Emergency medicine clinics of North America
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Toxic overdose can present with various clinical signs and symptoms. These may be the only clues to diagnosis when the cause of toxicity is unknown at the time of initial assessment. ⋯ Usually the drug or toxin can be quickly identified by a careful history, a directed physical examination, and commonly available laboratory tests. Once the patient has been stabilized, the physician must consider how to minimize the bioavailability of toxin not yet absorbed, which antidotes (if any) to administer, and if other measures to enhance elimination are necessary.
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Emerg. Med. Clin. North Am. · May 2007
ReviewEmergency department management of the salicylate-poisoned patient.
Salicylate toxicity continues to be encountered commonly in emergency medicine. This article portrays the signs and symptoms of salicylate toxicity, reviews the erratic absorption and elimination kinetics, describes the devastating physiologic effects of overdose, and illustrates the potentially subtle manifestations of chronic aspirin toxicity.
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Emerg. Med. Clin. North Am. · May 2007
ReviewManagement of beta-adrenergic blocker and calcium channel antagonist toxicity.
State-of-the-art therapy for beta-adrenergic receptor blocker and calcium channel antagonist toxicity is reviewed in the light of new insights into drug-induced shock. A brief discussion of pathophysiology, including cardiac, hemodynamic, and metabolic effects of cardiac drug toxicity, provides a foundation for understanding the basis of therapy. The major focus of this review is a critical evaluation of antidotal use of calcium, glucagon, catecholamines, insulin-euglycemia, and other novel therapies based on investigational studies and cumulative clinical experience.