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Epidemiology
Some knowledge of the epidemiology of poisoning (toxicoepidemiology), preferably from your area, is useful as an aid to diagnosis when the history of ingestion is unclear. Common poisonings occur commonly. The poisons ingested vary substantially between countries and between urban and rural areas (where pesticides and herbicides are more common). They are also different for adults, adolescents and children. Though the medications ingested must to some extent reflect what is prescribed in the community, patients are far more likely to ingest some types of drugs (per prescription) than others (Buckley et al 1995).
A combination of knowledge of the possible toxic effects of drugs, the frequency with which these effects occur and the frequency with which these drugs are taken in overdose leads to a much more sensible approach to diagnosis than one based solely on a list of drugs reported to have caused a particular complication (see differential diagnosis).
REFERENCES
Buckley NA, Dawson AH, Whyte IM, McManus P & Ferguson N. Six years of self-poisoning in Newcastle: 1987-1992. Med J Aust 1995;162:190-193.
Buckley NA, Dawson AH, Whyte IM, McManus P & Ferguson N. Correlations between prescriptions and drugs taken in self-poisoning: Implications for prescribers and drug regulation. Med J Aust 1995;162:194-197.
Chan TY, Critchley JA. The spectrum of poisonings in Hong Kong: an overview. Veterinary & Human Toxicology 1994;36:135-137.
Jacobsen D, Frederichsen PS, Knutsen KM, Sorum Y, Talseth T, Odegaard OR. A prospective study of 1212 cases of acute poisoning: general epidemiology. Hum Toxicol 1984;3:93-106.
Litovitz TL, Felberg L, Soloway RA, Ford M, Geller R. 1994 annual report of the American Association of Poison Cont rol Centers Toxic Exposure Surveillance System. American Journal of Emergency Medicine 1995;13:551-597.
Meredith TJ. Epidemiology of poisoning. Pharmacology & Therapeutics 1993;59:251-256.
Senanayake N, Karalliedde L. Pattern of acute poisoning in a medical unit in central Sri Lanka. Forensic Science International 1988;36:101-104.
Whyte IM, Buckley NA. Progress in clinical toxicology: From case reports to toxicoepidemiology. Med J Aust 1995; 163(7):340-341.
Buckley NA. Poisoning and epidemiology: 'toxicoepidemiology'. Clin Exp Pharmacol Physiol 1998; 25(3-4):195-203.