Current Awareness in Clinical Toxicology Editors: Damian Ballam Msc and Allister Vale MD

Current Awareness in Clinical Toxicology Editors: Damian Ballam MSc and Allister Vale MD

December 2014

CONTENTS General toxicology 8 Metals 32 Management 17 Pesticides 35 Drugs 19 Chemical warfare 37 Chemical incidents & 27 Plants 38 pollution Chemicals 28 Animals 38

CURRENT AWARENESS PAPERS OF THE MONTH

Position paper update: Whole bowel irrigation for gastrointestinal decontamination of overdose patients Thanacoody R, Caravati EM, Troutman WG, Höjer J, Benson BE, Hoppu K, Erdman A, Bedry R, Mégarbane B. Clin Toxicol 2014; online early: doi: 10.3109/15563650.2014.989326: Context A position paper on the use of whole bowel irrigation (WBI) was first published in 1997 by the American Academy of Clinical Toxicology (AACT) and the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) and updated in 2004. The aims of this paper are to briefly summarize the content of the 2004 Position Paper and to present any new data and recommendations. Methods A systematic review of the literature from January 2003 to February 28, 2013 was conducted using multiple online databases for articles concerning WBI for gastrointestinal decontamination. An evidence table was created for applicable articles. The authors produced the initial draft that was reviewed by AACT and EAPCCT.

Current Awareness in Clinical Toxicology is produced monthly for the American Academy of Clinical Toxicology by the Birmingham Unit of the UK National Poisons Information Service, with contributions from the Cardiff, Edinburgh, and Newcastle Units.

The NPIS is commissioned by Public Health England

Results The literature search produced 60 articles with the possibility of applicable human data. Based mainly on volunteer studies, WBI can be considered for potentially toxic ingestions of sustained-release or enteric-coated drugs particularly for those patients presenting later than 2 h after drug ingestion when activated charcoal is less effective. WBI can be considered for patients who have ingested substantial amounts of iron, lithium, or potassium as the morbidity is high and there is a lack of other potentially effective options for gastrointestinal decontamination. WBI can be considered for removal of ingested packets of illicit drugs in "body packers." However, controlled data documenting improvement in clinical outcome after WBI are lacking. WBI is contraindicated in patients with bowel obstruction, perforation, or ileus, and in patients with hemodynamic instability or compromised unprotected airways. WBI should be used cautiously in debilitated patients and in patients with medical conditions that might be further compromised by its use. The concurrent administration of activated charcoal and WBI might decrease the effectiveness of the charcoal. The clinical relevance of this interaction is uncertain. Conclusion WBI can facilitate removal of select toxicants from the gastrointestinal tract in some patients, but there is no convincing evidence from clinical studies that it improves the outcome of poisoned patients. There is no new evidence that would require a major revision of the conclusions of the 2004 position statement. Full text available from: http://dx.doi.org/10.3109/15563650.2014.989326

Characteristics of analytically confirmed 3-MMC-related intoxications from the Swedish STRIDA project Bäckberg M, Lindeman E, Beck O, Helander A. Clin Toxicol 2014; online early: doi: 10.3109/15563650.2014.981823: Background 3-Methylmethcathinone (3-MMC) is a synthetic cathinone stimulant structurally related to the new psychoactive substance (NPS) mephedrone (4-methylmethcathinone, 4-MMC). We describe a case series of analytically confirmed intoxications involving 3-MMC presented to emergency departments in Sweden and included in the STRIDA project. Study design Observational case series of consecutive patients with self-reported or suspected use of NPS presenting to hospitals in Sweden between August 2012 and March 2014. Methods NPS analysis was performed by a liquid chromatography–mass spectrometry (MS)/MS method that is updated with new substances as they appear. Data on clinical features were collected during Poisons Information Centre consultations and retrieved from medical records. Results 3-MMC was detected in 50 (6.4%) of the 786 cases included in the STRIDA project during the 20-month study period, with the peak occurring in August 2013. The age range of patients testing positive for 3-MMC was 17–49 years (median 24) and 76% of them were men. The 3-MMC concentration in serum ranged between 0.002 and 1.49 µg/mL (median, 0.091) and between 0.007 and 290 µg/mL (median, 3.05) in urine. Co-exposure to other NPS and/or traditional drugs was very common, and 3-MMC mono-intoxication was found in only 4 (8%) cases. The most frequent clinical features were tachycardia (48% of cases) and

agitation (42%). Other features included a reduced level of consciousness (32%), dilated pupils (24%), hallucinations (20%), diaphoresis (12%), seizures (8%), and hyperthermia (6%). Most patients (60%) needed hospital care for only 1 day but in 8% for 3 days or longer. Conclusion The majority of patients with analytically confirmed 3-MMC exposure had sympathomimetic features similar to those associated with mephedrone intoxication. However, the high incidence of co-exposure to other drugs makes the clinical interpretation difficult. Nevertheless, 3-MMC was associated with a high admittance rate to intensive care (30%), and detected in two cases with a fatal outcome, suggesting that 3-MMC is a harmful drug. Full text available from: http://dx.doi.org/10.3109/15563650.2014.981823

Understanding the availability, prevalence of use, desired effects, acute toxicity and dependence potential of the novel opioid MT-45 Siddiqi S, Verney CH, Dargan PI, Wood DM. Clin Toxicol 2014; online early: doi: 10.3109/15563650.2014.983239: Introduction 1-Cyclohexyl-4-(1,2-diphenylethyl)piperazine (MT-45) is a novel psychoactive substance available over the Internet. MT-45 is an opioid-like compound. This study provides an overview of availability, use and desired and unwanted effects of MT-45 through triangulation of available data sources. Methods Searches of the published scientific literature and 'grey' information sources, using the keywords 'MT 45', 'MT-45' and '1-cyclohexyl-4-(1,2-diphenylethyl)piperazine' were undertaken in June 2014 to identify information on the availability, prevalence of use and desired/unwanted effects of MT-45. In addition an Internet snapshot survey in English was undertaken in May 2014 to determine the availability and cost of MT-45. Results In June 2014 we were unable to identify any studies reporting the prevalence of use of MT- 45. The Internet snapshot study identified 17 Internet sites selling MT-45. Information on price was available from 9 sites, with the mean price of MT-45 decreased with increasing purchase amounts from US$57.60 ± 19.37 per gram for a 1-g purchase to US$3.36 ± 1.83 per gram for a 1-kg purchase. We identified one published scientific paper reporting on the acute harms in nine cases of analytically confirmed MT-45 toxicity, one US government report relating to two MT-45-related deaths and 20 user reports on Internet discussion forums relating to the use of MT-45. All these suggest that the desired and unwanted effects of MT-45 are similar to those seen with other opioids, and that the opioid-like unwanted effects may be reversed with the opioid antagonist naloxone. There were user reports of MT-45 being used in heroin withdrawal and of 'withdrawal symptoms' after use, suggesting that long-term use may be associated with dependency as seen with other opioids. Conclusions Combining published scientific literature and 'grey' information sources, we have demonstrated that MT-45 has opioid-like desired and unwanted effects. Whilst the information is limited at the moment, it has the potential to have similar dependence liability to other opioids. Full text available from: http://dx.doi.org/10.3109/15563650.2014.983239

The pharmacotherapy for pit viper envenoming in the United States: a brief retrospective on roots, recurrence, and risk Weinstein SA. Clin Toxicol 2014; online early: doi: 10.3109/15563650.2014.983240: Introduction

The report by Bush and colleagues ("Comparison of F(ab')2 versus Fab antivenom (AV) for pit viper envenomation: A prospective, blinded, multicentre, randomized clinical trial") in this issue of Clinical Toxicology presents the results of a controlled Phase-3 study comparing the therapeutic efficiency of two Fab AVs, equine-derived F(ab')2 and ovine-derived Fab (Fig. 1), for treating pit viper (crotaline) envenomation. The study was conducted at 18 clinical sites and included envenoming attributed to at least 12 identified crotaline species with the majority (102) of bites ascribed non-specifically as "rattlesnake" or "unidentified" bites. Most of the 114 patients ultimately included in the three study groups (F(ab')2/F(ab')2, F(ab')2 /placebo, and Fab/Fab) exhibited characteristics reasonably representative of commonly encountered envenomed patients in the US, for example, predominantly white males with a median age between 32.9 and 45.6 years. Children aged less than 10 years, and mostly in the F(ab')2 /F(ab')2 group, were also included. The study by Bush et al. (2014) provides encouraging support for the clinical efficiency of

