Modern Medical Toxicology

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Modern Medical Toxicology

Modern Medical Toxicology



General Principles

Introduction


Epidemiology of Poisoning
Historical Overview - Toxicology
Poison Control Centres
Mortality from Poisoning
Poisoning Severity Score

Diagnosis of Poisoning


Diagnosis of Poisoning

General Management of Poisoning


General Management of Poisoning
Stabilisation: Assessment - General Management of Poisoning
Stabilisation: Management - General Management of Poisoning
Evaluation - General Management of Poisoning
Decontamination - General Management of Poisoning
Elimination - General Management of Poisoning
Antidote Administration - General Management of Poisoning
Nursing and Psychiatric Care - General Management of Poisoning

Medicolegal Aspects of Poisoning


Medicolegal Duties of a Doctor in Suspected/Actual Poisoning
Indian Statutes on Drugs/Poisons
Toxicology and the Criminal Law
Medicolegal Problems Involving Consent
Toxicology and the Workmen’s Compensation Act
Postmortem Examination in a Case of Poisoning
Chemical Analysis - Medicolegal Aspects of Poisoning
Histopathological Examination

Corrosive or Caustic Poisons

Mineral Acids Inorganic Acids


Caustics - Corrosive(Caustic) Poisons
Acids - Corrosive(Caustic) Poisons
Sulfuric Acid - Corrosive(Caustic) Poisons
Nitric Acid - Corrosive(Caustic) Poisons
Hydrochloric Acid - Corrosive(Caustic) Poisons
Hydrofluoric Acid - Corrosive(Caustic) Poisons
Phosphoric Acid - Corrosive(Caustic) Poisons
Boric Acid - Corrosive(Caustic) Poisons
Chromic Acid - Corrosive(Caustic) Poisons

Organic Acids


Acetic Acid - Corrosive(Caustic) Poisons
Formic Acid - Corrosive(Caustic) Poisons
Carbolic Acid - Corrosive(Caustic) Poisons
Oxalic Acid - Corrosive(Caustic) Poisons

Alkalis and Other Caustics


Alkalis - Corrosive(Caustic) Poisons
Potassium Permanganate - Corrosive(Caustic) Poisons
Iodine - Corrosive(Caustic) Poisons
Hydrogen Peroxide - Corrosive(Caustic) Poisons
Cetrimide - Corrosive(Caustic) Poisons

Chemical Poisons

Non Metallic Chemical Poisons


Phosphorus - Chemical Poisons
Phosphine - Chemical Poisons
Aluminium Phosphide - Chemical Poisons
Zinc Phosphide - Chemical Poisons
Chlorine - Chemical Poisons
Bromine - Chemical Poisons
Fluorine - Chemical Poisons

Heavy Metals


Arsenic - Chemical Poisons
Lead - Chemical Poisons
Lead - Chemical Poisons: Diagnosis
Lead - Chemical Poisons: Treatment
Lead - Chemical Poisons: Forensic Issues
Mercury - Chemical Poisons
Iron - Chemical Poisons
Copper - Chemical Poisons
Antimony - Chemical Poisons
Barium - Chemical Poisons
Cadmium - Chemical Poisons
Cobalt - Chemical Poisons
Lithium - Chemical Poisons
Magnesium - Chemical Poisons
Manganese - Chemical Poisons
Potassium (Kalium) - Chemical Poisons
Thallium - Chemical Poisons
Metal Fume Fever - Chemical Poisons

Organic Poisons Toxins

Irritant Plants


Irritant Plants
Classification of Irritant Plants
Oropharyngeal Irritant Plants
Dumbcane - Oropharyngeal Irritant Plants
Philodendron - Oropharyngeal Irritant Plants
Castor - Gastric Irritant Plants
Colocynth(Citrullus colocynthis) - Gastric Irritant Plants
Croton(Croton tiglium) - Gastric Irritant Plants
Glory Lily(Gloriosa superba) - Gastric Irritant Plants
Marking Nut(Semecarpus anacardium) - Gastric Irritant Plants
Mayapple (May Apple) - Gastric Irritant Plants
Red Pepper - Gastric Irritant Plants
Rosary Pea - Gastric Irritant Plants
Dermal Irritant Plants

