Principles and Practice of Critical Care Toxicology Omender Singh, Deven Juneja
INDEX
Page numbers followed by b refer to box, f refer to figure, fc refer to flowchart, and t refer to table
A
Abrus precatorius 357, 358
Accidental poisoning 70
Acetaminophen 20, 23, 203, 208, 274
concentration, serum 205
metabolism of 204fc
normal metabolism of 204fc
poisoning 32b, 203
toxicity, management of 275t
Acetazolamide 28, 215
Acetylcholine 110
Acetylcholinesterase 23
Acetylcysteine 16, 32, 33
Acetylene 152
Acid 4, 8, 218
absorbable 28
addition of 26
adenosine diphosphate 342
base
abnormalities 211
analysis 30
disorders 26, 212, 370
disturbances 26
status 26
ibotenic 368, 370
injury 219
Acidosis 28, 124, 340
acute respiratory 29
dilutional 28
intracellular 29
lactic 27, 387
respiratory 29
Acrylonitrile 152
Actinoplanes utahensis 391
Activated charcoal 7, 8b, 16, 36, 135, 232
multiple dose 8, 36, 188, 196, 211, 232, 264, 276
Activated partial thromboplastin time 48, 49, 237
Acute respiratory distress syndrome 220, 251, 309
Adamsite 397
Adenosine
antagonism 110
monophosphate, cyclic 180
triphosphate 243, 342, 388
cardiac 61
Adnexa 219
Adult respiratory distress syndrome 115
Advanced cardiac life support 3, 16, 168, 251
Agitation 186
Agriculture fertilizers and industrial refrigerant 223
Air filtration 401
Airway 3, 61, 148, 214, 296
management 86
protection 220
Alanine aminotransferase 370
Albumin dialysis 9, 10
Albuminuria 163
Alcohol 4, 8, 93, 136
dehydrogenase
inhibitor 27
hepatic 278
intoxication, acute 229
like ethanol 5
use disorder 118
Aldehyde dehydrogenase 119
Aldicarb 304
Aldrin 321, 324
Alkalemia 215
Alkali 219
ingestion 4
injury 223
Alkalinization 214, 300
therapy 215
Alkalosis
acute respiratory 29
metabolic 29
prevents drug 52
respiratory 29
Alkylating agents 378, 380
Allergic reactions 32, 62
Allergies 211
Allobarbital 275
Alpha-glucosidase inhibitors 386, 391
Alprazolam 81
Aluminum 174
phosphide 5, 19, 27, 174, 330
poisoning 174, 176
toxicity 47, 50
Alveolitis, acute 315
Amanita 367, 368, 370, 371
pantherina 368
phalloides 52, 268, 358, 367
poisoning 369
stages of 369t
Amatoxin 367
poisoning 371
American Academy of Clinical Toxicology 7, 36, 65
American College of Chest Physicians 47
American College of Medical Toxicology 61
Amino acids, excitatory 110
Aminocarb 304
Aminopyridine 110
Amiodarone 4, 10, 167, 227
Amitriptyline 6, 8, 186
Ammonia 151, 154
anhydrous 223
Amoxapine 186
Amphetamine 5, 14, 20, 28, 81, 85, 257
Analgesics 248
Anaphylaxis 207
management of 381
Anemia 50
hemolytic 342
severe 238
Angiotensin converting enzyme 146
Anion gap 12, 13, 27, 124
metabolic acidosis, causes of 13t
Anorexia 344
Anthracyclines 382
Anthrax 400
immune globulin 400
Antiarrhythmics 185
beta-blockers 4
treatment 188
Antibiotic 24, 380
Antibody fragments, digoxin-specific 40
Anticancer drug 24
Anticholinergic 5
effects 186
symptoms 371
Anticoagulants 4, 5, 148, 330, 331
rodenticide 228, 330, 332
rodenticide poisoning 46
Anticonvulsants 5, 133
overdose 133
management of 141
Antidepressants 5
cyclic 5
Antidigoxin fab 197
Antidotal therapy 90, 298
Antidotes 3, 15, 15t, 31, 72, 74t, 206, 274, 306, 378
for specific
drug 148t
poison 148t
mechanism of action of 31t
second-line 307
universal 36
Antiepileptic drugs 24, 133
classification of 133t
intravenous 109
overdose, management of 134
Antifungal drugs 24
Antihistamines 5, 185, 190
Antihyperglycemic agents 386
Anti-infective agents 248
Antimetabolites 231, 378, 380
Antimicrobials drugs 231
Antimitotic agents 380
Antimycobacterial drugs 248
Antioxidants 317
Antiplatelets 148
Antipsychotics 185, 257
Antisnake venom 56, 57b, 148, 349
indications of 56b
treatment 351
Antitoxins 400
Antivenom 352
indications of 351b
Apamin 110
Apixaban 238, 239
Apoptosis 313
Areca catechu 363, 363f
Argatroban 236
Argon 152
Argyreia nervosa 104
Arrhythmias 33, 178, 188, 279
beta-blockers 326
cardiac 15, 326
management of 96
ventricular 52
Arsenic 5, 112, 258, 260, 330, 331, 342
poisoning 39b
Arterial blood gas 14, 112, 130, 175, 246, 249, 370
analysis 187
Artery catheter, pulmonary 180
Ascites 222
Asphyxiants, simple 152t, 154
Aspiration 297
pneumonia 4
Aspirin 27, 212, 280
Asthma 4, 46
Ataxia 50
Atomic absorption spectrophotometer 21
Atrial fibrillation 94, 194
chronic non-valvular 236
Atrial tachycardia, paroxysmal 94
Atropine 16, 33, 33b, 112, 160, 196, 298, 306
indications of 33t
Atropinization, signs of 307
Attention deficit hyperactivity disorder 186
Autonomic nervous system 129
Azadirachta indica 363, 363f
B
Bacillus 400
anthracis 398, 399
Bacteria 399
Barbiturate 4, 14, 20, 77, 114, 134, 136, 138, 259, 262, 266, 274, 275
toxicity, management of 276t
Barium 9, 110, 330, 331
bromethalin 334
carbonate 330
Bee venom 110
Beers drinker's cardiomyopathy 339
