Course Title: Pharmacology
Course No.: PHL 462
Professor Name Dr. Nawal Al-Rasheed
Lecture outline (1 &2)
General management of the poisoning patient
Clinical and laboratory results and their evaluation
Clinical evaluation
1. History
2. Physical examination
Vital signs
Eyes
Skin
Breath
Lungs
Abdomen
Laboratory tests
Blood tests
Arterial blood gas analysis
Electrocardiogram
Others
The toxic screen
1. Indications
2. Limitations
3. General methods
Reference Textbook:
- Clinical Management of Poisoning and Drug Overdose, 3rd ed, Haddad, L., Shannon,
M and Winchester, J, 1998. Chapter 1
- Medical Toxicology, Schonwald, S, 2001. Chapter 3
Course No: PHL 462
Professor Name Dr. Nawal Al-Rasheed
Lecture outline (3)
Supportive therapy
Airway management
Circulatory support
Hypotension
Hypertension
Hypothermia
Convulsion
Acid-base balance
Metabolic acidosis
Metabolic alkalosis
Fluid and electrolyte imbalance
Reference Textbook:
Clinical Management of Poisoning and Drug Overdose
Chapter 1 and chapter 5
Course No: PHL 462
Professor Name Dr. Nawal Al-Rasheed
Lecture outline (3)
Insulin and oral hypoglycemic agents toxicity
Insulin
Actions
Pharmacokinetics
Clinical presentation of overdose
 Hypoglycemia
 Other manifestations
Drug interactions
Diagnosis
Treatment
 Antidotes
Oral hypoglycemic agents
Sulfonylureas
Mechanism
Pharmacokinetics
Side effects
Clinical presentation of overdose
Drug interactions
Diagnosis
Treatment
 Antidotes
Biguanides
Mechanism of action
Side effects
Overdose of biguanides
Treatment
Reference Textbook:
- Clinical Management of Poisoning and Drug Overdose
Chapter 47
- Medical Toxicology, Schonwald, S, 2001. Chapter 29
Course No: PHL 462
Professor Name Dr. Nawal Al-Rasheed
Lecture outline (4)
Diuretics
The main classes of diuretics
Thiazides
 Mechanism of action
 Pharmacokinetics
 Overdose
 Long-term therapy
 Drug interaction
 Diagnosis
 Treatment
Loop diuretics
 Mechanism of action
 Pharmacokinetics
 Drug interactions
 Treatment
Potassium sparing diuretics
 Mechanism of action
 Pharmacokinetics
 Overdose
 Drug interactions
 Treatment
Medical Toxicology, Schonwald, S, 2001. pp 282-286
Course No: PHL 462
Professor Name Dr. Nawal Al-Rasheed
Lecture outline (5)
Antidepressant drugs
The main classes of antidepressants
Tricyclic antidepressants (TCAs)
Pharmacological effects
Pharmacokinetics
Overdose
 Cardiac toxicity
 CNS
 Hyperthermia
 Others
Diagnosis
 Analytic methods
 Blood level
 ECG
Treatment
 Supportive measures
 Antidotes
Interactions
MAOIs
 Toxicity
 Serotonin syndrome
 Drug and food interaction
Selective serotonin reuptake inhibitors (SSRIs) (will be discussed in the lab)
Course No: PHL 462
Professor Name Dr. Nawal Al-Rasheed
Lecture outline (7)
Food toxicology (lec 7 and 8)
Historical clues
Drugs
Food
Travel
Water
Clinical presentations
Non-inflammatory diarrhea
Inflammatory diarrhea
Vomiting
Peritonitis
Neurological effects
Laboratory
Fecal leukocytes
Ova and parasites
Stool cultures
Treatment
Oral hydration
IV hydration
Antibiotics
Anti-peristaltic agents
Examples of bacterial foodborne illness
Salmonella, vibrio, botulism
Include, descriptions of clinical presentations, causes, mechanism of
toxicity, diagnosis and treatments
Viral gastroenteritis
Differences from bacterial
Rotavirus
Parvovirus
Clinical presentations
Treatments
Gastrointestinal parasites
Amebiasis
Giardia Lamblia
Clinical presentations and treatments
Reference Textbook:
- Clinical Management of Poisoning and Drug Overdose
Chapter
- Medical Toxicology, Schonwald, S, 2001. Chapter 41