verdun, QC, Canada
Kirk L. Cumpston Division of Clinical Toxicology, Department of Emer-gency Medicine, Virginia Commonwealth University Health System, Rich-mond, VA, USA
Steven C. Curry Department of Medical Toxicology, Banner – UniversityMedical Center Phoenix, Phoenix, AZ, USA
Kim Dalhoff Department of Clinical Pharmacology, Bispebjerg and Freder-iksberg University Hospital, Copenhagen, Denmark
Paul I. Dargan Clinical Toxicology, Guy’s and St Thomas’NHS FoundationTrust, London, UK
G. Patrick Daubert Department of Emergency Medicine for the KaiserPermanente South Sacramento Medical Center, Kaiser Permanente Northern
Contributors xxxiii
California Regional Toxicology Service, Sacramento, CA, USA
Andrew H. Dawson Sydney Medical School, The University of Sydney,Sydney, NSW, Australia
Luc de Haro Toxicovigilance Unit, Poison Centre of Marseille, Marseille,France
Dylan W. de Lange Department of Intensive Care Medicine and the DutchNational Poison Information Center, (NPIC) of the University Medical Center,University Utrecht, Utrecht, The Netherlands
Irma de Vries National Poisons Information Center, University MedicalCenter Utrecht, Utrecht, The Netherlands
Bradley L. Demeter Harvard Medical Toxicology Fellow, Children’s Hos-pital, Boston, MA, USA
J. Ward Donovan Emergency Medicine, Penn State University, Hershey,PA, USA
Stephen C. Dreskin Division of Allergy and Clinical Immunology, Depart-ment of Medicine, University of Colorado Denver – Anschutz Medical Cam-pus, Aurora, CO, USA
Pierre-André Dubé Department of Environmental Health and Toxicology,Institut national de santé publique du Québec, QC, Canada
Faculty of Pharmacy, Université Laval, QC, Canada
Anna Rouse Dulaney Clinical Toxicology, Carolinas Poison Center andCarolinas Medical Center, Charlotte, NC, USA
Michael Eddleston Pharmacology, Toxicology and Therapeutics, The Uni-versity of Edinburgh, Edinburgh, UK
Cristy Eidelman Pharmacology and Toxicology, Children’s Mercy HospitalKansas City, Kansas City, MO, USA
M. P. Emswiler Department of Emergency Medicine, Toxicology, VirginiaCommonwealth University, Richmond, VA, USA
Kristin Engebretsen Department of Emergency Medicine, Regions Hospi-tal, Minneapolis, MN, USA
Marlene Entres Center for Poisoning Control, Federal University of Paraná,Curitiba, Brazil
Timothy B. Erickson Division of Medical Toxicology, Department of Emer-gency Medicine, Brigham and Women’s Hospital Faculty, Harvard MedicalSchool and Harvard Humanitarian Initiative, Boston, MA, USA
Florian Eyer Department of Clinical Toxicology, Klinikum rechts der Isar –Technical University of Munich, Munich, Germany
xxxiv Contributors
Peter Eyer Walther-Straub-Institute of Pharmacology and Toxicology,Ludwig-Maximilians-University, Munich, Germany
Hui Wen Fan Instituto Butantan, São Paulo, Brazil
Brenna Farmer Weil Cornell Medical College, New York, NY, USA
Heinz Faulstich Max-Planck-Institut für medizinische Forschung, Heidel-berg, Germany
Frederick W. Fiesseler Department of Emergency Medicine, MorristownMedical Center, Morristown, NJ, USA
Robert N. E. French Department of EmergencyMedicine, The University ofArizona, Tucson, AZ, USA
L. Keith French Department of Emergency Medicine, Oregon Health Sci-ences University, Portland, Oregon, USA
R. Brent Furbee Department of Emergency Medicine / Division of MedicalToxicology, Indiana University School of Medicine, Indianapolis, IN, USA
Jakub Furmaga Emergency Medicine, The University of Texas Southwest-ern Medical Center, Dallas, TX, USA
Ann-Jeannette Geib Rutgers Robert Wood Johnson Medical School,Rutgers University, New Brunswick, NJ, USA
Marc Ghannoum Department of Nephrology, University of Montreal, Ver-dun Hospital, Verdun, QC, Canada
Aniruddha Ghose Department of Medicine, Chittagong Medical College,Chittagong, Bangladesh
Sophie Gosselin Department of Medicine and Emergency Medicine, McGillUniversity Health Centre, Montreal, QC, Canada
Kimberlie A. Graeme Medical Toxicology, Banner — University MedicalCenter, Phoenix, AZ, USA
Andis Graudins Clinical Toxicology and Emergency Medicine, School ofClinical Sciences at Monash Health, Monash University and Monash Health,Dandenong, VIC, Australia
Shaun Greene Victorian Poisons Information Centre, Heidelberg, VIC,Australia
Hallam Gugelmann Clinical Pharmacy, University of California SanFrancisco School of Pharmacy, San Francisco, CA, USA
José María Gutiérrez Instituto Clodomiro Picado, Facultad de Micro-biología, Universidad de Costa Rica, San José, Costa Rica
Peter Eyer and Heinz Faulstich are retired.
