This university program brings you closer to the advances in the treatments applied to patients suffering from gas poisoning"

Social and economic changes influence the presence of intoxicated persons in the emergency department. Apart from the control and prevention measures in consumer products, there are individual behaviors associated with leisure that lead to alcohol poisoning or drug overdose, especially in the youth population group. Likewise, drug abuse by people with mental disorders is also notable in the Emergency department. Two scenarios, where the medical professional must be aware of the most consumed substances, their effects on the body and the therapeutic approach.

Therefore, emetics, gastric lavage, activated charcoal, forced diuresis or alkaline diuresis are the techniques of absorption or purification of toxins most commonly used by medical professionals, who, however, must be up to date with the advances made in the diagnoses and treatments currently used in patients who have suffered poisoning by heavy metals, pesticides or medical devices. In this scenario, TECH has developed a Master's Degree that will allow students to delve into Emergency Toxicology in a dynamic manner. 

The multimedia teaching resources that make up the syllabus of this university program will favor the medical professionals who seek to update their knowledge in a visual and agile way. Accordingly, the program will delve into the most frequent poisonings, as well as the products, food or animals that cause the mildest to the most serious poisonings. This program will also delve into the protection measures of health care personnel, as well as the most relevant legal aspects of toxicological care.

This Master's Degree is, therefore, an excellent opportunity for professionals who wish to update their knowledge through an exclusively online and flexible format, which will allow them to balance their medical functions with a university education. With no classroom attendance or fixed class timetables, students who take part in this program will only need an electronic device with an Internet connection to access the complete syllabus hosted on the virtual campus. Additionally, the Relearning system, used by this academic institution in all its programs, reduces the long hours of study that are so common in other teaching methods.  

TECH provides you with all the necessary tools to update your knowledge in Toxicology in an agile and comfortable way"

This Master's Degree in Emergency Toxicology contains the most complete and up-to-date scientific program on the market. Its most outstanding features are:

• The development of practical cases presented by experts in Toxicology
• The graphic, schematic, and practical contents with which they are created, provide scientific and practical information on the disciplines that are essential for professional practice
• Practical exercises where the self-assessment process can be carried out to improve learning
• Its special emphasis on innovative methodologies
• Theoretical lessons, questions to the expert, debate forums on controversial topics, and individual reflection assignments
• Content that is accessible from any fixed or portable device with an Internet connection

The library of educational resources will immerse you in synthetic drug intoxication so that you are aware of their effects on the patient"

The program’s teaching staff includes professionals from the sector who contribute their work experience to this program, as well as renowned specialists from leading societies and prestigious universities.

Its multimedia content, developed with the latest educational technology, will allow the professional a situated and contextual learning, that is, a simulated environment that will provide an immersive education programmed to prepare in real situations.

The design of this program focuses on Problem-Based Learning, in which the professional will have to try to solve the different professional practice situations that will arise throughout the academic course. For this purpose, the student will be assisted by an innovative interactive video system created by renowned experts. 

Delve into prolonged latency syndromes in a much more engaging way thanks to the multimedia content of this university program"

You can access the most exhaustive syllabus on the most common toxidromes in the Emergency Department."

The syllabus of this Master's Degree has been developed by a specialized teaching team with extensive experience in the diagnosis and emergency treatment of patients who have suffered poisoning. Given the multiple cases that can produce such poisonings, this program delves into drugs of abuse, poisoning by gases, solvents, heavy metals, phytosanitary products, cleaning products or plants, mushrooms and animals. All this with a theoretical-practical approach that is reflected in the video summaries, videos in detail or specialized readings.

The detailed videos and clinical cases will be of great use to you, offering you a more real and direct vision of the patient with intoxication"

Module 1. Introduction

1.1. Introduction 
1.2. Basic Concepts of Toxicology 

1.2.1. Concepts of Toxicology, Intoxication, Toxicants and Toxicity 
1.2.2. Clinical Toxicology 

1.2.2.1. Types of Toxicity 
1.2.2.2. Types of Intoxication 
1.2.2.3. Dose-Response 
1.2.2.4. Causes of Intoxication 
1.2.2.5. Toxicity Mechanisms 