Bendiocarb 304, 305
Bentonite 36
Benzene hexachloride 324
Benzodiazepines 4, 20, 77, 78, 93, 96, 114, 134, 138, 148, 211, 257, 371
ingestion 258
poisoning 41
Benzyl alcohol 47
Benzylpenicillin, intravenous 371
Benzylpiperazines 102
Beta-adrenergic blocking agents 291
Beta-blocker 34, 110, 178, 179, 257
poisoning 37
role of 96
toxicity 179t
Beta-chain variant 247
Betamethasone 22
Bicarbonate 12
administration of 29
K 27
level 14
wasting of 26
Biguanides 387
Bilirubin 204
Biochemistry 179, 330
Biogenic amines 110
Biological warfare 398
agents 399
classification of agents of 399t
Bipyridyl agent 312
Bishydroxycoumarin 227
Bivalirudin 236
Biventricular devices 171
Bleeding 237, 258
intracranial 237, 238
Bleomycin 375
Blood 71
agents 397
brain barrier 304
carboxyhemoglobin levels 163t
cyanide levels 251t
flow, mechanical assistance of 288
glucose 14
lead levels 24, 38, 343
methemoglobin levels 23
pressure, systolic 15, 298
stream infections, catheter-associated 298
transfusion, role of 332
urea 179
nitrogen 14, 27, 120
Blurred vision 186
Body packer syndrome 94
Boric acid 10
Botulinum
antitoxin-heptavalent 34
immunoglobulin 35
dose of 35b
toxin 4, 400
Botulism 34, 128
differential diagnosis of 130t
signs of 129t
symptoms of 129t
Bowel obstruction 8
Bowel perforations 8
Bradyarrhythmia 40, 169
management of 196
Bradycardia 5, 5t, 167b, 250, 279, 305
symptomatic 40
Brain
ischemia, mechanism of 243
syndrome, acute 91
Breathing 4, 61, 148, 214, 296, 297
British anti-lewisite 39, 112
dosing regimens of 39b
Brodifacoum 227, 332
Bromadiolone 227
Bromethalin 331
Bromides 9
Bromine 151, 266
Bromocriptine 35
Bronchiolitis obliterans organizing pneumonia 340, 375, 380
Bronchorrhea 33, 297, 305
Bronchospasm 4, 33
Brugada pattern 187
Bupivacaine 185
Bupropion 27
Burkholderia mallei 398
Butane 152
Butyrylcholinesterase 23
C
Cadmium 258, 260, 341, 345
poisoning 38
treatment 345
Calcium 37, 174, 179, 182
channel blocker 4, 5, 10, 37, 64, 73, 167, 178, 179, 179t, 265, 299
overdose 178
poisoning 34, 37
chloride 16, 37, 180
disodium 37
gluconate 16, 37, 180
intravenous 180
oxalate crystals 122f
Camphechlor 322
Camphor 27, 266
Cannabinoids 78, 93
synthetic 100, 101
toxicity 80
Cannabis indica 77
Capillary blood glucose 179
Capsaicin spray 397
Carbamates 5, 8, 167, 303
and newer insecticides 303
compounds 304t
poisoning 33, 48
characteristics of 304t
toxicity, diagnosis of 305
Carbamazepine 8, 10, 20, 24, 133, 134, 185, 266, 274, 276, 277
toxicity, management of 276t
Carbaryl 303305
Carbofuran 304, 305
Carbon dioxide 4, 70, 152, 156, 246
partial pressure of 147
Carbon monoxide 4, 5, 28, 112, 148, 152, 162, 164, 242245, 257
poisoning 4, 43, 162, 242, 244246, 290
Carbonate 27
Carbonic anhydrase 250
inhibitor 28, 215
Carboxyhemoglobin 21, 43, 147, 162, 242, 245, 246f
Carboxyhemoglobinemia 242
Carboxymethyl cellulose 36
Carcinoid 54
Cardiac arrest 189, 250
Cardiac glycosides 194, 198
poisoning 34
Cardiotoxic plants 357
Cardiovascular abnormalities 351
Cardiovascular effects 187, 245
Cardiovascular system 186, 211, 219
Cardiovascular toxicity 95, 378, 379t
management 378
Castor seeds 359f
Cathartics 7
Cathinones 28
synthetic 100
Cavity, abdominal 222
Cellular hyoxia 4
Central nervous system 11, 19, 63, 73, 77, 82, 85, 86, 93, 94, 100, 110, 119, 124, 133, 186, 219, 232, 248, 270, 304, 391
complications 189
depressant 77, 81t
overdose 78
depression 124
drugs 231
effects 187
mild 259
stimulants 85
Cerbera manghas 194
Cerbera odollam 358, 361, 361f
Cerebellum 251
Cerebral edema 283
development of 283
risk of 283
Cerebrospinal fluid 130, 280
exchange 9, 269
Chemical
asphyxiants 152t
warfare agents 148, 158, 159t, 396
weapons convention 396
Chemotherapeutic agents 231, 380t
classification of 378t
extravasation of 382
toxicity 374
Chemotherapeutic drug 374, 377
Cherry pepper 361
Chest pain 55, 96
Chloral hydrate 6
Chloramphenicol 400
Chlordane 321, 324
Chloride 12
depletion alkalosis 29
loss 29
Chlorine 27, 151, 155, 159, 396
Chlorophacinone 227
Chlorophyllum molybdites 367
Chloropicrin 396
Chloroquine 185
Chlorpropamide 9, 262
Choking agents 396
Cholecalciferol 330, 331
Cholestasis 380
Cholestyramine 28, 326
Cholinergic 5
agents 167
receptors, over stimulation of 112
toxidrome 305
symptoms of 309
Cholinesterase 20
levels 15, 22
Christmas pepper 361
Chromatography
mass spectrometry 95
thin-layer 22, 102
Chromium 9, 341, 345
Chronic obstructive pulmonary disease 78, 282
Chrysanthemum cinerariaefolium 308
Cicuta douglasii 111
Ciguatoxin 110
Cimetidine 207, 371
Circulation 5, 61, 148, 214, 296
Cisplatin 9
toxicity 377
Citrullus colocynthis 359, 359f
Cleistanthus collinus 358, 363, 364f
Clobazam 134
Clomipramine 186
Clonazepam 134
Clonidine 5, 167, 257, 299
Clostridium botulinum 34, 128, 400
Cluster pepper 361
Coagulopathy, absence of 232
