Toxicology

A Medical Toxicology curriculum for medical students has been suggested by a consensus group in the USA. See below for Prescribing Safety Assessment Domains:

Table 1: Prescribing Safety Assessment Question Domains

  1. Review the exam format, time available, open book resources allowed. There are 8 domains tested in the PSA.
Prescription Writing Writing a prescription requiring decisions regarding specific drug, dose, route and frequency based on clinical circumstances and supplementary information.
Prescription Review Deciding which components of the current prescription list are inappropriate, unsafe, or ineffective based on clinical circumstances.
Planning Management Deciding which combination of therapies would be the most appropriate to manage a particular clinical situation.
Providing Information Deciding which are the important pieces of information that should be provided to patients to allow them to choose whether to take the medication, or to enhance its safety and effectiveness.
Calculation Skills Making an accurate drug dosage calculation based on numerical information.
Adverse Drug Reactions Identifying likely adverse reactions of specific drugs, drugs that are likely to be causing specific adverse drug reactions, potentially dangerous drug interactions and deciding on the best approach to managing a clinical presentation that results from the adverse effects of a drug.
Drug Monitoring Deciding on how to monitor the beneficial and harmful effects of medicines.
Data Interpretation Deciding on the meaning of the results of investigations as they relate to decisions about on-going drug therapy.
  1. Since the Canadian PSA is open book, decide on resources that you want to use during the exam, for example, UptoDate, Lexicomp, RxTx, ODB formulary, etc.
  2. Take time to do all of the practice exams allowed.

Holbrook A, Liu JT, Rieder M, Gibson M, Levine M, Foster G, et al. Prescribing competency assessment for Canadian medical students: a pilot evaluation. Canadian Medical Education Journal. 2019;10(1):e103-e110.

Liu J, Wong S, Foster G, Holbrook A. Prescribing Competency of Medical Students: National Survey of Medical Education Leaders. Journal of Population Therapeutics and Clinical Pharmacology January 2018; doi 10.22374/1710-6222.25.1.2

Access the Canadian Antidote Guideline from the Quebec Poison Centre here (language can be switched to English if required) Antidote Guideline

The following poison control resources for health professionals can be found on the Ontario Poison Centre website:

Patient care resources – Resources

Priority – Priority Queue

Overdose management – Opioid Overdose Management

Antidotes – Antidotes

Personal health information – Privacy

Toxicology Times Newsletter:

  1. Volume 1, Issue 1A – Acetaminophen
  2. Volume 1, Issue 1B – Acetaminophen
  3. Volume 1, Issue 2 – Mushrooms

Below you will find the link to an informative talk on toxicology. *Disclaimer: you must have, and use, a medportal login to access this talk.

Toxicology | Session – Medportal

Toxicology Textbook: Students should review Goldfrank’s Toxicologic Emergencies (11th Edition). This text is available to purchase online, however students should be able to access this resource through their institutional library.

License

Clinical Pharmacology and Prescribing Skills: Copyright © by Dr Anne Holbrook,MD,PharmD,MSc,FRCPC is licensed under a Ontario Commons License, except where otherwise noted.

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