Acute Care of Poisoned Patients
The acute medical care of poisoned patients is a core component of the field of medical toxicology. I have helped to expand, review, and systematize knowledge that assists medical toxicologists in caring for acutely poisoned patients. I have conducted a systematic review of vilazodone poisoning which drew attention to this uniquely dangerous antidepressant. I conducted a single-center retrospective review of pediatric sympatholytic poisoning that highlighted the typically benign clinical course of these poisonings. I have researched and written a high-quality narrative review of the management of poisoning due to medications prescribed for diabetes mellitus. With collaborators, I have published or presented several important case reports of acute poisoning, including a case illustrating the dynamic nature of QRS interval changes in benzonatate poisoning.
Opioid Use Disorder
Opioid use disorder is a leading cause of mortality and morbidity in the United States, and new strategies to increase adoption of medications for opioid use disorder are urgently needed. As part of my clinical work in addiction medicine, I helped to develop and deploy a micro-induction protocol to allow patients to transition from full opioid agonists to buprenorphine without an intervening period of withdrawal. I published our center’s clinical experience with this protocol in Clinical Toxicology after presenting our findings as part of a platform presentation at the North American Congress of Clinical Toxicology.
Snake envenomation remains a major source of morbidity in the United States. The majority of published research on North American snake envenomation focuses on rattlesnakes; I have worked to review, summarize, and communicate the ways in which the management of Agkistrodon envenomation differs. I have pursued this work through a review article and several letters to the editor addressing controversies in snake envenomation, including those listed below. I have also participated in a multi-investigator review of data from the North American Snakebite Registry on the topic of non-native snake envenomations.