Goldfrank's Toxicologic Emergencies, Ninth Edition / Edition 9

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Overview

The most trusted, rigorous, and up-to-date toxicology resource and educational companion available – now in full color

A Doody's Core Title ESSENTIAL PURCHASE for 2011!

Goldfrank’s Toxicologic Emergencies continues to be the source you can turn to first for any poisoning or overdose. The text provides clear information on every aspect of toxicologic emergencies, from pharmacology to clinical presentation to management.

Fully referenced and featuring a consistent organization, Goldfrank’s begins with an in-depth examination of general principles of medical toxicology. It then progresses to the biochemical principles and molecular basis of toxicology, and provides detailed insight into how xenobiotics affect vital signs, organs, and systems throughout the body. Next, a wide spectrum of clinically important exposures -- including drugs, plants, metals, household products, occupational and environmental xenobiotics are covered within logical categories for easy access to information. Finally, the book concludes with sections on principles of practicing clinical toxicology in today’s challenging healthcare environment.

NEW TO THIS EDITION

  • Full-color design and uniformly drawn figures clarify key concepts
  • Special Considerations focus on decision-making in unique toxicologic circumstances, that influence clinical practice and have the potential to improve patient care
  • Antidotes in Depth, following pertinent chapters, place each antidote in its proper context to ensure immediate availability of essential information relevant for clinical use
  • More clinically-relevant figures and quick-reference tables
  • Online learning center, available at www.goldfrankstoxicology.com, includes case studies, and a database of multiple choice questions that allow you to create a custom test for review and study.
  • Every chapter is thoroughly rewritten and new chapters are added to reflect the very latest thinking in the field
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Product Details

  • ISBN-13: 9780071605939
  • Publisher: McGraw-Hill Professional Publishing
  • Publication date: 7/16/2010
  • Edition description: New Edition
  • Edition number: 9
  • Pages: 1968
  • Sales rank: 288,449
  • Product dimensions: 11.32 (w) x 11.02 (h) x 2.61 (d)

Meet the Author

Lewis S. Nelson, MD, FAACT, FACEP, FACMT

Associate Professor of Emergency Medicine

New York University School of Medicine

Attending Physician, Emergency Medicine

Bellevue Hospital Center and New York University
Langone

Medical Center

Director, Fellowship in Medical Toxicology

New York City Poison Center and New York University

School of Medicine

New York, NY

Neal A. Lewin, MD, FACEP, FACMT, FACP

The Stanley and Fiona Druckenmiller Clinical Professor of

Emergency Medicine and Medicine (Pharmacology)

New York University School of Medicine

Director, Didactic Education

Emergency Medicine Residency

Attending Physician, Emergency Medicine and Internal Medicine

Bellevue Hospital Center and New York University Langone

Medical Center

Consultant, New York City Poison Center

New York, NY

Mary Ann Howland, PHARMD , DABAT, FAACT

Clinical Professor of Pharmacy

St. John’s University

College of Pharmacy

Adjunct Professor of Emergency Medicine

New York University School of Medicine

Bellevue Hospital Center and New York University Langone

Medical Center

Senior Consultant in Residence

New York City Poison Center

New York, NY

Robert S. Hoffman, MD, FAACT, FACMT

Associate Professor, Emergency Medicine and Medicine

(Pharmacology)