1.2.2.5.1. Toxicokinetics 
1.2.2.5.2. Toxicodynamics 

1.3. Toxicology in its Historical Context 

1.3.1. The Use of Poisons in the Bronze Age 
1.3.2. Poisoning in Ancient Times 
1.3.3. The Middle Ages 
1.3.4. The Modern Age 
1.3.5. Contemporary Era 

1.4. Chemistry as a Weapon: The History of Criminal Toxicology 
1.5. Radiation as a Crime

Module 2. Assessment of the Poisoned Patient

2.1. Introduction to the Module

2.1.1. Medical History

2.1.1.1. Medical History
2.1.1.2. Physical Examination
2.1.1.3. Complementary Evaluations

2.1.2. Toxic Syndromes

2.1.2.1. Sympathomimetics
2.1.2.2. Cholinergic Drugs
2.1.2.3. Anticholinergics
2.1.2.4. Serotonergic Drugs
2.1.2.5. Opioids
2.1.2.6. Sedative-Hypnotic Drugs
2.1.2.7. Hallucinatory Drugs

2.1.3. Metabolic Acidosis in Toxicology
2.1.4. Diagnosis of Suspected Poisoning and Diagnostic Hypotheses
2.1.5. The Toxicological Information Service (TIS) of the National Institute of Toxicology as a Center for Diagnostic and Therapeutic Assistance
2.1.6. Conclusions and Key Points

2.2. Initial Assessment of Patients Suffering from Intoxication

2.2.1. Preliminary

2.2.1.1. Introduction
2.2.1.2. Index
2.2.1.3. Objectives

2.2.2. Hepatic Toxicology
2.2.3. Renal Toxicology
2.2.4. Hematological Toxicity
2.2.5. Neurological and Psychiatric Toxicology
2.2.6. Conclusions and Key Points
2.2.7. Cardiovascular and Respiratory Toxicology

2.3. Toxic Organ Involvement 

2.3.1. Preliminary 

2.3.1.1. Introduction 
2.3.1.2. Index 
2.3.1.3. Objectives 

2.3.2. Reproductive and Perinatal Toxicology 
2.3.3. Neonatal and Pediatric Toxicology 
2.3.4. Geriatric Toxicology

2.4. Group Toxicology

Module 3. Therapeutic Management of Poisoned Patients: Life Support

3.1. A Complete Overview of Poisoning Treatment
3.2. Life Support for Poisoned Patients: Cardiopulmonary Arrest

3.2.1. The Fundamental Pillars of Life Support in Cardiopulmonary Arrest
3.2.2. Respiratory Arrest and Ventilatory Support
3.2.3. Cardiorespiratory Arrest in Poisoned Patients
3.2.4. Conclusions and Key Points

3.3. Acute Respiratory Failure in Poisoned Patients and Therapeutic Management

3.3.1. Preliminary
3.3.2. Acute Respiratory Failure due to Airway Obstruction
3.3.3. Acute Respiratory Failure due to Hypoventilation
3.3.4. Acute Respiratory Failure due to Decrease in Inspiratory Oxygen Fraction
3.3.5. Acute Respiratory Failure due to Alveolocapillary Diffusion Impairment
3.3.6. Acute Respiratory Failure due to Altered Oxygen Transport or Tissue Oxygen Utilization
3.3.7. Acute Mixed Respiratory Failure
3.3.8. Conclusions and Key Points

3.4.Hemodynamic Stability and Instability in Poisoned Patients

3.4.1. Shock and its Different Types in Poisoned Patients
3.4.2. Therapeutic Management of Shock in Poisoned Patients
3.4.3. Hypotension and Hypertension in Poisoned Patients
3.4.4. Cardiac Arrhythmias in Acute Poisoning
3.4.5. Acute Coronary Syndrome in Poisoned Patients
3.4.6. Conclusions and Key Points

3.5. Neuropsychiatric Disorders Associated with Poisoning

3.5.1. Disorders of Consciousness Toxic Coma
3.5.2. Seizures.
3.5.3. Behavioral Disorder. Agitated Patient Management

3.5.3.1. Etiology of Psychomotor Agitation. Toxicology-Related Causes
3.5.3.2. Protective Measures for Healthcare Personnel
3.5.3.3. Verbal, Mechanical and Pharmacological Restraint Measures