Cobra 349
Cocaine 4, 5, 14, 20, 28, 81, 185
intoxication 93
poisoning 3
Colchicine ingestion 291
Collagen metabolism, derangement of 345
Coma 179, 186, 251, 283
cocktail 6, 6t
Common organophosphate compounds, classification of 296t
Complete blood count 14, 135
Computed tomography 112, 130
Cone pepper 361
Conocybe genera 367
Consciousness, level of 3
Continuous positive airway pressure 164
Copelandia 368
Copper sulfate 258, 259
Coprine 368
poisoning 370
Corrosive
acids, ingestion of 218
agents 222
poisoning 220b
ingestion 218
injury 223
management of 220
Cortical necrosis, acute 258
Coumarin derivatives 330
Crab's eyes 357
Crack lung 97
Cranial nerves 129
Creatinine 179
Croton tiglium 359, 359f
Crow beards 357
Crystal nephropathy 381
Crystalloids 211
intravenous 388
Cyanide 4, 5, 28, 148, 152, 250t
antidotes 251
poisoning 5, 246
signs of 251t
symptoms of 250t, 251t
toxicity 250
Cyanogen chloride 397
Cyanohemoglobin 147
Cyclooxygenase 211
Cyclopeptides 367
Cyclophosphamide 9, 375, 379
Cyclopropanecarboxylic ester structure 308
Cystitis, hemorrhagic 381
Cytochrome 247
oxidase 250
Cytopathic hyoxia 4
D
Dabigatran 238
etexilate 236
Dantrolene 38
Dapsone 8
Datura 258
fastuosa 358
seed 361t
Death cap mushroom 358
Deep tendon reflexes 130
Deferoxamine 39, 317
dose modification of 39t
Delirium 186
Deoxybarbiturate 134
Depression
myocardial 4
respiratory 15, 186, 279, 283
Depressive disorder, major 186
Desipramine 186
Desirudin 236
Desomorphine 104
Dexamethasone 22
Dexmedetomidine 167
Dexrazoxane 378, 382
Dextromethorphan 88
mechanism of toxicity of 89fc
poisoning 88t
toxicity 88
Dextropropoxyphene 8, 185
Dextrose 6, 112, 180, 182, 389
D-glucose 389
Diabetes
insipidus 258
mellitus 386
noninsulin dependent 277
Dialysis 32
indications of 10t
sustained low-efficiency 9, 265, 267
Diaphoresis 62, 344
Diarrhea 54, 261, 305
Diazepam 16, 81, 134, 266, 299
Diazinon 324
Dichlorodiphenyldichloroethylene 324
Dichlorodiphenyltrichloroethane 111, 112, 320, 321, 324
Dichloroethane 321
Dichlorophenoxyacetic acid 9
Dicofol 321
Dieldrin 321, 324
Diflunisal 9
Digitalis lanata 194
Digitalis purpurea 194
Digoxin 5, 20, 266, 270, 274, 284
ingestion, chronic 40
Dihydropyridines 178
Diltiazem 185
Diluted thrombin time 237
Dimercaprol 39
Dimercaptopropane sulfonate 343
Dimercaptosuccinic acid 51, 341
Dimethyltryptamine 81
Diode array detector 21
Dipeptidyl peptidase-4 inhibitors 391
Diphenadione 227
Diphenhydramine 185, 190
Diphenylchloroarsine 397
Diquat 314, 315
cardiovascular 315
gastrointestinal tract 315
hematological 315
neurological 315
pulmonary 315
renal 315
skin 315
Direct thrombin inhibitors 236
Disability-adjusted life-years 118
Disease-modifying antirheumatic drugs 375
Disopyramide 8
Dispersal method 395
Distress, respiratory 222
Disulfiram toxicity 370
Dithiobisnitrobenzoate 23
Divalproex 134
Dizziness 62
D-lactate 27
Dopamine 110
Dothiepin 186
Doxepin 186
Drugs 15t, 229
abuse 4
and cosmetics Act 68
and cosmetics Rules 69
category of 115t
induced liver injury, causes of 203
Dry flushed skin 186
Dry mouth 186
Dyshemoglobinemias 242
Dyspepsia 55
Dyspnea 62
Dysrhythmias 340
life-threatening 282
E
Early end-organ damage 270
Echocardiography, two-dimensional 95
Edema
cardiogenic pulmonary 4
noncardiogenic pulmonary 4
Edetate calcium disodium, dosing regimen of 38t
Edoxaban 238
Elapid snakes 260
Electrocardiogram 63, 86, 101, 111, 175, 187
toxidromes 12
Electrocardiography 95, 179, 187
Electroencephalograph 112
Electrolytes 179
correction of 196
serum 14, 213
Electromyogram 101
Electromyography 130
Electron impact mass spectrometry 101
Elemental mercury, acute 344
Emergency cardiopulmonary bypass 9
Emulsion therapy 135
Encainide 185
Encephalopathy 205, 340
ifosfamide-induced 44
Endosulfan 321, 324
Endothelial cells 210
Endotracheal
intubation 388
tube administration 34
End-stage renal disease 266
Environmental protection agency 339
Enzyme
acetylcholinesterase 303
cyclooxygenase 210
linked immunosorbent assay 101, 128, 196
Epipodophyllotoxins 378
Epsilon-aminocaproic acid 238
Erythema multiforme 381
Erythrocyte protoporphyrin 343
Erythromycin 28, 227, 400
Erythroxylum coca 93
Eslicarbazepine 133, 135
Ethane 152
Ethanol 4, 21, 28, 118
metabolite 20
Ethosuximide 133, 134, 138
Ethyl dibromide 10
Ethyl glucuronide 20
Ethylene 124, 152
glycol 4, 5, 10, 21, 26, 121, 122
poisoning 27, 41, 49, 122f, 125
toxicity 49, 55
Ethylenediaminetetraacetic acid 22, 71, 112, 341
Euglycemia 391
European Association of Poisons Centers and Clinical Toxicologists 7, 36
Extracellular fluid 29
Extracorporeal Life Support 168, 171, 183, 288
organization 288
Extracorporeal liver assist devices 269
Extracorporeal membrane oxygenation 9, 10, 16, 170, 176, 288291
mechanics of 289
Extracorporeal therapy 9, 169, 180, 183, 189, 207, 255, 264, 265, 274