New York University School of Medicine

Attending Physician, Emergency Medicine and Internal Medicine

Bellevue Hospital Center and New York University Langone

Medical Center

Director, New York City Poison Center

New York, NY

Lewis R. Goldfrank, MD, FAAEM, FAACT,

FACEP, FACMT, FACP

Herbert W. Adams Professor and Chair, Department of

Emergency Medicine

New York University School of Medicine

Director, Emergency Medicine

Bellevue Hospital Center and New York University Langone

Medical Center

Medical Director, New York City Poison Center

New York, NY

Neal E. Flomenbaum, MD, FACEP, FACP

Professor of Clinical Medicine

Weill Cornell Medical College of Cornell University

Emergency Physician-in-Chief

New York-Presbyterian Hospital

Weill Cornell Medical Center

Consultant, New York City Poison Center

New York, NY

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Table of Contents

Contributors

Preface

Acknowledgments

1 Historical Principles and Perspectives Paul M. Wax Wax, Paul M. 1

2 Toxicologic Plagues and Disasters in History Paul M. Wax Wax, Paul M. 18

PART A THE GENERAL APPROACH TO MEDICAL TOXICOLOGY 31

3 Initial Evaluation of the Patient: Vital Signs and Toxic Syndromes Neal E. Flomenbaum Flomenbaum, Neal E. 33

4 Principles of Managing the Acutely Poisoned or Overdosed Patient Neal E. Flomenbaum Flomenbaum, Neal E. 37

5 Diagnostic Imaging David T. Schwartz Schwartz, David T. 45

6 Laboratory Principles Petrie M. Rainey Rainey, Petrie M. 70

7 Techniques Used to Prevent Gastrointestinal Absorption Lotte C. G. Hoegberg Hoegberg, Lotte C. G. 90

A1 Syrup of Ipecac Mary Ann Howland Howland, Mary Ann 104

A2 Activated Charcoal Mary Ann Howland Howland, Mary Ann 108

A3 Whole-Bowel Irrigation and Other Intestinal Evacuants Mary Ann Howland Howland, Mary Ann 114