Contributors xxxv
Jonas Höjer Karolinska Institute, Swedish Poisons Information Centre,Stockholm, Sweden
Abdulrazaq G. Habib Infectious and Tropical Diseases Unit, College ofHealth Sciences, Bayero University, Kano, Nigeria
Dorothea Hall Department of Anesthesiology and Perioperative Medicine,UCLA, David Geffen School of Medicine, Los Angeles, CA, USA
Philippe E. Hantson Louvain Centre for Toxicology and Applied Pharma-cology, Catholic University of Louvain, Louvain, Belgium
Bryan D. Hayes Department of Pharmacy, Department of Emergency Med-icine Massachusetts General Hospital, Harvard Medical School, Boston, MA,USA
Kennon Heard School of Medicine, Emergency Medicine and MedicalToxicology and Pharmacology, University of Colorado-Denver, Aurora, CO,USA
Alan C. Heffner Department of Internal Medicine, Department of Emer-gency Medicine, Carolinas Medical Center, Charlotte, NC, USA
C. William Heise Center for Toxicology and Pharmacology Education andResearch, University of Arizona College of Medicine Phoenix, Phoenix, AZ,USA
Department of Medical Toxicology, Banner – UMCP, Phoenix, AZ, USA
Michelle A. Hieger VCU Health System, Richmond, VA, USA
James H. Ho Clinical Toxicology, Guy’s and St. Thomas’ NHS FoundationTrust, London, UK
Robert J. Hoffman Emergency Medicine, Sidra Medical and ResearchCenter, Doha, Qatar
Robert S. Hoffman Ronald O. Perelman Department of EmergencyMedicine, NYU Langone Medical Center, New York, NY, USA
Michael G. Holland Emergency Medicine, State University of New York,Upstate Medical University, Syracuse, NY, USA
B. Zane Horowitz Department of Emergency Medicine, Oregon Health andScience University, Portland, OR, USA
Knut Erik Hovda The Norwegian CBRNE Centre of Medicine, Departmentof Acute Medicine, Medical Division, Oslo University Hospital, Oslo,Norway
Christopher Hoyte UC Denver, Aurora, CO, USA
Chia Wei Hsu University of Texas Medical Branch, School of Medicine,Galveston, TX, USA
Janetta L. Iwanicki Medical Toxicology, Rocky Mountain Poison and DrugCenter, Denver, CO, USA
xxxvi Contributors
Jeena Jacob Medical Toxicology/Emergency Medicine, North Shore Uni-versity Hospital, Manhasset, NY, USA
Dag Jacobsen Department of Acute Medicine, Division of Medicine, OsloUniversity Hospital, Oslo, Norway
Heath A. Jolliff Wexner Medical Center, Ohio State University, Columbus,OH, USA
Alison L. Jones Faculty of Science, Medicine and Health, University ofWollongong, Wollongong, NSW, Australia
Prashant Joshi Paul L. Foster School of Medicine, Texas Tech UniversityHealth Sciences Center El Paso, El Paso, TX, USA
David Juurlink Departments of Medicine and Pediatrics, University ofToronto, Toronto, ON, Canada
Jorge Kalil Instituto Butantan, São Paulo, Brazil
Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
A. Min Kang Department of Medical Toxicology, Banner – UniversityMedical Center Phoenix, Phoenix, AZ, USA
Louise W. Kao Department of Emergency Medicine, Indiana UniversitySchool of Medicine, Indianapolis, IN, USA
Shikha Kapil Department of Emergency Medicine, Emory UniversitySchool of Medicine, Atlanta, GA, USA
Kenneth D. Katz University of South Florida Morsani School of Medicine,Tampa, FL, USA
Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
Medical Toxicology and Emergency Medicine Core Faculty, Lehigh ValleyHealth Network, Allentown, PA, USA
Ziad N. Kazzi Department of Emergency Medicine, Emory UniversitySchool of Medicine, Atlanta, GA, USA
Ashleigh Kennedy Department of Emergency Medicine, Maine MedicalCenter, Portland, ME, USA
William P. Kerns II Division of Medical Toxicology, Department of Emer-gency Medicine Carolinas Medical Center, Charlotte, NC, USA
Andrew M. King Emergency Medicine, Wayne State University School ofMedicine, Detroit, MI, USA
Joshua D. King Department of Medicine, Division of Nephrology; Depart-ment of Emergency Medicine, Division of Medical Toxicology, University ofVirginia, Charlottesville, VA, USA
