SalioSAM/toxsample11 huggingface dataset:
Poisoning cause: Severe Felodipine Toxicity
Toxic dose : Over 10 mg (adult), 0.3 mg/kg (child)
Management: Patients with bradycardia and hypotension require standard ACLS treatment. Place a central line and consider placement of an arterial line. Standard first line treatment includes atropine for bradycardia although in a serious poisoning it is rarely effective. High dose insulin and dextrose have been effective in animal studies and multiple case reports in patients with hypotension refractory to other modalities, and should be considered early in patients with significant hypotension. Use intravenous calcium in severe poisonings although in these cases, beneficial effects of calcium infusion may be very minimal or short-lived. Repeat bolus doses or a continuous intravenous infusion are often needed. Standard vasopressors should be administered to maintain blood pressure. Lipid emulsion has been successful in animal studies and a few case reports of patients with hypotension refractory to other therapies. Intravenous glucagon has been used with variable success. In a patient whose hemodynamic status continues to be refractory despite the treatment described above, extracorporeal membrane oxygenation or cardiopulmonary bypass should be considered. Treat seizures with IV benzodiazepines; barbiturates or propofol may be needed if seizures persist or recur.
Clinical effect 1: Severe circulatory collapse
Clinical effect 2: Hypotension
Clinical effect 3: Cardiogenic shock
Clinical effect 4: End-organ dysfunction
Clinical effect 5: Drowsiness/lethargy
Clinical effect 6: Bowel ischemia
Clinical effect 7: Renal failure
Clinical effect 8: Bradycardia
Clinical effect 9: Acidosis
Clinical effect 10: Death
Clinical effect 11: Hyperglycemia
Poisoning cause: Mild to Moderate Indomethacin Toxicity
Toxic dose : Over 175 mg (child), 1500 mg (adult)
Management: Treat GI distress and administer IV fluids. Manage mild hypotension with IV fluids.
Clinical effect 1: Nausea
Clinical effect 2: Vomiting
Clinical effect 3: Abdominal pain
Poisoning cause: Severe Indomethacin Toxicity
Toxic dose : Over 175 mg (child), 1500 mg (adult)
Management: Administer IV fluids, treat GI distress and monitor for GI bleeding. Patients with severe altered mental status may require intubation. Treat seizures with IV benzodiazepines; barbiturates or propofol may be needed if seizures persist or recur. Treat severe hypotension with IV 0.9% NaCl at 10 to 20 mL/kg. Add dopamine or norepinephrine if unresponsive to fluids. 
Clinical effect 1: CNS confusion
Clinical effect 2: Mental confusion
Clinical effect 3: Drowsiness/lethargy
Clinical effect 4: Upper GI bleeding
Clinical effect 5: Hypertension
Clinical effect 6: Renal failure
Poisoning cause: Mild to Moderate Sertraline Toxicity
Toxic dose : Over 250 mg.Based on Olson guidleine >500–2000 mg
Management: Primarily supportive care; activated charcoal may be helpful in patients presenting shortly after ingestion. Give benzodiazepines titrated to effect for anxiety and seizures. 
Clinical effect 1: Drowsiness/lethargy
Clinical effect 2: Dizziness
Clinical effect 3: Agitation/Irritability/Restlessness
Clinical effect 4: Nausea
Clinical effect 5: Vomiting
Clinical effect 6: Constipation
Clinical effect 7: Diarrhea
Clinical effect 8: Tachycardia
Clinical effect 9: Palpitations
Clinical effect 10: Hypertension
Clinical effect 11: Mydriasis
Clinical effect 13: Moderate Elevation of serum transaminase (100<ALT,AST<1000 ) 
Clinical effect 15: Cutaneous vasodilation
Poisoning cause: Severe Sertraline Toxicity
Management: Consider activated charcoal if patients present early after ingestion. If significant CNS depression occurs, intubate the patient for airway protection before giving charcoal. Consider intravenous lipid therapy early for patients with ventricular dysrhythmias or hypotension. Give benzodiazepines for seizures. Treat serotonin toxicity with benzodiazepine, and consider cyproheptadine, if symptoms persist. Severe cases may require neuromuscular paralysis. 
