Medical Toxicology

Code:

OPT153

Acronym:

TM

Keywords
Classification	Keyword
OFICIAL	Medicine

Instance: 2019/2020 - 2S (of 10-02-2020 to 31-07-2020)

Active?	Yes
Responsible unit:	Departamento de Biomedicina
Course/CS Responsible:	Integrated Master in Medicine

Cycles of Study/Courses

Acronym	No. of Students	Study Plan	Curricular Years	Credits UCN	Credits ECTS	Contact hours	Total Time
MIMED	21	Mestrado Integrado em Medicina- Plano oficial 2013 (Reforma Curricular)	4	-	3	26	81

Teaching language

Portuguese and english

Objectives

This course unit has as main objective to allow the contact in the pre-graduation with Medical Toxicology understood as the organized body of knowledge about the diagnosis, treatment and prevention of toxic actions of chemical agents in humans. In this context, enable the student and future doctor to diagnose and treat medical emergencies related to drugs and chemicals. In addition to this aspect of emergency medicine are also addressed themes of environmental toxicology with the study of poisons of animal and plant origin that have toxicity to humans.

It is intended that the student is able to:

1. Know the principles of Medical Toxicology
2. Identify and classify the various mechanisms of toxicity
3. Assess and identify in the intoxicated patient the signs and symptoms of toxicity
4. Identify the various Toxindromes, know the decision algorithm for a patient with acute intoxication, life support care, nonspecific therapy of poisonings and available antidotes.
5. Know the most common animal and plant poisons in Portugal as well as the medical approach in the case of intoxication in humans.
6. To know the toxics used as "chemical warfare" and to treat the toxic situation of each of these agents.
7. To know and to divulge strategies of prevention of intoxication / poisoning in the man

Learning outcomes and competences

To know the main chemical agents causing toxicity in humans, their mechanism of action and the medical procedures in case of intoxication in humans.

To know the various Toxidromes as well as the algorithm of decision in a patient with acute intoxication, life support care, nonspecific therapy of intoxications and the main antidotes.

Identify animals and plants with toxic potential as well as the mechanism of action of animal and plant poisons.

Working method

Presencial

Pre-requirements (prior knowledge) and co-requirements (common knowledge)

Knowledge of Physiology and Medical Pharmacology that allows understanding the mechanisms of action of drugs and toxic and respective cellular and systemic consequences.

Basic knowledge of medical semiology in order to recognize the signs and symptoms of toxicity in man.

Program

Program-28 Hours of contact (3 hours of tutorials, 8 hours of seminars, 16 hours of internship)

Tutorial 1. General principles of Medical toxicology. Environmental Toxicology. Preventive measures in toxic exposure. Indications on the implementation of the seminars and the final work of the students. (1h-Maria Augusta Vieira Coelho)

Tutorial 2. Mechanism of action of drugs and poisons. Approach of the patient with acute intoxication. Antidotes. (1h-Maria Augusta Vieira Coelho)

Tutorial 3. Dermatological expression of adverse drug reactions (2h-Sofia Magina)

Internship 1. Poisoning by CO and use of the hyperbaric chamber stage – Hospital Pedro Hispano, Matosinhos (4 hours-Dr. Óscar Camacho and Maria Augusta Vieira Coelho, X3 classes)

Internship 2. Medical approach of acute intoxications in man-intensive care unit of the urgency of CHSJ-Porto, (4 hours-Rui Veiga, X3turmas 2x2h).

Internship 3. Nephrological approach in the treatment of intoxications in man, promotion of toxic excretion. Various techniques of dialise. Nephrology Service of CHSJ, Porto, (4 hours – Luis Coentrão, X3turmas 2X2h).

Internship 4. Psychiatric approach of the patient after ingestion of medications or toxics with suicidal intentionality. (4 hours – Maria Augusta Vieira, X3turmas 1x4h).

Seminar 1. Presentation of studies carried out by students about accidental poisoning or suicidal intentionality involving drugs in the following areas: cardiovascular, metabolic/inflammatory, renal and hepatic (each student with 10 min of presentation with two Toxic-Total 2 hours-Maria Augusta Vieira Coelho)

Seminar 2. Presentation of studies carried out by students about accidental poisoning or suicidal intentionality involving drugs from the following areas: neurology, psychiatry, pain, and environmental/occupational exposure (each student with 10 min of presentation for two toxic subtances-total 2 hours-Maria Augusta Vieira Coelho).