F(ab')2 AV against North American pit viper venoms, as their study reports a notably lower percentage of patients who experienced late coagulopathy when respectively comparing the F(ab')2 /placebo (5.3%) and F(ab')2 /F(ab')2 (10.3%) groups with the Fab/Fab (29.7%) group. Also, although the overall adverse event incidence was similar in the F(ab')2 /F(ab')2 and Fab/Fab groups, adverse events associated with coagulopathy or hemorrhage (e.g., petechiae and gingival bleeding) were reported in 8.1 – 9.3% of those in the F(ab')2 /placebo and F(ab')2 /F(ab')2 groups in comparison to 24.4% in the Fab/Fab group. Of the nine patients who reportedly experienced serious adverse events, two-thirds were in the F(ab')2 /F(ab')2 group, but the authors indicate that all of these were not associated with the AVs, and provide several examples supporting their assertion. There were no reported life- threatening anaphylactic reactions in any of the groups. Full text available from: http://dx.doi.org/10.3109/15563650.2014.983240

Gila monster (Heloderma suspectum) envenomation: descriptive analysis of calls to United States Poison Centers with focus on Arizona cases French RNE, Brooks DE, Ruha AM, Shirazi FM, Chase PB, Boesen KJ, Walter FG. Clin Toxicol 2014; online early: doi: 10.3109/15563650.2014.988791: Background The Gila monster (Heloderma suspectum) is a venomous lizard native to the deserts of southwestern United States (US) and northern Mexico. The purpose of this study was to describe human exposures to Gila monsters reported to US poison control centers (PCCs) with a focus on Arizona cases. Methods The American Association of Poison Control Centers' National Poison Data System (NPDS) was used to access and retrospectively review all calls to US PCCs, concerning Gila monsters between January 1, 2000 and October 31, 2011. In addition, detailed records from the two Arizona PCCs were reviewed for the same time period.

Results A total of 319 calls regarding Gila monsters were identified in the NPDS. Of these, 105 (33%) were human exposures; most (79%) occurred in males. A total of 71 (68%) of these 105 cases were referred to a health care facility (HCF); 30 (29%) were managed on-site. Of the 71 HCF referrals, 36 (51%) were discharged home and 17 (24%) were admitted. Most (65%) admissions were to an intensive care unit (ICU). Arizona's PCCs received 70 unique reports of Gila monster bite. Most (77%) of the bites in Arizona involved an upper extremity. Eight (11%) involved patients under the age of 18 years. Eleven (16%) Arizona cases were work-related. Twenty-eight (40%) of the 70 bites in Arizona were evaluated in a HCF, but not admitted. Eleven (16%) were admitted, of which five were to an ICU. Six patients had edema of airway structures; three required emergent airway management, one by cricothyrotomy. There were no deaths. Conclusion Gila monster bites are uncommon. Many cases did not require hospitalization. Edema of airway structures is an infrequent, but life-threatening complication. Full text available from: http://dx.doi.org/10.3109/15563650.2014.988791

Poisoning in the United States: 2012 emergency medicine report of the National Poison Data System Dart RC, Bronstein AC, Spyker DA, Cantilena LR, Seifert SA, Heard SE, Krenzelok EP. Ann Emerg Med 2014; online early: doi: 10.1016/j.annemergmed.2014.11.001: Abstract and full text available from: http://dx.doi.org/10.1016/j.annemergmed.2014.11.001

Rapid and equivalent systemic bioavailability of the antidotes HI-6 and dicobalt edetate via the intraosseous and intravenous routes Hill SL, Thomas SHL, Flecknell PA, Thomas AA, Morris CM, Henderson D, Dunn M, Blain PG. Emerg Med J 2014; online early: doi: 10.1136/emermed-2014-204171: Abstract and full text available from: http://dx.doi.org/10.1136/emermed-2014-204171

Respiratory complications of organophosphorus nerve agent and insecticide poisoning – Implications for respiratory and critical care Hulse EJ, Davies JO, Simpson AJ, Sciuto AM, Eddleston M. Am J Respir Crit Care Med 2014; 190: 1342-54. Abstract and full text available from: http://dx.doi.org/10.1164/rccm.201406-1150CI

In vitro and in vivo toxicological studies of V nerve agents: molecular and stereoselective aspects Reiter G, Müller S, Hill I, Weatherby K, Thiermann H, Worek F, Mikler J. Toxicol Lett 2014; 232: 438-48. Abstract and full text available from: http://dx.doi.org/10.1016/j.toxlet.2014.11.010

Neurological outcomes associated with low-level manganese exposure in an inception cohort of asymptomatic welding trainees Baker MG, Criswell SR, Racette BA, Simpson CD, Sheppard L, Checkoway H, Seixas NS. Scand J Work Environ Health 2014; online early: doi: 10.5271/sjweh.3466: Abstract and full text available from: http://www.sjweh.fi/show_abstract.php?abstract_id=3466

Prevalence of carbon monoxide poisoning in patients presenting to a large emergency department Roth D, Schreiber W, Herkner H, Havel C. Int J Clin Pract 2014; 68: 1239-45. Abstract and full text available from: http://dx.doi.org/10.1111/ijcp.12432

Associations of respiratory symptoms and lung function with measured carbon monoxide concentrations among nonsmoking women exposed to household air pollution: the RESPIRE trial, Guatemala Pope D, Diaz E, Smith-Sivertsen T, Lie RT, Bakke P, Balmes JR, Smith KR, Bruce NG. Environ Health Perspect 2014; online early: doi: 10.1289/ehp.1408200: Abstract and full text available from: http://dx.doi.org/10.1289/ehp.1408200

Intravenous lipid emulsion therapy does not improve hypotension compared to sodium bicarbonate for tricyclic antidepressant toxicity: a randomized, controlled pilot study in a swine model Varney SM, Bebarta VS, Vargas TE, Boudreau S, Castaneda M. Acad Emerg Med 2014; 21: 1212-9. Abstract and full text available from: http://dx.doi.org/10.1111/acem.12513

Intraosseous versus intravenous infusion of hydroxocobalamin for the treatment of acute severe cyanide toxicity in a swine model Bebarta VS, Pitotti RL, Boudreau S, Tanen DA. Acad Emerg Med 2014; 21: 1203-11. Abstract and full text available from: http://dx.doi.org/10.1111/acem.12518

Comparing electronic news media reports of potential bioterrorism-related incidents involving unknown white powder to reports received by the United States centers for disease control and prevention and the federal bureau of investigation: U.S.A., 20092011 Fajardo GC, Posid J, Papagiotas S, Lowe L. J Forensic Sci 2014; online early: doi: 10.1111/1556-4029.12608: Abstract and full text available from: http://dx.doi.org/10.1111/1556-4029.12608

Maternal lead exposure and risk of congenital heart defects occurrence in offspring Liu Z, Yu Y, Li X, Wu A, Mu M, Li N, Deng Y, Jin X, Li S, Lin Y, Chen X, Wang F, Zhu J. Reprod Toxicol 2014; 51: 1-6. Abstract and full text available from: http://dx.doi.org/10.1016/j.reprotox.2014.11.002

Pregnancy outcomes in women with inflammatory bowel disease following exposure to thiopurines and antitumor necrosis factor drugs: a systematic review with meta-analysis Mozaffari S, Abdolghaffari AH, Nikfar S, Abdollahi M. Hum Exp Toxicol 2014; online early: doi: 10.1177/0960327114550882: Abstract and full text available from: http://dx.doi.org/10.1177/0960327114550882

TOXICOLOGY Vlcková H, El-Beqqali A, Novákova L, Solich P, Abdel- Rehim M. Analytical toxicology Determination of amphetamine and methadone in human Anzillotti L, Odoardi S, Strano-Rossi S. urine by microextraction by packed sorbent coupled directly Cleaning up blood samples using a modified "QuEChERS" to mass spectrometry: an alternative for rapid clinical and procedure for the determination of drugs of abuse and forensic analysis. benzodiazepines by UPLC-MSMS. J Sep Sci 2014; 37: 3306-13. Forensic Sci Int 2014; 243: 99-106.

