Toxicology Lecture Notes. Toxicology. The journal is relevant to all professionals at the interface of clinical toxicology with acute care, occupational and environmental medicine, public health, regulatory toxicology, pharmacology and pharmaceutics, and analytical and forensic pathology. Description : Clinical Toxicology is the second volume of a three-volume set on molecular, clinical and environmental toxicology that offers a comprehensive and in-depth response to the increasing importance and abundance of chemicals of daily life. The new edition presents the latest, up-to-date protocols for managing various toxic ingestions, and the antidotes and treatments associated with their pathology. It incorporates both theoretical and practical knowledge gathered over more than 35 years of clinical experience. John Trounce, who was the senior author of the first edition of this textbook, died on the 16 April 2007. Thanks in advance for your time. Clinical toxicology encompasses the expertise in the specialties of medical toxicology, applied toxicology, and clinical poison information. He is former editor of, Toxicology in Vitro and Journal of Pharmacological & Toxicological Methods, published, Dr. Barile is the recipient of Public Health Service research grants from the. Journal of Toxicology: Clinical Toxicology (1982 - 2004) Clinical Toxicology (1968 - 1981) Browse the list of issues and latest articles from Clinical Toxicology. Prices & shipping based on shipping country. 3.659 Clinical Toxicology is an international journal publishing research on the various aspects of clinical toxicology including the diagnosis and treatment of poisoning. replace and refine animal toxicology testing. By using this site you agree to the use of cookies. Mobile/eReaders – Download the Bookshelf mobile app at VitalSource.com or from the iTunes or Android store to access your eBooks from your mobile device or eReader. A_Textbook_of_Modern_Toxicology Identifier-ark ark:/13960/t6qz67j7b Ocr ABBYY FineReader 11.0 Pages 582 Ppi 300 Scanner Internet Archive Python library 0.9.1. plus-circle Add Review. Be the first one to write a review. Textbook All relevant information about clinical metal toxicology is found in this 600 A4 pages textbook in two volumes. The first edition was published in 2012. Clinical Toxicology:Diagnosis and treatment of poisoning; evaluation of methods of detection and intoxication, mechanism of action in humans (human tox, pharmaceutical tox) and animals (veterinary tox). ISBN 978-0-470-46206-5 (cloth) 1. This concise text is informed by the latest clinical research and takes a rigorous and structured risk assessment-based approach to decision making in the context of clinical toxicology. It satisfies an essential need for a concise yet detailed authoritative, fundamental text addressing the current principles of clinical toxicology. The second half of the book is devoted to specific toxicants, including plants, metals, drugs, and household poisons. Reviews There are no reviews yet. The target audience for this book is undergraduate and graduate toxicology students, clinical pharmacy (Pharm.D.) A textbook of modern toxicology / edited by Ernest Hodgson. Agency; National Institutes of Health Review Panel, Study Section Reviewer (2013); Scientific Advisory Committee on Alternative Toxicological Methods (SACATM, 2005–2009); National Toxicology Program (NTP) Interagency Center for the. Suitable for courses in environmental, pharmacological, medical, and veterinary toxicology, this essential text features chapters written by experts who address a range of key topics. • Offers a unique perspective for toxicology, pharmacology, pharmacy and health professions students. Fundamentals of Analytical Toxicology: Clinical and Forensic, 2 nd Edition is an indispensable resource for advanced students and trainee analytical toxicologists across disciplines, such as clinical science, analytical chemistry, forensic science, pathology, applied biology, food safety, and pharmaceutical and pesticide development. If you decide to participate, a new browser tab will open so you can complete the survey after you have completed your visit to this website. 16.5.4 DOM (2,5-dimethoxy-4-methylamphetamine, STP) and MDA (3,4-methylenedioxyamphetamine)...............................234. With special emphasis placed on signs and symptoms of diseases and pathology caused by toxins and clinical drugs, the new edition, examines the complex interactions associated with clinical toxicological events as a result of therapeutic drug administration or chemical exposure. comment. students, emergency medical personnel, regulatory agencies, and other related health science professionals. p. cm. I. Hodgson, Ernest, 1932– RA1211.H62 2010 615.9—dc22 2009045883 Printed in the United States of America 10 9 8 7 6 5 4 3 2 1 Evaluation of Alternative Toxicological Methods, Support Contract Reviewer (2014); U.S. Food and Drug Administration (U.S. FDA), National Center for Toxicology, Research, Systems Biology Subcommittee (2016); National Institute for Occupational, Safety and Health (NIOSH) and Oak Ridge Associated Universities, SK Profiles, Review Group (2014); U.S. Food and Drug Administration advisory committee on, alternative toxicological methods (2013); and has served as vice president of the. Dr. Barile has served on several U.S. government advisory committees, including: Toxicology Assessment Peer Review Committee, U.S. Environmental Protection. The new edition of this all-encompassing toxicology reference describes