Clinical effect 2: CNS depression
Clinical effect 3: Serotonergic toxicity
Clinical effect 4:  hyperreflexia
Clinical effect 5: clonus
Clinical effect 6: hemodynamic instability 
Clinical effect 7: Seizure
Clinical effect 8: Hyponatremia
Poisoning cause: Mild to Moderate Celexa (Citalopram) Toxicity
Toxic dose : Over 5 mg/kg or 100 mg(child). Adults:over  400-800 mg
Management: Most patients require only supportive care. Control agitation and confusion with either benzodiazepines or serotonin antagonist such as cyproheptadine or chlorpromazine. Manage mild hypotension with IV fluids. Hypertension and tachycardia are generally mild and well tolerated, and do not require specific treatment.
Clinical effect 1: Agitation/Irritability/Restlessness
Clinical effect 2: Confusion
Clinical effect 3: Tremor
Clinical effect 4: Nausea
Clinical effect 5: Vomiting
Clinical effect 6: Hyperreflexia
Clinical effect 7: Occasional clonus
Clinical effect 8: Myoclonus
Clinical effect 9: Hypoglycemia
Clinical effect 10: Hypertension
Clinical effect 11: Bradycardia
Poisoning cause: Severe Celexa (Citalopram) Toxicity
Toxic dose : Over 5 mg/kg or 100 mg(child). Adults:over  400-800 mg
Management: Early intubation, neuromuscular paralysis, ventilation assistance, and aggressive cooling should be performed if the patient presents with respiratory depression, severe muscle rigidity, and severe hyperthermia. Adequate circulatory support with IV fluids and vasopressors (if needed) should be assured if patient presents with circulatory collapse. Treat seizures with benzodiazepines; use barbiturates or propofol for recurrent seizures. Patients with wide-complex dysrhythmias should be treated with hypertonic sodium bicarbonate boluses. Although QTc interval prolongation is well described, torsade de pointes is rare. If torsade de pointes occurs, patients should be treated using standard interventions (magnesium sulfate 2 g IV, external or internal cardiac pacing). Because citalopram is lipid-soluble, consider intravenous lipid therapy for patients with ventricular dysrhythmias or hypotension who do not respond to other therapies
Clinical effect 1: Seizure
Clinical effect 2: Rigidity
Clinical effect 3: Hyperthermia
Clinical effect 4: Hypertension or hypotension
Clinical effect 5: QRS widening
Clinical effect 6: QTc prolongation
Clinical effect 7: Coma
Clinical effect 8: Death
Clinical effect 9: Mental status changes
Clinical effect 10: Confusion
Clinical effect 11: Hypomania
Clinical effect 12: Agitation/Irritability/Restlessness
Clinical effect 13: Myoclonus
Clinical effect 14: Hyperreflexia
Clinical effect 15: Diaphoresis
Clinical effect 16: Shivering
Clinical effect 17: Tremor
Clinical effect 18: Diarrhea
Clinical effect 19: Incoordination
Clinical effect 20: Fever/hyperthermia
Clinical effect 21: Wide complex tachyarrhythmias
Clinical effect 22: Torsade de pointes
Clinical effect 23: Cardiac arrest
Clinical effect 24: Neuroleptic malignant syndrome
Clinical effect 25: Serotonin syndrome
Poisoning cause: MILD TO MODERATE Escitalopram (Lexapro) TOXICITY
Toxic dose : Over 50 mg
Management: Most patients require only supportive care. Control agitation and confusion with either benzodiazepines or serotonin antagonist such as cyproheptadine or chlorpromazine. Manage mild hypotension with IV fluids. Hypertension and tachycardia are generally mild and well tolerated, and do not require specific treatment.
