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Clinical Toxicology

Specialisation

  1. Alister Vale MD, FRCP, FRCPE, FRCPG, FFOM, FAACT, FBTS, Hon. FRCPSG1,2,
  2. Sally Bradberry BSc, MD, MRCP3,4

Published Online: 15 DEC 2009

DOI: 10.1002/9780470744307.gat106

General, Applied and Systems Toxicology

General, Applied and Systems Toxicology

How to Cite

Vale, A. and Bradberry, S. 2009. Clinical Toxicology. General, Applied and Systems Toxicology. .

Author Information

  1. 1

    City Hospital, Consultant Clinical Pharmacologist, Director, National Poisons Information Service (Birmingham Unit) and West Midland Poisons Unit, Birmingham, UK

  2. 2

    University of Birmingham, School of Bioscience and College of Medical and Dental Sciences, Birmingham, UK

  3. 3

    City Hospital, Assistant Director, National Poisons Information Service (Birmingham Unit) and West Midlands Poisons Unit, Birmingham, UK

  4. 4

    University of Birmingham, School of Biosciences, Birmingham, UK

Publication History

  1. Published Online: 15 DEC 2009

Abstract

Clinical toxicology is a discipline within toxicology which is concerned with the impact of drugs and other chemicals on humans. The role of the clinical toxicologist encompasses the traditional therapeutic role, that is the management of patients with acute and chronic poisoning. In addition, the clinical toxicologist will usually provide expert advice via a poisons information service and will be familiar with the occupational and environmental impact of a wide range of chemicals. Clinical toxicologists are also likely to be involved in the development of strategies for the management of major chemical disasters, the evaluation of antidotes used against chemical warfare agents and the assessment of the adverse effects of pesticides and other chemicals whether resulting from a single exposure or chronic low-level exposure. This chapter describes the components that should make up a comprehensive clinical toxicology service. These include the provision of advice through a poisons information service, an in-patient treatment service, an out-patient clinical, occupational and environmental toxicology service, advice to Government, Regulatory and other international bodies, analytical support and the provision of an interpretive service for toxicological analyses, and opportunities for research and training in toxicology. The chapter also describes the presentation and complications of poisoning and details the general assessment and management of the poisoned patient. The chapter concludes with a discussion of the role of toxicovigilance.

Keywords:

  • clinical toxicology;
  • serotonin syndrome;
  • methaemoglobinaemia;
  • multiple-dose activated charcoal;
  • reduction of poison absorption;
  • rhabdomyolysis;
  • toxicovigilance;
  • urine alkalinization