3.5.4. Conclusions and Key Points

Module 4. Therapeutic Management of Poisoned Patients: Specific Treatment

4.1. The Three Phases of the Specific Treatment of Poisoning
4.2. Decrease Toxin Absorption

4.2.1. Digestive Decontamination:

4.2.1.1. Emetics
4.2.1.2. Gastric lavage
4.2.1.3. Activated Carbon
4.2.1.4. Cathartics
4.2.1.5. Whole Bowel Irrigation

4.2.2. Skin Decontamination
4.2.3. Ocular Decontamination
4.2.4. Prevention of Parenteral Absorption
4.2.5. Prevention of Pulmonary Absorption
4.2.6. Endoscopy and Surgery
4.2.7. Dilution
4.2.8. Conclusions and Key Points

4.3. Increasing Toxicant Elimination

4.3.1. Kidney Cleanse

4.3.1.1. Forced Diuresis
4.3.1.2. Alkaline Diuresis

4.3.2. Extrarenal Purification

4.3.2.1. Dialysis
4.3.2.2. Hemoperfusion, Hemofiltration, Hemodiafiltration
4.3.2.3. Plasmapheresis and Exchange Transfusion
4.3.2.4. Conclusions and Key Points

4.4. Antidotes

4.4.1. Main Antidotes

4.4.1.1. Indications, Contraindications, Side Effects and Precautions
4.4.1.2. Dose

4.4.2. Minimum Stock of Antidotes Depending on the Type of Hospital or Health Center
4.4.3. Conclusions and Key Points

4.5.Antidotes

4.5.1.Nasogastric or Orogastric Tube Placement Technique, and Gastric Lavage
4.5.2.Skin and Ocular Decontamination Techniques

Module 5. Therapeutic Management of Poisoned Patients: Additional Aspects

5.1. General Outline of Additional Aspects to Consider
5.2. The Suicidal Patient and Toxicology. Psychiatric Assessment

5.2.1. Introduction
5.2.2. Risk Factors for Self-Harming Behavior
5.2.3. Determining the Severity of Self-Harm Attempts
5.2.4. Suicidal Patient Management
5.2.5. Conclusions and Key Points

5.3. Medical and Legal Aspects of Toxicological Care

5.3.1. Introduction
5.3.2. Report to the Court
5.3.3. Medical and Legal Autopsy
5.3.4. Sampling of the Patient Corpse
5.3.5. Informed Consent and Voluntary Discharge of the Poisoned Patient
5.3.6. The Extraction of Blood Samples for Toxicological Studies in the Emergency Room
5.3.7. Conclusions and Key Points

5.4. Protective Measures for Healthcare Personnel

5.4.1. Introduction
5.4.2. Personal Protective Equipment (PPE)
5.4.3. Poison Prevention Measures for Healthcare Personnel
5.4.4. Conclusions and Key Points

5.5. General Criteria for Admission to an Intensive Care Unit

5.5.1. Introduction
5.5.2. Criteria Table
5.5.3. Conclusions and Key Points

5.6. Toxicant-Induced Rhabdomyolysis

5.6.1. Introduction
5.6.2. Definition and Pathophysiology
5.6.3. General Etiology and Toxicological Causes of Rhabdomyolysis
5.6.4. Clinical Manifestations, Laboratory Tests and Complications
5.6.5. Treatment
5.6.6. Conclusions and Key Points

5.7. Toxicant-Induced Methemoglobinemia

5.7.1. Introduction
5.7.2. Pathophysiology
5.7.3. Etiology of Methemoglobinemia
5.7.4. Clinical Manifestations
5.7.5. Suspected, Differential and Confirmatory Diagnosis
5.7.6. Treatment

5.8. Hypersensitivity and Anaphylaxis Secondary to Poisonings by Animal Stings or Bites

5.8.1. Introduction
5.8.2. Etiology
5.8.3. Hypersensitivity Types
5.8.4. Clinical Manifestations
5.8.5. Diagnosis
5.8.6. Treatment Management
5.8.7. Conclusions and Key Points