Clinical effect 1: Agitation/Irritability/Restlessness
Clinical effect 2: Confusion
Clinical effect 3: Tremor
Clinical effect 4: Nausea
Clinical effect 5: Vomiting
Clinical effect 6: Hyperreflexia
Clinical effect 7: Clonus
Clinical effect 8: Myoclonus
Clinical effect 9: Hypoglycemia
Clinical effect 10: Hypertension
Clinical effect 11: Bradycardia
Poisoning cause: SEVERE Escitalopram (Lexapro) TOXICITY
Toxic dose : Over 50 mg
Management: Early intubation, neuromuscular paralysis, ventilation assistance, and aggressive cooling should be performed if the patient presents with respiratory depression, severe muscle rigidity, and severe hyperthermia. Adequate circulatory support with IV fluids and vasopressors (if needed) should be assured if patient presents with circulatory collapse. Treat seizures with benzodiazepines; use barbiturates or propofol for recurrent seizures. Patients with wide-complex dysrhythmias should be treated with hypertonic sodium bicarbonate boluses. Although QTc interval prolongation is well described, torsade de pointes is rare. If torsade de pointes occurs, patients should be treated using standard interventions (magnesium sulfate 2 g IV, external or internal cardiac pacing). Because citalopram is lipid-soluble, consider intravenous lipid therapy for patients with ventricular dysrhythmias or hypotension who do not respond to other therapies.
Clinical effect 1: Seizure
Clinical effect 2: Rigidity
Clinical effect 3: Hyperthermia
Clinical effect 4: Hypertension
Clinical effect 5: Hypotension
Clinical effect 6: QRS widening
Clinical effect 7: QTc prolongation
Clinical effect 8: Coma
Clinical effect 9: Death
Clinical effect 10: Mental status changes
Clinical effect 11: Confusion
Clinical effect 12: Hypomania
Clinical effect 13: Agitation/Irritability/Restlessness
Clinical effect 14: Myoclonus
Clinical effect 15: Hyperreflexia
Clinical effect 16: Diaphoresis
Clinical effect 17: Shivering
Clinical effect 18: Tremor
Clinical effect 19: Diarrhea
Clinical effect 20: Incoordination
Clinical effect 21: Fever/hyperthermia
Clinical effect 22: Serotonin syndrome
Poisoning cause: MILD TO MODERATE Fluoxetine TOXICITY
Toxic dose : based on most referencess toxic dose is Over 100 mg. However   Per Olson guideline toxic dose  in adults :over 200-800 mg
Management: Primarily supportive care; a single dose of activated charcoal may be helpful in patients presenting shortly after ingestion
Clinical effect 1: Drowsiness/lethargy
Clinical effect 2: Dizziness
Clinical effect 3: Nausea
Clinical effect 4: Vomiting
Clinical effect 5: QTc prolongation
Poisoning cause: MILD TO MODERATE Gabapentin TOXICITY
Toxic dose : Over 35000 mg based on some references and more than 18 mg/kg based on other references
Management: Treatment of gabapentin exposure is largely supportive with mild/moderate symptoms. An observation period of 4 to 6 hours is reasonable
Clinical effect 1: Drowsiness/lethargy
Clinical effect 2: Ataxia
Clinical effect 3: Slurred speech
Clinical effect 4: Nystagmus
Clinical effect 5: Movement disorders
Clinical effect 6: Gastrointestinal upset
Poisoning cause: SEVERE Gabapentin TOXICITY
Toxic dose : Over 35000 mg based on some references and more than 18 mg/kg based on other references
Management: Treatment of gabapentin exposure is largely supportive in nature with careful attention to airway protection in severe cases. Hypotension is usually mild responding to intravenous fluid boluses. If hypotension persists, administer dopamine or norepinephrine. Admit all severely symptomatic patients. Treat seizures with IV benzodiazepines or barbiturates.
Clinical effect 1: Hypotension
Clinical effect 2: Drowsiness/lethargy
Clinical effect 3: Respiratory depression
Clinical effect 4: Coma
Clinical effect 5: Eosinophilic pneumonia
Poisoning cause: MILD TO MODERATE Loperamide (Imodium) TOXICITY
Toxic dose : Over 0.4 mg/kg (Infant and child Over 6 months old)
Management: Supportive care is the mainstay of treatment. Administer naloxone for CNS or respiratory depression. 