Kurt Kleinschmidt Emergency Medicine, The University of Texas South-western Medical Center, Dallas, TX, USA
Cynthia Koh University of California, San Diego, San Diego, CA, USA
Contributors xxxvii
Michael J. Kosnett Division of Clinical Pharmacology and Toxicology,Department of Medicine, University of Colorado School of Medicine, Aurora,CO, USA
Department of Environmental and Occupational Health, Colorado School ofPublic Health, Aurora, CO, USA
Allyson Kreshak Department of Emergency Medicine, University of Cali-fornia, San Diego Health Sciences, La Jolla, CA, USA
Eric J. Lavonas Department of Emergency Medicine and Rocky MountainPoison and Drug Center, Denver Health and Hospital Authority, Denver, CO,USA
Department of Emergency Medicine, University of Colorado School of Med-icine, Aurora, CO, USA
Hwee Min Lee Monash Emergency Medicine, Monash Health Clinical Tox-icology and Addiction Medicine Service, Melbourne, VIC, Australia
Jerrold B. Leikin University of Chicago Pritzker School of Medicine, Glen-view, IL, USA
Jenna M. LeRoy Emergency Medicine, Regions Hospital, Minneapolis,MN, USA
Michael Levine Medical Toxicology, Banner Good Samaritan Medical Cen-ter, Phoenix, AZ, USA
Department of Emergency Medicine, Division of Medical Toxicology, Uni-versity of Southern California, Los Angeles, CA, USA
Sara K. Lookabill Clinical Toxicology, Carolinas Poison Center and Caro-linas Medical Center, University of North Carolina Eshelman School ofPharmacy, Charlotte, North Carolina, USA
Annette M. Lopez Department of Emergency Medicine, Oregon HealthSciences University, Portland, OR, USA
Frank LoVecchio Medical Toxicology, Banner Poison and Drug InformationCenter, Phoenix, AZ, USA
Jennifer A. Lowry Section of Toxicology Pediatrician, Department of Pedi-atrics, Children’s Mercy Hospital, Kansas City, MO, USA
Scott Lucyk Department of Emergency Medicine, New York University,New York, NY, USA
Yael Lurie Israel Poison Information Center, Clinical Pharmacology andToxicology Section, Rambam Health Care Campus, The Rappaport Facultyof Medicine, Technion-Israel Institute of Technology, Haifa, Israel
Michael Lynch University of Pittsburgh, Pittsburgh, PA, USA
Bruno Mégarbane Department of Medical and Toxicological Critical Care,Lariboisière Hospital, Paris-Diderot University, Paris, France
xxxviii Contributors
Joseph K. Maddry Medical Toxicology, San Antonio Military MedicalCenter, San Antonio, TX, USA
Barbarajean Magnani Department of Pathology and Laboratory Medicine,Tufts Medical Center, Boston, MA, USA
Eric R. Malone Detroit Medical Center, Detroit, MI, USA
Kevin F. Maskell Jr. Division of Clinical Toxicology, Department of Emer-gency Medicine, Virginia Commonwealth University Health System, Rich-mond, VA, USA
Madeline L. McCarthy Pediatrics and Department to Pediatric EmergencyMedicine, Yale University, New Haven, CT, USA
Kenneth McMartin Department of Pharmacology, Toxicology and Neuro-science, Louisiana State University Health Sciences Center - Shreveport,Shreveport, LA, USA
Jan Meulenbelt National Institute for Public Health and the Environment,Utrecht, The Netherlands
Kirk C. Mills Emergency Medicine, Wayne State University, Detroit, MI,USA
Alicia B. Minns University of California, San Diego, San Diego, CA, USA
Andrew A. Monte University of Colorado School of Medicine, Aurora, CO,USA
Philip Moore Associates in Medical Toxicology, Harrisburg, PA, USA
Stephen Munday Sharp-Rees-Stealy Medical Group, San Diego, CA, USA
Lewis S. Nelson Rutgers New Jersey Medical School, New York, NewJersey, USA
Department of Emergency Medicine, New York University, New York, NY,USA
Ayrn D. O’Connor Department of Medical Toxicology, Banner –UniversityMedical Center Phoenix, Phoenix, AZ, USA
Department of Emergency Medicine, University of Arizona College of Med-icine Phoenix, Phoenix, AZ, USA
