summury of clinical toxology

1. Clinical
Toxicology

2. Definition
Clinical toxicology is defined as expertise in the
specialties of medical toxicology, applied
toxicology, and clinical poison facts.

3. HISTORY OF CLINICAL TOXICOLOGY
2000 BC
The use of toxic smoke
in ancient India
1
1000 BC
Formulas for creating
poisonous and noxious
vapors in Chinese
writings
2
600 BC
Documentation regarding the
use of antidotes can be found in
the Odyssey and Shastras
3
From 129 to 200 AD
Galen wrote book that described the
development of a universal antidote
4
1960s
use of activated
charcoal
5
2002
(FDA) enacted the Animal
Efficacy Rule,
6

4. poison control centers (PCCs)
• Improvements in the quality of care of the poisoned patient
• Share information through publications and national conferences
• Staffed by a medical director (medical toxicologist), administrator or
managing director, specialists in poison information, and educators for
poison prevention programs.

5. PCCs Provide:
Direct information
to patients with expert
recommendations for
needed treatment
Critical diagnostic
Treatment information
for healthcare
professionals
Education
For healthcare personnel,
poison prevention activities
through public education
Data
that can lead to the recognition of
improper use of medications,
emergence of new illicit drug
exposures or practice, prescription
product diversion, and product
tampering events.

6. CLINICAL STRATEGY FOR THE TREATMENT OF THE POISONED
PATIENT
01
Clinical Stabilization
assessment of the patient’s
airway, breathing, and circulation.
03
Physical Examination
to assess the patient’s condition,
determine the patient’s mental
status, and, if altered, determine
possible non toxicology
explanations for the abnormal
mental status such as trauma or
central nervous system infection.
02
Clinical History in the
Poisoned Patient
to determine the substance to
which the patient was exposed
and the extent and timing of
exposure.
04
Laboratory Evaluation
toxicologists can sometimes
gain important insight into what
potential drugs were ingested by
performing simple calculations
based on routine clinical
laboratory data

7. CLINICAL STRATEGY FOR THE TREATMENT OF THE POISONED PATIENT
05
Radiographic
Examination
plain radiographs can detect
a significant amount of
ingested oral medication
containing ferrous or
potassium salts.
07
Enhancement of
Poison Elimination
The primary methods employed for
this use today include alkalinization
of the urine, hemodialysis,
hemoperfusion, hemofiltration,
plasma exchange or exchange
transfusion, and the administration
of oral activated charcoal serially
during the treatment time course.
06
Prevention of Further
Poison Absorption
during the early phases of
treatment of a poisoned patient
who has had a toxic exposure via
the oral, inhalation, or topical
route, the opportunity to prevent
further absorption of the poison to
minimize the total amount of
chemical that reaches the
systemic circulation may be
possible.
08
Use of Antidotes in Poisoning
small number of specific antidotes
are available for clinical use in the
treatment of poisoning because of
practical difficulties in performing
clinical research on poisoned
patients, and the relatively small
financial incentives for the
commercial development of
poisoning antidotes.

8. CLINICAL STRATEGY FOR THE TREATMENT OF THE POISONED PATIENT
09
Supportive Care of the
Poisoned Patient
Poisoned patients who are unstable or at risk for
significant clinical instability during the later phases of
their poisoning are generally admitted to a critical care
unit for close monitoring.

9. Thank you