Goldfrank’s Toxicologic Emergencies is known worldwide as the most comprehensive and authoritative reference available on the management of poisoned and overdosed patients. This trusted classic covers all toxic substances –- including drugs, plants, household and industrial chemicals, and heavy metals. The new edition is both an outstanding educational resource and a valuable clinical companion. Much of the educational material is now available on the new online learning center, and more clinically-relevant figures and tables have been added to the book. Here's why Goldfrank's is known worldwide as the field's leading text: General Approach to Medical Toxicology; The Biochemical and Molecular Basis of Medical Toxicology; The Pathophysiologic Basis of Medical; Toxicology: The Organ System Approach; The Clinical Basis of Medical Toxicology: Analgesics and Nonprescription Medications; Prescription Medications Psychopharmacologic Medications; Alcohols and Drugs of Abuse; Food Poisoning; Botanicals; Heavy Metals; Household Toxins; Pesticides; Occupational and Environmental Toxins; Toxic Envenomations; V. Special Populations; Preventive, Psychosocial, Nursing, Epidemiologic, Research & Legal Perspectives. Table of Contents Table of Antidotes in Depth Contributors Preface Acknowledgments 1. Historical Principles and Perspectives, Paul M. Wax 2. Toxicologic Plagues and Disasters in History, Paul M. Wax PART A: THE GENERAL APPROACH TO MEDICAL TOXICOLOGY 3. Initial Evaluation of the Patient: Vital Signs and Toxic Syndromes, Lewis S. Nelson, Neal A. Lewin, Mary Ann Howland, Robert S. Hoffman, Lewis R. Goldfrank, and Neal F. Flomenbaum 4. Principles of Managing the Acutely Poisoned or Overdosed Patient, Lewis S. Nelson, Neal A. Lewin, Mary Ann Howland, Robert S. Hoffman, Lewis R. Goldfrank, and Neal F. Flomenbaum 5. Diagnostic Imaging, David T. Schwartz 6. Laboratory Principles, Petrie M. Rainey 7. Techniques Used to Prevent Gastrointestinal Absorption, Anne-Bolette J. Christophersen and Lotte C.G. Hoegberg A1. Syrup of Ipecac, Mary Ann Howland A2. Activated Charcoal, Mary Ann Howland A3. Whole-Bowel Irrigation and Other Intestinal Evacuants, Mary Ann Howland 8. Pharmacokinetic and Toxicokinetic Principles, Mary Ann Howland 9. Principles and Techniques Applied to Enhance Elimination, David S. Goldfarb 10. Use of The Intensive Care Unit, Mark A. Kirk PART B: THE FUNDAMENTAL PRINCIPLES OF MEDICAL TOXICOLOGY Section 1: Biochemical and Molecular Basis 11. Chemical Principles, Stephen J. Traub and Lewis S. Nelson 12. Biochemical and Metabolic Principles, Kurt C. Kleinschmidt and Kathleen A. Delaney 13. Neurotraansmitters and Neuromodulators, Steven C. Curry, Kirk C. Mills, Anne-Michalle Ruha, and Ayrn D. O'Connor 14. Withdrawal Principles, Richard J. Hamilton Section 2: Pathophysiologic Basis: Organ Systems 15. Thermoregulatory Principles, Susi U. Vassallo and Kathleen A. Delaney 16. Fluid, Electrolyte, and Acid-Based Principles, Alan N. Charney and Robert S. Hoffman 17. Psychiatric Principles, Kishor Malavade and Mark R. Serper 18. Neurologic Principles, Rama B. Rao 19. Ophthalmic Principles, Adhi Sharma 20. Otolaryngologic Principles, William K. Chiang 21. Respiratory Principles, Andrew Stolbach and Robert S. Hoffman 22. Electrophysiologic and Electrocardiographic Principles, Cathleen Clancy 23. Hemodynamic Principles, Robert A. Hessler 24. Hematologic Principles, Marco L.A. Sivilotti 25. Gastrointestinal Principles, Richard J. Church and Kavita M. Babu 26. Hepatic Principles, Kathleen A. Delaney 27. Renal Principles, Donald A. Feinfeld and Nikolas B. Harbord 28. Genitourinary Principles, Jason Chu 29. Dermatologic Principles, Neal A. Lewin and Lewis S. Nelson Section 3: Special Populations 30. Reproductive and Perinatal Principles, Jeffrey S. Fine 31. Pediatric Principles, Jeffrey S. Fine 32. Geriatric Principles, Judith C. Ahronheim and Mary