Jennifer A. Oakes Emergency Medicine and Medical Toxicology, KaweahDelta Medical Center, University of California, Irvine, Visalia, CA, USA
Ruben Olmedo Medical Toxicology – Emergency Medicine, The MountSinai Hospital, New York, NY, USA
Anthony F. Pizon University of Pittsburgh Medical Center, Division ofMedical Toxicology, Department of Emergency Medicine, Pittsburgh, PA,USA
Cyrus Rangan Bureau of Toxicology and Environment, Los AngelesCounty of Public Health, Los Angeles, CA, USA
Contributors xxxix
Rama B. Rao Weill Cornell Medical College, Cornell University, New York,NY, USA
Robert A. Raschke Critical Care Services, Banner Good Samaritan MedicalCenter, Phoenix, AZ, USA
J. J. Rasimas Hennepin County Medical Center, Minneapolis, MN, USA
Sean H. Rhyee Department of Emergency Medicine, University of Massa-chusetts Medical School, Worchester, MA, USA
Jon C. Rittenberger University of Pittsburgh, Pittsburgh, PA, USA
S. Rutherfoord Rose Division of Clinical Toxicology, Department of Emer-gency Medicine, Virginia Commonwealth University Health, Richmond, VA,USA
Harvey Rosenbaum Department of Anesthesiology and Perioperative Med-icine, UCLA, David Geffen School of Medicine, Los Angeles, CA, USA
Henry Rosenberg Department of Medical Education and Clinical Research,Saint Barnabas Medical Center, Livingston, NJ, USA
Mitchell P. Ross Critical Care Medicine, Providence Pediatric Intensive CareUnit St Vincent, Portland, OR, USA
Anne-Michelle Ruha Medical Toxicology, Banner – University MedicalCenter Phoenix, Phoenix, AZ, USA
Ceila Maria Sant’Ana Malaque Vital Brazil Hospital, Instituto Butantan,São Paulo, Brazil
Intensive Care Unit, Instituto de Infectologia Emilio Ribas, São Paulo, Brazil
Tammi H. Schaeffer Department of Emergency Medicine, Division ofMedical Toxicology, Maine Medical Center, Portland, ME, USA
Tufts University School of Medicine, Boston, MA, USA
Evan S. Schwarz Emergency Medicine, Washington University, St Louis,MO, USA
Donna Seger School of Medicine, Vanderbilt University, Nashville, TN,USA
Steven A. Seifert Department of Emergency Medicine, and New MexicoPoison and Drug Information Center, University of New Mexico HealthSciences Center, Albuquerque, NM, USA
Kapil Sharma Emergency Medicine, The University of Texas SouthwesternMedical Center, Dallas, TX, USA
Adhi N. Sharma Medical Affairs, South Nassau Communities Hospital,Healthy Way, Oceanside, NY, USA
Emergency Medicine, Hofstra Northwell School of Medicine, Hempstead,NY, USA
xl Contributors
Greene Shepherd Eshelman School of Pharmacy, University of North Car-olina, Chapel Hill, NC, USA
Richard D. Shih Division of Emergency Medicine, Florida Atlantic Univer-sity – Charles E. Schmidt College of Medicine, Boynton Beach, FL, USA
Karen E. Simone Northern New England Poison Center, MaineHealth/Maine Medical Center, Portland, ME, USA
Marco L. A. Sivilotti Departments of Emergency Medicine, and of Biomed-ical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
Aaron Skolnik Department of Critical Care Medicine, University of Pitts-burgh, Pittsburgh, PA, USA
SilasW. Smith Division ofMedical Toxicology, Ronald O. Perelman Depart-ment of EmergencyMedicine, NYU School ofMedicine, NewYork, NY, USA
Wayne R. Snodgrass Department of Pediatrics, The University of TexasMedical Branch at Galveston, Galveston, TX, USA
Curtis P. Snook Medicine, Geisel School ofMedicine,White River Junction,VT, USA
Jerry W. Snow Department of Emergency Medicine / Division of MedicalToxicology, Indiana University School of Medicine, Indianapolis, IN, USA
Meghan B. Spyres Department of Medical Toxicology, Banner – UniversityMedical Center Phoenix, Phoenix, AZ, USA
Dirk Steinritz Bundeswehr Institute of Pharmacology and Toxicology,Munich, Germany
Samuel J. Stellpflug Medical School, University ofMinnesota, Minneapolis,MN, USA
Erin Stewart Kerlan-Jobe Orthopaedic Clinic, Los Angeles, CA, USA