role of 212
selection of 9
Extracorporeal toxin removal 264, 269, 271, 271fc, 274, 275t, 276284
role of 274t, 275278, 280283
techniques of 9b
types of 265
F
False morel toxicity 49
Fanconi syndrome 259
Fast ventricular rate 195
Fat
absorption of 55
accumulation 62
Fatal poisoning 367
Fatty acid
long-chain 54
metabolism theory 61
Felbamate 133
Fentanyl 20, 81
Ferric chloride spot test 213
Fever 214
Fibrillation, ventricular 95, 186
Flecainide 185
Fluconazole 227
Fluid 215
attenuation inversion recovery 246
intravenous 215
management 168
Flumazenil 6, 16, 40, 148
role of 79
Fluoride 9, 262
ions 222
Fluoroacetamide 334
Fluoroacetates 334
Fluorouracil 9, 379
Flurazepam 81
Flushing 251
Folate, role of 377
Folic acid 42
Folinic acid 148, 376
Fomepizole 41, 125
dosing schedule of 41t
Foodborne botulism 128
Fool's mushroom 368
Forensic toxicology 68
Formaldehyde 151
Formic acid 122
Fosphenytoin 134
Francisella tularensis 399
Free radical generation 242
Fresh frozen plasma 148, 233, 239, 268, 299
Fumigants 303
Fungicides 303
G
Gaba receptor inhibition 112
Gabapentin 133, 134, 141, 257
Galerina 367
autumnalis 368
Gamma-aminobutyric acid 11, 77, 110, 112, 133, 134, 138, 186, 250, 323
Gamma-chain variant 247
Gamma-glutamyl transferase 204
Gamma-hydroxybutyrate 14, 148
Gamma-hydroxybutyric acid 78
overdose 80
Gangrene 46
Gas chromatography 21
mass spectrometry 21, 100, 190
Gasping syndrome 47
Gastric
decontamination 87, 175, 206
lavage 7, 71, 232, 298
mucosa 210
Gastrointestinal
bleeding 238
decontamination 7, 179, 214, 316
distress 119
disturbances 387
dysfunction 295
obstruction 46
perforation 221
system 211, 340
toxicity 376
toxins 368
tract 26, 186, 219
Genitourinary obstruction 46
Genitourinary toxicity 381
management 381
Glacial acetic acid 219
Glasgow coma scale 147, 297
score 5, 15, 64
Glomerular filtration rate 8
Gloriosa superba 365, 365f
Glucagon 16, 42, 148, 169, 182, 390
intravenous 180
Glucagonoma 42
Glucose
6-phosphate dehydrogenase 44, 247
deficiency 50
insulin 176
supplemental 214
transporter-2 inhibitors, serum 391
Glutamate 109
carboxypeptidase 377
dehydrogenase 250
receptor activation 112
Glutamic acid decarboxylase 138
Glutathione 31
reductase 340f, 346
S-transferase 340f
Glutethimide 10
Glyceryl trinitrate 16
Glycine 216
receptor inhibition 112
Glycol 26, 124
Glycolate 28
Glycopyrrolate 298
Glycoside
cardioactive 167
poisoning, nonpharmacological cardiac 40
Glycosuria 163, 314
Gold poisoning 39b
Green pit viper 349
Guanosine monophosphate 182
cyclic 171
Guillain-Barré syndrome 130
Gymnopilus 368
Gyromitra
ambigua 368
esculenta 111, 368
gigas 368
infula 368
mushroom 112
Gyromitrin 368
poisoning 369, 372
H
Hair 71
Haldane effect 242
Hallucinogenic intoxication, management of 89
Hallucinogens 87
Harassing agent 397
Headache 62, 327
Heart
block 40, 186
disease, ischemic 178
failure, congestive 379
Heavy metal 10, 112
poisoning 259, 339
toxicity 339, 340
diagnosis of 341t
mechanism of 340f
Hematological system 211
Hematuria 314
Hemodiafiltration 9
Hemodialysis 10, 41, 112, 125, 215, 262, 264, 316
advantages of 266t
disadvantages of 266t
indications of 215b
intermittent 9, 266, 276, 278284
role of 42
Hemodynamic status, assessment of 232
Hemofiltration 10
Hemoglobin 242, 244, 351
binding 242
M disease 247
Hemoglobinuria 352
Hemolytic uremic syndrome 379, 381
Hemoperfusion 9, 10, 265, 266, 276, 280, 281, 284, 300, 316
advantages of 267t
disadvantages of 267t
indications of 10t
Hemorrhage 4
gastrointestinal 229
intracerebral 237
intracranial 3, 46, 49, 289
subarachnoid 238
subdural 238
Hemostatic abnormalities 351, 352
Heparin overdose 48
Hepatic failure 32, 47, 208
Hepatitis, granulomatous 380
Hepatocellular injury 380
Hepatorenal syndrome 369, 380
Hepatotoxic plants 357
Hepatotoxicity 324
risk of 205
Hepatotoxins, chemotherapeutic 380t
Herbal
ecstasy 102
incense 101
products 230
smoking blends 101
Herbicides 64, 303
poisoning 312
Heroin 5
Hexachlorocyclohexane 320
High performance liquid chromatography 230
High-dose insulin 171
euglycemia
regimen 169b
therapy 169, 180, 181
therapy 42, 43b, 171
High-performance liquid chromatography 21
His-Purkinje fibers 185
Histamine ethanol 110
Hornet bite 258, 261
Human carcinogens 340
Hump-nosed viper 349
Hurricanes 242
Hyaluronidase 382
Hydantoin 134
Hydralazine 5
Hydration 376
Hydrazines 112
Hydrocarbon 4, 8
chlorinated 325
Hydrochloric acid 28, 222
Hydrocodone 81
Hydrocyanic acid 397
Hydrofluoric acid 222
burns 37
Hydrogen
chloride 151, 159
fluoride 159
peroxide 340f, 343
sulphide 4, 5, 28, 70, 151, 152
Hydroperoxide 343
Hydroxocobalamin 16, 43, 148
Hydroxychloroquine 185
Hymenoptera stings 354
Hyperammonemia 283
Hyperbaric oxygen 43, 112, 164
therapy 43, 44t, 157
Hyperglycemia 179
Hyperkalemia 261, 325
