MedTox 2021 LLSA Reading List


Levine M, Stellpflug SJ, Pizon AF, Peak DA, Villano J, Wiegand T, et al. Hypoglycemia and lactic acidosis outperform King's College criteria for predicting death or transplant in acetaminophen toxic patients. Clin Toxicol (Phila) 2018 July;56(7):622-25.

  • The development of post-resuscitation acidosis, which is often driven by lactic acid accumulation, has been shown to be a strong predictor of ___________________ in acetaminophen overdose.
  • In this study, the combination of ___________________, ___________________, and ___________________ were better predictors of the composite endpoint of death or transplant than the King’s College criteria.


Margolis AM, Heverling H, Pham PA, Stolbach A. A review of the toxicity of HIV medications. J Med Toxicol 2014 Mar;10(1):26-39.

  • Antiretroviral regimens today typically have three drugs, consisting of two ___________________ with either a boosted ___________________ or ___________________.
  • The hallmark toxicity of the NRTI class is ___________________.

Diagnostic Aids (e.g., contrast agents)

  • Gadolinium deposition has been shown to primarily occur in the ___________________ nucleus and ___________________.
  • No well-designed studies have produced evidence that patients have developed ___________________ or ___________________ illness following gadolinium-based contrast agent administration.


Kelkar AH, Smith NA, Martial A, Moole H, Tarantino MD, Roberts JC. An outbreak of synthetic cannabinoid-associated coagulopathy in Illinois. N Engl J Med 2018 Sept;379(13):1216-23.

  • Anticoagulant tests were positive for ___________________, ___________________, ___________________, and ___________________.
  • The most common bleeding symptom in the patients at presentation was ___________________, and the most common nonbleeding symptom was ___________________.

Industrial, Household, and Environmental Toxicant

Greenberg MI, Vearrier D. Metal fume fever and polymer fume fever. Clin Toxicol (Phila) 2015 May;53(4):195-203.

  • The most commonly implicated metal exposure associated with metal fume fever involves the inhalation of ___________________.
  • As with metal fever, polymer fume fever is typically a benign, self-limited disease with symptom resolution over a ___________________ period.


Braun JM, Hornung R, Chen A, Dietrich KN, Jacobs DE, Jones R, et al. Effect of residential lead-hazard interventions on childhood blood lead concentrations and neurobehavioral outcomes: a randomized clinical trial. JAMA Pediatr 2018 Oct;172(10):934-42.

  • The interventions included installing a ___________________ if the lead concentration in drinking water exceeded 2ug/L and replacing windows that have lead-based paint or show more than ___________________% deterioration.
  • Blood lead concentrations from 1 to 8 years of age were ___________________ among children in the intervention group compared with children in the control group.

Opioids, Injury Prevention

Babu KM, Brent J, Juurlink DN. Prevention of opioid overdose. N Engl J Med 2019;380(23):2246-55.

  • New, persistent opioid use is increasingly recognized as one of the most common complications after ___________________.
  • There is now widespread recognition that coprescribing of opioids and ___________________ is hazardous.

Psychoactive Drugs and Hallucinogens (Marijuana)

Noble MJ, Hedberg K, Hendrickson RG. Acute cannabis toxicity. Clin Toxicol (Phila) 2019 Aug;57(8):735-42.

  • Among all ages, ___________________ and ___________________ were more likely following inhalation exposures compared to ingestions.
  • Children had a higher likelihood of intensive care unit admission and intubation following exposure to ___________________ products.

Singh A, Saluja S, Kumar A, Agrawal S, Thind M, Nanda S, et al. Cardiovascular complications of marijuana and related substances: a review. Cardiol Ther 2018 Jun;7(1):45-59.

  • ___________________ is the most commonly reported adverse cardiovascular effect of cannabis use.
  • The risk of AMI increases nearly ___________________ within an hour of exposure to cannabis compared to nonusers.


Kazzi ZN. Acute radiation injuries. In: Brent J, editor. Critical care toxicology: diagnosis and management of the critically poisoned patient. Springer 2017: 605-17.

  • The biological effects of ionizing radiation result directly from the interaction of the alpha or beta particles with ___________________ or indirectly from the production of ___________________ through gamma ray-induced hydrolysis of intracellular water.
  • When the dose received is between 2 and 6 Gy, the ___________________ system is primarily affected.


  • Extracorporeal treatment is suggested if the blood pH is less than or equal to ___________________.
  • The workgroup favored ___________________ over continuous renal replacement techniques, even in the context of hypotension.


Cediel G, Carrillo X, García-García C, Rueda F, Oliveras T, Labata C, et al. β-Blocker treatment and prognosis in acute coronary syndrome associated with cocaine consumption: the RUTI-Cocaine Study. Int J Cardiol 2018 Jun;260:7-10.

  • Beta-blocker therapy is a ___________________ treatment option.
  • The myocardial protective benefits of beta-blockers may offset cocaine derived concerns and may provide important long-term ___________________ benefits.

Warfare and Terrorism, Chemical

Henretig FM, Kirk MA, McKay CA Jr. Hazardous chemical emergencies and poisonings. N Engl J Med 2019 Apr;380(17):1638-55.

  • For gases, the estimated median lethal dose ___________________ reflects both the ___________________ inhaled and the ___________________ of exposure.
  • Fourth generation nerve agents, also known as Novichok agents, persist on skin and environmental surfaces for ___________________ days, and have a latency period of ___________________ after dermal exposure.