====== Entire Curriculum ======

**1.0 Principles of Toxicology**

**[[:wikitox:1.1_pharmacology_and_toxicology|1.1 Pharmacology/Toxicology]]**
  * **[[:wikitox:1.1.1_pharmacokinetics_and_toxicokinetics|1.1.1 Pharmacokinetics/Toxicokinetics]]**
      * [[:wikitox:1.1.1.1_bioavailability_and_absorption|1.1.1.1 Bioavailability and Absorption]]
      * [[:wikitox:1.1.1.2_distribution|1.1.1.2 Distribution]]
      * [[:wikitox:1.1.1.3_metabolism|1.1.1.3 Metabolism]]
      * [[:wikitox:1.1.1.4_elimination|1.1.1.4 Elimination]]
      * [[:wikitox:1.1.1.5_clearance|1.1.1.5 Clearance]]
      * 1.1.1.6 Models (eg. compartmental, physiologic)

  * **1.1.2 Pharmacodynamics/Toxicodynamics**
      * [[:wikitox:1.1.2.1_dose_and_concentration_relationship_to_effect|1.1.2.1 Dose/Concentration Relationship to Effect]]
      * 1.1.2.2 Structure-Activity Relationship
      * [[:wikitox:1.1.2.3_receptor_agonism_and_antagonism|1.1.2.3 Receptor Agonism/Antagonism]]
      * 1.1.2.4 Receptor Regulation

  * **[[:wikitox:1.1.3_adverse_effects|1.1.3 Adverse Effects]]**
      * 1.1.3.1 Mechanistic (predictable)
      * 1.1.3.2 Idiosyncratic

  * **1.1.4 Interactions**
      * 1.1.4.1 Xenobiotic-Environment
      * 1.1.4.2 Xenobiotic-Food
      * 1.1.4.3 Xenobiotic-Xenobiotic (eg. drug-drug)

  * **1.1.5 Proteomics**
  * **1.1.6 Tolerance and Withdrawal**
      * 1.1.6.1 Behavioral Tolerance
      * 1.1.6.2 Biologic Tolerance

  * **1.1.7 Immunologic Response**
  * **1.1.8 Pharmacogenomics Toxicogenomics**  (eg. xenobiotic response, gene expression profiling)
  * **1.1.9 Organ toxicity**
      * 1.1.9.1 Renal toxicity

**1.2 Molecular Components and Mechanisms**

  * **1.2.1 Glycolysis and Oxidative Phosphorylation**
  * **1.2.2 Other Metabolic Pathways (eg. amino acids and urea cycle)**
  * **1.2.3 Membranes**
  * **1.2.4 Enzymes and Transport Proteins (eg. [[:wikitox:methaemoglobin|]], G6PD)**
  * **1.2.5 Channels and Pumps**
  * **1.2.6 Signal Transduction**
      * 1.2.6.1 Receptor Isoforms and Subtypes
      * 1.2.6.2 Regulation and Messengers
      * 1.2.6.3 Neurotransmitters

**1.3 Cytotoxic Mechanisms**  (eg. apoptosis, microtubular dysfunction)

**1.4 Mutagenesis and Carcinogenesis**

  * **1.4.1 Mutagenesis**
      * 1.4.1.1 Chromosome Aberrations (structural, numeric)
      * 1.4.1.2 Gene Mutation (oncogenes, tumor suppressor genes)
      * [[:wikitox:1.4.1.3_slides_of_mutagenesis|1.4.1.3 In Vitro Genetic Toxicity Testing]]

  * **1.4.2 Development of Neoplasia**
      * 1.4.2.1 Initiation (eg. genotoxic mechanisms)
      * 1.4.2.2 Procarcinogens and Conversion to Carcinogens
      * 1.4.2.3 Progression (eg. growth, invasiveness)
      * 1.4.2.4 Promotion (eg. nongenotoxic mechanisms biotransformation)

  * **1.4.3 Inhibition of Carcinogenesis-Modulating Factors**
      * 1.4.3.1 Endogenous Factors (eg. age, sex, immune status, hormones)
      * [[:wikitox:1.4.3.2_exogenous_factors|1.4.3.2 Exogenous Factors]] (eg. diet, radiation)

  * **1.4.4 Interactive Carcinogenesis**
      * 1.4.4.1 Xenobiotic: Gene Interactions
      * 1.4.4.2 Xenobiotic: Physical Interactions
      * 1.4.4.3 Xenobiotic: Radiation Interactions
      * 1.4.4.4 Xenobiotic: Viral Interactions

**1.5 Adverse Reproductive and Developmental Outcomes**

  * **1.5.1 Conception Impairment, Mutagenesis, and Teratogenesis**
      * 1.5.1.1 Chromosomal and Gene Abnormalities
      * 1.5.1.2 Effects on Gametogenesis and Gametes
      * 1.5.1.3 Effects on Gonads
      * 1.5.1.4 Spontaneous Abortion and Perinatal Death

  * **1.5.2 Factors Determining Fetal or Infant Exposure to Agents**
      * 1.5.2.1 Breast Milk Transfer
      * 1.5.2.2 Placental Transfer
      * 1.5.2.3 Xenobiotic Disposition (eg. maternal xenobiotic disposition, fetal pharmacokinetics)

  * **1.5.3 Offspring Effects**
      * 1.5.3.1 Cancer
      * 1.5.3.2 Congenital Anomalies and Malformations
      * 1.5.3.3 Development of Infant/Child
      * 1.5.3.4 Genetic Mutations