Hyperphosphatemia 222
Hypersensitivity reactions 49, 50, 55
Hypertension 5, 5t, 96, 178, 237, 344
abdominal 222
control of 87
Hyperthermia 62, 87, 94, 97, 114, 186
control of 90
malignant 38
Hypertriglyceridemia 114
Hyperventilation 4, 30
Hypnotics, nonbenzodiazepine 78
Hypocalcemia 222
Hypofibrinogenemia 267
Hypoglycemia 119, 179, 205, 386, 388, 389
sulfonylurea-induced 54
Hypokalemia 196
Hyponatremia 110
Hypoperfusion 27
Hypoprothrombinemia 46
Hypotension 5, 5t, 33, 52, 119, 124, 186, 188, 189, 250, 261, 279
Hypothermia 119, 211
Hypothyroidism 55
Hypoventilation 4, 119
Hypoxemia 4t, 27
Hypoxia inducible factor 1-alpha 244
I
Idarucizumab 239
Ifosfamide 377
Iminostilbene 134
Imipramine 22, 186
Indian Evidence Act 70
Indian Penal Code 69
Indian poisonous plants 357
Indoxacarb 185
Infant botulism, adult-type 129
Infarction, myocardial 97, 242, 245
Inferior vena cava 176
Inhibiting cellular oxygen utilization 152
Initial toxidrome 397
recognition 397t
Insecticide 5, 185, 303
Insulin 5, 112, 148, 182
glucose, peripheral 387
intravenous high-dose 180
Insulinoma 42
Intensive care unit 15, 64, 115, 131, 147, 187, 196, 220
International Agency for Research on Cancer 340
International normalized ratio 232, 237
Interstitial nephritis, chronic 258
Interstitial pneumonia, acute 340
Intestinal colonization botulism 129
Intoxication, features of 87
Intra-aortic balloon pump 170, 189
Intranasal spray 45
Intravenous lipid emulsion 170, 180182
therapy 171
Intubation 189
emergency 15
Iodide 9
Ion
channel modulation theory 61
coupled plasma atomic emission spectrometry 21
flux, disturbances of 110
Ipomoea violacea 104
Iron 8, 20
enhances toxicity 317
poisoning 39
Irritant gases, distribution of 152f
Ischemia, myocardial 94
Isoniazid 5, 9, 27, 110, 112
Isoprocarb 304
Isopropanol 123, 124
Isopropyl alcohol 123
J
Jatropha curcas 364, 364f
K
Kerosene 4, 7
Ketamine 20, 90
Ketoacidosis 27
alcoholic 28
Ketones 26, 28, 124
Ketosis 28
Kidney 47, 210, 313
disease, chronic 262, 381
injury, acute 257259
Kikendall and Zargar classification 219
Krait 349
Kratom 103
Kussmaul-Kien respirations 259
L
Labetalol 96
Lacosamide 133, 137
Lactate 26
dehydrogenase 370
Lactic acidosis, metformin associated 278, 387
Lactose 28
Lambert-Eaton syndrome 130
Lamotrigine 133, 134, 137
Lathyrus sativus 362, 362f
Lead 5, 112, 343
poisoning 37, 45, 258, 259
toxicity 343
Leiurus quinquestriatus 353
Lepiota 367
Leucovorin 53, 376
administration of 376
rescue therapy 376
Leukopenia 267
Levetiracetam 133, 134, 140
Levocarnitine 54
Levosimendan 181
Lidocaine 110
Lignocaine 189
Lindane 322, 324
Linezolid 88
Lipid emulsion
infusion 169
regimen 170b
therapy 60, 64b
initiation of 61
Lipid peroxidation 313, 340
Lipid sink theory 60
Liquid chromatography-mass spectrometry 100
Lithium 5, 810, 20, 112, 258, 260, 274, 277
toxicity, management of 277t
Liver 313
biopsy 371
cell failure 205
disease 41
chronic 54
pre-existing 207
failure
acetaminophen-induced 207t
acute 46, 203
function
abnormal 237
tests 14, 204, 214
parenchyma 229
transplant 207
Local anesthetic 60, 64, 185
eutectic mixture of 248
systemic toxicity 60, 63
Loperamide 381
Lorazepam 134
Low glomerular filtration rate 261
Low molecular-weight heparin 48, 48b, 238
Lung 313
fibrosis, early 316
injury, acute 62
Lycoperdons 368
Lysergic acid diethylamide 20, 88, 103, 397
M
Magnesium 174, 299
citrate 7, 28
sulfate 7
Magnetic resonance imaging 130, 131
Maintenance therapy 61
Mannitol 28
Maprotiline 186
Marijuana, synthetic 20
Mean arterial pressure 42
Mechanical ventilation 189
Medicolegal case 68
Meglitinides 390
Membrane stabilizing activity 179
Menadione 232, 333
Mental disorders, statistical manual of 118
Meprobamate 9
Mercury 341, 343
inorganic 344
organic 344
poisoning 39b
tablets 22
thermometers 344
Mesobuthus tamulus 352
Metabolic acidosis 13, 2628, 30, 125, 222, 259, 261
analysis of 26, 27fc
etiology of 26
high anion gap 26
normal anion gap 28
Metaflumizone 185
Metals 5, 223
fume fever 158, 340
Metamizole 266
Metformin 28, 274, 277, 386, 387
overdose 387
toxicity, management of 278t
Methadone 20, 45
metabolite 20
Methamphetamine 20, 85, 86
Methane 4, 152
Methanol 4, 10, 21, 26, 27, 120, 124, 257, 258, 274, 278
poisoning 9, 27, 41, 125
toxicity 53
management of 279t
Methaqualone 20, 266
Methemoglobin 21, 156, 242, 247f, 248
Methemoglobinemia 4, 5, 44, 147, 247, 248t, 249, 370
signs of 248t
symptoms of 248t
Methomyl 304, 305
Methotrexate 9, 24, 28, 148, 262, 374, 375, 379381
metabolism 374
pharmacokinetics of 374
poisoning 375
toxicity 52, 53, 374
management of 376
uses of 374
Methoxetamine 91
Methoxychlor 322
Methoxyketamine 91
Methyl isocyanate 151, 155
Methyl mercury 343, 344
Methylene blue 16, 44, 171, 182
Methylenedioxy-3-methoxy-phenethylamine 102
Methylenedioxymethamphetamine 20, 85, 102, 110, 111, 115