the risk assessment-based approach pioneered by its principal authors. -Es un asfixiante químico, es decir, es capaz de producir asfixia a bajas concentraciones atmosféricas sin necesidad de interferir con la concentración de oxígeno en el aire (15, 16). The free VitalSource Bookshelf® application allows you to access to your eBooks whenever and wherever you choose. GET BOOK. In these positions, he investigated the role of, pulmonary toxicants in collagen metabolism in cultured lung cells. The book was recently translated and published in Chinese and has been translated into Arabic, German, and Spanish. Review fundamental clinical toxicology principles, identify common acute toxic exposures and associated laboratory findings, and highlight drug overdose findings. The book contains reviews and posters of the 31st Congress of the EUROTOX (Maastricht 1991). Sign in to view your account details and order history. The target audience for this book is undergraduate and graduate toxicology students, clinical pharmacy (Pharm.D.) We are always looking for ways to improve customer experience on Elsevier.com. Privacy Policy please. Immunoassays to Screen for Drugs of Abuse Stacy E.F. Melanson, MD, PhD, Brigham and Women’s Hospital, Boston, MA Toxicology Handbook is a practical evidence-based guide on the care of the poisoned patient.. Wu, PhD. Preface...................................................................................................................xxxi, Acknowledgments............................................................................................... xxxiii, Author...................................................................................................................xxxv, Contributors........................................................................................................xxxvii, Chapter 1 Introduction...........................................................................................3, 1.1 Introduction................................................................................3, 1.2 Basic Definitions.........................................................................4, 1.2.1 Toxicology.....................................................................4, 1.2.2 Clinical Toxicology.......................................................4, 1.3 Types of Toxicology...................................................................5, 1.3.1 General Toxicology.......................................................5, 1.3.2 Mechanistic Toxicology................................................5, 1.3.3 Regulatory Toxicology..................................................5, 1.3.4 Descriptive Toxicology..................................................6, 1.4 Types of Toxicologist..................................................................7, 1.4.1 Forensic Toxicologist.....................................................7, 1.4.2 Clinical Toxicologist.....................................................8, 1.4.3 Research Toxicologist....................................................8, 1.4.4 Regulatory Toxicologist................................................8, References.............................................................................................8, Suggested Readings...............................................................................8, Review Articles.....................................................................................9, Chapter 2 Risk Assessment and Regulatory Toxicology..................................... 11, 2.1 Risk Assessment....................................................................... 11, 2.1.1 Introduction................................................................. 11, 2.1.2 Hazard Identification/Risk Assessment (HIRA)......... 11, 2.1.3 Dose–Response Evaluation......................................... 11, 2.1.4 Exposure Assessment and Assessment Modeling....... 12, 2.1.5 Risk Characterization.................................................. 14, 2.2 Regulatory Toxicology............................................................. 16, 2.2.1 Nuclear Regulatory Commission (NRC).................... 16, 2.2.2 Environmental Protection Agency (EPA)................... 17, 2.2.3 The Food and Drug Administration (FDA)................ 18, 2.2.4 Drug Enforcement Administration (DEA).................. 19, 2.2.5 Consumer Products Safety Commission (CPSC)........20, 2.2.6 Occupational Safety and Health Administrations, (OSHA)........................................................................22, References...........................................................................................23, Suggested Readings.............................................................................23, Review Articles...................................................................................23, Chapter 3 Therapeutic Monitoring of Adverse Drug Reactions (ADRs).............27, 3.1 Adverse Drug Reactions (ADRs) in Clinical Practice.............27, 3.1.1 The Joint Commission (TJC)......................................27, 3.1.2 Growing Medication Safety Concerns........................28, 3.1.3 National Patient Safety Goals (NPSG).......................28, 3.2 Factors that Contribute to Adverse Drug Reactions (ADRs)...29, 3.2.1 Inadequate Monitoring of Prescribed Drugs..............29, 3.2.2 Improper Adherence to Prescribed Directions........... 32, 3.2.3 Over-Prescribing and Overuse of Medications........... 32, 3.2.4 Drug–Drug and Drug–Disease Interactions............... 