Plants of Special Importance


Neem - Hepatotoxic Plants
Autumn Crocus(Colchicum autumnale)
Oduvan - Organic Poisons (Toxins)
Eucalyptus - Organic Poisons (Toxins)
Physic Nut - Organic Poisons (Toxins)

Venomous Bites and Stings


Snakes - Organic Poisons (Toxins)
Classification of Snakes
Identification of Venomous Snakes
Common Indian Venomous Snakes
Common Cobra - Organic Poisons (Toxins)
Common Krait - Poisons (Toxins)
Saw-scaled Viper - Poisons (Toxins)
Russell’s Viper - Poisons (Toxins)
King Cobra - Poisons (Toxins)
Banded Krait - Poisons (Toxins)
Pit Vipers - Poisons (Toxins)
Coral Snakes - Poisons (Toxins)
Sea Snakes - Poisons (Toxins)
Snake Venom
Snakebite: Epidemiology
Snakebite: Clinical Features
Diagnosis of Snakebite
Treatment of Snakebite
Prevention of Snakebite
Forensic Issues in Snakebite
Order Hymenoptera - Venomous Insects
Order Scorpionida - Venomous Arachnids
Order Aranea - Venomous Arachnids
Brown Recluse - Venomous Arachnids
Black Widow - Venomous Arachnids
Wolf Spider - Venomous Arachnids
Tarantula - Venomous Arachnids
Ticks and Mites - Venomous Creature
Centipedes - Venomous Creature
Millipedes - Venomous Creature
Marine Venomous Creatures
General Treatment Measures for Cnidarian Stings

Neurotoxic Poisons

Somniferous Drugs


Somniferous Drugs - Neurotoxic Poisons
Opium - Somniferous Drugs(Narcotics) Neurotoxic Poisons
Opium: Diagnosis, Treatment, Autopsy Features, Forensic Issues - Somniferous Drugs(Narcotics) Neurotoxic Poisons

Inebriants


Alcohols - Inebriant Neurotoxic Poisons
Ethanol - Inebriant Neurotoxic Poisons
Ethanol: Clinical Features - Inebriant Neurotoxic Poisons
Ethanol: Diagnosis - Inebriant Neurotoxic Poisons
Ethanol: Autopsy Features, Forensic Issues - Inebriant Neurotoxic Poisons
Ethanol and cardiac health
Methanol - Inebriant Neurotoxic Poisons
Isopropanol - Inebriant Neurotoxic Poisons
Ethylene Glycol - Inebriant Neurotoxic Poisons
Barbiturates - Inebriant Neurotoxic Poisons
Benzodiazepines - Inebriant Neurotoxic Poisons
Chloral Hydrate - Inebriant Neurotoxic Poisons
Paraldehyde - Inebriant Neurotoxic Poisons
Methaqualone - Inebriant Neurotoxic Poisons
Buspirone - Inebriant Neurotoxic Poisons
Zolpidem - Inebriant Neurotoxic Poisons
Zopiclone - Inebriant Neurotoxic Poisons

Deliriants


Datura - Deliriant Neurotoxic Poisons
Cannabis - Deliriant Neurotoxic Poisons

Stimulants


Amphetamines - Stimulant Neurotoxic Poisons
Designer Amphetamines - Stimulant Neurotoxic Poisons
Cocaine - Stimulant Neurotoxic Poisons
Cocaine: Clinical Features - Stimulant Neurotoxic Poisons
Cocaine: Diagnosis, Treatment - Stimulant Neurotoxic Poisons
Cocaine: Autopsy Features, Mediocosocial and Forensic Issues - Stimulant Neurotoxic Poisons