Methylenedioxy-N-hydroxyamphetamine 102
Methylnaltrexone 381
Methylphenidate 20
metabolite 20
Methylprednisolone 22
Methyltestosterone 231
Metoclopramide 5, 28
Microsomal ethanol oxidizing system 119
Midazolam 81
Minimum toxic dose 203
Mitochondrial dysfunction 242
Mitragyna speciosa 103
Molecular adsorbent recirculating system 10, 269
Monday morning fever 340
Monitoring plasma methotrexate concentration 376
Monoamine oxidase 85
inhibitors 44
Monoclonal antibodies 378
Morphine 20, 81
Multiorgan system failure 125, 259
Munchausen syndrome 229
Muscarine 368
poisoning 370
Muscimol poisoning 370
Mushroom
identification 370
management of 268
poisoning 52, 367
treatment of 371
Myasthenia gravis 48, 130
Mycena pura 367
Mydriasis 186
Myeloperoxidase 243, 244
Myoclonic twitching 186
Myoglobinuria 351, 352
N
N-acetylcysteine 31, 33, 176, 274, 317
adverse effects of 32, 207
dosage protocols of 32b
therapy, indications of 206
N-acetyl-P-benzoquinone imine 31, 203, 275
Naloxone 6, 16, 44, 90, 148
Narcotic Drugs and Psychotropic Substances Act 69
National Academy of Clinical Biochemistry 20
National Institute Alcohol Abuse and Alcoholism 118
Nausea 32, 62, 327, 387
Necrosis, hepatic 222
Neon 152
Nephritis, interstitial 257
Nephrotoxic agents 326
Nephrotoxicity 345, 375
long-term 324
Nephrotoxins, chemotherapeutic 381t
Nerium oleander 194, 358
Nerve agent 396
class of 396
poisoning 34
Nerve gas agents 112
Neurocritical Care Society 49
Neuroexcitation 114
Neuroglycopenic symptoms 389
Neuroleptic malignant syndrome 35
Neurological system 211
Neuromuscular dysfunction 297
Neuropathy, peripheral 50
Neurotoxic 348
envenoming 352
plants 357
signs 351
Neurotoxicity 250, 375
central 377
peripheral 377
Neurotoxin
chemotherapeutic 378t
ingestion 327
Neutral protamine hagedorn 49
Neutropenia 379
Nicotinamide adenine dinucleotide 247f
phosphate, oxidation of 313
Nitric oxide 181, 244
synthase 244
inhibition 61
Nitrites 148
Nitrofurantoin 4
Nitrogen 4, 152
mustards 151
oxides of 151, 152
Nitroglycerine 96
N-methyl-D-aspartate 88, 109, 244
Nondihydropyridines 178
Nonsteroidal anti-inflammatory drugs 27, 29, 210, 265
adverse effects of 211t
classification of 211t
overdose 210
Norbormide 331
Norepinephrine 110
Normobaric oxygen therapy 164, 246
Nortriptyline 186
Novichok agents 396
Nucleophilic agents 298
Nystagmus, multidirectional 279
O
Obidoxime 307
Obsessive-compulsive disorders 186
Obsolete technology 270
Obtundation 251
O-cresol reagent 22
Octreotide 54, 112
Omeprazole 227
Omphalotus olivascens 367
Ophthalmoplegia 186
Opiates 5, 14, 20, 29, 93
Opioid 4, 5, 10, 78, 257
long-acting 45
overdose 80
Oral anticoagulants, direct acting 236, 237t-239t
Oral hypoglycemic agents 112, 386, 386t
classification of 386fc
overdose, symptoms of 389t
Oral mucositis, management of 381
Oral N-acetyl cysteine protocol 206
Orellanine 368
poisoning 369
Organic phosphorus compounds 330
Organochlorines 320
pesticide 320, 321t, 324, 327
biological effects of 324t
poisoning, treatment of 325
Organophosphate 4, 5, 8, 33, 112, 257, 304
coma 297
compounds 167, 331
toxicity of 295
poisoning 33b, 47, 48t, 295, 296t
Organophosphorus 10, 23, 258, 295
pesticides 325
poisoning 15, 258
Osmolar gap 11, 28, 124
Oxalate 28
crystals 124
Oxandrolone 231
Oxcarbazepine 133, 134
Oximetry 249
Oxoproline 26
Oxycodone 20, 81
Oxygen 6, 148
saturation gap 15
supplementation 315
therapy 246, 246f
utilization 28
Oxyhemoglobin 156, 162
dissociation curve 242
Oxyphenbutazone 266
Ozone 151
P
Pacemaker 180, 182
Pain 62
abdominal 55, 258, 387
chronic 186
neuropathic 186
severe abdominal 222
Palamneus gravimanus 352
Pancreatitis 55, 62
Paracetamol 20, 22, 203
metabolism of 204fc
normal metabolism of 204fc
poisoning 31, 203
serum 23
Paraoxon 266
Paraphenylenediamine 257, 258
Paraquat 10, 258, 312, 314
detection of 22
induces nitric oxide 313
poisoning 259, 312
Parasiticides 64
Parathion 266
Paresthesias 50
Partial thromboplastin time 48
Paxillus involutus 368
Penicillamine 4, 45
Penicillins 400
Pentachlorophenol 324
Pentohexital sodium 275
Perampanel 138
Peritoneal dialysis 9, 10, 269, 377
Pesticide 293, 303
intoxications 306
poisoning 320
types of 320
Phallotoxins 367
Phencyclidine 5, 14, 20, 90
Phenethylamines 102
Phenformin 28
Phenobarbital 810, 20, 133
Phenobarbitone 24, 81, 134, 138
Phenol 222, 223
Phenothiazines 5, 22, 185
pseudoephedrine 5
Phentolamine 96
Phenylbutazone 266
Phenyltriazine 134
Phenytoin 8, 10, 24, 110, 133135, 274, 279, 280, 282
toxicity, management of 280t
Pheochromocytoma 42
Phosgene 151, 155, 159, 396
Phosphate 12
Phosphaturia aminoaciduria 314
Phosphides 174, 331, 334
Phosphine 152, 174, 331
Phosphodiesterase inhibitors 181
Photophobia 344
Physostigmine 5, 46
Phytomenadione 232
Phytonadione 46, 232, 332