**2.0 Toxins and Toxicants**

**2.1 Drugs**

  * **2.1.1 Analgesics, Anti-inflammatory Drugs**
      * [[:wikitox:2.1.1.1_acetaminophen|2.1.1.1 Acetaminophen]]
      * [[:wikitox:2.1.1.2_nonsteroidal_anti_inflammatory_drugs|2.1.1.2 Nonsteroidal Anti-inflammatory Drugs]]
      * [[:wikitox:2.1.1.3_opioids|2.1.1.3 Opioids]]
      * [[:wikitox:2.1.1.4_salicylates|2.1.1.4 Salicylates]]
      *  [[:wikitox:2.1.1.5_other_analgesics_anti_inflammatory|2.1.1.5 Others (eg. antigout drugs, gold)]]
        * [[:wikitox:2.1.1.5.1_colchicine|2.1.1.5.1 Colchicine]]

  * **2.1.2 Antimicrobials**
      * 2.1.2.1 Antibiotics
      * 2.1.2.2 Antifungals
      * 2.1.2.3 Antimycobacterials
      * 2.1.2.4 Antiparasitics
      * 2.1.2.5 Antiprotozoals
      * 2.1.2.6 Antiretrovirals
      * 2.1.2.7 Antiseptics
      * 2.1.2.8 Antivirals

  * **[[:wikitox:2.1.3_chemotherapeutic_drugs|2.1.3 Chemotherapeutic Drugs]]**
      * 2.1.3.1 Alkylators
      * 2.1.3.2 Antimetabolites
      * 2.1.3.3 Hormones
      * 2.1.3.4 Natural Drugs, (eg. vinca alkaloids, antibiotics)
      * 2.1.3.5 Miscellaneous (eg. platinum, hydroxyurea)

  * **2.1.4 Diagnostic Drugs (eg. radionuclides)**
  * **2.1.5 Drugs That Affect Cholesterol and Lipids**
  * **2.1.6 Drugs That Affect the Cardiovascular System**
      *  [[:wikitox:3.4.3.4_antiarrhythmics|2.1.6.1 Antidysrhythmics]]
        * [[:wikitox:2.1.6.1.1_calcium_channel_blockers|2.1.6.1.1 Calcium channel blockers]]
        * [[:wikitox:2.1.6.1.2_cardiac_glycosides|2.1.6.1.2 Cardiac glycosides]]
        * 2.1.6.1.3 Potassium channel blockers
        * 2.1.6.1.4 Sodium channel blockers
      *  [[:wikitox:2.1.6.2_antihypertensives|2.1.6.2 Antihypertensives]]
        * [[:wikitox:2.1.6.2.1_angiotensin_system_modulators|2.1.6.2.1 Angiotensin system modulators]]
        * 2.1.6.2.2 Adrenergic (and mixed) antagonists
        * [[:wikitox:clonidine|2.1.6.2.3 Centrally acting receptor agonists ]]Clonidine
        * 2.1.6.2.4 Diuretics
        * [[:wikitox:2.1.6.2.5_vasodilators|2.1.6.2.5 Vasodilators]] (eg. nitrates, nitrites)
      * [[:wikitox:2.1.6.3_inotropes|2.1.6.3 Inotropes]]

  * **2.1.7 Drugs That Affect the Endocrine System**
      * 2.1.7.1 Antidiabetic Drugs
        * [[:wikitox:2.1.7.1.1_insulin|2.1.7.1.1 Insulin]]
        * [[:wikitox:2.1.7.1.2_sulphonylureas|2.1.7.1.2 Oral hypoglycemics]]
        * [[:wikitox:2.1.7.1.3_others_eg_metformin_glitazones|2.1.7.1.3 Others (eg. metformin, glitazones)]]
      * 2.1.7.2 Bone Active Drugs (eg. calcitonin, bisphosphonates)
      * 2.1.7.3 Electrolytes and Minerals
      * 2.1.7.4 Glucocorticoids
      * 2.1.7.5 Sex Hormones, Growth Hormones, and Anabolic Steroids
      * [[:wikitox:2.1.7.6_thyroid_drugs|2.1.7.6 Thyroid Drugs]]
      * 2.1.7.7 Vasopressin and Somatostatin Analogues

  * **2.1.8 Drugs That Affect the Gastrointestinal System**
      * 2.1.8.1 Antidiarrhoeals
      * 2.1.8.2 Antiemetics
      * 2.1.8.3 Drugs Used for Biliary and Pancreatic Diseases (eg. bile salts, pancreatic enzymes)
      * 2.1.8.4 Drugs Used for Inflammatory Bowel Disease
      * 2.1.8.5 Drugs Used to Treat Acid-Peptic Diseases
      * 2.1.8.6 Laxatives
      * 2.1.8.7 Promotilic

  * **2.1.9 Drugs That Affect the Hematologic System**
      * [[:wikitox:2.2.7.5.1_anticoagulant|2.1.9.1 Anticoagulants]]
      * 2.1.9.2 Antifibrinolytics
      * 2.1.9.3 Antiplatelet Drugs
      * 2.1.9.4 Blood-Stimulating Drugs (eg. erythropoietin)
      * 2.1.9.5 Drugs Used to Treat Bleeding (eg. clotting factors, antiplasmin drugs
      * [[:wikitox:2.1.9.6_iron|2.1.9.6 Iron]]
      * 2.1.9.7 Thrombolytics