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Toennes SW, Hanisch S, Pogoda W, Wunder C, Paulke A. Luo S, Trübel H, Wang C, Pauluhn J. Pitfall in cannabinoid analysis-detection of a previously Phosgene- and chlorine-induced acute lung injury in rats: unrecognized interfering compound in human serum. comparison of cardiopulmonary function and biomarkers in Anal Bioanal Chem 2014; online early: exhaled breath. doi: 10.1007/s00216-014-8301-y: Toxicology 2014; 326: 109-18.

Biomarkers Cardiotoxicity Sakamoto M, Chan HM, Domingo JL, Oliveira RB, Bennett O, Kandala N-B, Ji C, Linnane J, Clarke A. Kawakami S, Murata K. Spatial variation in heart failure and air pollution in Significance of fingernail and toenail mercury concentrations Warwickshire, UK: an investigation of small scale variation as biomarkers for prenatal methylmercury exposure in at the ward level. relation to segmental hair mercury concentrations. Lancet 2014; 384, Supplement 2: S20. Environ Res 2015; 136: 289-94. Berie MB, King MS, Thomsen IP. Sazakli E, Villanueva CM, Kogevinas M, Maltezis K, Polymyxin B infusion leading to cardiac arrest: a case Mouzaki A, Leotsinidis M. report and literature review. Chromium in drinking water: association with biomarkers Infection 2014; online early: doi: 10.1007/s15010-014- of exposure and effect. 0704-3: Int J Environ Res Public Health 2014; 11: 10125-45. Dirican A, Levent F, Alacacioglu A, Kucukzeybek Y, Varol U, Watkins DJ, Ferguson KK, Del Toro LVA, Alshawabkeh AN, Kocabas U, Senøz O, Emren SV, Demir L, Coban E, Aksun S, Cordero JF, Meeker JD. Sutcu R, Tarhan MO. Associations between urinary phenol and paraben concen- Acute cardiotoxic effects of adjuvant trastuzumab treatment trations and markers of oxidative stress and inflammation and its relation to oxidative stress. among pregnant women in Puerto Rico. Angiology 2014; 65: 944-9. Int J Hyg Environ Health 2014; online early: doi: 10.1016/j.ijheh.2014.11.001: Kim H, Cha YS. Response letter to the editor. "Troponin I elevations and Carcinogenicity organophosphate poisoning: direct cardiac injury or demand ischemia?". Emeville E, Giusti A, Coumoul X, Thomé J-P, Blanchet P, Multigner L. Clin Toxicol 2014; online early: Associations of plasma concentrations of dichlorodiphenyl- doi: 10.3109/15563650.2014.980583: dichloroethylene and polychlorinated biphenyls with prostate cancer: a case-control study in Guadeloupe (French Lee H, Oh BJ, Sohn CH, Ryoo SM, Joeng R. West Indies). Predictive markers of cardiac and cerebral ischemic injury Environ Health Perspect 2014; online early: after acute carbon monoxide poisoning. doi: 10.1289/ehp.1408407: Ann Emerg Med 2014; 64: S138.

Friedman GD, Achacoso N, Habel LA. Ohara H, Nakamura Y, Watanabe Y, Cao X, Yamazaki Y, Confounding by alcohol use; benzodiazepines and risk of Izumi-Nakaseko H, Ando K, Yamazaki H, Yamazaki J, liver cancer. Ikeda T, Sugiyama A. Br J Clin Pharmacol 2014; online early: Azithromycin can prolong QT interval and suppress doi: 10.1111/bcp.12549: ventricular contraction, but will not induce Torsade de Pointes.

Cardiovasc Toxicol 2014; online early: Lamm SH, Robbins S, Chen R, Lu J, Goodrich B, Feinleib M. doi: 10.1007/s12012-014-9289-4: Discontinuity in the cancer slope factor as it passes from high to low exposure levels  Arsenic in the BFD-endemic area. Toxicology 2014; 326: 25-35. Park J-S, Choi BJ, Choi SY, Yoon MH, Hwang GS, Tahk SJ, Shin JH.

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Troponin elevations and organophosphate poisoning: St Helen G, Jacob P, III, Peng M, Dempsey DA, Hammond direct cardiac injury or demand ischemia? SK, Benowitz NL. Clin Toxicol 2014; online early: Intake of toxic and carcinogenic volatile organic compounds doi: 10.3109/15563650.2014.980582: from secondhand smoke in motor vehicles.

Cancer Epidemiol Biomarkers Prev 2014; online early: doi: 10.1158/1055-9965.EPI-14-0548: Dermal toxicity Abraham A, Roga G. Steinmaus C, Ferreccio C, Yuan Y, Acevedo J, González F, Topical steroid-damaged skin. Perez L, Cortés S, Balmes JR, Liaw J, Smith AH. Indian J Dermatol 2014; 59: 456-9. Elevated lung cancer in younger adults and low concentrations of arsenic in water. Mokhtari F, Nikyar Z, Naeini BA, Esfahani AA, Rahmani S. Am J Epidemiol 2014; Adverse cutaneous drug reactions: eight year assessment in hospitalized patients. Wagner M, Bolm-Audorff U, Hegewald J, Fishta A, J Res Med Sci 2014; 19: 720-5. Schlattmann P, Schmitt J, Seidler A. Occupational polycyclic aromatic hydrocarbon exposure Won H-K, Lee J-W, Song W-J, Klaewsongkram J, Kang M-G, and risk of larynx cancer: a systematic review and meta- Park H-K, Lee H-S, Kim M-H, Chang Y-S, Cho S-H, Min K-U. analysis. Lamotrigine-induced toxic epidermal necrolysis confirmed Occup Environ Med 2014; online early: by in vitro granulysin and cytokine assays. doi: 10.1136/oemed-2014-102317: Asia Pac Allergy 2014; 4: 253-6.

Developmental toxicology Mozaffari S, Abdolghaffari AH, Nikfar S, Abdollahi M. Ashley-Martin J, Dodds L, Arbuckle T, Ettinger A, Shapiro Pregnancy outcomes in women with inflammatory bowel disease following exposure to thiopurines and antitumor G, Fisher M, Morisset A-S, Taback S, Bouchard M, Monnier P, Dallaire R, Fraser W. necrosis factor drugs: a systematic review with meta- analysis. A birth cohort study to investigate the association between Hum Exp Toxicol 2014; online early: prenatal phthalate and bisphenol A exposures and fetal doi: 10.1177/0960327114550882: markers of metabolic dysfunction.

Environ Health 2014; 13: 84. Pereira G, Bell ML, Belanger K, De Klerk N.