32, 3.2.5 Allergic Reactions....................................................... 32, 3.2.6 Medication Warnings.................................................. 33, 3.2.7 Medication Errors....................................................... 33, 3.2.8 Adverse Drug Reactions (ADRS)............................... 33, 3.3 Treatment of ADRs and Poisoning in Patients......................... 35, 3.3.1 History......................................................................... 35, 3.3.2 Poison Control Centers (PCCs)................................... 35, 3.3.3 Clinical Management of ADRs...................................36, 3.3.4 Clinical Management of Toxicologic Emergencies.....36, 3.4 Drug Identification and Methods of Detection......................... 41, References...........................................................................................44, Suggested Readings.............................................................................44, Review Articles................................................................................... 45, Chapter 4 Classification of Toxins in Humans.................................................... 47, 4.1 Introduction.............................................................................. 47, 4.2 Target Organ Classification...................................................... 47, 4.2.1 Agents Affecting the Hematopoietic System.............. 47, 4.2.2 Immunotoxic Agents...................................................48, 4.2.3 Hepatotoxic Agents.....................................................48, 4.2.4 Nephrotoxic Agents.....................................................49, 4.2.5 Pulmonary Toxic Agents............................................. 52, 4.2.6 Agents Affecting the Nervous System........................54, 4.2.7 Agents Affecting the Cardiovascular (CV) System.... 55, 4.2.8 Dermatotoxic Agents................................................... 55, 4.2.9 Agents Affecting the Reproductive System................ 59, 4.2.10 Agents Affecting the Endocrine System..................... 59, 4.3 Classification According to use in the Public Domain.............60, 4.3.1 Insecticides, Herbicides, Fungicides, and, Rodenticides (Pesticides).............................................60, 4.3.2 Food and Color Additives........................................... 61, 4.3.3 Therapeutic Drugs.......................................................63, 4.3.4 By-Products of Combustion........................................63, 4.4 Classification According to Source..........................................63, 4.4.1 Botanical.....................................................................63, 4.4.2 Environmental.............................................................63, 4.5 Classification According to Effects..........................................64, 4.5.1 Pathologic....................................................................64, 4.5.2 Teratogenic, Mutagenic, and Carcinogenic.................64, 4.6 Classification According to Physical State...............................64, 4.6.1 Solids...........................................................................64, 4.6.2 Liquids.........................................................................64, 4.6.3 Gases...........................................................................65, 4.7 Classification According to Biochemical Properties................65, 4.7.1 Chemical Structure.....................................................65, 4.7.2 Mechanism of Action or Toxicity................................65, References...........................................................................................65, Suggested Readings.............................................................................65, Review Articles...................................................................................65, Chapter 5 Exposure..............................................................................................69, 5.1 Introduction..............................................................................69, 5.2 Route of Exposure....................................................................69, 5.2.1 Oral..............................................................................69, 5.2.2 Intranasal..................................................................... 70, 5.2.3 Inhalation.................................................................... 71, 5.2.4 Parenteral.................................................................... 71, 5.3 Duration and Frequency........................................................... 72, 5.3.1 Acute Exposure........................................................... 72, 5.3.2 Chronic Exposure........................................................ 73, 5.3.3 Single- or Repeated-Dose Exposure........................... 73, 5.4 Accumulation........................................................................... 73, 5.4.1 According to Physiological Compartment.................. 74, 5.4.2 According to Chemical Properties.............................. 74, 5.4.3 According to Other Biological Factors........................ 74, References........................................................................................... 76, Suggested Readings............................................................................. 76, Review Articles................................................................................... 