  * **2.1.10 Drugs That Affect the Immune System**  (eg. interferon, cyclophosphamide)
  * **2.1.11 Drugs That Affect the Nervous System**
      * 2.1.11.1 Anesthetics
        * [[:wikitox:2.1.11.1.1_inhalational_and_sedative_anesthetics_eg_nitrous_oxide_propofol|2.1.11.1.1 Inhalational and sedative anesthetics (eg. nitrous oxide, propofol)]]
        * 2.1.11.1.2 Local anesthetics
      * [[:wikitox:2.1.11.2_anticonvulsants|2.1.11.2 Anticonvulsants]]
      * 2.1.11.3 Antiparkinsonism Drugs
      * 2.1.11.4 Drugs That Affect Autonomic Homeostasis
        * [[:wikitox:2.1.11.4.1_anticholinergics|2.1.11.4.1 Anticholinergics]]
        * [[:wikitox:2.1.11.4.2_antihistamines|2.1.11.4.2 Antihistamines]]
        * 2.1.11.4.3 Antiserotonergics
        * 2.1.11.4.4 Cholinergics (eg. nicotine)
        * [[:wikitox:2.1.11.4.5.1_ergot_alkaloids|2.1.11.4.5 Ergot and derivatives]]
        * [[:wikitox:2.1.11.4.6_xanthines|2.1.11.4.6 Xanthines]]
        * 2.1.11.4.7 Serotonin agonists and other proserotonergics (eg. dextromethorphan)
        * [[:wikitox:2.1.11.4.8_sympathomimetics_eg_amphetamines_cocaine|2.1.11.4.8 Sympathomimetics (eg. amphetamines, cocaine)]]
      * [[:wikitox:2.1.11.5_ethanol|2.1.11.5 Ethanol]]
      * 2.1.11.6 Muscle Relaxants
      * 2.1.11.7 Neuromuscular Blockers
      * 2.1.11.8 Psychoactive Drugs and Hallucinogens (eg. marijuana, lysergic acid diethylamide [LSD])
      *  [[:wikitox:2.1.11.9_psychotropics|2.1.11.9 Psychotropics]]
        * [[:wikitox:2.1.11.9.1_miscellaneous_anxiolytics_and_sedative_hypnotics|2.1.11.9.1 Anxiolytics and sedative-hypnotics]]
        *  [[:wikitox:2.1.11.9.2_antidepressants|2.1.11.9.2 Antidepressants]]
          * [[:wikitox:2.1.11.9.2.1_tricyclic_antidepressants|2.1.11.9.2.1 Tricyclic Antidepressants]]
          * [[:wikitox:2.1.11.9.2.2_monoamine_oxidase_inhibitors|2.1.11.9.2.2 Monoamine Oxidase Inhibitors]]
          * [[:wikitox:2.1.11.9.2.3_serotonin_reuptake_inhibitors|2.1.11.9.2.3 Serotonin Reuptake Inhibitors]]
          * [[:wikitox:2.1.11.9.2.4_other_antidepressants|2.1.11.9.2.4 Other Antidepressants]] (bupropion, mirtazapine, mianserin, venlafaxine
        * [[:wikitox:2.1.11.9.3_antipsychotics|2.1.11.9.3 Antipsychotics]]
        * [[:wikitox:2.1.11.9.4_mood_stabilizers|2.1.11.9.4 Mood stabilizers]] (lithium)

  * **2.1.12 Pharmaceutical Additives (eg. excipients)**
  * **2.1.13 Veterinary Products**
  * **2.1.14 Vitamins**
  * **[[:wikitox:2.1.15_complementary_herbal_and_traditional_medicines|2.1.15 Complementary Herbal & Traditional Medicines]]**
**2.2 Industrial, Household, and Environmental Toxicants**

  * **2.2.1 Airborne Solids**
      * [[:wikitox:2.2.1.1_asbestos|2.2.1.1 Asbestos]]
      * 2.2.1.2 Coal Dust
      * 2.2.1.3 Organic Dust
      * 2.2.1.4 Silica
      * 2.2.1.5 Other Minerals (eg. man-made mineral fibers)

  * **[[:wikitox:2.2.2_cleansers_and_caustics|2.2.2 Cleansers and Caustics]]**
      * 2.2.2.1 Acids
      * 2.2.2.2 Alkali
      * 2.2.2.3 Bleach
      * 2.2.2.4 Detergents and Soaps
      * 2.2.2.5 Disinfectants and Topical Anti-infectives
      * 2.2.2.6 Swimming Pool Products

  * **2.2.3 Food Additives (eg. monosodium glutamate, sulfites)**
  * **2.2.4 Household Products**
      * 2.2.4.1 Aquarium Products
      * 2.2.4.2 Art Products
      * 2.2.4.3 Batteries
      * 2.2.4.4 Cosmetics
      * 2.2.4.5 Dental Products
      * 2.2.4.6 Hair Products
      * 2.2.4.7 Personal Hygiene Products