Clinical effect 1: Drowsiness/lethargy
Clinical effect 2: Nausea
Clinical effect 3: Vomiting
Clinical effect 4: Abdominal pain
Clinical effect 5: Headache
Clinical effect 6: Miosis
Clinical effect 7: Bradycardia
Clinical effect 8: Respiratory depression
Clinical effect 9: Dystonic reactions
Clinical effect 10: Pancreatitis
Clinical effect 11: Hyponatremia
Clinical effect 12: Seizure
Poisoning cause: MILD TO MODERATE acute L-thyroxine TOXICITY
Toxic dose : Over 0.5-2 mg (child). Adult:6 months - 79 years	≥2 mg
Management: Primarily supportive care; single dose activated charcoal is advised in patients presenting shortly after an ingestion of more than 3 mg. 
Clinical effect 1: Subtle tremor
Clinical effect 2: Anxiety
Clinical effect 3: Tachycardia
Clinical effect 4: Hypertension
Poisoning cause: SEVERE acute L-thyroxine TOXICITY
Toxic dose : Over 3 mg (child)
Management: Give activated charcoal if a patient presents early after ingestion of more than 3 mg. In case of seizure, severe agitation, or significant CNS depression, perform orotracheal intubation for airway protection before giving charcoal. Administer benzodiazepines to treat seizures and agitation. Signs of catecholamine excess such as significant hypertension and tachycardia are effectively treated with propranolol 10 to 80 mg orally every 4 to 6 hours. Consider a beta 1 selective agent (ie, esmolol 50 to 200 mcg/kg/min intravenously), or a calcium channel blocker (ie, diltiazem 1 to 3 mg/kg orally every 6 to 8 hours) in patients with a history of asthma. Carefully assess volume status especially in case of severe hyperthermia. In the case of an excessive ingestion of T4 consider dexamethasone (4 mg orally every 8 hours) or propylthiouracil (PTU) (75 to 100 mg orally every 6 to 8 hours) therapy to block conversion of T4 to T3. However, the efficacy of PTU is limited because it mainly inhibits de novo synthesis of T4. Administration of aspirin and NSAIDs for the treatment of hyperthermia is discouraged, because of possible displacement of T3 and T4 from plasma proteins
Clinical effect 1: CNS depression
Clinical effect 2: Agitation/Irritability/Restlessness
Clinical effect 3: Confusion
Clinical effect 5: Seizure
Clinical effect 6: Hyperthermia
Clinical effect 7: Hypertension
Clinical effect 8: Dysrhytmia
Clinical effect 9: Supraventricular tachycardia
Clinical effect 10: Diarrhea
Poisoning cause: CHRONIC L-thyroxine TOXICITY
Toxic dose : Over 5 mg (child)
Management: In case of seizure, severe agitation, or significant CNS depression, perform orotracheal intubation for airway protection before giving charcoal. Administer benzodiazepines to treat seizures and agitation. Signs of catecholamine excess such as significant hypertension and tachycardia are effectively treated with propranolol 10 to 80 mg orally every 4 to 6 hours. Consider a beta 1 selective agent (ie, esmolol 50 to 200 mcg/kg/min intravenously), or a calcium channel blocker (ie, diltiazem 1 to 3 mg/kg orally every 6 to 8 hours) in patients with a history of asthma. Carefully assess volume status especially in case of severe hyperthermia. In the case of an excessive ingestion of T4 consider dexamethasone (4 mg orally every 8 hours) or propylthiouracil (PTU) (75 to 100 mg orally every 6 to 8 hours) therapy to block conversion of T4 to T3. However, the efficacy of PTU is limited because it mainly inhibits de novo synthesis of T4. Administration of aspirin and NSAIDs for the treatment of hyperthermia is discouraged, because of possible displacement of T3 and T4 from plasma proteins. 
Clinical effect 1: Thyrotoxicosis
Poisoning cause: Mild Methylphenidate (Ritalin) toxicity
Toxic dose : Over 2 mg/kg or 60 mg, whichever is less (Immediate-Release), Over 4 mg/kg or 120 mg whichever is less (Sustained-Release)
Management: Patients may only need observation. Some patients may need benzodiazepines and intravenous fluids for symptomatic treatment. 
