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Clinical toxicology--past, present and future.
1Regional Poisoning Treatment Centre, Royal Infirmary of Edinburgh, UK.
Human Toxicology
|September 1, 1988
Summary
Acute poisoning cases increased significantly, leading to the creation of UK poisons services. Advances in toxicology have improved treatments, but challenges remain, especially with delayed paracetamol poisoning.
Area of Science:
- Clinical Toxicology
- Public Health
Background:
- Rising self-poisoning incidents in Western countries during the 1950s necessitated specialized services.
- The types of poisons involved in acute poisoning reflect community availability and prescribing trends, with psychotropic drugs and analgesics being predominant.
Purpose of the Study:
- To review the historical development and advancements in clinical toxicology and poisons information services.
- To highlight effective treatments and persistent challenges in managing acute poisoning cases.
Main Methods:
- Review of historical data and clinical practices in managing acute poisoning.
- Analysis of treatment efficacy for various poisoning agents, including supportive care, antidotes, and analytical toxicology contributions.
Main Results:
- Effective treatments like activated charcoal and haemoperfusion exist for certain poisonings (e.g., barbiturates).
- Key advancements include naloxone for opiate overdose, Fab fragments for digoxin toxicity, and established paracetamol poisoning treatment.
- Challenges persist with tricyclic antidepressants, paraquat poisoning, and delayed paracetamol presentation; psychiatric assessment remains debated.
Conclusions:
- While the peak 'epidemic' of acute poisoning may have passed, ongoing vigilance and adaptation of poisons information services are crucial.
- Future development should leverage computer-based technology to enhance poisons information services and address evolving challenges in toxicology.