Related Experiment Videos
Delayed toxidromes
1Department of Emergency Medicine, University of Louisville and Kentucky Regional Poison Center, 40292, USA.
Abstract:
Some toxins do not result in clinical manifestations until several hours after exposure. This article reviews those agents that may cause delayed-onset toxicity. They are organized into four classes: specific pharmaceuticals, biologicals, pharmaceutical dosage forms, and chemicals. There are five basic mechanisms for delayed toxicity: delayed absorption, distribution factors, metabolic factors, cellular and organ capacity effects, and unknown. Scientific evidence for delayed-onset of effects varies considerably among the individual toxins.
Insights
Certain toxins cause delayed clinical effects hours after exposure. This review categorizes agents and mechanisms of delayed-onset toxicity, highlighting varied scientific evidence.
Area of Science:
- Toxicology
- Pharmacology
- Environmental Health
Background:
- Clinical manifestations of some toxic exposures are not immediate.
- Delayed-onset toxicity presents unique diagnostic and management challenges.
Purpose of the Study:
- To review agents causing delayed-onset toxicity.
- To categorize these agents and their mechanisms.
- To discuss the varying scientific evidence for delayed effects.
Main Methods:
- Literature review of toxins with delayed clinical manifestations.
- Classification of agents into four groups: pharmaceuticals, biologicals, pharmaceutical dosage forms, and chemicals.
- Identification of five primary mechanisms for delayed toxicity.
Main Results:
- Agents causing delayed toxicity are diverse, spanning pharmaceuticals, biologicals, dosage forms, and chemicals.
- Key mechanisms include delayed absorption, distribution, metabolism, and cellular/organ capacity effects, with some mechanisms remaining unknown.
- The strength of scientific evidence supporting delayed-onset effects differs significantly across individual toxins.
Conclusions:
- Understanding delayed-onset toxicity is crucial for effective patient management.
- Categorization aids in identifying potential risks and understanding underlying mechanisms.
- Further research is needed to strengthen the evidence base for various delayed-acting toxins.