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Deadly Single Dose Agents
StatPearls. StatPearls Publishing: Treasure Island (FL).BOOK

Abstract
Although the basics of evaluating and treating most unknown ingestants are well known, many overdoses require very specific treatment if the patient is to have any chance of survival.[1] Countless studies have been published supporting Dr. Gideon Koren's 1993 landmark article "Medications Which Can Kill a Toddler with One Tablet or Teaspoonful" in the Journal of Toxicology.[2][3][4][5] while each has its own merits, most focus solely on pediatric overdoses, and relatively few of them provide an exhaustive list or act as a "quick-reference" when dealing with real-time ingestions.  Despite widespread public education, childproof containers, and other safety measures, accidental overdoses continue to occur.  In the United States, poison control centers receive over 2.2 million calls each year, 47% of which concern children less than six years of age.  Most pediatric accidental ingestions involve cosmetics and personal care products, followed by cleaning products, and then analgesics and prescription medications.  Adult overdoses usually are due to the intentional ingestion of analgesics and sedative-hypnotics.  Following are the list of toxic drugs (in decreasing severity/difficulty of treatment) included in this summary:  1. Alpha-2 adrenergic agonists - clonidine, naphazoline, oxymetazoline, tetrahydrozoline. 2. Sulfonylureas - chlorpropamide, glyburide, glipizide, glimepiride. 3. Calcium channel blockers - nifedipine, verapamil, diltiazem, amlodipine, nicardipine. 4. Beta-blockers - metoprolol, labetalol. 5. Tricyclic antidepressants - imipramine, desipramine, amitriptyline, nortriptyline. 6. Opioids - codeine, hydrocodone, methadone, morphine, heroin. 7. Anti-diarrheals - diphenoxylate + atropine, loperamide. 8. Salicylates/Methyl salicylates - wintergreen oil, bismuth subsalicylate, mentholated balms. 9. Antipsychotics - loxapine, thioridazine, chlorpromazine. 10. Antimalarials - chloroquine, hydroxychloroquine, quinine. 11. Antiarrhythmics - quinidine, disopyramide, procainamide, flecainide. 12. Terpenoid (camphor) - analgesic, anti-itch, and cooling gels, ointments, and balms. 13. Non-alkaloid toxic lignan - podophyllin, podofilox. 14. Plant toxin/secondary metabolite - colchicine. 15. Oral acetylcholinesterase inhibitors - rivastigmine, donepezil, galantamine. 16. Methylxanthine - theophylline: 1,3-dimethylxanthine. 17. Partial opioid agonist/synthetics - buprenorphine/fentanyl. 18. Toxic alcohols - methanol, ethylene glycol. 19. Caustics /household products - acidic or alkaline household products, hydrofluoric acid, selenious acid, ammonia fluoride, methacrylic acid (cosmetic glue), naphthalene (mothballs).

Publisher

StatPearls Publishing
Treasure Island (FL)

Language

eng

PubMed ID

28722879

Citation

Euwema MS, Swanson TJ: Deadly Single Dose Agents. StatPearls. StatPearls Publishing, 2021, Treasure Island (FL).
Euwema MS, Swanson TJ. Deadly Single Dose Agents. StatPearls. StatPearls Publishing; 2021.
Euwema MS & Swanson TJ. (2021). Deadly Single Dose Agents. In StatPearls. Treasure Island (FL): StatPearls Publishing
Euwema MS, Swanson TJ. Deadly Single Dose Agents. StatPearls. Treasure Island (FL): StatPearls Publishing; 2021.
* Article titles in AMA citation format should be in sentence-case
TY - CHAP T1 - Deadly Single Dose Agents BT - StatPearls A1 - Euwema,Michael S., AU - Swanson,Terrell J., Y1 - 2021/01// PY - 2017/7/20/pubmed PY - 2017/7/20/medline PY - 2017/7/20/entrez N2 - Although the basics of evaluating and treating most unknown ingestants are well known, many overdoses require very specific treatment if the patient is to have any chance of survival.[1] Countless studies have been published supporting Dr. Gideon Koren's 1993 landmark article "Medications Which Can Kill a Toddler with One Tablet or Teaspoonful" in the Journal of Toxicology.[2][3][4][5] while each has its own merits, most focus solely on pediatric overdoses, and relatively few of them provide an exhaustive list or act as a "quick-reference" when dealing with real-time ingestions.  Despite widespread public education, childproof containers, and other safety measures, accidental overdoses continue to occur.  In the United States, poison control centers receive over 2.2 million calls each year, 47% of which concern children less than six years of age.  Most pediatric accidental ingestions involve cosmetics and personal care products, followed by cleaning products, and then analgesics and prescription medications.  Adult overdoses usually are due to the intentional ingestion of analgesics and sedative-hypnotics.  Following are the list of toxic drugs (in decreasing severity/difficulty of treatment) included in this summary:  1. Alpha-2 adrenergic agonists - clonidine, naphazoline, oxymetazoline, tetrahydrozoline. 2. Sulfonylureas - chlorpropamide, glyburide, glipizide, glimepiride. 3. Calcium channel blockers - nifedipine, verapamil, diltiazem, amlodipine, nicardipine. 4. Beta-blockers - metoprolol, labetalol. 5. Tricyclic antidepressants - imipramine, desipramine, amitriptyline, nortriptyline. 6. Opioids - codeine, hydrocodone, methadone, morphine, heroin. 7. Anti-diarrheals - diphenoxylate + atropine, loperamide. 8. Salicylates/Methyl salicylates - wintergreen oil, bismuth subsalicylate, mentholated balms. 9. Antipsychotics - loxapine, thioridazine, chlorpromazine. 10. Antimalarials - chloroquine, hydroxychloroquine, quinine. 11. Antiarrhythmics - quinidine, disopyramide, procainamide, flecainide. 12. Terpenoid (camphor) - analgesic, anti-itch, and cooling gels, ointments, and balms. 13. Non-alkaloid toxic lignan - podophyllin, podofilox. 14. Plant toxin/secondary metabolite - colchicine. 15. Oral acetylcholinesterase inhibitors - rivastigmine, donepezil, galantamine. 16. Methylxanthine - theophylline: 1,3-dimethylxanthine. 17. Partial opioid agonist/synthetics - buprenorphine/fentanyl. 18. Toxic alcohols - methanol, ethylene glycol. 19. Caustics /household products - acidic or alkaline household products, hydrofluoric acid, selenious acid, ammonia fluoride, methacrylic acid (cosmetic glue), naphthalene (mothballs). PB - StatPearls Publishing CY - Treasure Island (FL) UR - https://www.unboundmedicine.com/medline/citation/28722879/StatPearls:_Deadly_Single_Dose_Agents L2 - https://www.ncbi.nlm.nih.gov/books/NBK441849 DB - PRIME DP - Unbound Medicine ER -
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