Ann Howland 33. Postmortem Toxicology, Rama B. Rao and Mark Flomenbaum SC1. Organ Procurement from Poisoned Patients, Rama B. Rao PART C: THE CLINICAL BASIS OF MEDICAL TOXICOLOGY Section 1: Case Studies A. Analgesics and Antiinflammatory Medications 34. Acetaminophen, Robert G. Hendrickson A4. N -Acetylcysteine, Mary Ann Howland and Robert G. Hendrickson 35. Salicylates, Neal E. Flomenbaum A5. Sodium Bicarbonate, Paul M. Wax 36. Nonsteroidal Antiinflammatory Drugs, William J. Holubek 37. Colchicine, Podophyllin, and the Vinca Alkoloids, Joshua G. Schier SC2. Intrathecal Administration of Xenobiotics, Rama B. Rao 38. Opioids, Lewis S. Nelson and Dean Olsen A6. Opioid Antagonists, Mary Ann Howland and Lewis Nelson B. Foods, Dietary and Nutritional Agents 39. Dieting Agents and Regimens, Jeanna M. Marraffa 40. Iron, Jeanmarie Perrone A7. Deferoxamine, Mary Ann Howland 41. Vitamins, Beth Y. Ginsburg 42. Essential Oils, S. Eliza Halcomb 43. Herbal Preparations, Oliver L. Hung 44. Athletic Performance Enhancers, Susi U. Vassallo 45. Food Poisoning, Michael G. Tunik 46. Botulism, Howard L. Geyer A8. Botulinum Antitoxin, Lewis R. Goldfarb and Howard L. Geyer C. Pharmaceuticals 47. Anticonvulsants, Suzanne Doyon A9. L-Carnitine, Mary Ann Howland 48. Antidiabetics and Hypoglycemics, George M. Bosse A10. Dextrose, Larissa I. Velez and Kathleen A. Delaney A11. Octreotide, Mary Ann Howland 49. Thyroid and Antithyroid Medications, Nicole C. Bouchard 50. Antihistamines and Decongestants, Anthony J. Tomassoni and Richard S. Weisman A12. Physostigmine Salicylate, Mary Ann Howland 51. Antimigraine Medications, Jason Chu 52. Antineoplastics Overview, Richard Y. Wang 53. Antineoplastics: Methotrexate, Richard Y. Wang A13. Leucovorin (Folinic Acid) and Folic Acid, Mary Ann Howland A14. Glucarpidase, (Carboxypeptidas G2), Silas W. Smith SC3. Extravasation of Xenobotics, Richard Y. Wang 54. Miscellaneous Antineoplastics, Richard Y. Wang 55. Pharmaceutical Additives, Sean P. Nordt and Lisa E. Vivero D. Antimicrobials 56. Antibacterials, Antifungals, and Antivirals, Christine M. Stork 57. Antituberculous Medications, Christina H. Hernon and Edward W. Boyer 58. Antimalarials, J. Dave Barry E. Cardiopulmonary Medications 59. Anticoagulants, Mark Su A16. Vitamin K, Mary Ann Howland A17. Protamine, Mary Ann Howland 60. Calcium Channel Blockers, Francis DeRoos A18. Insulin-Eyglycemia Therapy, William Kerns II 61. B-Adrenergic Antagonists, Jeffrey R. Brubacher A19. Glucagon, Mary Ann Howland 62. Other Antihypertensives, Francis DeRoos 63. Antidysrhythmics, Lewis S. Nelson and Neal A. Lewin 64. Cardioactive Steroids, Jason B. Hack A20. Digoxin-Specific Antibody Fragments, Mary Ann Howland 65. Methylxanthines and Selective B2 Adrenergic Agonists, Robert J. Hoffman F. Anesthetics and Related Medications 66. Local Anesthetics, David R. Schwartz and Brian Kaufman A21. Intravenous Fat Emulsions, Todd Bania 67. Inhalational Anesthetics, Brian Kaufman and Martin Griffel 68. Neuromuscular Blockers, Kenneth M. Sutin A22. Dantrolene Sodium, Kenneth M. Sutin G. Psychotropic Medications 69. Antipsychotics, David Juurlink 70. Lithium, Howard A. Greller 71. Monoamine Oxidase Inhibitors, Alex F. Manini 72. Serotonin Reuptake Inhibitors and Atypical Antidepressants, Christine M. Stork 73. Cyclic Antidepressants, Erica L. Liebelt 74. Sedative-Hynotics, David C. Lee and Kathy Ferguson A23. Flumazenil, Mary Ann Howland H. Substances of Abuse 75. Amphetamines, William K. Chiang 76. Cocaine, Jane M. Prosser and Robert S. Hoffman SC4. Internal Concealment of Xenobiotics, Jane M. Prosser A24. Benzodiazepines, Robert S. Hoffman, Lewis S. Nelson, and Mary Ann Howland 77. Ethanol, Luke Yip A25. Thiamine Hydrochloride, Robert S. Hoffman 78. Ethanol Withdrawal, Jeffrey Gold and Lewis S. Nelson 79. Disulfiram and Disulfiram-Like Reactions, Edwin K. Kuffner 80. Y-Hydroxybutyric Acid, Brenna