5.9. Emergencies Associated with Psychotropic Drugs

5.9.1. Introduction
5.9.2. Neuroleptic Malignant Syndrome.

5.9.2.1. Definition and Risk Factors
5.9.2.2. Clinical Manifestations and Differential Diagnosis
5.9.2.3. Treatment

5.9.3. Serotonin Syndrome

5.9.3.1. Causes
5.9.3.2. Clinical Manifestations and Differential Diagnosis
5.9.3.3. Treatment

5.9.4. Acute Dystonia
5.9.5. Drug-Induced Parkinsonism
5.9.6. Conclusions and Key Points

Module 6. Toxicology of Drugs of Abuse

6.1. Drug Addiction, Intoxication, Withdrawal Syndromes, Sexual Offenses, Drug Traffickers, Reinsertion
6.2. Epidemiology of Drugs of Abuse
6.3. CNS Depressant Poisoning

6.3.1. Preliminary

6.3.1.1. Introduction
6.3.1.2. Index
6.3.1.3. Objectives

6.3.1.3.1. Opiates (Heroin; Methadone; Oxycodone)
6.3.1.3.2. Alcohol Poisoning
6.3.1.3.3. Volatile Inhalable Substances
6.3.1.3.4. Conclusions and Key Points

6.4. Psychostimulant Poisoning

6.4.1. Preliminary

6.4.1.1. Introduction
6.4.1.2. Index
6.4.1.3. Objectives

6.4.1.3.1. Cocaine.
6.4.1.3.2. Amphetamines
6.4.1.3.3. Others (Ephedrine and Pseudoephedrine, Khat, Energy Drinks, Guarana)
6.4.1.3.4. Conclusions and Key Points

6.5. Hallucinogen Poisoning

6.5.1. Hallucinogenic Mushrooms (LSD, Amanita Muscaria, Psilocybe)
6.5.2. Hallucinogenic Plants

6.5.2.1. Cannabis
6.5.2.2. Mescaline
6.5.2.3. Stramonium
6.5.2.4. Belladonna
6.5.2.5. Scopolamine (Burundanga)
6.5.2.6. Vegetable Ecstasy

6.5.3. DMT and AMT
6.5.4. Dextromethorphan
6.5.5. Conclusions and Key Points

6.6. Poisoning by Synthetic Drugs

6.6.1. Synthetic Opiates (Fentanyl and Meperidine Derivatives)
6.6.2. Dissociative

6.6.2.1. Phencyclidine and Ketamine

6.6.3. Methaqualone Derivatives
6.6.4. Synthetic Phenylethylamines

6.6.4.1. DOM, BOB, 2C-B, MDA
6.6.4.2. Ecstasy (MDMA)
6.6.4.3. Liquid Ecstasy (GHB)
6.6.4.4. Conclusions and Key Points

6.7. Psychosocial Component of Drugs of Abuse
6.8. Sex and Drugs: Chemsex orChemical Sex 

6.8.1. What is Meant by Chemsex?
6.8.2. Historical Background and Epidemiologic Profile of Consumers
6.8.3. Risks Associated with the Practice of Chemsex
6.8.4. Most Commonly Used Drugs
6.8.5. Conclusions and Key Points

6.9. Language and Drugs

6.9.1. A Language that Emergency Physicians Must Know
6.9.2. Drug Slang
6.9.3. The Slang of Drugs of Abuse
6.9.4. Conclusions and Key Points

6.10. A Society Besieged by Drugs

6.10.1. Introduction
6.10.2. The "Botellón" a Toxic Social Phenomenon
6.10.3. Electronic Parties and Drugs of Abuse
6.10.4. The “Jarra Loca”
6.10.5. Conclusions and Key Points

6.11. Body Packers and Body Stuffers in Emergencies

6.11.1. Definition
6.11.2. Clinical Manifestations
6.11.3. Diagnosis
6.11.4. Treatment Management
6.11.5. Conclusions and Key Points

6.12. Chemical Submission

6.12.1. Concept
6.12.2. Epidemiology
6.12.3. Keys to Diagnosis
6.12.4.Crimes Related to Chemical Submission
6.12.5. Drugs Most Commonly Used in Chemical Submission
6.12.6. Conclusions and Key Points

6.13. Withdrawal Syndromes

6.13.1. Introduction and Objectives
6.13.2. Alcohol Withdrawal Syndrome

6.13.2.1. Concept
6.13.2.2. Clinical Manifestations and Criteria Diagnosis
6.13.2.3. Delirium Tremens
6.13.2.4. Alcohol Withdrawal Syndrome Treatment
6.13.2.5. Conclusions and Key Points

