Poisoning and Drug Overdose

831 Pages·2011·4.71 MB·English

by  Kent Olson (ed.)

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Environmental and Occupational Toxicology: Approach to hazardous materi-
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Index: Includes generic drug and chemical names and numerous brand name
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POISONING
& DRUG
OVERDOSE
Editedby
KentR.Olson,MD,FACEP,FACMT,FAACT
ClinicalProfessorofMedicineandPharmacy,
UniversityofCalifornia,SanFrancisco;
MedicalDirector,CaliforniaPoisonControlSystem,
SanFranciscoDivision
AssociateEditors
IleneB.Anderson,PharmD RichardF.Clark,MD,FACEP
ClinicalProfessorofPharmacy,Universityof ProfessorofMedicine,
California,SanFrancisco; UniversityofCalifornia,SanDiego;
SeniorToxicologyManagementSpecialist, Director,DivisionofMedicalToxicology
CaliforniaPoisonControlSystem, andMedicalDirector,
SanFranciscoDivision CaliforniaPoisonControlSystem,
SanDiegoDivision
NealL.Benowitz,MD ThomasE.Kearney,PharmD,ABAT
ProfessorofMedicine ProfessorofClinicalPharmacy,
andChief,DivisionofClinicalPharmacology UniversityofCalifornia,SanFrancisco;
andToxicology, ManagingDirector,
UniversityofCalifornia,SanFrancisco; CaliforniaPoisonControlSystem,
AssociateMedicalDirector, SanFranciscoDivision
CaliforniaPoisonControlSystem,
SanFranciscoDivision
PaulD.Blanc,MD,MSPH SusanY.Kim-Katz,PharmD
ProfessorofMedicineandChief,Divisionof ClinicalProfessorofPharmacy,
OccupationalandEnvironmentalMedicine, UniversityofCalifornia,SanFrancisco;
UniversityofCalifornia,SanFrancisco SeniorToxicologyManagementSpecialist,
CaliforniaPoisonControlSystem,
SanFranciscoDivision
AlanH.B.Wu,PhD
ProfessorofLaboratoryMedicine,
UniversityofCalifornia,SanFrancisco;
Chief,ClinicalChemistryLaboratory
SanFranciscoGeneralHospital
NewYork Chicago SanFrancisco Lisbon London Madrid MexicoCity
Milan NewDelhi SanJuan Seoul Singapore Sydney Toronto
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Contents
Authors vi
Preface xv
SectionI.ComprehensiveEvaluationandTreatment 1
Thissectionprovidesastep-wiseapproachtotheevaluationandtreatmentofcoma,
seizures,shock,andothercommoncomplicationsofpoisoningandtotheproperuse
ofgastricdecontaminationanddialysisprocedures.
SectionII.SpecificPoisonsandDrugs:DiagnosisandTreatment 69
Organizedalphabetically,thissectionlistsspecificdrugsandpoisons,aswellasthe
pathophysiology, toxic dose and level, clinical presentation, diagnosis, and specific
treatmentassociatedwitheachsubstance.
SectionIII.TherapeuticDrugsandAntidotes 438
This section provides descriptions of therapeutic drugs and antidotes discussed in
SectionsIandII,includingtheirpharmacology,indications,adverseeffects,drugin-
teractions,recommendeddosage,andformulations.
SectionIV.EnvironmentalandOccupationalToxicology 563
Thissectiondescribestheapproachtohazardousmaterialsincidents;theevaluation
ofoccupationalexposures;andthetoxiceffects,physicalproperties,andworkplace
exposurelimitsforover500commonindustrialchemicals.
