Introduction to Medical Toxicology
What is Medical Toxicology?
Medical Toxicology is a medical subspecialty focusing on the diagnosis, management and prevention of poisoning and other adverse health effects due to medications, occupational and environmental toxins, and biological agents. Medical Toxicology is officially recognized as a medical subspecialty by the American Board of Medical Specialties.
What are some examples of problems evaluated by Medical Toxicologists?
Medical toxicologists are involved in the comprehensive high level care of people and patients who come into contact with drugs, substances or other agents that pose a threat to their well being. The following is a brief list of some of these encounters.
- Unintentional and intentional overdoses of such agents as:
- Therapeutic drugs including antidepressants (e.g. tricyclics, serotonin reuptake inhibitors, etc), cardiac medications (e.g. beta-adrenergic blocking agents, calcium channel antagonists, cardioactive steroids such as digoxin, etc.), and many others
- Over-the-counter medicines such as aspirin, acetaminophen, ibuprofen, vitamins (e.g. iron supplements, vitamin A, etc.), and more
- Drugs of abuse such as cocaine, amphetamines, opioids, cannabis, etc., along with new and emerging agents of abuse such as Salvia Divinorum, ketamine and much more
- Exposure to industrial chemical products and environmental hazards such as:
- Heavy metals (e.g. lead, arsenic, mercury)
- Household products (e.g. cleaning agents)
- Toxic gases (e.g. carbon monoxide, hydrogen sulfide, hydrogen cyanide)
- Toxic alcohols (e.g. methanol, ethylene glycol) and other solvents
- Other industrial and environmental agents, including radiation exposures
- Drug abuse management including:
- Inpatient care for acute withdrawal states from addictive agents such as alcohol and benzodiazepines
- Outpatient Medical Review Officer services for industry and organization
- Diagnosis and management of exposures such as:
- Envenomations, such as snake bites, spider bites, scorpion stings
- Marine toxins such as ciguatera poisoning, paralytic shellfish poisoning, tetrodotoxin and many others
- Ingestion of food-borne toxins, such as botulism, scombroid poisoning and more
- Ingestion of toxic plants such as thevetia peruviana (i.e. yellow oleander) and mushrooms such as amanita phalloides (i.e. The Death Cap) and gyrometra esculenta (i.e. the false morel)
- Independent medical examinations, assessing injury or disability resulting from toxic exposures
What kind of professional services do physicians trained in Medical Toxicology provide?
Physicians trained in Medical Toxicology provide professional services in a variety of clinical, industrial, educational, and public health settings including:
- Emergency departments, intensive care units, and other in-patient units where they provide direct treatment and bedside consultation of acutely poisoned adults and children
- Outpatient clinics, offices, and job sites where they evaluate the health impact from acute and chronic exposure to toxic substances in the workplace, home and general environment
- National and regional poison control centers where they provide 24-hour phone consultation to health professionals, first responders, public health officials, corporate safety personnel, and the general public regarding hazard identification, decontamination, emergency management, and detailed clinical care of the poisoned patient
- Medical schools, universities, and clinical training sites where they teach, research, and provide advanced evidence based patient care
- Industry and commerce where they increasingly contribute to pharmaceutical research and development, product safety, occupational health services, and regulatory compliance
- Governmental agencies where they provide toxicology expertise to the U.S. Food and Drug Administration, the U.S. Environmental Protection Agency, and state and local health departments as well as non-governmental advocacy organizations, consumer groups and industrial associations
- Clinical and forensic laboratories where they aid in the design, conduction and interpretation of diagnostic tests and forensic studies
What if I am interested in becoming a member of the American College of Medical Toxicology?