6.13.3. Opioid Withdrawal Syndrome

6.13.3.1. Concept
6.13.3.2. Opioid Dependence and Tolerance
6.13.3.3. Clinical Manifestations and Diagnosis of the Withdrawal Syndrome
6.13.3.4. Treatment of Drug Addicts with Withdrawal Syndrome

6.13.4. Detoxification Treatment
6.13.5. Conclusions and Key Points

6.14. Addictive Behavior Unit

Module 7. Toxicology and Pharmacology

7.1. Poisoning by Analgesics and Anti-Inflammatory Drugs

7.1.1. Preliminary

7.1.1.1. Introduction
7.1.1.2. Index
7.1.1.3. Objectives

7.1.2. Paracetamol
7.1.3. NSAIDs
7.1.4. Salicylates
7.1.5. Colchicine
7.1.6. Conclusions and Key Points

7.2. Psychotropic Drug Poisoning

7.2.1. Preliminary

7.2.1.1. Introduction
7.2.1.2. Index
7.2.1.3. Objectives

7.2.2. Antidepressants

7.2.2.1. Tricyclics
7.2.2.2. Selective Serotonin Reuptake Inhibitors (SSRIs)
7.2.2.3. Monoamine Oxidase Inhibitors (MAOIs)

7.2.3. Lithium
7.2.4. Sedative-Hypnotic Drugs

7.2.4.1. Benzodiazepines
7.2.4.2. Barbiturates
7.2.4.3. Non-Benzodiazepine and Non-Barbiturate Sedative-Hypnotic Drugs

7.2.5. Antipsychotics
7.2.6. Anticonvulsants
7.2.7. Conclusions and Key Points

7.3.Antiarrhythmic and Antihypertensive Drug Poisoning

7.3.1.Preliminary

7.3.1.1. Introduction
7.3.1.2. Index
7.3.1.3. Objectives

7.3.2.Digoxin
7.3.3.Beta-Blockers
7.3.4.Calcium Antagonists
7.3.5.Conclusions and Key Points

7.4.Poisoning by Other Drugs

7.4.1.Preliminary

7.4.1.1. Introduction
7.4.1.2. Index
7.4.1.3. Objectives

7.4.2.Antihistamines
7.4.3.Anticoagulants
7.4.4.Metoclopramide
7.4.5.Hypoglycemics
7.4.6.Conclusions and Key Points

Module 8. Industrial Poisoning from Fumes

8.1.Effect of Different Types of Gases on the Respiratory System
8.2.Poisoning due to Inhalation of Fumes

8.2.1.Preliminary

8.2.1.1. Introduction
8.2.1.2. Index
8.2.1.3. Objective

8.2.2.Mechanisms of Toxicity Production and Airway Damage
8.2.3.Clinical Manifestations
8.2.4.Medical History, Examination and Suspected Diagnosis
8.2.5.Treatment Management
8.2.6.Conclusions and Key Points

8.3.Irritant Fume Poisoning

8.3.1.Preliminary

8.3.1.1. Introduction
8.3.1.2. Index
8.3.1.3. Objective

8.3.2.Hydrogen Sulfide Poisoning

8.3.2.1. Sources of Exposure
8.3.2.2. Toxicokinetics and Pathophysiology
8.3.2.3. Clinical Manifestations and Diagnosis
8.3.2.4. Treatment

8.3.3.Fluorine Derivative Poisoning

8.3.3.1. Sources of Exposure
8.3.3.2. Pathophysiology
8.3.3.3. Clinical Manifestations
8.3.3.4. Diagnosis and Treatment

8.3.4.Chlorine Derivative Poisoning

8.3.4.1. General Aspects of Poisoning

8.3.5.Nitrogen Derivative Poisoning

8.3.5.1. Ammonia Poisoning
8.3.5.2. Other Intoxications

8.4.Poisoning by Asphyxiating Fumes: Carbon Monoxide

8.4.1.Preliminary

8.4.1.1. Introduction
8.4.1.2. Index
8.4.1.3. Objective

8.4.2.Definition and Causes of Carbon Monoxide Hazards
8.4.3.Epidemiology of Carbon Monoxide Poisoning: A Known and a Hidden Epidemiology
8.4.4.Sources of Carbon Monoxide Exposure and Medical and Legal Causes of Poisoning
8.4.5.Pathophysiology of Carbon Monoxide Poisoning
8.4.6.Clinical Manifestations
8.4.7.Diagnosis of Suspicion and Diagnostic Confirmation. Pulse Oximetry in the Prehospital Setting
8.4.8.Poisoning Severity Criteria
8.4.9.Treatment of Poisoning
8.4.10.Observation, Admission and Discharge Criteria
8.4.11.Conclusions and Key Points