Index 691
The index includes generic drug and chemical names and numerous brand name
drugsandcommercialproducts.
v
Authors
TimothyE.Albertson,MD,MPH,PhD
ProfessorofMedicine,MedicalPharmacologyandToxicology,UniversityofCalifornia
MedicalCenter,Davis;MedicalDirector,CaliforniaPoisonControlSystem,Sacramento
Division
[email protected]
SectionII:Amphetamines;Barbiturates;Chloroquine;Dextromethorphan;Opiatesand
Opioids
JudithA.Alsop,PharmD,DABAT
HealthSciencesClinicalProfessor,SchoolofPharmacy,UniversityofCalifornia,San
Francisco;ClinicalProfessorofMedicine,SchoolofMedicine,UniversityofCalifornia,
Davis
[email protected]
SectionII:Plants;SectionIII:Metoclopramide;Ondansetron;Potassium;Propofol
IleneB.Anderson,PharmD
ClinicalProfessor,SchoolofPharmacy,UniversityofCalifornia,SanFrancisco;Senior
ToxicologyManagementSpecialist,CaliforniaPoisonControlSystem,SanFrancisco
Division
[email protected]
SectionII:Botulism;CamphorandOtherEssentialOils;Dextromethrophan;Ethylene
GlycolandOtherGlycols;LomotilandOtherAntidiarrheals;Methanol;Warfarinand
RelatedRodenticides
PatilArmenian,MD
MedicalToxicologyFellow,CaliforniaPoisonControlSystem,SanFranciscoDivision,
UniversityofCalifornia,SanFrancisco
SectionII:PhencyclidineandKetamine
JohnBalmes,MD
Professor,DepartmentofMedicine,UniversityofCalifornia,SanFrancisco;Chief,Division
ofOccupationalandEnvironmentalMedicine,SanFranciscoGeneralHospital
[email protected]
SectionII:Asbestos;Formaldehyde;Gases,Irritant;Molds;Phosgene;SulfurDioxide
NealL.Benowitz,MD
ProfessorofMedicineandChief,DivisionofClinicalPharmacologyandToxicology,
UniversityofCalifornia,SanFrancisco;AssociateMedicalDirector,CaliforniaPoison
ControlSystem,SanFranciscoDivision
[email protected]
SectionII:Anesthetics,Local;AntiarrhythmicDrugs;Antidepressants,General(Noncyclic);
Antidepressants,Tricyclic;Beta-AdrenergicBlockers;CardiacGlycosides;Cocaine;Ergot
Derivatives;Lithium;Marijuana;MonoamineOxidaseInhibitors;Nicotine;Nitratesand
Nitrites;Nitroprusside;Phencyclidine(PCP)andKetamine;Pseudoephedrine,
PhenylephrineandOtherDecongestants;QuinidineandOtherTypeIAAntiarrhythmic
Drugs;Quinine;Vacor(PNU);SectionIII:Dopamine;Epinephrine;Norepinephrine
KathleenBirnbaum,PharmD
ToxicologyManagementSpecialist,DepartmentofClinicalPharmacy,Universityof
California,SanFrancisco
[email protected]
SectionIII:Insulin;LeucovorinCalcium
PaulD.Blanc,MD,MSPH
ProfessorofMedicine,andChief,DivisionofOccupationalandEnvironmentalMedicine,
UniversityofCalifornia,SanFrancisco
[email protected]
SectionII:CarbonDisulfide;Cyanide;Isocyanates;Manganese;MetalFumeFever;
Methemoglobinemia;NitrogenOxides;SectionIV:EvaluationofthePatientwith
OccupationalChemicalExposure;TheToxicHazardsofIndustrialandOccupational
Chemicals
vi
AUTHORS vii
StephenC.Born,MD,MPH
AssociateClinicalProfessor,DivisionofOccupationalandEnvironmentalMedicine,
UniversityofCalifornia,SanFrancisco
[email protected]
SectionII:Dioxins,EthyleneOxide
AlanBuchwald,MD
ConsultantinMedicalToxicologyandMedicalDirector,OccupationalHealthCenter,
DominicanSantaCruzHospital,SantaCruz
[email protected]
SectionII:Copper
ChrisCamilleri,DO