Pink disease 344
Piperazines 102
Piperonyl butoxide 308
Pirimicarb 304
Piroxicam 227
Plant kingdom 357
Plasma acetaminophen levels versus time, semilogarithmic plot of 24f
Plasmapheresis 10, 268
Platelet 210
activation 243
transfusion 148
Pneumonia, ventilator-associated 115, 298
Pneumothorax 4
Podophyllum species 360
Poisoning 3, 19, 68, 72fc, 146fc
acute 19, 162, 274, 342
causes of 357
chronic 21
circumstances of 70
fulminant 315
homicidal 70
inhalational 151
management of 296
mild 314
moderate-to-severe 315
nonanticholinesterase 48
nonpharmaceutical 290
organocarbamate 295
plant 357
severity score 147
subacute 163
suicidal 70
Poisonous mushrooms
accidental consumption of 367
toxicity of 367
Poisonous plants, category of 357, 357t
Poisons 4, 15t, 74t
binding 265
counteract effects of 299, 299t
gastrointestinal 370
load, reduction of 298
neurodepressive effect of 297
Poliomyelitis 130
Polychlorinated biphenyls 324
Polyethylene glycol electrolyte solution 8
Polymerase chain reaction 128
Polyoxyethylated castor oil 47
Polysorbate 47
Posaconazole 24
Positive end-expiratory pressure 306
Potassium 8, 12, 27, 176
channel
blockers 110, 167
openers 110
chloride 215
cyanide test 249
iodide 55, 56b
permanganate 175
Pralidoxime 16, 47, 112, 148, 160
Prednisolone 22
Pregabalin 133, 141
Pregnancy test 14
Primidone 133, 134
Procainamide 185, 266
Propane 4, 152
Propofol 28, 114
infusion syndrome 114
Propoxur 303305
Propoxyphene 14, 20
Propranolol 110, 179, 227
Propylene glycol 26, 28, 279
toxicity 259
Propyphenazone 266
Protamine
neutralization dose of 48b, 48t
sulfate 48
Protein 265
binding 265
degree of 10
bound toxins 269
kinase inhibitor 378
modification 340
Proteinuria 314
Prothrombin complex 148
concentrate 233
Prothrombin time 232, 237
Proton pump inhibitors 20
Protriptyline 186
Proximal tubular cells 260
Prussian blue 112
Psathyrella 368
Psilocybe 368
Psilocybin 89, 368
poisoning 369
Psychoactive drugs 397
Pulmonary edema 29, 250
clinical features of 179
signs of 307
Pulse
contour cardiac output 180
pressure variation 168
Pylorospasm 213
Pyramidal signs 186
Pyrethroids 110, 111, 307, 308, 308t
Pyridoxine 49, 112
Q
Quick toxidrome recognition 397
Quinidine 5, 110, 185
Quinine 8, 185
R
Randomized control trials 60, 168, 196
Raxibacumab 400
Reactive airway dysfunction syndrome 152
Reactive oxygen species 243, 312, 343
Real time mass spectrometry 100
Rebound toxicity 229
risk of 233
Red blood cell 23, 304, 342
cholinesterase 23
Rehabilitation 352
Renal biopsy 371
Renal dysfunction 39t, 48, 387
Renal failure 27, 124, 260, 351, 374
Renal function
abnormal 237
tests 213
Renal replacement therapy 261
continuous 9, 215, 267, 276279, 281284
Renal tubular acidosis 26, 27, 260, 381
Renin angiotensin system 29
Respiratory 94
failure 145, 146, 146t, 388
pathogenesis of 145
irritants 151t, 153
rate 214
system 211
tract 219
Resuscitation 16
cardiopulmonary 16, 63, 168
Retigabine 133
Rhabdomyolysis 257t
Ricin toxin 400
Ricinus communis 358
plant 358ff
Rifampicin 136
Risperidone 5
Rivaroxaban 238, 239
Rodenticides 5, 258, 293, 303, 330
classification of 330
poisoning 332, 334t
Rohypnol 5
Ropivacaine 185
Rotenone 28
Rufinamide 133, 137
Rumack-Matthew nomogram 205f, 206
drawbacks of 206
Russell's viper 349
S
Salicylate 4, 810, 12, 20, 22, 26, 30, 112, 212, 213, 216, 262
levels, serum 23, 213
overdose 281
poisoning 52, 53
management of 214
toxicity, management of 281t
Salicylic acid 212, 274, 280, 317
Salmonella typhimurium 398
Salvia 103
Saw-scaled viper 349
Schilling's test, abnormal 55
Scorpion stings 352
Sea snakes 349
Sedation 87
Sedative
hypnotic 4, 5, 78
overdose, management of 79
overdose of 29
Seizures 15, 179, 186, 188
chemical agents causing 112t
epileptic 109
isoniazid-induced 49
toxin-induced 109, 113fc
treatment of 61
Selective serotonin reuptake inhibitor 44, 111
Selenium 266
Semecarpus anacardium 359, 360f
Serotonergic drugs 88
Serotonin 110
and norepinephrine reuptake inhibitors 44
Serum lactate predict life-threatening poisoning 179
Sesame oil, component of 308
Shell fish poisoning 130
Shock 257
cardiogenic 186
Silibinin 371
Silo Filler's disease 153
Silymarin 52
Single pass albumin dialysis 10
Sinoatrial node 188
Sinus bradycardia 55, 94, 186, 187, 195, 314
Skin 219
Slaughterhouse sledgehammer effect 153
Snake 258, 348
bite 4, 260
management of 260, 350, 350fc
neuroparalytic 148
therapeutic response of 349t
types of 348
venom 257
toxic effects of 348
Society of Critical Care Medicine 49
Sodium 12, 27
bicarbonate 16, 52, 188, 215
hypertonic 170
channel
blockers 110, 168, 185, 187t
opener 110
voltage-dependent 134
voltage-gated 112, 185
nitrite 16, 50
solution 50t
sulfate 7
thiosulfate 16, 51
valproate 138
Sorbitol 8, 298
Sotalol 167, 179
Stat quantitative serum toxicology assays 20
