CHAPTER 6
Toxicology
Jennie A. Buchanan, MD, Carrie D. Mendoza, MD,
Sean H. Rhyee, MD, MPH, and Jason Hoppe, DO
Differential Diagnosis by Chief Complaint 314
Toxidromes 314
Principles of Gastrointestinal Decontamination 315
INDUCEDEMESIS 315
GASTRICLAVAGE 316
ACTIVATEDCHARCOAL 317
WHOLE-BOWELIRRIGATION 317Principles of Enhanced Elimination 318
MULTIPLE-DOSEACTIVATEDCHARCOAL 319
URINARYALKALINIZATION 319
HEMODIALYSIS 319ECG Principles in Toxicology 320
Alcohols 320
ETHANOL 320
METHANOL 322
ETHYLENEGLYCO L 323
ISOPROPANOL(ISOPROPYLALCOHOL) 323Antidepressants 324
TRICYCLICANTIDEPRESSANTS 324
SELECTIVESEROTONINREUPTAKEINHIBITORS 327
MONOAMINEOXIDASEINHIBITORS 328
NEWERANTIDEPRESSANTS 329Antibiotics and Antiretrovirals 329
ISONIAZID 329
REVERSETRANSCRIPTASEINHIBITORS 330Anticholinergics/Cholinergics 331
ANTICHOLINERGICS 331
CHOLINERGICS 332