Toxicology: getting the basics right is essential for good outcomes.
As GPs, we see toxicology as poisoning or overdose … or extreme pharmacology. Call it what you like, but if you’re in front-line medicine, you’re going to see it frequently.
Poisoning is a major problem in our communities. According to a 2018 article in the MJA looking at information from the Australian Poisons Information Centres1: “the most frequent exposure circumstances were unintentional exposure (64.4% of exposures) and medication error (18.1%). The substances most frequently involved in poisonings were household cleaning agents (10.2% of substances involved) and paracetamol-containing analgesics (7.3%). The age groups most frequently affected were adults (40.1%) and toddlers (36.0%).”
Having a good understanding of medication pharmacology, pharmacokinetics and pharmacodynamics means that you can anticipate what’s going to happen following an intentional or accidental overdose, and have insight into the management of these cases.
This month we present a webinar excerpt with Dr Geoff Couser, who’s an Emergency Physician at the Royal Hobart Hospital. Dr Couser gives an introduction to Toxicology, and explains how sticking to the basics is so important when managing patients who present with overdose.
Dr Couser highlights the approach of RRSIDEAD:
- Risk Assessment
- Supportive Care
- Enhanced Elimination
Listen to the discussion by clicking play below.
Toxicology is a big topic, and an important one.
There are a few take home messages from this webinar, including to do the basics well, and a reminder of the National Poison Centre Network Number: 13 11 26.
We don’t go into the finer details in this excerpt, but there are many great online resources out there for further reading – we’ve listed a few below.
What is your favourite “go to” resource for toxicology?
- Huynh, Alanna & Cairns, Rose & Brown, Jared & Lynch, Ann-Maree & Robinson, Jeff & Wylie, Carol & Buckley, Nick & Dawson, Andrew. (2018). Patterns of poisoning exposure at different ages: the 2015 annual report of the Australian Poisons Information Centres. The Medical Journal of Australia. 209. 1. 10.5694/mja17.01063.
- Life In the Fast Lane – Tox Lab
- NSW Poisons Information
- Useful summary of Toxidromes (USA Resource: Florida’s Poison Control Centres)