Anticonvulsants and Antiparkinsonian Drugs


Classification of Anticonvulsant (Anti-Epileptic) Drug
Phenytoin - Anticonvulsant (Anti-Epileptic) Drug
Primidone - Anticonvulsant (Anti-Epileptic) Drug
Carbamazepine - Anticonvulsant (Anti-Epileptic) Drug
Valproic Acid - Anticonvulsant (Anti-Epileptic) Drug
Gabapentin - Anticonvulsant (Anti-Epileptic) Drug
Topiramate - Anticonvulsant (Anti-Epileptic) Drug
Zonisamide - Anticonvulsant (Anti-Epileptic) Drug
Antiparkinsonian Drugs
Levodopa - Antiparkinsonian Drug
Bromocriptine - Antiparkinsonian Drug
Pergolide - Antiparkinsonian Drug
Trihexiphenidyl - Antiparkinsonian Drug
Benztropine - Antiparkinsonian Drug

Anaesthetics and Muscle Relaxants


Anaesthetics Classification
Nitrous Oxide - Inhalational Anaesthetics
Halothane - Inhalational Anaesthetics
Other Inhalational Anaesthetics
Etomidate - Intravenous Anaesthetics
Ketamine - Intravenous Anaesthetics
Fentanyl and Droperidol - Intravenous Anaesthetics
Propofol - Intravenous Anaesthetics
Cocaine and Other Local Anaesthetics
Muscle Relaxants
Baclofen - Central Skeletal Muscle Relaxants
Carisoprodol - Central Skeletal Muscle Relaxants
Other Central Muscle Relaxants
Neuromuscular Blocking Agents
Orphenadrine - Muscle Relaxants
Dantrolene - Muscle Relaxants
Cyclobenzaprine - Muscle Relaxants

Drugs Used in Psychiatry


Antipsychotics - Drugs Used in Psychiatry
Classical Neuroleptics
Dibenzodiazepines - Atypical Neuroleptics
Benzisoxazoles - Atypical Neuroleptics
Antidepressants
Cyclic Antidepressants
Selective Serotonin Reuptake Inhibitors (SSRI) - Antidepressants
Monoamine Oxidase Inhibitors (MAOIs) - Antidepressants
Atypical Antidepressants
Lithium - Anti-Manic Drugs
Anti-Migraine Drugs
Ergot Alkaloids - Anti-Migraine Drugs
Sumatriptan - Anti-Migraine Drugs
Tacrine - Drugs Used in Alzheimer’s Disease

Hallucinogens Psychedelic Drugs


Hallucinogens (Psychedelic Drugs)
Lysergic Acid Diethylamide (LSD) - Hallucinogen(Psychedelic Drug)
Phencyclidine - Hallucinogen(Psychedelic Drug)
Dimethyltryptamine (DMT) - Hallucinogen(Psychedelic Drug)
Mescaline - Hallucinogen(Psychedelic Drug)
Inhalants (Glue Sniffing; Volatile Substance Abuse)

Spinal and Peripheral Neurotoxic Agents


Strychnine - Spinal and Peripheral Neurotoxic Agents
Poison Hemlock - Spinal and Peripheral Neurotoxic Agents
Water Hemlock(Cicuta maculata.) - Spinal and Peripheral Neurotoxic Agents