  * **[[:wikitox:2.2.5_hydrocarbons_solvents_and_fuels|2.2.5 Hydrocarbons, Solvents and Fuels]]**
      * 2.2.5.1 Aldehydes
      *  [[:wikitox:2.2.5.2_alcohols_and_glycols|2.2.5.2 Alcohols and Glycols]]
        * 2.2.5.2.1 Diethylene glycol
        * [[:wikitox:2.2.5.2.2_ethylene_glycol|2.2.5.2.2 Ethylene glycol]]
        * 2.2.5.2.3 Glycol ethers
        * 2.2.5.2.4 Isopropanol
        * [[:wikitox:2.2.5.2.5_methanol|2.2.5.2.5 Methanol]]
      * 2.2.5.3 Aliphatic Hydrocarbons
        * 2.2.5.3.1 Hexane and congeners
        * 2.2.5.3.2 Mixtures (eg. gasoline, kerosene)
      * 2.2.5.4 Aromatic Hydrocarbons
        * 2.2.5.4.1 Benzene
        * 2.2.5.4.2 Polycyclic aromatic hydrocarbons
        * 2.2.5.4.3 Toluene
      * 2.2.5.5 Halogenated Hydrocarbons
        * 2.2.5.5.1 Carbon tetrachloride
        * 2.2.5.5.2 Chloroform
        * 2.2.5.5.3 Methylene chloride
        * 2.2.5.5.4 Perchloroethylene
        * 2.2.5.5.5 Trichloroethylene
        * 2.2.5.5.6 Vinyl chloride
      * 2.2.5.6 Hydrazines
      * 2.2.5.7 Ketones
      * 2.2.5.8 Peroxides
      * 2.2.5.9 Terpenes

  * **[[:wikitox:2.2.6_metals_and_metalloids|2.2.6 Metals/Metalloids]]**
      * [[:wikitox:2.2.6.1_arsenic|2.2.6.1 Arsenic]] (2.2.9.2.6 Arsine)
      * [[:wikitox:2.2.6.2_barium|2.2.6.2 Barium]]
      * [[:wikitox:2.2.6.3_beryllium|2.2.6.3 Beryllium]]
      * [[:wikitox:2.2.6.4_cadmium|2.2.6.4 Cadmium]]
      * [[:wikitox:2.2.6.5_chromium|2.2.6.5 Chromium]]
      * [[:wikitox:2.2.6.6_cobalt|2.2.6.6 Cobalt]]
      * [[:wikitox:2.2.6.7_copper|2.2.6.7 Copper]]
      * [[:wikitox:2.2.6.8_lead|2.2.6.8 Lead]]
      * [[:wikitox:2.2.6.9_manganese|2.2.6.9 Manganese]]
      * [[:wikitox:2.2.6.10_mercury|2.2.6.10 Mercury]]
      * 2.2.6.11 Nickel
      * [[:wikitox:2.2.6.12_thallium|2.2.6.12 Thallium]]
      * [[:wikitox:2.2.6.13_caesium|2.2.6.13 Caesium]]

  * **[[:wikitox:2.2.7_pesticides|2.2.7 Pesticides]]**
      * 2.2.7.1 Fumigants and Sterilants
      * 2.2.7.2 Fungicides
      *  [[:wikitox:2.2.7.3_herbicides|2.2.7.3 Herbicides]]
        * [[:wikitox:2.2.7.3.1_paraquat|2.2.7.3.1 Paraquat]]
        * [[:wikitox:2.2.7.3.2_chlorphenoxy_herbicides|2.2.7.3.2 Chlorphenoxy Herbicides]]
        * [[:wikitox:2.2.7.3.2_propanil|2.2.7.3.2 Propanil]]
        * [[:wikitox:glyphosate|2.2.7.3.2 Glyphosate]]
      *  [[:wikitox:2.2.7.4_insecticides_and_repellents|2.2.7.4 Insecticides and Repellents]]
        * [[:wikitox:2.2.7.4.1_carbamates|2.2.7.4.1 Carbamates]]
        * 2.2.7.4.2 DEET
        * [[:wikitox:2.2.7.4.3_moth_balls|2.2.7.4.3 Moth balls]]
        * [[:wikitox:2.2.7.4.4_organochlorines|2.2.7.4.4 Organochlorines]]
        * [[:wikitox:2.2.7.4.5_organophosphates|2.2.7.4.5 Organophosphates]]
        * [[:wikitox:2.2.7.4.6_pyrethrins_and_pyrethroids|2.2.7.4.6 Pyrethrins and pyrethroids]]
        * [[:wikitox:2.2.7.4.7_neonicotinoids|2.2.7.4.7 Neonicotinoids]]
        * [[:wikitox:2.2.7.4.8_avermectins|2.2.7.4.8 Avermectins]]
        * [[:wikitox:2.2.7.4.9_n_phenylpyrazole|2.2.7.4.9 N-phenylpyrazole]]
      * 2.2.7.5 Rodenticides
        * [[:wikitox:2.2.7.5.1_anticoagulant|2.2.7.5.1 Anticoagulant]]
        * 2.2.7.5.2 Nonanticoagulant
      * 2.2.7.6 Other (eg. molluscides)

  * **2.2.8 Pollutants**
      * 2.2.8.1 Air Pollutants (eg. respirable particulates)
      * 2.2.8.2 Persistent Organic Pollutants (eg, polychlorinated biphenyls, dibenzodioxins)
      * 2.2.8.3 Water Pollutants (eg. trihalomethanes)