8 Pharmacokinetic and Toxicokinetic Principles Mary Ann Howland Howland, Mary Ann 119

9 Principles and Techniques Applied to Enhance Elimination David S. Goldfarb Goldfarb, David S. 135

10 Use of The Intensive Care Unit Mark A. Kirk Kirk, Mark A. 148

PART B THE FUNDAMENTAL PRINCIPLES OF MEDICAL TOXICOLOGY 155

SECTION 1 Biochemical and Molecular Basis 157

11 Chemical Principles Lewis S. Nelson Nelson, Lewis S. 157

12 Biochemical and Metabolic Principles Kathleen A. Delaney Delaney, Kathleen A. 170

13 Neurotransmitters and Neuromodulators Ayrn D. O'Connor O'Connor, Ayrn D. 189

14 Withdrawal Principles Richard J. Hamilton Hamilton, Richard J. 221

SECTION 2 Pathophysiologic Basis: Organ Systems 228

15 Thermoregulatory Principles Kathleen A. Delaney Delaney, Kathleen A. 228

16 Fluid, Electrolyte, and Acid-Base Principles Robert S. Hoffman Hoffman, Robert S. 249

17 Psychiatric Principles Mark R. Serper Serper, Mark R. 265

18 Neurologic Principles Rama B. Rao Rao, Rama B. 275

19 Ophthalmic Principles Adhi Sharma Sharma, Adhi 285

20 Otolaryngologic Principles William K. Chiang Chiang, William K. 292

21 Respiratory Principles Robert S. Hoffman Hoffman, Robert S. 303

22 Electrophysiologic and Electrocardiographic Principles Cathleen Clancy Clancy, Cathleen 314

23 Hemodynamic Principles Robert A. Hessler Hessler, Robert A. 330

24 Hematologic Principles Marco L. A. Sivilotti Sivilotti, Marco L. A. 340

25 Gastrointestinal Principles Kavita M. Babu Babu, Kavita M. 359

26 Hepatic Principles Kathleen A. Delaney Delaney, Kathleen A. 367

27 Renal Principles Nikolas B. Harbord Harbord, Nikolas B. 381

28 Genitourinary Principles Jason Chu Chu, Jason 396

29 Dermatologic Principles Lewis S. Nelson Nelson, Lewis S. 410

SECTION 3 Special Populations 423

30 Reproductive and Perinatal Principles Jeffrey S. Fine Fine, Jeffrey S. 423

31 Pediatric Principles Jeffrey S. Fine Fine, Jeffrey S. 447

32 Geriatric Principles Mary Ann Howland Howland, Mary Ann 461

33 Postmortem Toxicology Mark A. Flomenbaum Flomenbaum, Mark A. 471

SC1 Organ Procurement from Poisoned Patients Rama B. Rao Rao, Rama B. 479

PART C THE CLINICAL BASIS OF MEDICAL TOXICOLOGY 481

SECTION 1

A Analgesics and Antiinflammatory Medications 483

34 Acetaminophen Robert G. Hendrickson Hendrickson, Robert G. 483

A4 N-Acetylcysteine Robert G. Hendrickson Hendrickson, Robert G. 500

35 Salicylates Neal E. Flomenbaum Flomenbaum, Neal E. 508

A5 Sodium Bicarbonate Paul M. Wax Wax, Paul M. 520

36 Nonsteroidal Antiinflammatory Drugs William J. Holubek Holubek, William J. 528

37 Colchicine, Podophyllin, and the Vinca Alkaloids Joshua G. Schier Schier, Joshua G. 537

SC2 Intrathecal Administration of Xenobiotics Rama B. Rao Rao, Rama B. 548

38 Opioids Dean Olsen Olsen, Dean 559

A6 Opioid Antagonists Lewis S. Nelson Nelson, Lewis S. 579

B Foods, Dietary and Nutritional Xenobiotics 586

39 Dieting Agents and Regimens Jeanna M. Marraffa Marraffa, Jeanna M. 586

40 Iron Jeanmarie Perrone Perrone, Jeanmarie 596

A7 Deferoxamine Mary Ann Howland Howland, Mary Ann 604

41 Vitamins Beth Y. Ginsburg Ginsburg, Beth Y. 609

42 Essential Oils Sarah Eliza Halcomb Halcomb, Sarah Eliza 624

43 Herbal Preparations Oliver L. Hung Hung, Oliver L. 631

44 Athletic Performance Enhancers Susi U. Vassallo Vassallo, Susi U. 654

45 Food Poisoning Michael G. Tunik Tunik, Michael G. 668

46 Botulism Howard L. Geyer Geyer, Howard L. 682

A8 Botulinum Antitoxin Howard L. Geyer Geyer, Howard L. 695

C Pharmaceuticals 698

47 Anticonvulsants Suzanne Doyon Doyon, Suzanne 698

A9 L-Carnitine Mary Ann Howland Howland, Mary Ann 711

48 Antidiabetics and Hypoglycemics George M. Bosse Bosse, George M. 714

A10 Dextrose Kathleen A. Delaney Delaney, Kathleen A. 728

A11 Octreotide Mary Ann Howland Howland, Mary Ann 734

49 Thyroid and Antithyroid Medications Nicole C. Bouchard Bouchard, Nicole C. 738

50 Antihistamines and Decongestants Richard S. Weisman Weisman, Richard S. 748

A12 Physostigmine Salicylate Mary Ann Howland Howland, Mary Ann 759

51 Antimigraine Medications Jason Chu Chu, Jason 763

52 Antineoplastics Overview Richard Y. Wang Wang, Richard Y. 770

53 Antineoplastics: Methotrexate Richard Y. Wang Wang, Richard Y. 778

A13 Leucovorin (Folinic Acid) and Folic Acid Mary Ann Howland Howland, Mary Ann 783