Cardiovascular Poisons

Diurets Antihypertensives and Antiarrhythmics


Carbonic Anhydrase Inhibitors - Diuret Cardiovascular Poison
Osmotic Diuretics - Cardiovascular Poison
Loop Diuretics - Cardiovascular Poison
Thiazide Diuretics - Cardiovascular Poison
Potassium Sparing Diuretics - Cardiovascular Poison
Antihypertensives - Cardiovascular Poison
Methyldopa - Sympatholytic Drug Cardiovascular Poison
Clonidine - Sympatholytic Drug Cardiovascular Poison
Ganglionic Blocking Agents - Sympatholytic Drug Cardiovascular Poison
Adrenergic Neuron Blocking Agents - Sympatholytic Drug Cardiovascular Poison
Reserpine - Sympatholytic Drug Cardiovascular Poison
Beta Adrenergic Antagonists (Beta Blockers) - Sympatholytic Drug Cardiovascular Poison
Alpha Adrenergic Antagonists (Alpha Blockers) - Sympatholytic Drug Cardiovascular Poison
Vasodilators - Sympatholytic Drug Cardiovascular Poison
Hydralazine - Sympatholytic Drug Cardiovascular Poison
Minoxidil - Sympatholytic Drug Cardiovascular Poison
Sodium Nitroprusside - Sympatholytic Drug Cardiovascular Poison
Calcium Channel Blockers - Sympatholytic Drug Cardiovascular Poison
Angiotensin Converting Enzyme Inhibitors (ACE Inhibitors) - Sympatholytic Drug Cardiovascular Poison
Angiotensin II Receptor Antagonists - Sympatholytic Drug Cardiovascular Poison
Antiarrhythmics - Cardiovascular Poison
Disopyramide - Antiarrhythmic Cardiovascular Poison
Procainamide - Antiarrhythmic Cardiovascular Poison
Lignocaine (Lidocaine) - Antiarrhythmic Cardiovascular Poison
Mexiletine and Tocainide - Antiarrhythmic Cardiovascular Poison
Propafenone (Fenopraine) - Antiarrhythmic Cardiovascular Poison
Amiodarone - Antiarrhythmic Cardiovascular Poison
Adenosine - Antiarrhythmic Cardiovascular Poison

Cardiac Drugs and Lipid Lowering Agents


Drugs Used in Heart Failure
Cardiac Glycosides - Cardiovascular Poisons
Dopamine - Beta Adrenergic Receptor and Dopaminergic Receptor Agonists
Dobutamine - Beta Adrenergic Receptor and Dopaminergic Receptor Agonists
Amrinone (Inamrinone) - Cardiovascular Poisons
Dipyridamole - Cardiovascular Poisons
Anti-anginal Drugs - Cardiovascular Poisons
Organic Nitrates - Cardiovascular Poisons
HMG CoA Reductase Inhibitors - Cardiovascular Poisons
Bile Acid Binding Resins
Probucol - Cardiovascular Poisons
Fibric Acid Derivatives - Cardiovascular Poisons

Anticoagulants and Related Drugs


Anticoagulants
Heparins and Low Molecular Weight Heparins - Cardiovascular Poison
Oral Anticoagulants - Cardiovascular Poison
Aprotinin - Antifibrinolytic Cardiovascular Poison
Epsilon Aminocaproic Acid - Antifibrinolytic Cardiovascular Poison
Hirudin - Antifibrinolytic Cardiovascular Poison
Thrombolytics - Antifibrinolytic Cardiovascular Poison
Antiplatelet Drugs - Antifibrinolytic Cardiovascular Poison

Cardiotoxic Plants


Cardiotoxic Plants
Aconite - Cardiotoxic Plant
Common Oleander - Cardiotoxic Plant
Yellow Oleander - Cardiotoxic Plant
Suicide Tree - Cardiotoxic Plant

Asphyxiant Poisons

Toxic Gases


Toxic Gases
Carbon Dioxide - Simple Asphyxiant Poisons
Aliphatic Hydrocarbon Gases - Simple Asphyxiant Poison
Ammonia - Respiratory Irritants Asphyxiant Poison
Formaldehyde - Respiratory Irritants Asphyxiant Poison
Hydrogen Sulfide - Respiratory Irritants Asphyxiant Poison
Methyl Isocyanate (MIC) - Respiratory Irritants Asphyxiant Poison
Phosgene - Respiratory Irritants Asphyxiant Poison
Carbon Monoxide - Systemic Asphyxiant Poison
Cyanide - Systemic Asphyxiant Poison
Smoke - Systemic Asphyxiant Poison

