Table of Contents
This is an outline of a course which includes clinical problems and is designed to support a curriculum in clinical toxicology which can be delivered either online or face to face.
Feel free to make suggestions.
A version of this with tuition was delivered through the Peoples-Uni.org The course has been more fully developed to a Diploma and Masters Course delivered through the PGIM of Colombo University. [Click here for details]
CORE PRINCIPLES OVERVIEW
- Section 1 Pharmacokinetics and Pharmacodynamics (Pharmacokinetics and Pharmacodynamics, Protein binding, Clinical Toxicology- Assessment of patients, Decontamination)
- Section 2 Pharmacokinetics in toxicological practice (Paracetamol, Lithium)
- Section 3 Psychiatric Drugs and pH manipulation (pH manipulation in toxicology, Psychiatric drugs)
- Core Principles Reading List This contains a complete list of all the reading and in addition a number of powerpoint slides.
FURTHER WITH PHARMACEUTICALS
CHEMICALS AND INDUSTRIAL
This section covers the common or important chemicals used in agriculture.
Organophosphate poisoning is the major global cause of death from deliberate selfharm. It is both life threatening and can be a difficult poisoning to manage. Paraquat poisoning is less common but important because of its high mortality and uncertain management. Some insecticides, such as propanil, are powerful oxidants and can cause methaemoglobinaemia. Other chemicals and pharmaceuticals that can cause methaemoglobinaemia will also be discussed. Other insecticides and herbicides to consider here are the organochlorines, pyrethrins, DEET and glyphosate.
This section covers hydrocarbons, toxic alcohols and corrosive chemicals. The hydrocarbon topic will concentrate on the toxic alcohols: ethylene glycol and methanol. Hydrofluoric acid will be discussed separately from other corrosives because of its unique toxicity and management. With all these agents there are common pitfalls in the management of poisonings particularly with regard to decontamination and the potential for systemic complications and the appropriate use of potential antidotes. These will be explored in detail.
This section covers heavy metal poisoning. Although uncommon an understanding of clinical manifestations and the role of chelation therapy is important in the practice of clinical toxicology. Lead, arsenic, thallium and mercury will be discussed in detail and other, less common heavy metal poisonings will be reviewed.
Products of combustion include cyanide, carbon monoxide and some inhalation. Other sources of cyanide poisoning will also be considered. Particular attention will be paid to the controversies surrounding the role of antidotes for cyanide and carbon monoxide.
PLANTS AND ANIMALS
This course should enable you to describe the principles of toxicity from venomous animals and toxic plants.
Specifically you should be able to develop an approach to the management of toxicity from these animals and plants.