![]() ![]() Others with a long duration of action, such as methadone or naltrexone, can have toxicity recrudescence hours after an apparent good response to an antidote. ![]() Some toxins are notable for the delay from time of ingestion to onset of symptoms (e.g., acetaminophen, Amanita mushroom poisoning, valproic acid, sulfonylureas). Skills in taking a history and performing a thorough physical exam, as well as knowledge of the common toxidromes and the appropriate use of laboratory and/or radiologic studies, are required.Ĭare of poisoned patients is mainly symptomatic and supportive, but some toxins can be treated with a reversal agent or require extracorporeal removal. Poisoned patients are frequently encountered in the intensive care setting and often pose a diagnostic challenge.
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