76, Chapter 6 Effects.................................................................................................. 79, 6.1 General Classification............................................................... 79, 6.1.1 Introduction to Principles of Immunology.................. 79, 6.1.2 Chemical Allergies...................................................... 79, 6.1.3 Idiosyncratic Reactions...............................................86, 6.1.4 Immediate versus Delayed Effects..............................86, 6.1.5 Reversible versus Irreversible Reactions.....................86, 6.1.6 Local versus Systemic Effects.....................................86, 6.1.7 Target Therapeutic Effects..........................................87, 6.2 Chemical Interactions...............................................................87, 6.2.1 Potentiation..................................................................87, 6.2.2 Additive.......................................................................87, 6.2.3 Synergistic...................................................................88, 6.2.4 Antagonistic................................................................88, References...........................................................................................88, Suggested Readings.............................................................................88, Review Aricles.....................................................................................89, Chapter 7 Dose–Response................................................................................... 91, 7.1 General Assumptions............................................................... 91, 7.1.1 Types of Dose–Response Relationships...................... 91, 7.1.2 Concentration–Effect and Presence at the, Receptor Site...............................................................93, 7.1.3 Criteria for Measurement............................................93, 7.2 LD50 (Lethal Dose 50%)...........................................................93, 7.2.1 Definition.....................................................................93, 7.2.2 Experimental Protocol................................................93, 7.2.3 Factors That Influence the LD50..................................94, 7.3 ED50 (Effective Dose 50%), TD50 (Toxic Dose 50%), and, TI (Therapeutic Index).............................................................95, 7.3.1 Relationship to LD50....................................................95, 7.3.2 Assumptions Using the TI...........................................95, 7.4 IC50 (Inhibitory Concentration 50%)........................................96, 7.4.1 Definition.....................................................................96, 7.4.2 Experimental Determination.......................................97, 7.4.3 For In Vitro Systems....................................................97, References...........................................................................................97, Suggested Readings.............................................................................97, Review Articles...................................................................................98, Chapter 8 Descriptive Animal Toxicity Tests......................................................99, 8.1 Correlation with Human Exposure...........................................99, 8.1.1 Human Risk Assessment.............................................99, 8.1.2 Predictive Toxicology and Extrapolation to, Human Toxicity...........................................................99, 8.2 Species Differentiation.............................................................99, 8.2.1 Selection of a Suitable Animal Species......................99, 8.2.2 Cost-Effectiveness..................................................... 100, 8.2.3 Institutional Animal Care and Use Committee, (IACUC).................................................................... 100, 8.3 Descriptive Tests..................................................................... 101, 8.3.1 Required LD50 and Two Routes............................... 101, 8.3.2 Chronic and Subchronic Exposure............................ 101, 8.3.3 Types of Tests............................................................ 101, References......................................................................................... 102, Suggested Readings........................................................................... 102, Review Aricles................................................................................... 103, Chapter 9 In Vitro Alternatives to Animal Toxicity.......................................... 105, 9.1 In Vitro Methods.................................................................... 105, 9.1.1 Cell Culture Methods................................................ 105, 9.1.2 Organ System Cytotoxicity....................................... 105, 9.1.3 Applications to Clinical Toxicology.......................... 106, 9.1.4 Relationship to Animal Experiments........................ 107, 9.2 Correlation with Human Exposure......................................... 107, 9.2.1 Risk Assessment........................................................ 107, 9.2.2 Extrapolation to Human Toxicity.............................. 107, 9.2.3 Predictive Toxicology................................................ 108, References......................................................................................... 108, Suggested Readings........................................................................... 