Jenny M. Stitt Division of Allergy and Clinical Immunology, Department ofMedicine, University of Colorado Denver – Anschutz Medical Campus,Aurora, CO, USA
Maude St-Onge Department of Family Medicine and Emergency Medicine,Université Laval / Quebec Poison Centre, Quebec city, QC, Canada
Mark K. Su New York City Poison Control Center, NY, USA
New York University School of Medicine, NY, USA
Daniel Sudakin Environmental and Molecular Toxicology, Oregon StateUniversity, Corvallis, OR, USA
Mark A. Suguitan Emergency Medicine, New York-Presbyterian Hospital,New York, NY, USA
Greg S. Swartzentruber University of Pittsburgh Medical Center, Divisionof Medical Toxicology, Department of Emergency Medicine, Pittsburgh, PA,USA
Contributors xli
Matthew D. Sztajnkrycer Mayo Clinic, Rochester, MN, USA
Minnesota Poison Control System, Minneapolis, MN, USA
R. Steven Tharratt Pulmonary, Critical Care, and SleepMedicine, UCDavisMedical Center, Sacramento, CA, USA
Horst Thiermann Bundeswehr Institute of Pharmacology and Toxicology,Munich, Germany
Anthony J. Tomassoni EmergencyMedicine, Yale School of Medicine, YaleNew Haven Center for Emergency Preparedness and Disaster Response, NewHaven, CT, USA
Laura M. Tormoehlen Clinical Emergency Medicine and Neurology, Indi-ana University School of Medicine, Indianapolis, IN, USA
J. Allister Vale National Poisons Information Service (Birmingham Unit),City Hospital, Birmingham, UK
School of Biosciences, University of Birmingham, Birmingham, UK
Richard S. Vetter Department of Entomology, University of California,Riverside, CA, USA
Eric Villeneuve Department of Pharmacy, McGill University Health Centre,Montreal, QC, Canada
Steven J. Walsh Division of Medical Toxicology, Einstein Medical Center,Philadelphia, PA, USA
Frank G. Walter Department of Emergency Medicine, The University ofArizona, Tucson, AZ, USA
George Sam Wang Department of Pediatrics, University of ColoradoAnschutz Medical Campus, Children’s Hospital Colorado, Aurora, CO, USA
Richard Y. Wang National Center for Environmental Health, Centers forDisease Control and Prevention, Atlanta, Georgia, USA
Brandon J.Warrick Department of Emergency Medicine, and NewMexicoPoison and Drug Information Center, University of New Mexico HealthSciences Center, Albuquerque, NM, USA
Scott A. Weinstein Clinical and Research Toxinologist/Family Physician,Women’s and Children’s Hospital, Adelaide, SA, Australia
Julian White Toxinology Department, Women’s and Children’s Hospital,North Adelaide, Australia
David M. Wood Clinical Toxicology, Guy’s and St. Thomas’ NHS Founda-tion Trust and King’s Health Partners, London, UK
Clinical Toxicology, Faculty of Life Sciences and Medicine, King’s CollegeLondon, London, UK
Alan D. Woolf Pediatric Environmental Health Center, Division of GeneralPediatrics, Boston Children’s Hospital, Boston, MA, USA
xlii Contributors
Peter Wu Department of Medicine, University Health Network, Universityof Toronto, Toronto, ON, Canada
Chen-Chang Yang Clinical Toxicology and Occupational Medicine, Depart-ment of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Joseph H. Yanta University of Pittsburgh Medical Center, Division of Med-ical Toxicology, Department of Emergency Medicine, Pittsburgh, PA, USA
Christopher Yates Emergency Medicine Department, Clinical ToxicologyUnit, Hospital Universitari Son Espases, Palma de Mallorca, Spain
Luke Yip Denver Health, Rocky Mountain Poison and Drug Center Depart-ment of Medicine, Section of Medical Toxicology Denver, Colorado, USA
Thomas Zilker Clinical Toxicology, Technical University of Munich,Munich, Germany
Matthew Zuckerman Department of Emergency Medicine, University ofColorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
Thomas Zilker is retired.
The original version of this book was revised. An erratum to this book can be found at https://doi.org/10.1007/978-3-319-17900-1_186
Contributors xliii