VolunteerClinicalFaculty,InternalMedicine,UniversityofCalifornia,DavisMedicalCenter,
ShingleSprings
SectionII:Benzene
F.LeeCantrell,PharmD
AssistantClinicalProfessor,SchoolofPharmacy,UniversityofCalifornia,SanDiegoand
SanFrancisco;InterimDirector,CaliforniaPoisonControlSystem,SanDiegoDivision
[email protected]
SectionII:ThyroidHormone;SectionIII:Cyproheptadine;Deferoxamine;FolicAcid;
Inamrinone(formerlyAmrinone)
ShaunD.Carstairs,MD
AssistantProfessor,DepartmentofEmergencyMedicine,UniformedServicesUniversityof
theHealthSciences,SanDiego
SectionII:PolychlorinatedBiphenyls(PCBs);Trichloroethane,Trichloroethyleneand
Tetrachloroethylene
RichardF.Clark,MD
ProfessorofMedicine,UniversityofCalifornia,SanDiego;Director,DivisionofMedical
Toxicology,UniversityofCaliforniaMedicalCenter,SanDiego;MedicalDirector,California
PoisonControlSystem,SanDiegoDivision
[email protected]
SectionII:Hymenoptera;LionfishandOtherScorpaenoidea;Scorpions;Snakebite;
SectionIII:Antivenom,Crotalinae(Rattlesnake);Antivenom,LatrodectusMactans(Black
WidowSpider);Antivenom,MicrurusFulvius(CoralSnake)
G.PatrickDaubert,MD,FACEP
AssociateMedicalDirector,SacramentoDivision,CaliforniaPoisonControlSystem;
DivisionofEmergencyMedicine,KaiserPermanente,SouthSacramentoMedicalCenter,
Sacramento
SectionII:Aconite
DeliaA.Dempsey,MD,MS
AssistantAdjunctProfessorofPediatrics,Medicine,andClinicalPharmacy,Universityof
California,SanFrancisco;AssistantMedicalDirector,CaliforniaPoisonControlSystem,
SanFranciscoDivision
[email protected]
SectionI:SpecialConsiderationsinPediatricPatients;SectionII:Bromides;Methyl
Bromide;PentachlorophenolandDinitrophenol
CharleneDoss
SchoolofPharmacy,UniversityofCalifornia,SanFrancisco
SectionII:Antiseptics
JoEllenDyer,PharmD
ClinicalProfessor,DepartmentofPharmacy,UniversityofCalifornia,SanFrancisco;
SeniorToxicologyManagementSpecialist,CaliforniaPoisonControlSystem,San
FranciscoDivision
[email protected]
SectionI:SpecialConsiderationsintheEvaluationofDrug-FacilitatedAssault;
SectionII:Azide,Sodium;Gamma-Hydroxybutyrate(GHB)
viii POISONING&DRUGOVERDOSE
GaryW.Everson,PharmD
ToxicologyManagementSpecialist,CaliforniaPoisonControlSystem,Fresno/Madera
Division
[email protected]
SectionII:PhenolandRelatedCompounds;SectionIII:Mannitol
JeffreyFay,PharmD
AssistantClinicalProfessor,DepartmentofPharmacy,UniversityofCalifornia,San
Francisco;ToxicologyManagementSpecialist,CaliforniaPoisonControlSystem,
Fresno/MaderaDivision
[email protected]
SectionII:Vasodilators
ThomasJ.Ferguson,MD,PhD
AssociateClinicalProfessorofInternalMedicine,UniversityofCalifornia,Davis;Medical
Director,CowellStudentHealthCenter,UniversityofCalifornia,Davis
[email protected]
SectionII:Chromium;Thallium
FrederickFung,MD,MS
ClinicalProfessorofOccupationalMedicine,UniversityofCalifornia,Irvine;Medical
Director,OccupationalMedicineDepartmentandToxicologyServices,SharpRees-Stealy
MedicalGroup,SanDiego
[email protected]
SectionII:CarbonTetrachlorideandChloroform;Radiation
MarkJ.Galbo,MS
EnvironmentalToxicologist,SchoolofPharmacy,UniversityofCalifornia,SanFrancisco;
PoisonInformationSpecialist,CaliforniaPoisonControlSystem,SanFranciscoDivision
