Toxicologie humaine [ WSBIM2246 ]

The student is supposed ta have basic knowledge of anatomy, physiology and biochemistry. The material consists mainly of the slide presentations during the lessons.

The lessons are focusing on the important concept of target organ. The basis of the presentation will be the experience accumulated from the management of acutaly poisoned patients (drug overdoses). For each main organ (brain, heart, lung...), the topic will be introduced by a clinical case. From the clinical manifestations, the pathophysiology will be discussed in depth. Criteria of severity will be defined for the most common toxins. Treatment will also be discussed, with a critical analysis of the use of the antidotes. In addition to the adverse effects of drugs, other aspects of environmental toxicology will be covered : exposures to toxic plants, animals, gases... Some illustrative situations are described (Seveso, nephrotoxicity due to herbal remedies).

The objective of these lessons is to give to the student a general overview of the most common mechanisms of toxicity that could be observed in clinical medicine. A large variety of substances will be covered, including therapeutic drugs but also illicit substances. At the end of the formation, the student should be able to distinguish functional and lesional toxins. He should also be able to assess the responsability of toxic agent in clinical manifestations.

The evaluation is made with a questionnaire with multiple choise questions and open questions.

content method :

The following chapter's will be illustrated by clinical case :

- Epidemiology of drug poisoning

- Pharmaco and toxicokinetics and toxicodynamics

- Toxins inducing central nervous system disturbances : drug and illicite substance

- Toxic causes of metabolic acidosis

- Mechanisms of cardiotoxicity

- Paracetamol-induced liver failure

- Toxicity due to animals and plants

- Carbon monoxide and cyanide poisoning