  * **2.2.9 Toxic Gases**
      * 2.2.9.1 Cellular Asphyxiant Gases
        * [[:wikitox:2.2.9.1.1_carbon_monoxide|2.2.9.1.1 Carbon monoxide]]
        * [[:wikitox:2.2.9.1.2_cyanide|2.2.9.1.2 Cyanide]]
        * [[:wikitox:2.2.9.1.3_hydrogen_sulphide|2.2.9.1.3 Hydrogen sulphide]]
      * 2.2.9.2 Irritant Gases
        * [[:wikitox:2.2.9.2.1_chlorine|2.2.9.2.1 Chlorine]]
        * 2.2.9.2.2 Nitrogen oxides
        * 2.2.9.2.3 Ozone
        * [[:wikitox:2.2.9.2.4_phosgene|2.2.9.2.4 Phosgene]]
        * 2.2.9.2.5 Sulfur oxides
        * [[:wikitox:2.2.9.2.6_arsene|2.2.9.2.6 Arsene]]
      * 2.2.9.3 Radon
      * 2.2.9.4 Simple Asphyxiants (eg. methane, nitrogen)
      * [[:wikitox:2.2.9.5_smoke_inhalation|2.2.9.5 Smoke Inhalation]]

  * **2.2.10 Miscellaneous Toxicants**
      * 2.2.10.1 Acrolein
      * 2.2.10.2 Acrylamides
      * 2.2.10.3 Acrylates
      * 2.2.10.4 Amines
      * 2.2.10.5 Aniline Compounds
      * 2.2.10.6 Azides
      * 2.2.10.7 Bromide Compounds
      * 2.2.10.8 Butadienes
      * 2.2.10.9 Carbon Disulfide
      * 2.2.10.10 Chlorates
      * 2.2.10.11 Coal Tar Products
      * 2.2.10.12 Diamines
      * 2.2.10.13 Dibromochloropropane (DBCP)
      * 2.2.10.14 Dimethylacetamide (DMAC)
      * 2.2.10.15 Dimethylformamide (DMF)
      * 2.2.10.16 Dinitrobenzene
      * 2.2.10.17 Dinitrotoluene (DNT)
      * 2.2.10.18 Epichlorohydrin
      * 2.2.10.19 Ethylene Dibromide (EDB)
      * 2.2.10.20 Ethylenediamine (EDA)
      * 2.2.10.21 Fluoride Compounds
      * 2.2.10.22 Fuels
      * 2.2.10.23 Hexachloro-1,3-Butadiene (HCBD)
      * 2.2.10.24 Isocyanates (eg, toluene diisocyante)
      * 2.2.10.25 Maleic Anhydride
      * 2.2.10.26 Mercaptans
      * 2.2.10.27 Methylene Diamine (MDA)
      * 2.2.10.28 Nitriles
      * 2.2.10.29 O-Phenylenediamine (OPD)
      * [[:wikitox:2.2.10.30_phosphorus_and_phosphides|2.2.10.30 Phosphorus/phosphides]]
      * 2.2.10.31 Phthalates
      * 2.2.10.32 Polymers
      * 2.2.10.33 Resins
      * 2.2.10.34 Styrene
      * 2.2.10.35 Trimellitic Anhydride
      * 2.2.10.36 Triorthocresylphosphate (TOCP)
      * 2.2.10.37 Xylidine

  * **2.2.11 Syndromes Attributed to the Environment, Not Specified Elsewhere**
      * 2.2.11.1 Event-Specific Syndromes (eg. Gulf War syndrome, World Trade Center cough)
      * 2.2.11.2 Mold
      * 2.2.11.3 Multiple Chemical Sensitivity Syndrome
      * 2.2.11.4 Tight Building Syndrome

2.3 Natural Products

  * **2.3.1 Food Poisoning**
      * 2.3.1.1 Bacterial
      * [[:wikitox:2.3.1.2_marine|2.3.1.2 Marine]]

  * **2.3.2 Fungi**
      * 2.3.2.1 Mushrooms
      * 2.3.2.2 Other Fungal Toxins (eg. aflatoxins, trichothecene mycotoxins)

  * **[[:wikitox:2.3.3_herbal_and_dietary_supplements|2.3.3 Herbal and Dietary Supplements]]**
  * **[[:wikitox:2.3.4_plants|2.3.4 Plants]]**
      * [[:wikitox:2.3.4.1_cardiovascular_toxic_plants|2.3.4.1 Cardiovascular Toxic Plants]] (eg. //[[:wikitox:2.3.4.1.2_aconitum_napellus|Aconitum napellus]]//, //[[:wikitox:2.3.4.1.1_yellow_oleander|Nerium oleander]]//)
      * [[:wikitox:2.3.4.2_cutaneous_mucus_membrane_toxic_plants|2.3.4.2 Cutaneous/Mucus Membrane Toxic Plants]] (eg. //Toxicodendron sp//., //Dieffenbachia sp.//)
      * [[:wikitox:2.3.4.3_gastrointestinal_toxic_plants|2.3.4.3 Gastrointestinal Toxic Plants]] (eg. //Phytolacca Americana//, //Solanum sp.//)
      * [[:wikitox:2.3.4.4_hepatotoxic_plants|2.3.4.4 Hepatotoxic Plants]] (eg. //Bilghia sapida//, //Symphatum sp.//)
      * [[:wikitox:2.3.4.5_multisystem_toxic_plants|2.3.4.5 Multisystem Toxic Plants]] (eg. //Prunus sp.//, //[[:wikitox:ricinus_communis|Ricinus communis]]//)
      * [[:wikitox:2.3.4.6_neurotoxic_plants|2.3.4.6 Neurotoxic Plants]] (eg. //[[:wikitox:datura|Datura sp.]]//, //Nicotiana tabacum//)
      * [[:wikitox:2.3.4.7_hallucinogenic_plants|2.3.4.7 Hallucinogenic Plants]]

