Clinical Pearls in Medical Toxicology: Updates Ranging From Decontamination to Elimination

Abstract

Such as any field of medicine, it is imperative to stay current with the latest advances and treatment modalities in toxicology. With the absence of rigorous randomized controlled trials, many updated guidelines are created by expert consensus and/or case reports and clinical experience. Over the past 10 years, there have been several changes in the management of drug overdoses in light of new data available. Although this is not a comprehensive review of all available antidotes, this article will focus on several important interventions including the use of gastrointestinal decontamination, hyperinsulinemic–euglycemic therapy, methylene blue, intravenous lipid emulsion, hemodialysis, and extracorporeal membrane oxygenation.

Contemporary Topics in Critical Care With Evolving Medication Management Considerations

“…Updates in the use of gastrointestinal decontamination, hyperinsulinemic–euglycemic therapy, methylene blue, intravenous lipid emulsion, hemodialysis, and extracorporeal membrane oxygenation in the management of ICU patients presenting with an overdose are reviewed. 11 A highly relevant topic that continues to evolve is the management of a patient presenting to the ICU with an endocrine emergency. Recognition and management of severe conditions such as acute adrenal insufficiency, thyroid crisis, hypoglycemia and hyperglycemic crisis, and life-threatening electrolyte disorders are reviewed.…”