Seminar 3. Presentation of studies carried out by students on poisons of animal origin (each student with 10 min of presentation with two toxic substances-(total 2 hours-Maria Augusta Vieira Coelho).

Seminar 4. Presentation of studies carried out by students about poisons of vegetal origin (each student with 10 min of presentation with two toxics-(total 2 hours-Maria Augusta Vieira Coelho).

Mandatory literature

Goldfrank L, Flomenbaum N, Lewin N, Howland MA, Hoffman R, Nelson L.; Goldfrank's Toxicologic Emergencies, 11th edition, McGraw-Hill, New York, NY, 2013 , McGraw-Hill, 2019. ISBN: ISBN-13: 978-1259859618

Teaching methods and learning activities

Teaching is in person. It is done in seminars, tutorials and in short clinical internships

This unit has the external collaboration from Dr. Óscar Camacho, head of Hyperbaric Medicine of Pedro Hispano unit in Hospital Matosinhos. This internship allows to know the signs and symptoms of the carbon monoxide poisoning, as well as the procedures to be faced with this intoxication including the use of the hyperbaric chamber.

The clinical internships are organized in order to give the student the skills to deal with acute poisoning in man. Thus, the internships are prepared according to the most used medical procedures with the patient with acute intoxication that goes to the Hospital:

- General urgency of CHSJ-Intensive Care Unit (Dr. Rui Veiga, intensivist)

- Nephrology Department of CHSJ (Professor Luís Coentrão, intensivist and nephrologist).

- Metropolitan Urgency of Psychiatry, CHSJ (Professor Maria Augusta Vieira Coelho, Pharmacologist and Psychiatrist)

keywords

Health sciences > Medical sciences > Medicine
Health sciences > Medical sciences > Medicine > Intensive care
Health sciences > Pharmacological sciences > Toicology > Poisoning
Health sciences > Pharmacological sciences > Toicology

Evaluation Type

Distributed evaluation without final exam

Assessment Components

Designation	Weight (%)
Participação presencial	25,00
Trabalho escrito	25,00
Trabalho prático ou de projeto	25,00
Defesa pública de dissertação, de relatório de projeto ou estágio, ou de tese	25,00
Total:	100,00

Amount of time allocated to each course unit

Designation	Time (hours)
Apresentação/discussão de um trabalho científico	8,00
Frequência das aulas	12,00
Realização de Estágio	16,00
Trabalho escrito	15,00
Elaboração de relatório/dissertação/tese	10,00
Estudo autónomo	20,00
Total:	81,00

Eligibility for exams

According to the FMUP Pedagogical Regulation.

Calculation formula of final grade

The evaluation result is expressed on a scale of 0-20 (minimum: 10 points). The assessment is made according to:

1. (A) In-person and active student participation during internships and seminars. 25%

2. (B) Public defense with oral presentation on the poisons project (animal and plant origin). 25%

3. (C) Practical work - preparation and presentation of a seminar on acute poisoning in man. 25%

4. (D) Written work on the technical file of poisons presented in public defense 25%



Final grade calculation = (A * 0.25) + (B * 0.25) + (C * 0.25) + (D * 0.25)

Examinations or Special Assignments

1. Presentation of two practical works in seminars, one on acute intoxications with drugs, the second on two poisons, one of animal origin and another of vegetal origin.

2. Written work on the technical file of animal and plant poisons presented in the seminars.

Internship work/project

Develop a technical sheet on two poisons of interest for Medical Toxicology.

Special assessment (TE, DA, ...)

Students with a statute or special condition may request replacement of the continuous assessment component (A), which is replaced by a written examination (E).

These students will also have to do assignments B (Public defense), C (practical work) and D (written work).



The date of submission of the public defense (B) and practical work (C) may be agreed in advance with the Professor.



So for these students:



Final grade calculation = (E * 0.25) + (B * 0.25) + (C * 0.25) + (D * 0.25)