Medical Toxicology
Clinically Applied Pharmacology in Emergency Medicine
The Medical Toxicology Section at UTHealth Houston Emergency Medicine provides specialized expertise in the diagnosis, evaluation, and management of toxicologic emergencies.
Rooted in clinically applied pharmacology, the section supports bedside consultation, education, and systems-based care for patients exposed to medications, substances of abuse, environmental toxins, and envenomations.
Toxicology in Practice
Medical toxicology focuses on the recognition and management of illness resulting from drug, chemical, and biologic exposures. Faculty within the section provide real-time consultation across Memorial Hermann Hospital (external link) sites, supporting emergency clinicians in the evaluation of complex overdoses, toxic syndromes, and exposure-related illness.
Memorial Hermann – TMC (external link)
Children’s Memorial Hermann – TMC (external link)
Care is centered on rapid identification of toxidromes, targeted antidotal therapy, and evidence-based decontamination and enhanced elimination strategies when indicated. The service integrates closely with emergency medicine, critical care, pharmacy, and addiction medicine to guide high-acuity patient care.
Clinical Consult Service
The toxicology service provides bedside and phone consultation for a broad range of toxicologic emergencies, including:
- Prescription and over-the-counter medication overdoses
- Drugs of abuse and withdrawal syndromes
- Environmental and industrial exposures
- Plant, animal, and marine envenomations
- Toxic alcohols and chemical ingestion
- Complex multi-agent ingestions
Clinical care emphasizes structured toxicologic history-taking, focused physical examination, EKG interpretation, and interpretation of targeted laboratory and toxicology testing.
Faculty support emergency teams in real-time decision-making involving antidotal therapy, decontamination strategies, and advanced elimination techniques such as dialysis when appropriate.
Medical Toxicology Elective
The Medical Toxicology elective provides learners with structured exposure to clinical toxicology practice through direct patient care, didactics, and scholarly activity.
Students participate in daily clinical rounds and evaluate an average of five new patients per week under faculty supervision. Teaching is integrated into clinical service through daily educational sessions and bedside learning.
Key educational components include:
- Toxidrome identification and management
- Toxicologic history and physical examination
- EKG and laboratory interpretation in overdose
- Antidotal therapy and decontamination strategies
- Addiction medicine and withdrawal recognition
- Toxicology consultation and clinical reasoning
Learners also participate in a robust academic curriculum including:
- Picture Project presentations (5–10 minute focused toxicology topics)
- End-of-rotation presentations (in-depth topic analysis and management)
- Toxicology journal club with critical appraisal of current literature
This structure emphasizes communication, clinical reasoning, and applied pharmacology in real-world toxicology practice.
Curriculum Focus Areas
The toxicology curriculum spans a wide range of clinically relevant exposures and mechanisms, including:
- Acute overdose and toxic ingestion
- Pharmacokinetics and toxicokinetics in overdose states
- Organ-specific toxic injury (hepatic, cardiac, neurologic)
- Phase I and II metabolism and enzyme saturation effects
- Toxidrome recognition and syndrome-based diagnosis
- Toxicologic laboratory interpretation and limitations
- Antidotal therapies and enhanced elimination techniques
This foundation prepares learners to approach toxicologic illness with a systematic, physiologically grounded framework.
Unique Features
Medical Toxicology at UTHealth Houston offers a distinctive blend of:
- High-acuity consultative clinical practice
- Clinically applied pharmacology education
- Structured case-based learning and journal club
- Image-driven “Picture Project” teaching model
- Integration of addiction medicine principles into acute care
- Direct faculty mentorship in bedside toxicology consultation
Together, these elements create a focused and immersive learning environment centered on real-world toxicologic decision-making.