Fine particulate matter and risk of preterm birth and pre- Bach CC, Bech BH, Brix N, Nohr EA, Bonde JPE, Henriksen TB. labor rupture of membranes in perth, Western Australia Perfluoroalkyl and polyfluoroalkyl substances and human 1997–2007: a longitudinal study. fetal growth: a systematic review. Environ Int 2014; 73: 143-9. Crit Rev Toxicol 2014; online early: doi: 10.3109/10408444.2014.952400: Sexton K, Salinas JJ. Concurrent fetal exposure to multiple environmental Botton J, Kogevinas M, Gracia-Lavedan E, Patelarou E, chemicals along the U.S.-Mexico border: an exploratory Roumeliotaki T, Iñiguez C, Marina LS, Ibarluzea J, Ballester study in Brownsville, Texas. F, Mendez MA, Chatzi L, Sunyer J, Villanueva CM. Int J Environ Res Public Health 2014; 11: 10165-81. Postnatal weight growth and trihalomethane exposure during pregnancy. Wang Y, Chen A, Dietrich KN, Radcliffe J, Caldwell KL, Environ Res 2015; 136: 280-8. Rogan WJ. Postnatal exposure to methyl mercury and neuro- Brender J, Shinde M, Zhan F, Gong X, Langlois P. psychological development in 7-year-old urban inner-city Maternal residential proximity to chlorinated solvent children exposed to lead in the United States. emissions and birth defects in offspring: a case-control Child Neuropsychol 2014; 20: 527-38. study. Environ Health 2014; 13: 96. Driving under the influence of alcohol da Silva AMC, Moi GP, Mattos IE, de Souza Hacon S. and other drugs Low birth weight at term and the presence of fine Van Dyke N, Fillmore MT. particulate matter and carbon monoxide in the Brazilian Acute effects of alcohol on inhibitory control and simulated Amazon: a population-based retrospective cohort study. driving in DUI offenders. J Safety Res 2014; 49: 5-11. BMC Pregnancy Childbirth 2014; 14: 309.

Vindenes V, Boix F, Koksæter P, Strand MC, Bachs L, Jensen MS, Anand-Ivell R, Nørgaard-Pedersen B, Jönsson Mørland J, Gjerde H. BAG, Bonde JP, Hougaard DM, Cohen A, Lindh CH, Ivell R, Drugged driving arrests in Norway before and after the Toft G. implementation of per se law. Amniotic fluid phthalate levels and male fetal gonad Forensic Sci Int 2014; 245: 171-7. function.

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Chelating agents Mirfazaelian H, Nikfar S, Abdollahi M. DMPS The efficacy of oximes in acute organophosphorus poisoning; an updated systematic review and meta-analysis. Wang S, Shi N, Geng Z, Li X, Hu X, Wang Z. Value Health 2014; 17: A750. Inhibitory mechanism of dimercaptopropanesulfonic acid (DMPS) in the cellular biomethylation of arsenic. Biochimie 2014; 106: 167-74. Wilhelm CM, Snider TH, Babin MC, Jett DA, Platoff GE, Jr., Yeung DT. Fab fragments A comprehensive evaluation of the efficacy of leading oxime therapies in guinea pigs exposed to organophosphorus Lloyd M. chemical warfare agents or pesticides. Digoxin-specific antibody fragments in the treatment of Toxicol Appl Pharmacol 2014; online early: digoxin toxicity: Chan BSH, Buckley NA. Clin Toxicol 2014;52:82436. doi: 10.1016/j.taap.2014.10.009: J Emerg Med 2014; 47: 754. HI-6 Nordt SP, Clark RF, Machado C, Cantrell FL. Hill SL, Thomas SHL, Flecknell PA, Thomas AA, Morris CM, Assessment of digoxin-specific fab fragment dosages in Henderson D, Dunn M, Blain PG. digoxin poisoning. Rapid and equivalent systemic bioavailability of the Am J Ther 2014; online early: antidotes HI-6 and dicobalt edetate via the intraosseous doi: 10.1097/MJT.0000000000000127: and intravenous routes. Emerg Med J 2014; online early: doi: 10.1136/emermed- Hydroxocobalamin 2014-204171: Bebarta VS, Pitotti RL, Boudreau S, Tanen DA. Intraosseous versus intravenous infusion of Sodium bicarbonate hydroxocobalamin for the treatment of acute severe cyanide toxicity in a swine model. Varney SM, Bebarta VS, Vargas TE, Boudreau S, Castaneda M. Acad Emerg Med 2014; 21: 1203-11. Intravenous lipid emulsion therapy does not improve hypotension compared to sodium bicarbonate for tricyclic Hyperbaric oxygen therapy antidepressant toxicity: a randomized, controlled pilot Tahir AR, Westhuyzen J, Dass J, Collins MK, Webb R, study in a swine model. Hewitt S, Fon P, McKay M. Acad Emerg Med 2014; 21: 1212-9. Hyperbaric oxygen therapy for chronic radiation-induced tissue injuries: Australasia's largest study. Asia Pac J Clin Oncol 2014; online early: Beta blockers doi: 10.1111/ajco.12289: Richards JR, Laurin EG, Albertson TE. Beta-blocker use for toxicity from "bath salts". Lipid emulsion therapy J Emerg Med 2014; online early: Jeong J. doi: 10.1016/j.jemermed.2014.09.046: Continuous renal replacement therapy circuit failure after antidote administration. Clomethiazole Clin Toxicol 2014; online early: Kamudoni P, Grunder G, Sychla H, Juha B. doi: 10.3109/15563650.2014.981824: An evaluation of the comparative effectiveness of Macala K, Tabrizchi R. clomethiazole against diazepam in the treatment of alcohol withdrawal syndrome in routine clinical practice. The effect of fat emulsion on hemodynamics following treatment with propranolol and clonidine in anesthetized rats. Value Health 2014; 17: A454. Acad Emerg Med 2014; 21: 1220-5. Crocin Schmidt M, Farna H, Kurcova I, Zakharov S, Fric M, Razavi BM, Hosseinzadeh H, Abnous K, Khoei A, Waldauf P, Ilgova Z, Pazout J, Pachl J, Duska F. Imenshahidi M. Succesfull treatment of supralethal caffeine overdose with Protective effect of crocin against apoptosis induced by a combination of lipid infusion and dialysis  A case report. subchronic exposure of the rat vascular system to diazinon. Am J Emerg Med 2014; online early: Toxicol Ind Health 2014; online early: doi: 10.1016/j.ajem.2014.11.002: doi: 10.1177/0748233714554941:

Varney SM, Bebarta VS, Vargas TE, Boudreau S, Castaneda M. Dexmedetomidine Intravenous lipid emulsion therapy does not improve Rushton WF, Charlton NP. hypotension compared to sodium bicarbonate for tricyclic Dexmedetomidine in the treatment of serotonin syndrome. antidepressant toxicity: a randomized, controlled pilot study Ann Pharmacother 2014; 48: 1651-4. in a swine model. Acad Emerg Med 2014; 21: 1212-9. Diazepam Oximes Kamudoni P, Grunder G, Sychla H, Juha B. Abdollahi M, Nikfar S, Mirfazaelian H. An evaluation of the comparative effectiveness of The efficacy of oximes in acute human organophosphorus clomethiazole against diazepam in the treatment of poisoning; an updated meta-analysis. alcohol withdrawal syndrome in routine clinical practice. Value Health 2014; 17: A505. Value Health 2014; 17: A454.

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Ther Apheresis Dial 2014; online early: doi: 10.1111/1744-9987.12233: Naloxone Ray B, O'Donnell D, Kahre K. Tjajadi M. Police officer attitudes towards intranasal naloxone Extracorporeal treatment for acetaminophen poisoning: training. recommendations from the EXTRIP workgroup: Gosselin S, Drug Alcohol Depend 2014; online early: Juurlink DN, Kielstein JT, et al. Clin Toxicol 2014;52:85667. doi: 10.1016/j.drugalcdep.2014.10.026:

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Take-home emergency naloxone to prevent deaths from Haemodialysis heroin overdose. Becknell B, Smoyer WE, O'Brien NF. Br Med J 2014; 349: Hemodialysis for near-fatal sodium phosphate toxicity in a child receiving sodium phosphate enemas. Weiner SG, Mitchell PM, Temin ES, Langlois BK, Dyer KS. Pediatr Emerg Care 2014; 30: 814-7. Use of intranasal naloxone by basic life support providers. Ann Emerg Med 2014; 64: S52. Haemoperfusion Gao Y, Zhang X, Yang Y, Li W. Pregabalin Early haemoperfusion with continuous venovenous Scanlon A. haemofiltration improves survival of acute paraquat- Pregabalin for detoxification from opioids: a single case study. poisoned patients. Ment Health Subst Use 2014; 7: 263-85. J Int Med Res 2014; online early: doi: 10.1177/0300060514549782: Propylene glycol Solano JJ, Ganetsky M, Salhanick S. Nasa P, Singh A, Juneja D, Singh O, Javeri Y. Potential protective effects of propylene glycol in daily Continuous venovenous hemodiafiltration along with acetaminophen dosing. charcoal hemoperfusion for the management of life- Ann Emerg Med 2014; 64: S139. threatening lercanidipine and amlodipine overdose. Saudi J Kidney Dis Transpl 2014; 25: 1255-8. Trypsin Parker Cote JL, O'Rourke D, Brewer KL, Lertpiriyapong K, Glycopyrrolate Girard J, Bush SP, Miller SN, Punja M, Meggs WJ. Bhandarkar AA. Efficacy of trypsin in treating coral snake envenomation in Efficacy of atropine alone and with glycopyrrolate the porcine model. combination in organophosphate poisoning. Ann Emerg Med 2014; 64: S138-S139. Value Health 2014; 17: A750-A751. Whole bowel irrigation MARS® Thanacoody R, Caravati EM, Troutman WG, Höjer J, Benson BE, Hoppu K, Erdman A, Bedry R, Mégarbane B. Pillukat M, Schomacher T, Baier P, Gabriels G, Pavenstädt Position paper update: Whole bowel irrigation for gastro- H, Schmidt HH. ® intestinal decontamination of overdose patients. Early initiation of MARS dialysis in Amanita phalloides- Clin Toxicol 2014; online early: induced acute liver failure prevents liver transplantation. doi: 10.3109/15563650.2014.989326: Transpl Int 2014; 27: 40.

Nabilone DRUGS Lam PW, Frost DW. General Nabilone therapy for cannabis withdrawal presenting as Aiso M, Adachi M, Miura K, Miura R, Tachizawa N, protracted nausea and vomiting. Takamori Y, Tanaka A, Takikawa H. BMJ Case Rep 2014; doi: 10.1136/bcr-2014-205287: A survey of the drug-induced liver injury cases during the past 16 years in Department of Medicine, Teikyo University Hospital. Neostigmine Teikyo Med J 2014; 37: 141-9. Liu SH, Tseng CY, Lin CC. Is neostigmine effective in severe pufferfish-associated Dart RC, Bronstein AC, Spyker DA, Cantilena LR, Seifert tetrodotoxin poisoning? SA, Heard SE, Krenzelok EP. Clin Toxicol 2014; online early: Poisoning in the United States: 2012 emergency medicine doi: 10.3109/15563650.2014.980581: report of the National Poison Data System. Ann Emerg Med 2014; online early: Opioid maintenance therapy doi: 10.1016/j.annemergmed.2014.11.001:

Buprenorphine Haegerich TM, Paulozzi LJ, Manns BJ, Jones CM. Li X, Shorter D, Kosten TR. What we know, and don't know, about the impact of state Buprenorphine in the treatment of opioid addiction: policy and systems-level interventions on prescription drug opportunities, challenges and strategies. overdose. Expert Opin Pharmacother 2014; 15: 2263-75. Drug Alcohol Depend 2014; 145: 34-47.

DRUGS Acetaminophen (see paracetamol) General Lee D, Delcher C, Maldonado-Molina MM, Bazydlo LAL, Alkyl nitrites Thogmartin JR, Goldberger BA. Pahlitzsch M, Mai C, Joussen AM, Bergholz R. Trends in licit and illicit drug-related deaths in Florida from Poppers maculopathy: complete restitution of macular 2001 to 2012. changes in OCT after drug abstinence. Forensic Sci Int 2014; 245: 178-86. Semin Ophthalmol 2014; online early:

doi: 10.3109/08820538.2014.962175: Leschke TM, Guse C, Schlotthauer A, Layde P. Drug poisoning incidence in Wisconsin: does age matter? Ann Emerg Med 2014; 64: S80. Amfetamines and MDMA (ecstasy) Bramness JG, Reid MJ, Solvik KF, Vindenes V. Mokhtari F, Nikyar Z, Naeini BA, Esfahani AA, Rahmani S. Recent trends in the availability and use of amphetamine Adverse cutaneous drug reactions: eight year assessment and methamphetamine in Norway. in hospitalized patients. Forensic Sci Int 2014; online early: J Res Med Sci 2014; 19: 720-5. doi: 10.1016/j.forsciint.2014.11.010:

Mut L, Grobosch T, Binscheck-Domaß T, Frenzel W. Toxicological screening of human plasma by on-line SPE- Curtin K, Fleckenstein AE, Robison RJ, Crookston MJ, HPLC-DAD: identification and quantification of basic drugs Smith KR, Hanson GR. and metabolites. Methamphetamine/amphetamine abuse and risk of Biomed Chromatogr 2014; online early: Parkinson's disease in Utah: a population-based assessment. doi: 10.1002/bmc.3377: Drug Alcohol Depend 2014; online early: doi: 10.1016/j.drugalcdep.2014.10.027: Perinpam L, Haag JD, Baudoin MR, Fowler CL, Sunga KL, Bellamkonda VR, Bradley PJ, Rudis MI. Glasner-Edwards S, Mooney LJ. Preventability and severity scoring of drug-related problems Methamphetamine psychosis: epidemiology and manage- in the emergency department. ment. Ann Emerg Med 2014; 64: S100-S101. CNS Drugs 2014; online early: doi: 10.1007/s40263-014- Rallis D, Stefanopoulos A, Petropoulos A, Karakosta V, 0209-8: Angelopoulos K, Botsa E, Orfanou I. Epidemiology of drug overdose/poisoning in paediatric Jackson AR, Shah A, Kumar A. population in a single centre over 2 year period. Methamphetamine alters the normal progression by Arch Dis Child 2014; 99: A575. inducing cell cycle arrest in astrocytes. PLoS ONE 2014; 9: e109603. Roveri G, Nascimbeni F, Rocchi E, Ventura P. Drugs and acute porphyrias: reasons for a hazardous Steuer AE, Schmidhauser C, Liechti ME, Kraemer T. relationship. Development and validation of an LC-MS/MS method after Postgrad Med 2014; 126: 108-20. chiral derivatization for the simultaneous stereoselective

determination of methylenedioxy-methamphetamine Teschke R, Zhang L, Melzer L, Schulze J, Eickhoff A. (MDMA) and its phase I and II metabolites in human Green tea extract and the risk of drug-induced liver injury. blood plasma. Expert Opin Drug Metab Toxicol 2014; 10: 1663-76. Drug Test Anal 2014; online early:

Thevis M, Thomas A, Schänzer W. doi: 10.1002/dta.1740: Detecting peptidic drugs, drug candidates and analogs in sports doping: current status and future directions. Vlcková H, El-Beqqali A, Novákova L, Solich P, Abdel- Expert Rev Proteomics 2014; 11: 663-73. Rehim M. Determination of amphetamine and methadone in human Vindenes V, Boix F, Koksæter P, Strand MC, Bachs L, urine by microextraction by packed sorbent coupled directly Mørland J, Gjerde H. to mass spectrometry: an alternative for rapid clinical and Drugged driving arrests in Norway before and after the forensic analysis. implementation of per se law. J Sep Sci 2014; 37: 3306-13. Forensic Sci Int 2014; 245: 171-7. Wang T, Shen B, Shi Y, Xiang P, Yu Z. 2,4-dinitrophenol Chiral separation and determination of R/S-meth- Le P, Wood B, Kumarasinghe SP. amphetamine and its metabolite R/S-amphetamine in urine Cutaneous drug toxicity from 2,4-dinitrophenol (DNP): using LCMS/MS. case report and histological description. Forensic Sci Int 2014; online early: Australas J Dermatol 2014; online early: doi: 10.1016/j.forsciint.2014.11.009: doi: 10.1111/ajd.12237:

ACE Inhibitors Anaesthetics Lisinopril Mepivacaine Singh G, Kachalia A, Kaur J, Kachalia K, Liu S, Rizzo V. Brockmann WG. Cholestatic hepatitis: an unusual presentation of lisinopril Mepivacaine: a closer look at its properties and current induced hepatotoxicity. utility. Brit J Med Pract 2014; 7: a721. Gen Dent 2014; 62: 70-5.