[email protected]
SectionII:NaphthaleneandParadichlorobenzene;WarfareAgents—Chemical
FabianGarza,PharmD
SchoolofPharmacy,UniversityofCalifornia,SanFrancisco;ToxicologyManagement
Specialist,CaliforniaPoisonControlSystem,Fresno/MaderaDivision
[email protected]
SectionIII:MethyleneBlue
RichardJ.Geller,MD,MPH
AssociateClinicalProfessorofEmergencyMedicine,UniversityofCalifornia,San
Francisco;MedicalDirector,CaliforniaPoisonControlSystem,Fresno/MaderaDivision
SectionII:Disulfiram;ParaquatandDiquat;Selenium;SectionIII:Atropineand
Glycopyrrolate;Pralidoxime(2-PAM)&OtherOximes
JoanneM.Goralka
ToxicologyManagementSpecialist,DepartmentofClinicalPharmacy,Universityof
California,Sacramento
SectionIII:Ondansetron;Propofol
ChristineA.Haller,MD
AssistantProfessorofMedicineandLaboratoryMedicine,UniversityofCalifornia,San
Francisco;CaliforniaPoisonControlSystem,SanFranciscoDivision;SanFrancisco
GeneralHospital
[email protected]
SectionII:HerbalandAlternativeProducts
SandraHayashi,PharmD
AssistantClinicalProfessor,SchoolofPharmacy,UniversityofCalifornia,SanFrancisco;
ToxicologyManagementSpecialist,CaliforniaPoisonControlSystem,SanFrancisco
Division
[email protected]
SectionII:AngiotensinBlockersandACEInhibitors;SectionIII:PrussianBlue
AUTHORS ix
PatriciaHessHiatt,BS
AdministrativeOperationsManager,CaliforniaPoisonControlSystem,SanFrancisco
Division
[email protected]
SectionIV:TheToxicHazardsofIndustrialandOccupationalChemicals
RaymondHo,PharmD
ToxicologyManagementSpecialist,CaliforniaPoisonControlSystem,SanFrancisco
Division
[email protected]
SectionIII:BotulinumAntitoxin;Flumazenil;Thiosulfate,Sodium
Yao-MinHung,MD,MPH
AttendingPhysician,DepartmentofInternalMedicine,LongCyuanVeteransHospital,
KaohsiungCity,Taiwan
SectionII:OxalicAcid
LeslieM.Israel,DO,MPH
AssociateClinicalProfessorofOccupationalMedicine,UniversityofCalifornia,Irvine
[email protected]
SectionII:Cadmium
SamJackson,MD,MBA
GlobalSafetyOfficer,AmgenGlobalSafety,BiotechnologyCompany,SanFrancisco,
California
SectionIII:NeuromuscularBlockers
ThanjiraJiranantakan,MD
MedicalToxicologyFellow,CaliforniaPoisonControlSystem,UniversityofCalifornia,San
Francisco,USA;Instructor,PreventiveandSocialMedicineDepartment,SirirajHospital
FacultyofMedicine,MahidolUniversity,Thailand
SectionII:EthyleneGlycolandOtherGlycols;Methotrexate;Lithium
ThomasE.Kearney,PharmD,DABAT
ProfessorofClinicalPharmacy,UniversityofCalifornia,SanFrancisco;ManagingDirector,
CaliforniaPoisonControlSystem,SanFranciscoDivision
[email protected]
SectionII:CarbamazepineandOxcarbazepine;ValproicAcid;SectionIII:Introduction;
Acetylcysteine(N-Acetylcysteine[NAC]);Benzodiazepines(Diazepam,Lorazepam,and
Midazolam);Benztropine;Bicarbonate,Sodium;Bromocriptine;Charcoal,Activated;
CimetidineandOtherH2Blockers;Dantrolene;Diazoxide;Digoxin-SpecificAntibodies;
Diphenhydramine;Esmolol;Ethanol;Fomepizole(4-Methylpyrazole,4-MP);Glucagon;
Glucose;HaloperidolandDroperidol;Isoproterenol;Labetalol;Lidocaine;Methocarbamol;
Morphine;NeuromuscularBlockers;Nicotinamide(Niacinamide);Nifedipine;Nitroprusside;
Octreotide;Penicillamine;Pentobarbital;Phenobarbital;Phentolamine;Physostigmineand