108, Review Articles................................................................................. 108, Chapter 10 Toxicokinetics................................................................................... 111, 10.1 Toxicokinetics......................................................................... 111, 10.1.1 Relationship to Pharmacokinetics............................. 111, 10.1.2 One-Compartment Model......................................... 111, 10.1.3 Two-Compartment Model......................................... 112, 10.1.4 Application to Clinical Toxicology........................... 112, 10.2 Absorption.............................................................................. 112, 10.2.1 Ionic and Nonionic Principles................................... 112, 10.2.2 Henderson–Hasselbalch Equation and Degree of, Ionization................................................................... 114, 10.2.3 Route of Administration and Solubility.................... 118, 10.2.4 Absorption in Nasal and Respiratory Mucosa.......... 119, 10.2.5 Transport of Molecules............................................. 120, 10.3 Distribution............................................................................. 121, 10.3.1 Fluid Compartments.................................................. 121, 10.3.2 Ionic and Nonionic Principles................................... 122, 10.3.3 Plasma Protein Binding............................................. 123, 10.3.4 Lipids......................................................................... 125, 10.3.5 Liver and Kidney....................................................... 125, 10.3.6 Blood–Brain Barrier.................................................. 125, 10.3.7 Placenta..................................................................... 125, 10.3.8 Other Factors Affecting Distribution........................ 126, 10.4 Biotransformation (Metabolism)............................................ 126, 10.4.1 Principles of Detoxification....................................... 126, 10.4.2 Phase I Reactions...................................................... 127, 10.4.3 Phase II Reactions..................................................... 128, 10.5 Elimination............................................................................. 131, 10.5.1 Urinary...................................................................... 131, 10.5.1.1 First-Order Elimination............................. 132, 10.5.1.2 Zero-Order Elimination............................. 134, 10.5.2 Fecal.......................................................................... 135, 10.5.3 Pulmonary................................................................. 135, 10.5.4 Mammary Glands..................................................... 136, 10.5.5 Secretions.................................................................. 136, References......................................................................................... 136, Suggested Readings........................................................................... 136, Review Articles................................................................................. 137, Chapter 11 Chemical– and Drug–Receptor Interactions..................................... 139, 11.1 Types of Chemical and Drug Receptors................................. 139, 11.1.1 Ion Channels.............................................................. 139, 11.1.2 G-Protein-Coupled Receptors................................... 142, 11.1.3 Kinases and Enzyme-Coupled Receptors................. 143, 11.1.4 Intracellular Receptors.............................................. 145, 11.2 Signal Transduction................................................................ 148, References......................................................................................... 150, Suggested Readings........................................................................... 150, Review Articles................................................................................. 150, Chapter 12 Toxicogenomics................................................................................. 151, Anirudh J. Chintalapati, Zacharoula Konsoula, and Frank A. Barile, 12.1 Introduction............................................................................ 151, 12.2 Human Genomic Variation..................................................... 151, 12.2.1 Genomic Variation in Target Molecules................... 152, 12.2.2 Genomic Variation in Drug Metabolism................... 154, 12.3 Gene Structure and Function.................................................. 154, 12.3.1 DNA Alterations and Genotoxic Effects................... 155, 12.3.2 DNA Repair Mechanisms......................................... 157, 12.3.3 Experimental Monitoring for Genetic Toxicity......... 159, 12.3.4 Clinical Monitoring for Genetic Toxicity.................. 159, 12.4 Epigenetic Toxicology............................................................ 160, 12.4.1 Mechanisms of Epigenetic Toxicity.......................... 161, 12.4.1.1 DNA Methylation...................................... 161, 12.4.1.2 Posttranslational Modifications of, Histone Proteins......................................... 162, 12.4.1.3 Noncoding RNA........................................ 162, 12.4.2 Epigenetics and Disease............................................ 163, Referenes........................................................................................... 