  * **2.3.5 Toxic Envenomations**
      *  [[:wikitox:2.3.5.1_arthropods|2.3.5.1 Arthropods]]
        * [[:wikitox:2.3.5.1.1_red_back_spiders|2.3.5.1.1 Red Back Spider]]
        * [[:wikitox:2.3.5.1.2_funnel_web_spiders|2.3.5.1.2 Funnel Web Spider]]
        * [[:wikitox:2.3.5.1.3_other_spiders|2.3.5.1.3 Other Spiders]]
      * [[:wikitox:2.3.5.2_marine_creatures|2.3.5.2 Marine Creatures]]
      *  [[:wikitox:2.3.5.3_reptiles|2.3.5.3 Reptiles and Snakes]]
        * [[:wikitox:2.3.5.3.1_south_east_asian_snakes|2.3.5.3.1 South East Asian Snakes]]
        * [[:wikitox:2.3.5.3.2_australian_venomous_snakes|2.3.5.3.2 Australian Venomous Snakes]]
      * 2.3.5.4 Amphibians

**2.4 Warfare, Terrorism, and Riot Control Agents**

  * **[[:wikitox:2.4.1_biological|2.4.1 Biological]]**
      * 2.4.1.1 Bacteria (eg. anthrax, plague)
      * 2.4.1.2 Toxins (eg. botulinum, staphylococcus B)
      * 2.4.1.3 Viruses (eg. smallpox)

  * **[[:wikitox:2.4.2_chemical|2.4.2 Chemical]]**
      * 2.4.2.1 Acetylcholinesterase Inhibitors (eg. sarin, soman, VX)
      * 2.4.2.2 Blister Agents (eg. mustard)
      * 2.4.2.3 Incapacitating Agents (eg. calmatives, BZ [3-quinuclidinyl benzilate])
      * 2.4.2.4 Tear Gases (eg. pepper spray)

**2.4.3 Nuclear/Radiological**

**3.0 Therapeutics**

**3.1 ABCs Resuscitation**

  * **[[:wikitox:3.1.1_hypotension|3.1.1 Hypotension]]**
  * **[[:wikitox:3.4.1_control_of_coma|3.1.2 Coma]]**
  * **[[:wikitox:3.1.3_seizures|3.1.3 Seizures]]**
**[[:wikitox:3.2_initial_management|3.2 Initial Management]]**
  *  [[:wikitox:3.2.1_assessment_skills|3.2.1 Assessment Skills]]
      * [[:wikitox:3.2.1.1_differential_diagnosis|3.2.1.1 Differential Diagnosis]]
      * [[:wikitox:3.2.1.2_signs_and_symptoms|3.2.1.2 Signs and Symptoms]]
      * [[:wikitox:3.2.1.3_toxidromes|3.2.1.3 Toxidromes]]
  *  [[:wikitox:3.2.2_decontamination_strategies|3.2.2 Decontamination Strategies]]
      * [[:wikitox:3.2.2.1_dermal|3.2.2.1 Dermal]]
      *  [[:wikitox:3.2.2.2_gastrointestinal_decontamination|3.2.2.2 Gastrointestinal]]
        * [[:wikitox:3.2.2.2.1_emesis|3.2.2.2.1 Emesis]]
        * [[:wikitox:3.2.2.2.2_gastric_lavage|3.2.2.2.2 Gastric lavage]]
        * [[:wikitox:3.2.2.2.3_activated_charcoal|3.2.2.2.3 Activated charcoal]]
        * [[:wikitox:3.2.2.2.4_whole_bowel_irrigation_lavage|3.2.2.2.4 Whole bowel irrigation (lavage)]]
      * [[:wikitox:3.2.2.3_ocular|3.2.2.3 Ocular]]
  * **[[:wikitox:3.2.3_enhance_elimination_techniques|3.2.3 Enhance Elimination Techniques]]**
      * [[:wikitox:3.2.3.1_extracorporeal_removal|3.2.3.1 Extracorporeal Removal]]
      * [[:wikitox:3.2.2.2.4_whole_bowel_irrigation_lavage|3.2.3.2 Gastrointestinal Dialysis]]
      * 3.2.3.3 Urinary Approaches

**3.3 Pharmacological Basis of Antidote Use**

  * **3.3.1 Antagonize Effects of Poison**
      * 3.3.1.1 Enzyme Inhibitors (eg. [[:wikitox:3.3.1.1.1_physostigmine|physostigmine]])
      * 3.3.1.2 Enzyme Reactivators (eg. pralidoxime)
      * 3.3.1.3 Physiological Antagonists (eg. calcium, [[:wikitox:3.3.1.3.2_glucagon|glucagon]])
      * 3.3.1.4 Receptor Antagonists (eg. atropine, flumazenil, naloxone)
      * 3.3.1.5 Reducing Agent (eg. methylene blue, N-acetylcysteine)

