Applied clinical pharmacology and public health in rural Asia – preventing deaths from organophosphorus pesticide and yellow oleander poisoning


  • Michael Eddleston

    Corresponding author
    1. National Poisons Information Service – Edinburgh, Royal Infirmary, Edinburgh, UK
    2. South Asian Clinical Toxicology Research Collaboration, Sri Lanka
    3. Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
    • Clinical Pharmacology Unit, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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Dr Michael Eddleston, CPU, QMRI E3.20, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.

Tel.: 0131 242 9214

Fax: 0131 242 9215



Self-poisoning with pesticides or plants is a major clinical problem in rural Asia, killing several hundred thousand people every year. Over the last 17 years, our clinical toxicology and pharmacology group has carried out clinical studies in the North Central Province of Sri Lanka to improve treatment and reduce deaths. Studies have looked at the effectiveness of anti-digoxin Fab in cardiac glycoside plant poisoning, multiple dose activated charcoal in all poisoning, and pralidoxime in moderate toxicity organophosphorus insecticide poisoning. More recently, using a Haddon matrix as a guide, we have started conducting public health and animal studies to find strategies that may work outside of the hospital. Based on the 2009 GSK Research in Clinical Pharmacology prize lecture, this review shows the evolution of the group's research from a clinical pharmacology approach to one that studies possible interventions at multiple levels, including the patient, the community and government legislation.