A14 Glucarpidase (Carboxypeptidase G2) Silas W. Smith Smith, Silas W. 787

SC3 Extravasation of Xenobiotics Richard Y. Wang Wang, Richard Y. 793

54 Miscellaneous Antineoplastics Richard Y. Wang Wang, Richard Y. 796

55 Pharmaceutical Additives Lisa E. Vivero Vivero, Lisa E. 803

D Antimicrobials 817

56 Antibacterials, Antifungals, and Antivirals Christine M. Stork Stork, Christine M. 817

57 Antituberculous Medications Edward W. Boyer Boyer, Edward W. 834

A15 Pyridoxine Mary Ann Howland Howland, Mary Ann 845

58 Antimalarials J. Dave Barry Barry, J. Dave 849

E Cardiopulmonary Medications 861

59 Anticoagulants Mark Su Su, Mark 861

A16 Vitamin K1 Mary Ann Howland Howland, Mary Ann 876

A17 Protamine Mary Ann Howland Howland, Mary Ann 880

60 Calcium Channel Blockers Francis Jerome DeRoos DeRoos, Francis Jerome 884

A18 Insulin-Euglycemia Therapy William Kerns Kerns, William 893

61 β-Adrenergic Antagonists Jeffrey R. Brubacher Brubacher, Jeffrey R. 896

A19 Glucagon Mary Ann Howland Howland, Mary Ann 910

62 Other Antihypertensives Francis Jerome DeRoos DeRoos, Francis Jerome 914

63 Antidysrhythmics Neal A. Lewin Lewin, Neal A. 925

64 Cardioactive Steroids Jason B. Hack Hack, Jason B. 936

A20 Digoxin-Specific Antibody Fragments Mary Ann Howland Howland, Mary Ann 946

65 Methylxanthines and Selective β2 Adrenergic Agonists Robert J. Hoffman Hoffman, Robert J. 952

F Anesthetics and Related Medications 965

66 Local Anesthetics Brian Kaufman Kaufman, Brian 965

A21 Intravenous Fat Emulsions Theodore C. Bania Bania, Theodore C. 976

67 Inhalational Anesthetics Martin Griffel Griffel, Martin 982

68 Neuromuscular Blockers Kenneth M. Sutin Sutin, Kenneth M. 989

A22 Dantrolene Sodium Kenneth M. Sutin Sutin, Kenneth M. 1001

G Psychotropic Medications 1003

69 Antipsychotics David N. Juurlink Juurlink, David N. 1003

70 Lithium Howard A. Greller Greller, Howard A. 1016

71 Monoamine Oxidase Inhibitors Alex F. Manini Manini, Alex F. 1027

72 Serotonin Reuptake Inhibitors and Atypical Antidepressants Christine M. Stork Stork, Christine M. 1037

73 Cyclic Antidepressants Erica L. Liebelt Liebelt, Erica L. 1049

74 Sedative-Hypnotics Kathy Lynn Ferguson Ferguson, Kathy Lynn 1060

A23 Flumazenil Mary Ann Howland Howland, Mary Ann 1072

H Substances of Abuse 1078

75 Amphetamines William K. Chiang Chiang, William K. 1078

76 Cocaine Robert S. Hoffman Hoffman, Robert S. 1091

SC4 Internal Concealment of Xenobiotics Jane M. Prosser Prosser, Jane M. 1103

A24 Benzodiazepines Mary Ann Howland Howland, Mary Ann 1109

77 Ethanol Luke Yip Yip, Luke 1115

A25 Thiamine Hydrochloride Robert S. Hoffman Hoffman, Robert S. 1129

78 Ethanol Withdrawal Lewis S. Nelson Nelson, Lewis S. 1134

79 Disulfiram and Disulfiram-Like Reactions Edwin K. Kuffner Kuffner, Edwin K. 1143

80 γ-Hydroxybutyric Acid Brenna M. Farmer Farmer, Brenna M. 1151

81 Inhalants Heather Long Long, Heather 1157

82 Hallucinogens Kavita M. Babu Babu, Kavita M. 1166

83 Cannabinoids Michael A. McGuigan McGuigan, Michael A. 1177

84 Nicotine Sari Soghoian Soghoian, Sari 1185

85 Phencyclidine and Ketamine Ruben E. Olmedo Olmedo, Ruben E. 1191

86 Aluminum Brenna M. Farmer Farmer, Brenna M. 1202

I Metals 1207

87 Antimony Asim F. Tarabar Tarabar, Asim F. 1207

88 Arsenic Marsha D. Ford Ford, Marsha D. 1214

A26 Dimercaprol (British Anti-Lewisite or BAL) Mary Ann Howland Howland, Mary Ann 1229

89 Bismuth Rama B. Rao Rao, Rama B. 1233

90 Cadmium Robert S. Hoffman Hoffman, Robert S. 1237

91 Chromium Steven B. Bird Bird, Steven B. 1243

92 Cobalt Gar Ming Chan Chan, Gar Ming 1248

93 Copper Lewis S. Nelson Nelson, Lewis S. 1256

94 Lead Fred M. Henretig Henretig, Fred M. 1266

A27 Succimer (2, 3-Dimercaptosuccinic Acid) Mary Ann Howland Howland, Mary Ann 1284

A28 Edetate Calcium Disodium (CaNa2 EDTA) Mary Ann Howland Howland, Mary Ann 1290