  * **3.3.2 Dispositional Agents**
      * 3.3.2.1 Alcohol Dehydrogenase Antagonists
      * 3.3.2.2 Antivenoms/Antibodies
      * 3.3.2.3 Chelators
      * 3.3.2.4 Cyanide Antidotes
      * 3.3.2.5 Enzyme/Cofactor Replacement (eg. folinic acid, pyridoxine)
      * 3.3.2.6 Oxygen/Hyperbaric Oxygen

  * **3.3.3 Other Antidotes**
  * 3.3.3.1 Intravenous Lipid Emulsion - {{:wikitox:intravenous_lipid_emulsion.ppt|Intravenous lipid emulsion.ppt}}  [5.4 MB]

**3.4 Supportive and Other Care**

  * **[[:wikitox:3.4.1_adjunctive_therapy|3.4.1 Adjunctive Therapy]] (eg. granulocyte colony-stimulating factor)**
  * **[[:wikitox:2.1.11.2_anticonvulsants|3.4.2 Anticonvulsants]]**
  * **[[:wikitox:3.4.3.4_antiarrhythmics|3.4.3 Antidysrrhythmics]]**
  * **3.4.4 Control of Agitation**
  * **[[:wikitox:3.4.5_control_of_temperature|3.4.5 Control of Temperature]]**
  * **3.4.6 Correct Electrolyte and Acid-Base Disturbances**
  * **3.4.7 Critical Care Procedures (eg. arterial catheter and central line placement-**
  * **[[:wikitox:3.4.8_fluid_resuscitation|3.4.8 Fluid Resuscitation]]**
  * **3.4.9 Patient Monitoring**
  * **[[:wikitox:3.4.10_pressor_agents_and_control_of_blood_pressure|3.4.10 Pressor Agents and Control of Blood Pressure]]**
  * **[[:wikitox:3.4.11_protect_airway_ventilation_manage_airway_injury|3.4.11 Protect Airway, Ventilation and Manage Airway Injury]]**
  * **3.4.12 Psychiatric Issues**
  * **3.4.13 Social Issues**
  * **3.4.14 Transplantation**
  * **[[:wikitox:3.4.15_rhabdomyolysis|3.4.15 Rhabdomyolysis]]**
  * **[[:wikitox:anaphylaxis|3.4.16 Management of Anaphylaxis]]**
**3.5 Drug & Alcohol Syndromes**

  * **[[:wikitox:3.5.1_drug_and_alcohol_issues|3.5.1 Alcohol]]**
  * **[[:wikitox:3.5.2_opioid_withdrawal|3.5.2 Opioid]]**
  * **[[:wikitox:3.5.3.1_benzodiazepine_withdrawal|3.5.3 Sedative-Hypnotic]]**
  * **3.5.4 Stimulant and Nicotine**
  * **3.5.5 Mixed Pattern**
**4.0 Assessment and Population Health**

**[[:wikitox:4.1_criteria_for_causal_inference|4.1 Criteria for Causal Inference]]**
  * **4.1.1 Biological Plausibility**
  * **4.1.2 Consistency**
  * **4.1.3 Dose-Response Relationship (biological gradient)**
  * **4.1.4 Specificity (of exposure or outcome)**
  * **4.1.5 Strength of Association**
  * **4.1.6 Temporal Relationship**
**[[:wikitox:4.2_information|4.2 Information]]**
  * **4.2.1 Consultation Resources (eg. databases, National Library of Medicine)**
  * **4.2.2 Surveys and Surveillance (eg. poison center data, National Report on Human Exposures**
**4.3 Monitoring**

  * **4.3.1 Biological Monitoring and Biomarkers (eg. population norms, indicators of excessive exposure)**
  * **4.3.2 Environmental Sampling/Exposure Monitoring**
**4.4 Occupational Assessment and Prevention**

  * **4.4.1 Medical Surveillance**
  * **4.4.2 Personal Protective Equipment**
  * **4.4.3 Preemployment Screening**
  * **4.4.4 Workplace Safety Engineering**
**4.5 Principles of Epidemiology and Statistics**

  * **4.5.1 Statistical Concepts (eg. interpretation of Pvalue, power calculation)**
  * **4.5.2 Study Design**
      * 4.5.2.1 Basic Types (eg. case series, randomized controlled trial)
      * 4.5.2.2 Basics of Validity/Generalizability (eg. bias, confounding, randomisation
      * 4.5.2.3 Measurements (eg. sensitivity, predictive value, limits of detection)
      * 4.5.2.4 Measures of Association (eg. odds ratios)

**4.6 Regional Poison Centers**

  * **4.6.1 Administration/Organization**
  * **4.6.2 Consultation at a Distance**
  * **4.6.3 Education**
  * **4.6.4 Prevention**
  * **4.6.5 Surveillance/Interaction With Other Professional Health Organizations**
  * **4.6.6 Triage**
**4.7 Response to Hazardous Materials (Hazmat) Incidents, Including Terrorism**

  * **4.7.1 Chemical Weapons Convention and Other Treaties**
  * **4.7.2 Decontamination (eg. patients and responders)**
  * **4.7.3 Incident Command System, Site Safety, and Control Zones**
  * **4.7.4 Incident Response Planning and Emergency Preparedness**
  * **4.7.5 National Pharmaceutical Stockpile: Deployment**
  * **4.7.6 National Response Team: Federal Agency Coordination**
  * **4.7.7 Regulatory and Legal Background (eg. Hazardous Waste Operations**
**4.8 Risk**

