Toxicology testing is an extremely valuable asset to the pharmacist in the evaluation and management of the poisoned patient. There is extensive use of toxicology screens and expensive and time-consuming quantitative analysis for toxins that could be more appropriately directed by the pharmacist who has an extensive background in toxicokinetics and pharmacology. The managed care environment mandates even more prudent use of toxicology testing. Application of the results of toxicology testing by the pharmacist can contribute to decisions regarding the patient's therapy and prognosis.
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References
1.
Litovitz TL, Felberg L, White S, et al: 1995 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med14:487-537, 1996
2.
Clark RF, Harchelroad F: Toxicology screening of the trauma patient: A changing profile. Ann Emerg Med20:151-153, 1991
3.
Mahoney JD, Gross PL, Stem TA, et al: Quantitative toxic serum screening in the management of suspected drug overdose . Am J Emerg Med8:16-22, 1990
4.
Brett AS: Implications of discordance between clinical impression and toxicology analysis in drug overdose. Arch Intern Med148:437-441, 1988
5.
Ashbourne JF, Olson KR, Khayam-Bashi H: Value of rapid screening for acetaminophen in all patients with intentional drug overdose. Ann Emerg Med18:1035-1038, 1989
6.
Kellerman AL, Fihn SD, LoGerfo JP, et al: Impact of drug screening in suspected overdose. Ann Emerg Med16:1206-1216, 1987
7.
Yerasi AB, Butts JD, Buth JD: Disposal of used fentanyl patches. Am J Health-Syst Pharm54:85-86, 1997
8.
Yip L, Dart DC, Gabow PA: Concepts and controversies in salicylate toxicity. Emerg Med Clinics N Am12:351-364, 1994
9.
Nierenberg DW, Semprebon M: The central nervous serotonin syndrome. Clin Pharmacol Ther53:84-88, 1993
10.
Skop BP, Finkelstein JA, Mareth TR: The serotonin syndrome associated with paroxetine, an over-the-counter cold remedy, and vascular disease. Am J Emerg Med12:642-644, 1994
11.
Ruis F: Fluoxetine and the serotonin syndrome. Ann Emerg Med24:983-985, 1994
12.
Smilkstein MJ, Knapp GL, Kulig KW, et al: Efficacy of oral N-acetylcysteine in the treatment of acetaminophen overdose: Analysis of the National Multicenter study. N Engl J Med319:1557-1562, 1988
13.
Ellenhom MJ, Barceloux DG (eds): Methanol, In Medical Toxicology—Diagnosis and Treatment of Human Poisoning. New York, NY, Elsevier, pp 801-805, 1988
14.
Bayer MJ: Recognition and management of digitalis intoxication: Implications for emergency medicine . Am J Emerg Med9:29-32, (suppl 1), 1991
15.
Amdisen A: Clinical features and management of lithium poisoning. Med Toxicol3:18-32, 1988
16.
Brody SL, Slovis CM: Recognition and management of complications related to cocaine abuse. Emerg Med Reports9:41-48, 1988
Doem A, Unger PF: Possible interference of flumazenil on benzodiazepine measurement in the blood and urine. Am J Emerg Med6:683, 1988
19.
Banner W, Bach P, Burk B, et al: Influence of assay methods on serum concentrations of digoxin during fab fragment treatment. Clin Toxicol30:259-267, 1992