8.5.Chemical Asphyxia: Cyanide

8.5.1.Preliminary

8.5.1.1. Introduction
8.5.1.2. Index
8.5.1.3. Objective

8.5.2.Sources of Exposure
8.5.3.Toxicokinetics and Pathophysiology
8.5.4.Clinical Manifestations, Suspicion and Confirmation Diagnosis
8.5.5.Treatment
8.5.6.Conclusions and Key Points

Module 9. Industrial Poisoning by Solvents 

9.1.Introduction to the Module
9.2.Hydrocarbon Poisoning

9.2.1.Preliminary

9.2.1.1. Introduction
9.2.1.2. Index
9.2.1.3. Objective

9.2.2.Aliphatic or Linear

9.2.2.1. Short Chain Hydrocarbons: Butane, Propane, Ethane and Methane 
9.2.2.2. Long-Chain Hydrocarbons: Pentanes, Hexanes, Heptanes and Octanes 
9.2.2.3. Petroleum Distillates: Gasoline, Kerosene, and Others 
9.2.2.4. Halogenated Products 
9.2.2.5. Carbon Tetrachloride 
9.2.2.6. Chloroform 
9.2.2.7. Dichloromethane 
9.2.2.8. Trichloroethylene 
9.2.2.9. Tetrachloroethylene 
9.2.2.10. Trichloroethane

9.2.3.Aromatic or Cyclic

9.2.3.1. Benzene 
9.2.3.2. Toluene 
9.2.3.3. Conclusions and Key Points

9.3.Aliphatic Alcohols Poisoning

9.3.1.Preliminary

9.3.1.1. Introduction 
9.3.1.2. Index 
9.3.1.3. Objective

9.3.2.Methyl Alcohol 
9.3.3.Isopropyl Alcohol 
9.3.4.Conclusions and Key Points

9.4.Glycol Poisoning 

9.4.1.Preliminary

9.4.1.1. Introduction 
9.4.1.2. Index 
9.4.1.3. Objective 

9.4.2.Ethylene Glycol 
9.4.3.Diethylene Glycol 
9.4.4.Propylene Glycol 
9.4.5.Conclusions and Key Points 

9.5.Nitrogen Derivative Poisoning 

9.5.1.Preliminary 

9.5.1.1. Introduction 
9.5.1.2. Index 
9.5.1.3. Objective 

9.5.2.Aniline 
9.5.3.Toluidine 
9.5.4.Nitrobenzene 
9.5.5.Conclusions and Key Points 

9.6.Acetone Poisoning 

9.6.1.Preliminary 

9.6.1.1. Introduction 
9.6.1.2. Index 
9.6.1.3. Objective 

9.6.2.Conclusions and Key Points 

Module 10. Industrial Poisoning by Heavy Metal

10.1.Introduction: General Aspects of Heavy Metals and their Main Chelating Agents
10.2.Iron Poisoning

10.2.1.Definition, General Aspects 
10.2.2.Sources of Exposure 
10.2.3.Toxicokinetics and Mechanism of Action 
10.2.4.Clinical Manifestations 
10.2.5.Diagnosis 
10.2.6.Treatment 
10.2.7.Conclusions and Key Points

10.3.Phosphorus Poisoning

10.3.1.Definition, General Aspects 
10.3.2.Sources of Exposure 
10.3.3.Toxicokinetics and Mechanism of Action 
10.3.4.Clinical Manifestations 
10.3.5.Diagnosis 
10.3.6.Treatment 
10.3.7.Conclusions and Key Points

10.4.Lead Poisoning

10.4.1.Definition, General Aspects 
10.4.2.Sources of Exposure 
10.4.3.Toxicokinetics and Mechanism of Action 
10.4.4.Clinical Manifestations 
10.4.5.Diagnosis 
10.4.6.Treatment 
10.4.7.Conclusions and Key Points 