Status epilepticus 109, 115
complications of 115
nonconvulsive 115
refractory 115, 116fc
super-refractory 109
ST-elevation myocardial infarction 95
Steroids 22
Stevens-Johnson syndrome 381
Street pharmacists 99
Stroke 237
syndromes 130
volume variation 168
Strophanthus gratus 194
Strychnine 330, 331, 334
Strychnos nuxvomica 358
Succinimide 134
Succinylcholine 46
Suicide tree 358, 361, 361f
Sulfate 12
Sulfhemoglobinemia 251
Sulfmethemoglobin 73
Sulfonamides 9, 262
Sulfonylureas 112, 388
agents, toxicity of 388
classification of 388fc
Sulfur dioxide 151
Sulfuric acid 218
Superoxide dismutase 340f
Superwarfarin 232
poisoning, management of 333fc
toxicity 227
Sympathomimetics 5
drugs 84
Syndrome of inappropriate antidiuretic hormone secretion 134
Systemic inflammatory response syndrome 162
T
Tachyarrhythmia 40, 170
management of 197
Tachycardia 5, 5t, 168b, 186, 251, 261, 307, 344
control of 87
supraventricular 95
ventricular 95, 186
Tachypnea 214, 257
Tear gases 397
Terlipressin 171
Testosterone 231
Tetanus 4
Tetracycline 400
Tetrahydrocannabinol 20
Tetrahydrofolate 120
Tetramine 330, 331, 334
Tetrodotoxin 185
Thaimine 6
Thallium 9, 112, 274, 281
sulfate 330, 331
toxicity, management of 282t
Theophylline 5, 8, 10, 20, 27, 112, 274, 282
anhydrous 282
toxicity 282, 283t
Therapeutic plasma 268
exchange 9, 10, 268
Therapeutic serum levels 276
Thevetia peruviana 194, 358, 364
Thiamine 55
Thiopentone 81
Thioridazine 185
Thiosulfate 148
Thrombin time 237
Thrombocytopenia 47
Thrombolytics 4
Thrombotic thrombocytopenic purpura 379
Thymidine 377
Thymidylate
salvage 377
synthase 375
Thyroid stimulating hormone secretion 55
Thyroxine 10, 265
Tiagabine 133, 134
Tick paralysis 130
Tiletamine 91
Tissue
hypoxemia 27
necrosis of 219
Topiramate 28, 133, 134, 140
Topoisomerase inhibitors 378, 380
Toxaphene 322
Toxic agents 258
Toxic alcohol 28, 118, 259
parameter, comparisons of 124t
poisoning 42, 52, 53
Toxic dose 174, 210, 321t
ingestion of 230
Toxic epidermal necrolysis 381
Toxic inhalation gases 4
Toxic manifestations 88, 212
Toxic megacolon 186
Toxic plants 357
Toxic substances 306
Toxicity 52, 64, 212, 327, 395
acute 340, 342
aspects of 227
chemotherapy-induced 374
hematopoietic 378, 379t
mechanism of 89fc, 242, 312, 323, 342, 345
mitochondrial 313
mucocutaneous 376
multiorgan 340
neurological 377
pulmonary 375, 379
stages of 88t
systemic 151
Toxicodynamics 174, 228
Toxicokinetics 186, 190, 228, 274278, 280283, 308
considerations 9
Toxicological analysis, systematic 21
Toxicology 28, 68, 203
tests 21
advanced 21
Toxidromes 3, 9, 11t
approach 72
Toxins 9t, 185, 229, 400
biochemical effects of 323
chemotherapeutic pulmonary 380t
dialyzability of 264
diarrhea-inducing 28
direct metabolism of 28
examples of 110t
extracorporeal
elimination of 9
removal of 264
hematological 225, 375
induced acute renal failure 257
renal 255
Tramadol 20, 88
Tranexamic acid 238
Transfusion reactions, risk of 233
Tricyclic antidepressant 4, 5, 10, 14, 20, 29, 64, 111, 168, 185, 186t, 257, 265, 274, 291
poisoning 52
toxicity, clinical features of 186t
Trimipramine 186
Troponins, cardiac 95
Tryptamines 103
Tubular necrosis, acute 258, 340, 381
Tyrosine kinase inhibitor 380
U
Unconsciousness 5b
Upper gastrointestinal endoscopy 221
contraindications of 221t
indications of 221t
Urinary
acidification, role of 90
alkalization 262
retention 186
toxicology panel 112
tract infection, catheter-associated 298
Urine 71
acidification 9, 87
alkalization 9, 376
drug screens 20
limitations of 20
V
Valproate 138
Valproic acid 20, 133, 134, 136, 139, 274, 283
toxicity 283
management of 284t
Vancomycin 24
Vasoplegia 44
Vasopressors 168, 180, 182
therapy 181
Venoarterial-extracorporeal membrane oxygenation 148, 183
Venovenous hemofiltration, continuous 176
Ventricular premature complexes 195
Verapamil 4, 185
Verpa bohemica 368
Vigabatrin 133, 134, 138
Viperid snakes 260
Vipomas 54
Viral hemorrhagic fevers 400
Virotoxins 367
Visual disturbance 125
Visual dysfunction 278
Vitamin
B complex 363
B6 110
B9 42
C 317
E 317
K 228, 229, 332
antagonists 46
optimum dose of 333
serum levels of 230
therapy 233
K1 46, 148, 232, 233, 332
prophylactic 334
K3 232, 333
Vomiting 32, 62, 327, 397
Voriconazole 24
Warfarin 227229
ingestion, acute 233
mechanism of action of 228ff
serum levels of 230
toxicity 46, 229, 233
W
Water hemlock 111
Wernicke's encephalopathy 55
White phosphorus 222
Whole blood clotting time 57
Whole bowel irrigation 8, 179
Woolsorter disease 399
Wound botulism 128
X
Xanthine oxidase 250
Ximelagatran 236
Y
Yellow oleander 358, 364, 365f
Yellow phosphorus 330, 331, 334
Yersinia pestis 399
Z
Zargar classification 220, 222t
Zinc 174
chloride 290
phosphide 330
shakes 340
Zonisamide 133, 134, 137
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