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Poisoning & Drug Overdose provides practical advice for the diagnosis and management of poisoning and drug overdose and concise information about common industrial chemicals.

The manual is divided into four sections and an index. Section I leads the reader through initial emergency management, including treatment of coma, hypotension, and other common complications; physical and laboratory diagnosis; and methods of decontamination and enhanced elimination of poisons. Section II provides detailed information for approximately 150 common drugs and poisons. Section III describes the use and side effects of approximately 60 antidotes and therapeutic drugs. Section IV describes the medical management of chemical spills and occupational chemical exposures and includes a table of over 500 chemicals. The Index is comprehensive and extensively cross-referenced.

The manual is designed to allow the reader to move quickly from section to section, obtaining the needed information from each. For example, in managing a patient with isoniazid intoxication, the reader will find specific information about isoniazid toxicity in Section II, practical advice for gut decontamination and management of complications such as seizures in Section I, and detailed information about dosing and side effects for the antidote pyridoxine in Section III.


The success of the first and second editions of this manual would not have been possible without the combined efforts of the staff, faculty, and fellows of the San Francisco Bay Area Regional Poison Control Center, to whom I am deeply indebted. From its inception, this book has been a project by and for our poison center; as a result, all royalties from its sale have gone to our center's operating fund and not to any individual editor or author.

In January 1997, four independent poison control centers joined their talents to become the California Poison Control System, administered by the University of California, San Francisco. With the third, fourth, and fifth editions, the manual became a project of our statewide system, bringing in new authors and editors.

On behalf of the authors and editors of the sixth edition, my sincere thanks go to all those who contributed to one or more of the first five editions:

Timothy E. Albertson, MD, PhD
Judith A. Alsop, PharmD
Ilene Brewer Anderson, PharmD
Margaret Atterbury, MD
Georgeanne M. Backman
John Balmes, MD
Shireen Banerji, PharmD
James David Barry, MD
Charles E. Becker, MD
Neal L. Benowitz, MD
Bruce Bernard, MD
David P. Betten, MD
Kathleen Birnbaum, PharmD
Paul D. Blanc, MD, MSPH
Stephen Born, MD
Christopher R. Brown, MD
Randall G. Browning, MD, MPH
James F. Buchanan, PharmD
Alan Buchwald, MD
Cindy Burkhardt, PharmD
F. Lee Cantrell, PharmD
Terry Carlson, PharmD
Gregory Cham, MD
Chulathida Chomchai, MD
Summon Chomchai, MD
Richard F. Clark, MD
Matthew D. Cook, MD
Delia Dempsey, MD
Chris Dutra, MD
Jo Ellen Dyer, PharmD
Brent R. Ekins, PharmD
Andrew Erdman, MD
Gary Everson, PharmD
Thomas J. Ferguson, MD, PhD
Donna E. Foliart, MD, MPH
Frederick Fung, MD
Mark J. Galbo, MS
Fabian Garza, PharmD
Rick Geller, MD
Robert L. Goldberg, MD
Colin S. Goto, MD
Gail M. Gullickson, MD
Christine A. Haller, MD
Jennifer Hannum, MD
Patricia H. Hiatt, BS
B. Zane Horowitz, MD
Yao-min Hung, MD
David L. Irons, PharmD
Leslie Isreal, DO, MPH
Gerald Joe, PharmD
Jeffrey R. Jones, MPH, CIH
Thomas E. Kearney, PharmD
Kathryn H. Keller, PharmD
Michael T. Kelley, MD
Susan Y. Kim, PharmD
Michael Kosnett, MD
Amy Kunihiro, MD
Grant D. Lackey, PharmD
Chi-Leung Lai, PharmD
Rita Lam, PharmD
Shelly Lam, PharmD
John P. Lamb, PharmD
Belle L. Lee, PharmD
Darrem Lew, PharmD
Diane Liu, MD, MPH
Binh T. Ly, MD
Richard Lynton, MD
Beth Manning, PharmD
Anthony S. Manoguerra, PharmD
Kathy Marquardt, PharmD
Timothy D. McCarthy, PharmD
Howard E. McKinney, PharmD
Kathryn H. Meier, PharmD
Michael A. Miller, MD
Eileen Morentz
Walter H. Mullen, PharmD
Stephen W. Munday, MD, MPH, MS
Nancy G. Murphy, MD
Frank J. Mycroft, PhD, MPH
Steve Offerman, MD
Kent R. Olson, MD
Michael O'Malley, MD, MPH
Gary Joseph Ordog, MD
John D. Osterloh, MD
Gary Pasternak, MD
Manish Patel, MD
Paul D. Pearigen, MD
Cyrus Rangan, MD
Brett A. Roth, MD
Freda M. Rowley, PharmD
Thomas R. Sands, PharmD
Aaron Schnier, MD
Jay Schrader
Kerry Schwarz, PharmD
Dennis J. Shusterman, MD, MPH
Karl A. Sporer, MD
Jeffrey R. Suchard, MD
Winnie W. Tai, PharmD
David A. Tanen, MD
S. Alan Tani, PharmD
John H. Tegzes, VMD
R. Steven Tharratt, MD
Josef G. Thundiyil, MD, MPH
Ben Tsutaoka, PharmD
Mary Tweig, MD
Peter H. Wald, MD, MPH
Michael J. Walsh, PharmD
Jonathan Wasserberger, MD
Janet S. Weiss, MD
R. David West, PharmD
Timothy J. Wiegand, MD
Saralyn R. Williams, MD
Olga F. Woo, PharmD
Evan T. Wythe, MD
Peter Yip, MD
Shoshana Zevin, MD

We are also grateful for the numerous comments and suggestions received from colleagues, students, and the editorial staff at McGraw-Hill, which helped us to improve the manual with each edition.

San Francisco, California
August 2011

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