⚠️ Toxicology · Schwartz Chapter 83

Toxidromes · decontamination · antidotes · elimination enhancement · poison control

Rapid assessment: airway, breathing, circulation, glucose, naloxone. Toxidrome-based recognition saves lives. Activated charcoal within 1 hour for most ingestions. Antidotes are available for <3% of poisonings – supportive care is paramount.

📋 Step 1 — Select toxidrome & clinical clues
📌 Toxicologic interventions & antidotes
📖 Schwartz Ch 83 (Toxicology)

Select toxidrome (cholinergic, anticholinergic, opioid, sympathomimetic, sedative), ingestion type, or specific poison clue → tool provides decontamination method, antidote (if available), elimination enhancement, and supportive care based on AAP/poison center guidelines.

✔️ Opioid toxidrome: miosis, respiratory depression → naloxone.
✔️ Cholinergic: SLUDGE, miosis → atropine + pralidoxime.
✔️ Anticholinergic: dilated pupils, dry skin, delirium → physostigmine (caution).
✔️ Acetaminophen: NAC within 8 hours prevents hepatotoxicity.
✔️ Salicylates: respiratory alkalosis + metabolic acidosis → urine alkalinization.
✔️ Iron: whole bowel irrigation + deferoxamine.
✔️ Always call Poison Control: 1-800-222-1222.
📘 Schwartz pearls: decontamination & elimination
• Activated charcoal 1 g/kg, avoid if hydrocarbon/caustic/airway unprotected.
• Whole bowel irrigation (GoLYTELY) for iron, lithium, sustained-release, body packers.
• Multiple-dose charcoal: theophylline, carbamazepine, phenobarbital.
• Alkaline diuresis (pH ≥7.5) for salicylates, phenobarbital.
• Hemodialysis: severe methanol/ethylene glycol, lithium, salicylate.