Analgesics Shah SN, Chauhan GR, Manjunatha BS, Dagrus K. Flupirtin Drug induced erythema multiforme: two case series with Borchert DH, Jungst C, Roller J, Klein F, Rudolph B, review of literature. Glanemann M, Eisele RM. J Clin Diagn Res 2014; 8: ZH01-ZH04. Flupirtin induced liver toxicity: indication for transplantation. Transpl Int 2014; 27: 39-40. Azithromycin Ohara H, Nakamura Y, Watanabe Y, Cao X, Yamazaki Y, Antiarrhythmics Izumi-Nakaseko H, Ando K, Yamazaki H, Yamazaki J, Roden DM. Ikeda T, Sugiyama A.

Pharmacology and toxicology of Nav1.5-Class 1 anti- Azithromycin can prolong QT interval and suppress ventricular arrhythmic drugs. contraction, but will not induce Torsade de Pointes. Card Electrophysiol Clin 2014; 6: 695-704. Cardiovasc Toxicol 2014; online early: doi: 10.1007/s12012-014-9289-4: Amiodarone Kang IS, Kim KJ, Kim Y, Park S-H. Colistin The diagnostic utility of chest computed tomography Wadia S, Tran B. scoring for the assessment of amiodarone-induced Colistin-mediated neurotoxicity. pulmonary toxicity. Korean J Intern Med 2014; 29: 746-53. BMJ Case Rep 2014; doi: 10.1136/bcr-2014-205332:

Digoxin Polymyxin B García-Cabrera L, Sanchez-Castellano C, Mateos-del Nozal Berie MB, King MS, Thomsen IP. J, Baeza-Monedero ME, Cruz-Jentoft AJ. Polymyxin B infusion leading to cardiac arrest: a case Therapeutic levels of digoxin could be different in elderly report and literature review. patients. Infection 2014; online early: doi: 10.1007/s15010-014- Eur Geriatr Med 2014; 5: S224. 0704-3:

Lloyd M. Digoxin-specific antibody fragments in the treatment of Vancomycin digoxin toxicity: Chan BSH, Buckley NA. Clin Toxicol Mergenhagen KA, Borton AR. 2014;52:82436. Vancomycin nephrotoxicity: a review. J Emerg Med 2014; 47: 754. J Pharm Pract 2014; 27: 545-53.

Nordt SP, Clark RF, Machado C, Cantrell FL. Anticoagulants Assessment of digoxin-specific fab fragment dosages in digoxin poisoning. Schulman S, Furie B. Am J Ther 2014; online early: How I treat: poisoning with vitamin K antagonists. doi: 10.1097/MJT.0000000000000127: Blood 2014; online early: doi: 10.1182/blood-2014-08- 597781: Scholl JHG, van Eekeren R, van Puijenbroek EP. Six cases of (severe) hypoglycaemia associated with Dabigatran gabapentin use in both diabetic and non-diabetic patients. Montaruli B, Erroi L, Vitale C, Berutti S, Cosseddu D, Br J Clin Pharmacol 2014; online early: Sivera P, Coglitore R, Marangella M, Migliardi M. doi: 10.1111/bcp.12548: Case report of laboratory coagulation parameters and

hemodialysis of a 85-yearold man with dabigatran overdose. Antibiotics Biochim Clin 2014; 38: 508. Sorensen C. Serious bleeding events due to warfarin and antibiotic co- prescription in a cohort of veterans: Lane M, Zeringue A, Warfarin McDonald J. Am J Med 2014;127:657-63.e2. Sorensen C. J Emerg Med 2014; 47: 617. Serious bleeding events due to warfarin and antibiotic co- prescription in a cohort of veterans: Lane M, Zeringue A, Aminoglycosides McDonald J. Am J Med 2014;127:657-63.e2. Destache CJ. J Emerg Med 2014; 47: 617. Aminoglycoside-induced nephrotoxicity – A focus on mon- itoring: a review of literature. Anticonvulsants J Pharm Pract 2014; 27: 562-6. Günaydin YK, Akilli NB, Dündar ZD, Köylü R, Sert ET, Çekmen B, Akinci E, Cander B. Wargo KA, Edwards JD. Antiepileptic drug poisoning: three-year experience. Aminoglycoside-induced nephrotoxicity. Toxicol Rep 2014; online early: J Pharm Pract 2014; 27: 573-7. doi: 10.1016/j.toxrep.2014.11.004:

Amoxicillin De Lemos A, Ghabril M, Rockey DC, Gu J, Barnhart HX, Gabapentin Russo MW, Bonkovsky HL. Kaufman KR, Parikh A, Chan L, Bridgeman M, Shah M. Amoxicillin-clavulanate induced DILI: 113 cases from the Myoclonus in renal failure: two cases of gabapentin US Drug-Induced Liver Injury Network (DILIN). toxicity. Hepatology (Baltimore, Md ) 2014; 60: 711A-2A. Epilspsy Behav Case Rep 2014; 2: 8-10.

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Abdollahi M, Nikfar S, Mirfazaelian H. Radwan NM, El-Nabarawy NA. The efficacy of oximes in acute human organophosphorus poisoning; an updated meta-analysis. The role of muscle injury in organophosphate poisoning and development of intermediate syndrome. Value Health 2014; 17: A505. Int J Pharm Sci Rev Res 2014; 28: 61-6.

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Kim H, Cha YS. Chlorpyrifos Response letter to the editor. "Troponin I elevations and Nielsen SS, Checkoway H, Zhang J, Hofmann JN, Keifer organophosphate poisoning: direct cardiac injury or MC, Paulsen M, Farin FM, Cook TJ, Simpson CD. demand ischemia?". Blood -synuclein in agricultural pesticide handlers in Clin Toxicol 2014; online early: central Washington state. doi: 10.3109/15563650.2014.980583: Environ Res 2015; 136: 75-81.

Diazinon CHEMICAL WARFARE, Razavi BM, Hosseinzadeh H, Abnous K, Khoei A, Imenshahidi M. BIOLOGICAL WARFARE AND Protective effect of crocin against apoptosis induced by RIOT CONTROL AGENTS subchronic exposure of the rat vascular system to diazinon. Toxicol Ind Health 2014; online early: Biological warfare doi: 10.1177/0748233714554941: Fajardo GC, Posid J, Papagiotas S, Lowe L. Comparing electronic news media reports of potential Paraquat and diquat bioterrorism-related incidents involving unknown white powder to reports received by the United States centers Gao Y, Zhang X, Yang Y, Li W. for disease control and prevention and the federal bureau Early haemoperfusion with continuous venovenous of investigation: U.S.A., 20092011. haemofiltration improves survival of acute paraquat- J Forensic Sci 2014; online early: doi: 10.1111/1556- poisoned patients. 4029.12608: J Int Med Res 2014; online early: doi: 10.1177/0300060514549782: Chemical warfare Lin C, Yen T-H, Juang Y-Y, Lin J-L, Lee S-H. General Psychiatric comorbidity and its impact on mortality in Hill SL, Thomas SHL, Flecknell PA, Thomas AA, Morris CM, patients who attempted suicide by paraquat poisoning Henderson D, Dunn M, Blain PG. during 2000–2010. Rapid and equivalent systemic bioavailability of the PLoS ONE 2014; 9: e112160. antidotes HI-6 and dicobalt edetate via the intraosseous and intravenous routes. Maturana MV, Pinheiro AS, de Souza TLF, Follmer C. Emerg Med J 2014; online early: doi: 10.1136/emermed- Unveiling the role of the pesticides paraquat and rotenone 2014-204171: on -synuclein fibrillation in vitro. Neurotoxicology 2014; online early: Wilhelm CM, Snider TH, Babin MC, Jett DA, Platoff GE, Jr., doi: 10.1016/j.neuro.2014.11.006: Yeung DT. A comprehensive evaluation of the efficacy of leading oxime Pyrethroid insecticides therapies in guinea pigs exposed to organophosphorus chemical warfare agents or pesticides. General Toxicol Appl Pharmacol 2014; online early: Radwan M, Jurewicz J, Wielgomas B, Sobala W, doi: 10.1016/j.taap.2014.10.009: Piskunowicz M, Radwan P, Hanke W.