Hydrocarbons and Pesticides

Hydrocarbon


Hydrocarbon
Aliphatic Hydrocarbons
Benzene - Aromatic Hydrocarbons
Naphthalene - Aromatic Hydrocarbons
Polycyclic Aromatic Hydrocarbons
Halogenated Hydrocarbons

Pesticides


Pesticides
Organophosphates (Organophosphorus Compounds) - Insecticides
Carbamates - Insecticide
Organochlorines - Insecticide
Pyrethrins and Pyrethroids - Insecticide
Rodenticides
Paraquat and Diquat - Herbicides (Weedicides)
Chlorophenoxy Compounds - Herbicides (Weedicides)
Glyphosate - Herbicides (Weedicides)
Thiocarbamates - Fungicides
Ethylene dibromide - Nematicides
Acaricides
Metaldehyde - Molluscicides
Forensic Issues (All Pesticides)

Miscellaneous Drugs and Poisons

Analgesics and Antihistamines


Analgesics and Antihistamines
Salicylates - Analgesic-Antipyretics
Paracetamol - Analgesic-Antipyretics
Paracetamol: Diagnosis, Treatment on Poisons - Analgesic-Antipyretics
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Pyrazolones - Non-Steroidal Anti-Inflammatory Drug(NSAID)
Propionic Acids - Non-Steroidal Anti-Inflammatory Drug(NSAID)
Fenamic Acids - Non-Steroidal Anti-Inflammatory Drug(NSAID)
Heterocyclic Acetic Acids - Non-Steroidal Anti-Inflammatory Drug(NSAID)
Aryl Acetic Acids - Non-Steroidal Anti-Inflammatory Drug(NSAID)
Oxicams - Non-Steroidal Anti-Inflammatory Drug(NSAID)
Nimesulide - Non-Steroidal Anti-Inflammatory Drug(NSAID)
Cox-2 Inhibitors - Non-Steroidal Anti-Inflammatory Drug(NSAID)
Antihistamines
H1 Receptor Antagonists (Classical Antihistamines)
H2 Receptor Antagonists
5-Hydroxytryptamine (5-HT) Antagonists

Anti Infectives


Antimicrobial Agents
Antiprotozoal Agents
Antibacterials - Antimicrobials
Quinolones - Antimicrobials
Penicillins - Antimicrobials
Cephalosporines - Antimicrobials
Aminoglycosides - Antimicrobials
Tetracyclines - Antimicrobials
Chloramphenicol - Antimicrobials
Macrolides - Antimicrobials
Anti-tubercular Drugs - Antimicrobials
Antileprotic Drugs - Antimicrobials
Other Antibacterial Drugs
Antiherpesvirus Agents
Antiretroviral Agents
Other Antiviral Agents
Amphotericin B - Antifungals
Flucytosine - Antifungal
Imidazoles - Antifungal
Griseofulvin - Antifungal
Antimalarials - Antiprotozoal Agent
Chloroguanide (Proguanil) - Antifungal
Primaquine - Antifungal
Quinine and Quinidine - Antifungal
Chloroquine and Amodiaquine - Antifungal
Mefloquine, Halofantrine, Endoperoxidases, Pyrimethamine, Mepacrine - Antimalarial Drugs
Antiamoebics - Anti-Infectives
Antihelminthics (Anthelmintics)
Autopsy Features (Anti-infective Overdose Deaths)
Forensic Issues (Anti-infectives)