95 Manganese Sari Soghoian Soghoian, Sari 1294

96 Mercury Young-Jin Sue Sue, Young-Jin 1299

97 Nickel David A. Haggerty Haggerty, David A. 1308

98 Selenium Diane P. Calello Calello, Diane P. 1316

99 Silver Michele Burns Ewald Ewald, Michele Burns 1321

100 Thallium Robert S. Hoffman Hoffman, Robert S. 1326

A29 Prussian Blue Robert S. Hoffman Hoffman, Robert S. 1334

101 Zinc Nima Majlesi Majlesi, Nima 1339

J Household Products 1345

102 Antiseptics, Disinfectants, and Sterilants Paul M. Wax Wax, Paul M. 1345

103 Camphor and Moth Repellents Edwin K. Kuffner Kuffner, Edwin K. 1358

104 Caustics Jessica A. Fulton Fulton, Jessica A. 1364

105 Hydrofluoric Acid and Fluorides Mark Su Su, Mark 1374

A30 Calcium Mary Ann Howland Howland, Mary Ann 1381

106 Hydrocarbons David D. Gummin Gummin, David D. 1386

107 Toxic Alcohols Sage W. Wiener Wiener, Sage W. 1400

SC5 Diethylene Glycol Joshua G. Schier Schier, Joshua G. 1411

A31 Fomepizole Mary Ann Howland Howland, Mary Ann 1414

A32 Ethanol Mary Ann Howland Howland, Mary Ann 1419

K Pesticides 1423

108 Pesticides: An Overview of Rodenticides and a Focus on Principles Neal E. Flomenbaum Flomenbaum, Neal E. 1423

109 Barium Andrew Dawson Dawson, Andrew 1434

110 Sodium Monofluoroacetate and Fluoroacetamide Fermin Barrueto Barrueto, Fermin 1437

111 Phosphorus Michael C. Beuhler Beuhler, Michael C. 1440

112 Strychnine Yiu-Cheung Chan Chan, Yiu-Cheung 1445

113 Insecticides: Organic Phosphorus Compounds and Carbamates Richard Franklin Clark Clark, Richard Franklin 1450

A33 Pralidoxime Mary Ann Howland Howland, Mary Ann 1467

A34 Atropine Mary Ann Howland Howland, Mary Ann 1473

114 Insecticides: Organic Chlorines, Pyrethrins/Pyrethroids, and Insect Repellents Michael G. Holland Holland, Michael G. 1477

115 Herbicides Darren M. Roberts Roberts, Darren M. 1494

116 Methyl Bromide and Other Fumigants Keith K. Burkhart Burkhart, Keith K. 1516

L Natural Toxins and Envenomations 1522

117 Muschrooms Lewis R. Goldfrank Goldfrank, Lewis R. 1522

118 Plants Joseph M. Betz Betz, Joseph M. 1537

119 Arthropods In-Hei Hahn Hahn, In-Hei 1561

A35 Antivenom (Scorpion and Spider) Richard Franklin Clark Clark, Richard Franklin 1582

120 Marine Envenomations D. Eric Brush Brush, D. Eric 1587

121 Snakes and Other Reptiles Anne-Michelle Ruha Ruha, Anne-Michelle 1601

A36 Antivenom (Crotaline) Anne-Michelle Ruha Ruha, Anne-Michelle 1611

M Occupational and Environmental Toxins 1615

122 Industrial Poisoning: Information and Control Peter H. Wald Wald, Peter H. 1615

123 Nanotoxicology Silas W. Smith Smith, Silas W. 1625

124 Simple Asphyxiants and Pulmonary Irritants Oladapo A. Odujebe Odujebe, Oladapo A. 1643

125 Carbon Monoxide Christian Tomaszewski Tomaszewski, Christian 1658

A37 Hyperbaric Oxygen Stephen R. Thom Thom, Stephen R. 1671

126 Cyanide and Hydrogen Sulfide Mark A. Kirk Kirk, Mark A. 1678

A38 Sodium and Amyl Nitrite Mary Ann Howland Howland, Mary Ann 1689

A39 Sodium Thiosulfate Mary Ann Howland Howland, Mary Ann 1692

A40 Hydroxocobalamin Mary Ann Howland Howland, Mary Ann 1695

127 Methemoglobin Inducers Dennis P. Price Price, Dennis P. 1698

A41 Methylene Blue Mary Ann Howland Howland, Mary Ann 1708

128 Smoke Inhalation Mark A. Kirk Kirk, Mark A. 1711

N Disaster Preparedness 1721

129 Risk Assessment and Risk Communication Charles A. McKay McKay, Charles A. 1721

130 Hazmat Incident Response Bradley J. Kaufman Kaufman, Bradley J. 1727

131 Chemical Weapons Jeffrey R. Suchard Suchard, Jeffrey R. 1735

132 Biological Weapons Jeffrey R. Suchard Suchard, Jeffrey R. 1750

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