163, Suggested Readings........................................................................... 163, Review Articles................................................................................. 164, Section II Toxicity of Therapeutic Agents, Chapter 13 Sedative/Hypnotics............................................................................ 167, Frank A. Barile and Anirudh J. Chintalapati, 13.1 Barbiturates............................................................................ 167, 13.1.1 History and Classification......................................... 167, 13.1.2 Epidemiology............................................................ 167, 13.1.3 Medicinal Chemistry................................................. 167, 13.1.4 Pharmacology and Clinical Use................................ 168, 13.1.5 Toxicokinetics and Metabolism................................ 168, 13.1.6 Mechanism of Toxicity.............................................. 169, 13.1.7 Signs and Symptoms of Acute Toxicity.................... 169, 13.1.8 Emergency Guidelines.............................................. 171, 13.1.9 Clinical Management of Acute Overdose................. 171, 13.1.10 Tolerance and Withdrawal......................................... 172, 13.1.11 Methods of Detection................................................ 172, 13.2 Benzodiazepines (BZ)............................................................ 172, 13.2.1 Epidemiology............................................................ 172, 13.2.2 Medicinal Chemistry................................................. 173, 13.2.3 Pharmacology and Mechanism of Toxicity............... 173, 13.2.4 Toxicokinetics........................................................... 173, 13.2.5 Signs and Symptoms of Acute Toxicity.................... 174, 13.2.6 Emergency Guidelines.............................................. 174, 13.2.7 Clinical Management of Acute Overdose................. 174, 13.2.8 Tolerance and Withdrawal......................................... 174, 13.2.9 Methods of Detection................................................ 174, 13.3 Miscellaneous Sedative/Hypnotics........................................ 176, 13.3.1 Chloral Hydrate......................................................... 176, 13.3.2 Meprobamate (Miltown®, Equanil®)......................... 176, 13.3.3 Zolpidem tartrate (Ambien®)..................................... 177, 13.3.4 Buspirone (Buspar®).................................................. 177, 13.3.5 Flunitrazepam (Rohypnol®)...................................... 177, 13.3.6 Gamma-hydroxybutyrate (GHB)............................... 178, 13.3.7 Ethchlorvynol (Placidyl®), Methaqualone, Methyprylon (Noludar®)............................................ 178, 13.4 Methods of Detection and Laboratory Tests for S/H............. 179, References......................................................................................... 179, Suggested Readings........................................................................... 180, Review Articles................................................................................. 181, Chapter 14 Opioids and Related Agents.............................................................. 183, 14.1 Opioids.................................................................................... 183, 14.1.1 U.S. Public Health and Historical Use...................... 183, 14.1.2 Neonatal Abstinence Syndrome (NAS).................... 185, 14.1.3 Classification............................................................. 186, 14.1.4 Medicinal Chemistry................................................. 189, 14.1.5 Mechanism of Toxicity.............................................. 189, 14.1.6 Brain Chemistry........................................................ 191, 14.1.7 Toxicokinetics........................................................... 191, 14.1.8 Mechanism of Toxicity.............................................. 191, 14.1.9 Signs and Symptoms of Clinical Toxicity................. 192, 14.1.10 Clinical Management of Acute Overdose................. 192, 14.1.11 Tolerance and Withdrawal......................................... 193, 14.1.12 Clinical Management of Addiction........................... 195, 14.2 Specific Opioid Derivatives.................................................... 195, 14.2.1 Codeine..................................................................... 195, 14.2.2 Diphenoxylate............................................................ 196, 14.2.3 Fentanyl..................................................................... 196, 14.2.4 Meperidine................................................................ 196, 14.2.5 Pentazocine............................................................... 197, 14.2.6 Propoxyphene............................................................ 197, 14.2.7 Hydrocodone/Oxycodone.......................................... 197, 14.2.8 Tramadol................................................................... 198, 14.2.9 Clonidine................................................................... 199, 14.3 Methods of Detection............................................................. 199, References.........................................................................................200, Suggested Readings...........................................................................200, Review Articles................................................................................. 