M. Farmer 81. Inhalants, Heather Long 82. Hallucinogens, Kavita M. Babu 83. Cannabinoids, Michael A. McGuigan 84. Nicotine, Sari Soghoian 85. Phencyclidine and Ketamine, Ruben Olmedo 86. Aluminum, Brenna M. Farmer I. Metals 87. Antimony, Asim F. Tarabar 88. Arsenic, Stephen W. Munday and Marsha Ford A26. Dimercaprol (British Anti-Lewisite or Bal), Mary Ann Howland 89. Bismuth, Rama B. Rao 90. Cadmium, Stephen J. Traub and Robert s. Hoffman 91. Chromium, Steven B. Bird 92. Cobalt, Gar Ming Chan 93. Copper, Lewis S. Nelson 94. Lead, Fred M. Henretig A27. Succimer (2,3-Dimercaptosuccinic Acid), Mary Ann Howland A28. Edetate Calcium Disodium (CaNa2EDTA), Mary Ann Howland 95. Manganese, Sari Soghoian 96. Mercury, Young-Jin Sue 97. Nickel, John Curtis and David A. Haggerty 98. Selenium, Diane P. Calello 99. Silver, Melisa W. Lai Becker and Michele Burns Ewald 100. Thallium, Maria Mercurio and Robert S. Hoffman A29. Prussian Blue, Robert S. Hoffman 101. Zinc, Nima Majlesi J. Household Products 102. Antiseptics, Disinfectants, and Sterilants, Paul M. Wax 103. Camphor and Moth Repellents, Edwin K. Kuffner 104. Caustics, Jessica A. Fulton 105. Hydrofluoric Acid and Fluorides, Mark Su A30. Calcium, Mary Ann Howland 106. Hydrocarbons, David D. Gummin 107. Toxic Alcohols, Sage W. Wiener SC5. Diethylene Glycol, Joshua G. Schier A31. Fomepizole, Mary Ann Howland A32. Ethanol, Mary Ann Howland K. Pesticides 108. Pesticides: An Overview with a Focus on Principles and Rodenticides, Neal F. Flomenbaum 109. Barium, Andrew Dawson 110. Sodium Monofluoroacetate and Fluroacetamide, Fermin Barrueeto Jr. 111. Phosphorus, Michael Beuhler 112. Strychnine, Yiu-Cheung Chan 113. Insecticides: Organic Phosphorus Compounds and Carb... Lewis S. Nelson, MD, FACEP, FACMT (New York, NY) , Director, Medical Toxicology Fellowship Program; Associate Director, New York City Poison Center; Attending Physician, Department of Emergency Medicine, Bellevue Hospital Center and New York University Medical Center; Assistant Professor of Emergency Medicine, New York University School of Medicine, New York, New York. Neal A. Lewin, MD, FACP, FACEP, FACMT (New York, NY) , Director of Didactic Education NYULMC/Bellevue Emergency Medicine Residency Program The Stanley and Fiona Druckenmiller Professor of Emergency Medicine and Medicine (Pharmacology), Attending Physician, Department of Emergency Medicine, Bellevue Hospital Center and New York University Medical Center; Clinical Associate Professor of Emergency Medicine and Medicine (Clinical Pharmacology), New York University School of Medicine; Consultant, New York City Poison Center, New York, New York. Mary Ann Howland, PharmD, DABAT, FAACT (New York, NY) , Clinical Professor of Pharmacy, St. John’s University College of Pharmacy; Consultant, Department of Emergency Medicine, Bellevue Hospital Center and New York University Medical Center; Senior Consultant in Residence, New York City Poison Center, New York, New York. Robert S. Hoffman, MD, FAACT, FACMT (New York, NY) , Director, New York City Poison Center; Attending Physician, Department of Emergency Medicine, Bellevue Hospital Center and New York University Medical Center; Associate Professor, Emergency Medicine and Medicine (Clinical Pharmacology), New York University School of Medicine, New York, New York. Lewis R. Goldfrank, MD, FACEP, FAAEM, FAACT, FACMT, FACP (New York, NY) , Professor and Chair, Department of Emergency Medicine, New York University School of Medicine; Director, Emergency Medicine, Bellevue Hospital Center and New York University Medical Center; Medical Director, New York City Poison Center, New York, New York. Neal E. Flomenbaum, MD, FACP, FACEP (New York, NY) , Emergency Physician-in-Chief, New York Presbyterian Hospital; Professor of Clinical Medicine, Weill Medical College, Cornell University; Consultant, New York City Poison Center, New York, New York.