10.5.Mercury Poisoning

10.5.1.Definition, General Aspects
10.5.2.Sources of Exposure
10.5.3.Toxicokinetics and Mechanism of Action
10.5.4.Clinical Manifestations
10.5.5.Diagnosis
10.5.6.Treatment
10.5.7.Conclusions and Key Points

10.6.Arsenic Poisoning

10.6.1.Definition, General Aspects
10.6.2.Sources of Exposure
10.6.3.Toxicokinetics and Mechanism of Action
10.6.4.Clinical Manifestations
10.6.5.Diagnosis
10.6.6.Treatment
10.6.7.Conclusions and Key Points

10.7.Cadmium Poisoning 

10.7.1.Definition, General Aspects
10.7.2.Sources of Exposure
10.7.3.Toxicokinetics and Mechanism of Action
10.7.4.Clinical Manifestations
10.7.5.Diagnosis
10.7.6.Treatment
10.7.7.Conclusions and Key Points

Module 11. Pesticide or Phytosanitary Product Poisoning in Rural Areas

11.1.Introduction to the Module: General Aspects of Pesticide Poisoning

11.1.1.Concept of Pesticides 
11.1.2.Classification of Pesticides 
11.1.3.Preventive and Protective Measures for Workers 
11.1.4.First Aid at the Poisoning Site 

11.2.Poisoning by Insecticides and Fungicides 

11.2.1.Preliminary 

11.2.1.1. Introduction 
11.2.1.2. Index 
11.2.1.3. Objective 

11.2.2.Organochlorines 
11.2.3.Organophosphates 
11.2.4.Carbamates 
11.2.5.Pyrethroids 
11.2.6.Conclusions and Key Points 

11.3.Herbicide Poisoning 

11.3.1.Preliminary 

11.3.1.1. Introduction 
11.3.1.2. Index 
11.3.1.3. Objective 

11.3.2.Diquat 
11.3.3.Paraquat 
11.3.4.Conclusions and Key Points 

11.4.Fungicide Poisoning 

11.4.1.Conclusions and Key Points 
11.5.Rodenticide Poisoning 
11.5.1.Conclusions and Key Points 

Module 12. Household Poisoning from Cleaning Products, Personal Hygiene Products and Caustic Poisons

12.1.Introduction to the Module 
12.2.Poisoning from Cleaning, Personal Hygiene and Cosmetic Products 

12.2.1.Classification According to Toxicity 
12.2.2.Specific Poisonings 

12.2.2.1. Soaps and Shampoos 
12.2.2.2. Nail Polish and Nail Polish Remover 
12.2.2.3. Hair Substances: Hair Dyes, Hairsprays, Hair Softeners, etc. 
12.2.2.4. Others 

12.2.3.General Therapeutic Measures and Controversies 
12.2.4.Conclusions and Key Points 

12.3.Caustic Poisoning 

12.3.1.Introduction 
12.3.2.Main Caustic Substances 
12.3.3.Pathophysiology 
12.3.4.Clinical Symptoms 
12.3.5.Diagnosis 
12.3.6.Acute and Late Complications 
12.3.7.Treatment and Attitude to be Followed 
12.3.8.Conclusions and Key Points

Module 13. Poisoning from Natural Agents: Plants, Mushrooms and Animals

13.1.Plant Poisoning

13.1.1.Classification According to Target Organ, Apparatus or System

13.1.1.1. Gastrointestinal 
13.1.1.2. Cardiovascular 
13.1.1.3. Central Nervous System 
13.1.1.4. Others

13.1.2.Conclusions and Key Points

13.2.Mushroom Poisoning

13.2.1.Epidemiology of Mushroom Poisoning 
13.2.2.Pathophysiology 
13.2.3.The Clinical History as a Fundamental Element for Diagnosis 
13.2.4.Classification According to the Latency Period of Onset of Clinical Manifestations and Clinical Syndromes 

13.2.4.1. Short Latency Syndromes 

13.2.4.1.1. Acute Mushroom Gastroenteritis (Gastroenteritic, Resinoid or Lividian Syndrome) 
13.2.4.1.2. Intolerance Syndrome 
13.2.4.1.3. Delirium Syndrome (Mycoatropinic or Anticholinergic) 
13.2.4.1.4. Muscarinic Syndrome (Mycocholinergic or Sweat Syndrome) 
13.2.4.1.5. Hallucinatory Syndrome (Psychotropic or Narcotic) 
13.2.4.1.6. Nitritoid Syndrome (Coprinic or Antabus Effect Syndrome) 
13.2.4.1.7. Hemolytic Syndrome 