Semen quality and the level of reproductive hormones after environmental exposure to pyrethroids. Mustard gas J Occup Environ Med 2014; 56: 1113-9. Jowsey PA, Blain PG. Whole genome expression analysis in primary bronchial Alpha cypermethrin epithelial cells after exposure to sulphur mustard. Hongsibsong S, Stuetz W, Sus N, Prapamontol T, Grune T, Toxicol Lett 2014; 230: 393-401. Frank J. Dietary exposure to continuous small doses of - Razavi SM, Negahban Z, Pirhosseinloo M, Razavi MS, cypermethrin in the presence or absence of dietary Hadjati G, Salamati P. curcumin does not induce oxidative stress in male Wistar Sulfur mustard effects on mental health and quality-of-life: rats. a review. Toxicol Rep 2014; online early: Iran J Psychiatr Behav Sci 2014; 8: 11-21. doi: 10.1016/j.toxrep.2014.10.025: Zhu X-J, Xu R, Meng X, Chu HB, Zhao C, Lian C-J, Wang Transfluthrin T, Guo W-J, Zhang S-M. Pauluhn J, Ozaki K. Mechanistic insights of sulfur mustard-induced acute Transfluthrin: comparative efficacy and toxicity of tracheal injury in rats. reference and generic versions. Int J Toxicol 2014; 33: 382-92. Regul Toxicol Pharmacol 2014; online early: doi: 10.1016/j.yrtph.2014.11.003: Phosgene Luo S, Trübel H, Wang C, Pauluhn J. Rodenticides Phosgene- and chlorine-induced acute lung injury in rats: Schulman S, Furie B. comparison of cardiopulmonary function and biomarkers in How I treat: poisoning with vitamin K antagonists. exhaled breath. Blood 2014; online early: doi: 10.1182/blood-2014-08- Toxicology 2014; 326: 109-18. 597781: Nerve agents Rotenone Chen S, Ruan Y, Brown JD, Hadad CM, Badjic JD. Maturana MV, Pinheiro AS, de Souza TLF, Follmer C. The recognition characteristics of an adaptive vesicular Unveiling the role of the pesticides paraquat and rotenone assembly of amphiphilic baskets for selective detection on -synuclein fibrillation in vitro. and mitigation of toxic nerve agents. Neurotoxicology 2014; online early: J Am Chem Soc 2014; online early: doi: 10.1016/j.neuro.2014.11.006: doi: 10.1021/ja510477q:

Nerve agents ANIMALS Hulse EJ, Davies JO, Simpson AJ, Sciuto AM, Eddleston M. Respiratory complications of organophosphorus nerve agent Fish/marine poisoning and insecticide poisoning – Implications for respiratory and Boulet LP, Laberge F. critical care. Occupational asthma to fish. Am J Respir Crit Care Med 2014; online early: Occup Environ Med 2014; 71: 804. doi: 10.1164/rccm.201406-1150CI: Ciguatera Reiter G, Müller S, Hill I, Weatherby K, Thiermann H, Gomez J, Thomas M, Halstead-Kenny JJ. Worek F, Mikler J. Something fishy – Ciguatera poisoning. In vitro and in vivo toxicological studies of V nerve agents: PM and R 2014; 6: S211. molecular and stereoselective aspects.

Toxicol Lett 2014; online early: doi: 10.1016/j.toxlet.2014.11.010: Pufferfish Liu SH, Tseng CY, Lin CC. Is neostigmine effective in severe pufferfish-associated PLANTS tetrodotoxin poisoning? Baptisia spp. (False indigo) Clin Toxicol 2014; online early: Anderson MJ, Kurtycz DFI, Cline JR. doi: 10.3109/15563650.2014.980581: Baptisia poisoning: a new and toxic look-alike in the neighborhood. J Emerg Med 2014; online early: Heloderma suspectum (Gila monster) doi: 10.1016/j.jemermed.2014.09.037: French RNE, Brooks DE, Ruha AM, Shirazi FM, Chase PB, Boesen KJ, Walter FG.

Gila monster (Heloderma suspectum) envenomation: Camellia sinensis (Tea) descriptive analysis of calls to United States Poison Centers Teschke R, Zhang L, Melzer L, Schulze J, Eickhoff A. with focus on Arizona cases. Green tea extract and the risk of drug-induced liver injury. Clin Toxicol 2014; online early: Expert Opin Drug Metab Toxicol 2014; 10: 1663-76. doi: 10.3109/15563650.2014.988791:

Hyoscyamus niger (Black henbane) Scorpions Alizadeh A, Moshiri M, Alizadeh J, Balali-Mood M. Kularatne SAM, Dinamithra NP, Sivansuthan S, Weerakoon Black henbane and its toxicity – A descriptive review. KGAD, Thillaimpalam B, Kalyanasundram V, Ranawana KB. Avicenna J Phytomed 2014; 4: 297-311. Clinico-epidemiology of stings and envenoming of Hottentotta tamulus (Scorpiones: Buthidae), the Indian Mitragyna speciosa (Kratom) red scorpion from Jaffna peninsula in northern Sri Lanka. Karinen R, Fosen JT, Rogde S, Vindenes V. Toxicon 2015; 93: 85-9. An accidental poisoning with mitragynine. Forensic Sci Int 2014; 245: e29-e32. Snake bites

Coral snake Mushrooms Arce-Bejarano R, Lomonte B, Gutiérrez JM. Colak S, Kandis H, Afacan MA, Erdogan MO, Gunes H, Intravascular hemolysis induced by the venom of the Kaya E, Akdemir HU, Saritas A. Eastern coral snake, Micrurus fulvius, in a mouse model: Assessment of patients who presented to the emergency identification of directly hemolytic phospholipases A2. department with mushroom poisoning. Toxicon 2014; 90: 26-35. Hum Exp Toxicol 2014; online early: doi: 10.1177/0960327114557902: Parker Cote JL, O'Rourke D, Brewer KL, Lertpiriyapong K,

Girard J, Bush SP, Miller SN, Punja M, Meggs WJ. Gawlikowski T, Romek M, Satora L. Efficacy of trypsin in treating coral snake envenomation in Edible mushroom-related poisoning: a study on circumstances the porcine model. of mushroom collection, transport, and storage. Ann Emerg Med 2014; 64: S138-S139. Hum Exp Toxicol 2014; online early: doi: 10.1177/0960327114557901: Colubridae Amanita mushrooms Fernando WKBKM, Kularatne SAM, Wathudura SPK, de Pillukat M, Schomacher T, Baier P, Gabriels G, Pavenstädt Silva A, Mori A, Mahaulpatha D. H, Schmidt HH. First reported case of systemic envenoming by the Sri Early initiation of MARS® dialysis in Amanita phalloides- Lankan keelback (Balanophis ceylonensis). induced acute liver failure prevents liver transplantation. Toxicon 2015; 93: 20-3. Transpl Int 2014; 27: 40. Crotalinae (Pit vipers) Poppy Weinstein SA. Monteil-Ganiere C, Gaulier J-M, Chopineaux D, Barrios L, The pharmacotherapy for pit viper envenoming in the Pineau A, Dailly É, Clément R. United States: a brief retrospective on roots, recurrence, Fatal anoxia due to rachacha consumption: two cases and risk. reported. Clin Toxicol 2014; online early: Forensic Sci Int 2014; 245: e1-e5. doi: 10.3109/15563650.2014.983240:

INDEX

2,4-dinitrophenol ...... 20 Cobalt ...... 33 ACE Inhibitors ...... 20 Cobinamide ...... 17 Acetaminophen ...... 25 Cocaine...... 23 Acrylamide ...... 28 Codeine ...... 25 Air pollution ...... 27 Colchicine ...... 23 Alcohol ...... 28 Colistin ...... 21 Alkyl nitrites ...... 20 Colubridae ...... 38 Alpha cypermethrin ...... 37 Coral snake ...... 38 Amanita mushrooms ...... 38 Corrosives ...... 29 Amfetamines ...... 20 Crocin ...... 18 Aminoglycosides ...... 21 Crotalinae ...... 38 Amiodarone ...... 21 Cyanide ...... 29 Amitriptyline ...... 27 Cytotoxic drugs ...... 23 Amlodipine ...... 23 Dabigatran ...... 21 Amoxicillin ...... 21 Dermal toxicity ...... 9 Anaesthetics ...... 20 Desferrioxamine ...... 23 Analgesics ...... 21 Designer drugs ...... 23 Analytical toxicology ...... 8 Desipramine ...... 27 Animals, general ...... 38 Detergents ...... 29 Antiarrhythmics ...... 21 Developmental toxicology ...... 10 Antibiotics ...... 21 Dexmedetomidine...... 18 Anticoagulants ...... 21 Diacetylmorphine...... 24 Anticonvulsants ...... 21 Diamorphine ...... 25 Antidotes ...... 17 Diazepam ...... 18 Antihypertensives ...... 22 Diazinon ...... 37 Antimalarial drugs ...... 22 Dichlorodiphenyldichloroethylene ...... 29 Antineoplastics ...... 22 Diclofenac ...... 25 Antipsychotics ...... 22 Dietary supplements ...... 24 Antivenom ...... 17 Digoxin ...... 21 Antiviral drugs ...... 22 Dioxin ...... 29 Arsenic ...... 33 Diquat ...... 37 Atropine ...... 17 DMPS...... 18 Azithromycin ...... 21 Driving under the influence ...... 10 Baclofen ...... 22 Drugs, general ...... 19 Baptisia spp...... 38 E-cigarettes ...... 29 Benzene ...... 28 Ecstasy ...... 20 Benzodiazepines ...... 22 Epidemiology...... 10 Beryllium ...... 33 Ethanol ...... 28 Beta blockers ...... 18, 23 Ethnic remedies ...... 24 Biological warfare...... 37 Ethylene glycol ...... 30 Biomarkers ...... 8 Extracorporeal treatments ...... 19 Bisphenol A ...... 28 Fab fragments ...... 18 Bisphosphonates ...... 23 False indigo ...... 38 Black henbane ...... 38 Fish/marine poisoning ...... 38 Buprenorphine ...... 19 Fluorocarbons ...... 30 Cadmium ...... 33 Flupirtin ...... 21 Caffeine...... 23 Forensic toxicology ...... 11 Calciferol ...... 27 Fungicides ...... 35 Calcium channel blockers...... 23 Gabapentin ...... 21 Camellia sinensis ...... 38 Ganciclovir ...... 22 Cannabis ...... 23 Gila monster ...... 38 Carbon black ...... 29 Glufosinate ...... 35 Carbon monoxide ...... 29 Glycopyrrolate ...... 19 Carcinogenicity ...... 9 Haemodialysis ...... 19 Cardiotoxicity ...... 9 Haemoperfusion ...... 19 Chelating agents ...... 18 Hazardous waste ...... 27 Chemical warfare, general ...... 37 Heloderma suspectum ...... 38 Chemicals, general ...... 28 Hepatotoxicity ...... 12 Chlorine...... 29 Herbal medicines ...... 24 Chloroanilines ...... 29 Herbicides ...... 35 Chloroquine ...... 22 Heroin ...... 24 Chlorpyrifos ...... 36 HI-6 ...... 18 Chromium ...... 33 Hydrogen sulphide ...... 30 Ciguatera ...... 38 Hydroxocobalamin ...... 18 Clomethiazole ...... 18 Hydroxychloroquine ...... 22 Clonidine ...... 22 Hyoscyamus niger ...... 38 Clozapine...... 22 Hyperbaric oxygen therapy ...... 18

Ibuprofen ...... 25 Phthalate esters ...... 30 Ifosfamide ...... 22 Pit vipers ...... 38 Inhalation toxicity ...... 13 Plants, general ...... 38 Iodine ...... 30 Pollution ...... 27 Irinotecan ...... 22 Polybrominated diphenyl ethers ...... 31 Kerosene ...... 30 Polychlorinated biphenyls ...... 31 Ketamine ...... 24 Polycyclic aromatic hydrocarbons ...... 31 Kratom ...... 38 Polymorphisms ...... 16 Lamotrigine ...... 22 Polymyxin B ...... 21 Lanthanum ...... 34 Poppy ...... 38 Latex ...... 30 Pregabalin ...... 19 Lead...... 34 Propranolol ...... 23 Lercanidipine ...... 23 Propylene glycol ...... 19 Levamisole ...... 24 Psychiatric aspects ...... 17 Lipid emulsion therapy ...... 18 Pufferfish ...... 38 Lisinopril ...... 20 Pyrethroid insecticides, general ...... 37 Lithium ...... 24, 34 Radiation ...... 31 Lopinavir ...... 22 Reprotoxicity ...... 17 Management, general ...... 17 Risk assessment ...... 17 Manganese ...... 34 Rodenticides ...... 37 Marijuana ...... 23 Rotenone ...... 37 MARS® ...... 19 Scopolamine ...... 26 MDMA ...... 20 Scorpions ...... 38 Medication errors ...... 13 Sertraline ...... 26 Mepivacaine...... 20 Smoke ...... 31 Mercury ...... 34 Snake bites ...... 38 Metals, general ...... 32 Sodium bicarbonate ...... 18 Methadone ...... 25 Sodium fluoride ...... 32 Methotrexate ...... 23 Solvents ...... 32 Methoxetamine ...... 24 SSRIs and SNRIs ...... 26 Mineral fibres ...... 30 Steroids ...... 26 Minoxidil ...... 24 Substance abuse ...... 26 Mitragyna speciosa...... 38 Suicide ...... 17 Monoclonal antibodies ...... 24 Surfactants ...... 32 Mushrooms ...... 38 Synthetic cannabinoids ...... 26 Mustard gas ...... 37 Synthetic cathinones ...... 26 Nabilone ...... 19 Tapentadol ...... 25 Naloxone ...... 19 Tea ...... 38 Neonicotinoids ...... 35 Temozolomide ...... 22 Neostigmine ...... 19 Tenofovir ...... 22 Nephrotoxicity ...... 13 Tetrachlorodibenzo-p-dioxin ...... 32 Nerve agents ...... 37 Tetrachloroethylene ...... 32 Neurotoxicity ...... 13 Thallium...... 35 Nicotine ...... 24 Thiopurines ...... 27 NSAIDs ...... 25 Thioridazine ...... 22 Occupational toxicology ...... 14 Tobacco ...... 32 Ocular toxicity ...... 15 Toxicology, general ...... 8 Opioid maintenance therapy ...... 19 Tramadol ...... 25 Opioids ...... 25 Transfluthrin ...... 37 Organochlorine pesticides, general ...... 36 Trastuzumab ...... 24 Organophosphorus insecticides, general ...... 36 Triclosan ...... 32 Oxaliplatin ...... 22 Tricyclic antidepressants ...... 27 Oximes ...... 18 Trihalomethane ...... 32 Oxycodone ...... 25 Trypsin ...... 19 Paediatric toxicology ...... 15 Valproate ...... 22 Parabens ...... 30 Vancomycin ...... 21 Paracetamol ...... 25 Vigabatrin ...... 22 Paraquat ...... 37 Vinyl chloride ...... 32 Pendimethalin ...... 35 Vitamins...... 27 Perfluorinated compounds ...... 30 Warfarin ...... 21 Pesticides, general ...... 35 Water pollution ...... 28 Phenol ...... 30 Whole bowel irrigation ...... 19 Phosgene ...... 37 Zinc ...... 35 Phosphate enema ...... 26 Zoledronic acid ...... 23

The NPIS is commissioned by Public Health England