Neostigmine;Propranolol;Protamine;Pyridoxine(VitaminB6);Thiamine(VitaminB1);
VitaminK1(Phytonadione)
PaulA.Khasigian,PharmD
ToxicologyManagementSpecialist,CaliforniaPoisonControlSystem,Universityof
California,SanFrancisco,Madera
SectionII:PhosphineandPhosphides;PyrethrinsandPyrethroids
SusanY.Kim-Katz,PharmD
ProfessorofClinicalPharmacy,UniversityofCalifornia,SanFrancisco;SeniorToxicology
ManagementSpecialist,CaliforniaPoisonControlSystem,SanFranciscoDivision
[email protected]
SectionII:AntidiabeticAgents;AntineoplasticAgents;Beta-2AdrenergicStimulants;Food
Poisoning:Bacterial;FoodPoisoning:FishandShellfish;JellyfishandOtherCnidaria;
Salicylates;SkeletalMuscleRelaxants
x POISONING&DRUGOVERDOSE
LadaKokan,MD
AssistantClinicalProfessor,DepartmentofPharmacology,UniversityofCalifornia,
SanFrancisco
[email protected]
SectionII:MonoamineOxidaseInhibitors
MichaelJ.Kosnett,MD,MPH
AssociateClinicalProfessorofMedicine,DepartmentofClinicalPharmacologyand
Toxicology,UniversityofColoradoHealthSciencesCenter,Denver
[email protected]
SectionII:Arsenic;Arsine;Lead;Mercury;SectionIII:BAL(Dimercaprol);EDTA,Calcium
(CalciumDisodiumEDTA,CalciumDisodiumEdetate,CalciumDisodiumVersenate);
Succimer(DMSA);Unithiol(DMPS)
AllysonKreshak,MD
MedicalToxicologyFellow,EmergencyMedicine,DivisionofMedicalToxicology,University
ofCalifornia,SanDiego
SectionII:Ethanol;Phosphorus
GrantD.Lackey,PharmD,PhD,CSPI,FASCP
AssistantClinicalProfessorofMedicine,UniversityofCalifornia,Davis;AssistantClinical
ProfessorofMedicine,UniversityofCalifornia,SanFrancisco;ToxicologyManagement
Specialist,CaliforniaPoisonControlSystem,SacramentoDivision
[email protected]
SectionII:AntipsychoticDrugs,IncludingPhenothiazines;SectionIII:Phenytoinand
Fosphenytoin
Chi-LeungLai,PharmD
AssistantClinicalProfessorofPharmacy,UniversityofCalifornia,SanFrancisco;Assistant
ClinicalProfessorofMedicine,UniversityofCaliforniaMedicalCenter,Davis;Toxicology
ManagementSpecialist,CaliforniaPoisonControlSystem,SacramentoDivision
[email protected]
SectionII:BoricAcid,Borates,andBoron
DarrenH.Lew,PharmD
ToxicologyManagementSpecialist,CaliforniaPoisonControlSystem,Fresno/Madera
Division
[email protected]
SectionII:ChlorinatedHydrocarbonPesticides
JonLorett,PharmD
ToxicologyManagementSpecialist,DepartmentofClinicalPharmacy,Universityof
California,SanFrancisco
[email protected]
SectionII:IpecacSyrup;SectionIII:IpecacSyrup
DerrickLung,MD,MPH
MedicalToxicologyFellow,CaliforniaPoisonControlSystem,SanFranciscoDivision;
UniversityofCalifornia,SanFrancisco
SectionII:Caustic&CorrosiveAgents;Hydrocarbons;SectionIII:Carnitine
BinhT.Ly,MD,FACMT,FACEP
ProfessorofEmergencyMedicine;Director,MedicalToxicologyFellowshipProgram,
DivisionofMedicalToxicology;Director,EmergencyMedicineResidencyProgram;
DepartmentofEmergencyMedicine,UniversityofCalifornia,SanDiego;CaliforniaPoison
ControlSystem
[email protected]
SectionII:HydrogenFluorideandHydrofluoricAcid;MethyleneChloride;
SectionIII:Calcium
TatianaM.Mamantov,MD
MedicalToxicologyFellow,DepartmentofMedicine,UniversityofCalifornia,SanFrancisco
SectionII:Freons&Halons;SectionIII:DTPA