13.2.4.2. Long-Latency Syndromes 

13.2.4.2.1. Giromitrile Syndrome (Ogiromitrile) 
13.2.4.2.2. Orellanic Syndrome (Cortinaric or Nephrotoxic) 
13.2.4.2.3. Phalloid, Hepatotoxic or Cyclopeptide Syndrome 

13.2.4.2.3.1. Etiology 
13.2.4.2.3.2. Pathophysiology and Toxicokinetics 
13.2.4.2.3.3. Clinical Symptoms 
13.2.4.2.3.4. Diagnosis 
13.2.4.2.3.5. Treatment 
13.2.4.2.3.6. Prognosis 

13.2.4.3. New Syndromes 

13.2.4.3.1. Proximal Syndrome 
13.2.4.3.2. Erythromelalgia or Achromelalgia 
13.2.4.3.3. Rhabdomyolysis 
13.2.4.3.4. Hemorrhagic Syndrome (or Szechwan's Syndrome) 
13.2.4.3.5. Neurotoxic Poisoning 
13.2.4.3.6. Encephalopathy 
13.2.4.4. Conclusions and Key Points 

13.3.Animal Poisoning: Snakes 

13.3.1. Preliminary 

13.3.1.1. Introduction 
13.3.1.2. Index 
13.3.1.3. Objectives 

13.3.2. Epidemiology of Snake Bites 
13.3.3. Classification of Snakes 
13.3.4. Differences between Vipers and Snakes 
13.3.5. The Poison Apparatus of Snakes 
13.3.6. The Effect of Snake Venoms on Humans 
13.3.7. Clinical Symptoms 

13.3.7.1. Clinical Syndromes 

13.3.7.1.1. Neurological Syndrome 
13.3.7.1.2. Hemotoxic-Cytotoxic Syndrome 
13.3.7.1.3. Cardiotoxic and Myotoxic Syndromes 
13.3.7.1.4. Hypersensitivity Syndromes 
13.3.7.2. Clinical Grading of the Intensity of the Poisoning 

13.3.8.Treatment 

13.3.8.1. Symptoms 
13.3.8.2. Specific 

13.3.9.Conclusions and Key Points 

13.4.Animal Bites: Mammals 

13.4.1.Preliminary 

13.4.1.1. Introduction 
13.4.1.2. Index 
13.4.1.3. Objectives 

13.4.2.Epidemiological Aspects 
13.4.3.Clinical-Diagnostic Aspects 
13.4.4.Therapeutic Aspects 

13.4.4.1. Initial Management 
13.4.4.2. Surgical Management: Suture 
13.4.4.3. Antibiotic Prophylaxis 
13.4.4.4. Tetanus Prophylaxis 
13.4.4.5. Rabies Prophylaxis 
13.4.4.6. Antiviral Prophylaxis: Anti-Hepatitis B and Anti-HIV 

13.4.5.Conclusions and Key Points 

13.5.Marine Animals 

13.5.1.Fish Poisoning 

13.5.1.1. Stonefish 
13.5.1.2. Viperfish 
13.5.1.3. Stingray 

13.5.2.Food Poisoning from Fish and Shellfish 

13.5.2.1. Paralytic Shellfish Poisoning 
13.5.2.2. Scombroidosis. Histamine Poisoning 
13.5.2.3. Pufferfish Poisoning 

13.5.3.Coelenterate Poisoning 

13.5.3.1. Jellyfish Stings 
13.5.3.2. Physalia Physalis or the Portuguese Man o’ War Sting 
13.5.3.3. Treatment 

13.5.4.Conclusions and Key Points 

13.6.Invertebrates 

13.6.1.Preliminary 

13.6.1.1. Introduction 
13.6.1.2. Index 
13.6.1.3. Objectives 

13.6.2.Insects: Wasps, Bees and Bumblebees 
13.6.3.Arachnids 

13.6.3.1. Spiders 
13.6.3.2. Scorpions 
13.6.3.3. Ticks 

13.6.4. Conclusions and Key Points  

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