201, Chapter 15 Sympathomimetics............................................................................203, 15.1 Amphetamines and Amphetamine-like Agents.....................203, 15.1.1 Incidence...................................................................203, 15.1.2 Classification.............................................................203, 15.1.3 Medicinal Chemistry.................................................204, 15.1.4 Pharmacology and Clinical Use................................204, 15.1.5 Toxicokinetics...........................................................206, 15.1.6 Effects and Mechanism of Toxicity...........................206, 15.1.7 Chronic Methamphetamine Use...............................208, 15.1.8 Tolerance and Withdrawal.........................................208, 15.1.9 Clinical Management of Amphetamine Addiction...208, 15.1.10 Methods of Detection................................................209, 15.2 Cocaine...................................................................................209, 15.2.1 Incidence and Occurrence.........................................209, 15.2.2 Medicinal Chemistry................................................. 210, 15.2.3 Pharmacology and Clinical Use................................ 210, 15.2.4 Toxicokinetics........................................................... 211, 15.2.5 Signs and Symptoms of Acute Toxicity.................... 212, 15.2.6 Clinical Management of Acute Overdose................. 212, 15.2.7 Tolerance and Withdrawal......................................... 213, 15.2.8 Clinical Management of Cocaine Addiction............. 213, 15.2.9 Methods of Detection................................................ 213, 15.3 Xanthine Derivatives.............................................................. 213, 15.3.1 Source and Medicinal Chemistry.............................. 213, 15.3.2 Occurrence................................................................ 214, 15.3.3 Pharmacology and Clinical Use................................ 214, 15.3.4 Toxicokinetics........................................................... 216, 15.3.5 Signs and Symptoms and Clinical Management, of Caffeine Toxicity................................................... 216, 15.3.6 Signs and Symptoms and Clinical Management, of Theophylline Toxicity........................................... 217, 15.3.7 Tolerance and Withdrawal......................................... 217, 15.4 Other Specific Sympathomimetic Agents.............................. 217, 15.4.1 Strychnine................................................................. 217, 15.4.2 Nicotine..................................................................... 218, 15.4.3 Ephedrine.................................................................. 219, 15.4.4 Phenylpropranolamine..............................................220, 15.4.5 Pseudoephedrine.......................................................220, References.........................................................................................220, Suggested Readings...........................................................................220, Review Articles................................................................................. 221, Chapter 16 Hallucinogenic Agents......................................................................225, 16.1 History and Description.........................................................225, 16.2 Ergot Alkaloids.......................................................................225, 16.2.1 Incidence and Occurrence.........................................225, 16.2.2 Medicinal Chemistry.................................................226, 16.2.3 Pharmacology and Clinical Use................................226, 16.2.4 Signs and Symptoms of Acute Toxicity....................227, 16.2.5 Clinical Management of Acute Overdose.................227, 16.3 Lysergic Acid Diethylamide (LSD)........................................228, 16.3.1 Incidence and Occurrence.........................................228, 16.3.2 Mechanism of Toxicity..............................................228, 16.3.3 Hallucinogenic Effects..............................................228, 16.3.4 Toxicokinetics...........................................................229, 16.3.5 Signs and Symptoms of Acute Toxicity....................229, 16.3.6 Clinical Management of Acute Overdose.................229, 16.3.7 Tolerance and Withdrawal.........................................230, 16.3.8 Methods of Detection................................................230, 16.4 Tryptamine Derivatives..........................................................230, 16.4.1 Incidence and Occurrence.........................................230, 16.4.2 Mechanism of Toxicity..............................................230, 16.4.3 Signs and Symptoms of Acute Toxicity.................... 231, 16.4.4 Clinical Management of Acute Overdose................. 231, 16.4.5 Tolerance and Withdrawal......................................... 231, 16.4.6 Methods of Detection................................................ 231, 16.5 Phenethylamine Derivatives................................................... 232, 16.5.1 Incidence and Occurrence......................................... 232, 16.5.2 Medicinal Chemistry................................................. 232, 16.5.3 Mescaline.................................................................. 232. 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