Gastrointestinal and Endocrinal Drugs


Antacids and Anti-ulcer Drugs
Laxatives - Gastrointestinal Drugs
Antidiarrhoeals
Antiemetics - Antiemetics and Prokinetic Drug
Prokinetic Drugs - Antiemetics and Prokinetic Drug
Bile Acids and Pancreatic Enzymes - Antiemetics and Prokinetic Drug
Anterior Pituitary Hormones - Endocrinal Drug
Thyroid and Antithyroid Drugs - Endocrinal Drug
Antithyroid Drugs - Endocrinal Drug
Oestrogens - Endocrinal Drug
Anti-oestrogens
Progestins - Endocrinal Drug
Anti-progestins
Androgens (Anabolic Steroids)
Anti-androgens
Adrenocorticotropic Hormone and Corticosteroids - Endocrinal Drug
Insulin
Oral Hypoglycaemics
Sulfonylureas - Oral Hypoglycaemics
Biguanides - Oral Hypoglycaemics
Other Hypoglycaemics
Anti-Asthmatic Drugs
Corticosteroids - Anti-inflammatory Drugs
Catecholamines
Immunomodulators
Immunostimulants
Antineoplastic Agents
Antimetabolites
Drugs Acting on the Uterus
Radiocontrast Agents
Sildenafil - Drugs Used in the Treatment of Impotence

Food Poisons

Food Poisoning


Causes and Diagnosis of Food Poisoning
General Treatment Measures of Food Poisoning
Prevention of Food Poisoning
Bacillus cereus - Microbial Food Poisoning
Staphylococcus aureus - Microbial Food Poisoning
Salmonella - Microbial Food Poisoning
Shigella - Microbial Food Poisoning
Vibrio - Microbial Food Poisoning
Escherichia coli - Microbial Food Poisoning
Campylobacter - Microbial Food Poisoning
Yersinia enterocolitica - Microbial Food Poisoning
Listeria monocytogenes - Microbial Food Poisoning
Clostridium Microbial Food Poisoning
Clostridium perfringens - Clostridium Microbial Food Poisoning
Clostridium botulinum - Clostridium Microbial Food Poisoning
Clinical Features - Clostridium Microbial Food Poisoning
Diagnosis - Microbial Food Poisoning
Treatment - Microbial Food Poisoning
Prevention of Botulism - Microbial Food Poisoning
Forensic Issues - Microbial Food Poisoning
Viruses - Food Poisoning
Protozoa - Microbial Food Poisoning
Parasites - Food Poisoning
Fungi: Mushrooms - Food Poisoning
Fungi: Aflatoxins - Food Poisoning
Fungi: Trichothecenes - Food Poisoning
Cyanogenic Plants - Food Poisoning
Sweet Pea - Food Poisoning
Prickly Poppy - Food Poisoning
Fish - Food Poisoning
Scombroid Poisoning (Histamine Fish Poisoning)
Ciguatera Fish Poisoning
Tetrodotoxic Poisoning
Shellfish Poisoning
Chemicals: Monosodium Glutamate (MSG) - Food Poisoning

Substance Abuse

Substances of Dependence and Abuse


Substances of Dependence and Abuse
Classification - Substances of Dependence and Abuse
Tobacco - Substances of Dependence and Abuse
Cocaine - Substances of Dependence and Abuse
Cocaine: Diagnosis, Treatment - Substances of Dependence and Abuse
Cannabis - Substances of Dependence and Abuse
Amphetamines - Substances of Dependence and Abuse
Designer Drugs - Substances of Dependence and Abuse
Hallucinogens (Psychedelics, Psychotomimetics) - Substances of Dependence and Abuse
Inhalants (“Glue Sniffing”,Volatile Substance Abuse, Inhalant-related Disorders)

Analytical Toxicology

Biochemical and Haematological Tests


Analytical Toxicology: Biochemical and Haematological Tests
Biochemical Tests - Analytical Toxicology
Haematological Tests - Analytical Toxicology

Analytical Instrumentation


Analytical Methods Used In Toxicology
Qualitative Tests - Analytical Toxicology Instrumentation
Quantitative Assays - Analytical Toxicology Instrumentation
Applications of High Performance Liquid Chromatography (HPLC)



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