Medical Toxicology

Welcome:

Welcome to the Division of Medical Toxicology at the University of Texas Health Science Center, McGovern Medical School, in Houston, Texas! We are pleased by your interest and invite you to learn more about the division.

History:

The Department of Emergency Medicine initiated the establishment of the Division of Medical Toxicology in 2021. The division seeks to promote clinical excellence in patient care; quality education for medical students, residents, fellows, and attending physicians; and the cultivation of innovative and collaborative research and scholarly initiatives. The division looks forward to growth in these areas, as well as increasing an educational and social media presence.

Clinical Service:

Bedside consultation is offered at Memorial Hermann Hospital – Texas Medical Center, and Children’s Memorial Hermann Hospital. Patients are evaluated and treated in a variety of clinical settings, including the emergency department, inpatient units, and intensive care areas.

If you are a clinician seeking expert medical toxicology consultation, please contact Dr. Billington via PerfectServe by searching “Mary Billington” or “Toxicology”.

Please consider medical toxicology consultation particularly for:

  • Any toxicologic or suspected toxicologic condition (serotonin syndrome, anticholinergic syndrome, NMS, malignant hyperthermia, cholinergic excess, sympathomimetic, sedative-hypnotic requiring antidote consideration)
  • Consideration of any antidote use (e.g. activated charcoal, methylene blue, physostigmine, flumazenil, naloxone, NAC, etc.)
  • Acetaminophen overdose (acute and chronic exposures)
  • Hepatic failure related to toxins/medications
  • Adverse medication effects (include drug interactions, unexpected drug effects, drug-induced liver injury, drug administration errors)
  • Altered mental status suspected secondary to drug, metal, or other toxin
  • Acute drug overdoses (prescription, OTC, supplements, drugs of abuse)
  • Acute drug withdrawal syndromes (including difficult or refractory alcohol withdrawal)
  • Snake bites, toxic spider evenomation
  • Chemical exposures (including pesticides, occupational exposures, household products)
  • Caustic agent exposure (ingestion, topical, inhalational)
  • Carbon monoxide exposure; inhalational exposures (not including mold/fungus)
  • Buprenorphine induction, management of medication-assisted therapy agents in-hospital
  • Foodborne illness (toxin-related)
  • Suspected exposure to novel drugs of abuse

Educational Activities:

A one-week elective PharmTox rotation is offered to emergency medicine resident physicians in the UT Health / McGovern Medicine School residency program. This elective rotation is highly focused on education of the resident physician. Strong emphasis is placed on essential pharmacologic and foundational topics in medical toxicology.

 

The division looks forward to the anticipated initiation of a clinical educational rotation for Pediatric Emergency Medicine fellow physicians. The division additionally looks forward to extending an early career subspecialty exposure offering to medical students at UT McGovern Medical School.

 

Research and Scholarship:

The division is engaged in both internal and inter-institutional research endeavors. Resident physicians interested in medical toxicology are enthusiastically encouraged to contact Dr. Winkler to initiate a scholarly project with a focus on individual interests.

 

Goals/Vision:

The division aims to maintain a positive trajectory towards expanding clinical services, research engagement, and educational initiatives. The division aims to actively facilitate early student exposure to the subspecialty and actively assist in vocational discernment to stimulate growth and excellence in the field of medical toxicology.

 

We are pleased to hear from motivated students and physicians interested in engaging in our multifaceted growth initiatives.

 

Bio of Director of Medical Toxicology, Garret A. Winkler III, MD:

 

Garry Winkler, M.D. is an Emergency Medicine physician and Medical Toxicologist based out of Houston, Texas. He graduated from Trinity University in San Antonio, Texas with a Bachelor of Science in Biochemistry and Molecular Biology in 2008. After receiving his Medical Degree at the University of Texas Health Science Center in San Antonio, he completed his surgical internship at Boston Medical Center in Boston, MA. He completed his Emergency Medicine Residency at the University of Arizona Tucson University Campus and received a distinction in Medical Education. He further completed his Medical Toxicology fellowship at the University of California San Diego. He is currently based at the University of Texas Health Houston practicing Emergency Medicine and Toxicology. Garry serves as the current co-chair for the American Academy of Clinical Toxicology’s Diversity, Inclusion, and Equity section.

Dr. Winkler is very enthusiastic to offer Medical Toxicology consultation services at Memorial Hermann Hospital and is additionally happy to assist with consultations related to Addiction Medicine. For consultation requests please contact him through PerfectServe. If he is unable to be contacted through PerfectServe please contact him via email at garret.a.winkler@uth.tmc.edu. He also can also be contacted by email if there is interest in Toxicology educational sessions or didactics.