  * **4.8.1 Risk Assessment**
      * 4.8.1.1 Carcinogenicity Testing
      * 4.8.1.2 Extrapolation From High to Low Dose
      * 4.8.1.3 Extrapolation of Animal Studies to Humans
      * 4.8.1.4 Human Epidemiological Studies in Risk Assessment
      * 4.8.1.5 Interpretation of Key Terms (eg, recommended exposure limit [REL])
      * 4.8.1.6 No Observed and Lowest Observed Adverse Effect Levels (NOAEL, LOAEL)
      * 4.8.1.7 Role of Risk Assessment in Formulating Regulations
      * 4.8.1.8 Target Risks (eg. 10 or 10 )
      * 4.8.1.9 “Uncertainty Factors” (reasons for them, approximate values)

  * **4.8.2 Risk Perception and Risk Communication**
**4.9 Role of Federal and International Agencies in Toxicology**

  * **4.9.1 Agency for Toxic Substances and Disease Registry (ATSDR)**
  * **4.9.2 Centers for Disease Control and Prevention (CDC)**
  * **4.9.3 Consumer Product Safety Commission (CPSC)**
  * **4.9.4 Environmental Protection Agency (EPA)**
  * **4.9.5 Food and Drug Administration (FDA)**
  * **4.9.6 Health Resources and Services Administration (HRSA)**
  * **4.9.7 National Institute of Occupational Safety and Health (NIOSH)**
  * **4.9.8 Occupational Safety and Health Administration (OSHA)**
  * **4.9.9 World Health Organization (WHO)**
**4.10 Toxic Outbreaks of Historical Significance**

**5.0 Analytical and Forensic Toxicology**

**[[:wikitox:5.1_assay_methods_and_interpretation|5.1 Assay Methods and Interpretation]]**
  * **5.1.1 Clinical Drug Testing**
      * 5.1.1.1 Confirmatory Tests
        * 5.1.1.1.1 Atomic Absorption
        * 5.1.1.1.2 Gas Chromatography/Mass Spectrometry (GC/MS)
        * 5.1.1.1.3 High-Pressure Liquid Chromatography (HPLC)
      * 5.1.1.2 Screening Tests
        * 5.1.1.2.1 Gas Chromatography (GC)
        * 5.1.1.2.2 Immunoassays (eg, enzyme-multiplied immunoassay technique EMIT
        * 5.1.1.2.3 Colorimetric Tests (eg, color tests, thin layer chromatography)
      * 5.1.1.3 Serum/Blood Drug Levels and Interpretation
      * 5.1.1.4 Urine Drug Testing
        * 5.1.1.4.1 Interpretive Challenges (eg, benzodiazepines, opioids)
        * 5.1.1.4.2 Adulteration Techniques
        * 5.1.1.4.3 Analytical Limitations and Interferences

  * **5.1.2 Hair Analysis**
  * **5.1.3 Laboratory Issues**
      * 5.1.3.1 Point of Care Testing
      * 5.1.3.2 Quality Assurance/Quality Control

  * **5.1.4 Special Toxicology Testing**
      * 5.1.4.1 Heavy Metal Screens
      * 5.1.4.2 Cholinesterase Determinations

  * **5.1.5 Therapeutic Drug Monitoring**
**5.2 Laboratory and Other Diagnostic Assessments**

  * **[[:wikitox:anion_gap_acidosis|5.2.1 Anion Gap]]**
  * **5.2.2 Blood Gases and Co-oximetry**
  * **5.2.3 Electrolytes**
  * **5.2.4 Hematologic and Coagulation Abnormalities**
  * **5.2.5 Liver Function Tests**
  * **5.2.6 Osmolality**
  * **5.2.7 Renal Manifestations (eg. urine color, crystals)**
  * **5.2.8 Other Supportive Testing**
      * 5.2.8.1 Diagnostic Imaging
      * 5.2.8.2 Electroencephalography
      * 5.2.8.3 Electrocardiography
      * 5.2.8.4 Electromyography/Nerve Conduction Studies

**5.3 Forensics**

  * **5.3.1 Chain of Custody**
  * **5.3.2 Clandestine Laboratories**
  * **5.3.3 Definition and Scheduling of Controlled Substances**
  * **5.3.4 Interpretation of Postmortem Drug Levels**
  * **5.3.5 Necrokinetics**
  * **5.3.6 Selection of Postmortem Specimens**
  * **5.3.7 Special Issues**
      * 5.3.7.1 Meconium
      * 5.3.7.2 Vitreous Humor

**5.4 Legal Ethanol**

  * **5.4.1 Alcohol and the Law**
  * **5.4.2 Alcohol-Induced Psychomotor Impairment**
  * **5.4.3 Blood and Urine Alcohol Analysis**
  * **5.4.4 Breath Alcohol Analysis**
  * **5.4.5 Collection and Storage of Alcohol Specimens**
  * **5.4.6 Disposition of Alcohol**
  * **5.4.7 Saliva and Other Media**
**5.5 Medical Legal Issues (eg. role of expert witness)**

**5.6 Workplace Drug Test Interpretation**

  * **5.6.1 Cutoffs**
  * **5.6.2 Guidelines for Federal Workplace Drug Testing Programs**
  * **5.6.3 Role of Medical Review Officer (MRO)**
**6.0 Poisons Centre Operations**

  * **[[:wikitox:6.1_guidelines_for_training_poisons_centre_staff|6.1 Guidelines for training poisons centre staff]]**