Clinical effect 1: Diaphoresis
Clinical effect 2: Hyperventilation/tachypnea
Clinical effect 3: Mydriasis
Clinical effect 4: Tremor
Clinical effect 5: Nausea
Clinical effect 6: Hypertension
Clinical effect 7: Tachycardia
Clinical effect 8: Euphoria
Clinical effect 9: Agitation/Irritability/Restlessness
Clinical effect 10: Headache
Poisoning cause: Severe Methylphenidate (Ritalin) toxicity
Toxic dose : Over 2 mg/kg or 60 mg, whichever is less (Immediate-Release), Over 4 mg/kg or 120 mg whichever is less (Sustained-Release)
Management: Treatment is symptomatic and supportive. Sedation is the mainstay of treatment. The goals of treatment are to control agitation and prevent or limit end organ toxicity. Liberal use of benzodiazepines is recommended for agitation/delirium until patient is mildly sedated. Typical antipsychotics may be used in patient who are refractory to benzodiazepines.
Clinical effect 1: Hyperthermia
Clinical effect 2: Agitation/Irritability/Restlessness
Clinical effect 3: Seizure
Clinical effect 4: Hemorrhage
Clinical effect 5: Abnormal movements
Clinical effect 6: Psychosis
Clinical effect 7: Rhabdomyolysis
Clinical effect 8: Renal failure
Clinical effect 9: Dysrhythmia
Clinical effect 10: Vasospasm
Clinical effect 11: Myocardial infarction (MI)
Clinical effect 12: Aortic dissection
Clinical effect 13: Ischemic events
Poisoning cause: Severe chronic Melatonin toxicity
Toxic dose : •Adult: Tolerated up to 1g/day of Melatonin, but large doses (e.g., 570mg Over 2 days in chronic acuity) can cause notable side effects. 
•Child: Ingestions up to 425mg of Melatonin have led to only mild symptoms
Management: Treatment is symptomatic and supportive. Insulating blankets, heating lamps, hot water bottles or heating pads may be used to increase the patient's core temperature in cases of significant hypothermia.
Clinical effect 1: Drowsiness/lethargy
Clinical effect 2: Asthenia
Clinical effect 3: Confusion
Clinical effect 6: Agitation/Irritability/Restlessness
Clinical effect 7: Ataxia
Clinical effect 8: Vertigo/dizziness
Clinical effect 9: Headache
Clinical effect 10: Electrolyte disturbances
Clinical effect 11: Slurred speech
Clinical effect 12: Tremors
Clinical effect 13: Psychotic effects
Clinical effect 14: Hallucinations
Clinical effect 15: Nightmares
Poisoning cause: MILD TO MODERATE Metformin TOXICITY
Toxic dose : Over 5000 mg (adult), In children, a toxic dose is considered to be greater than 100 mg/kg.In children doses up to 1700 mg are well tolerated
Management:  Symptomatic Support: Main treatment; manage coingestion hypoglycemia with dextrose.
Clinical effect 1: Nausea
Clinical effect 2: Vomiting
Clinical effect 3: Abdominal pain
Clinical effect 4: Malaise
Clinical effect 5: Myalgia
Clinical effect 6: Acute pancreatitis
Poisoning cause: SEVERE Metformin TOXICITY
Toxic dose : Over 5000 mg (adult), In children, a toxic dose is considered to be greater than 100 mg/kg.In children doses up to 1700 mg are well tolerated
Management:  Respiratory/Mental Status Depression: Early intubation and ventilation. •Circulatory Collapse: Ensure IV fluids and vasopressors if needed. • Severe Acidosis (pH ≤ 7.1): Administer IV sodium bicarbonate (1-2 mEq/kg bolus) to correct pH (>7.2); consider hemodialysis for severe lactic acidosis and renal insufficiency.
Clinical effect 1: Severe lactic acidosis
Clinical effect 2: Confusion
Clinical effect 3: CNS depression
Clinical effect 4: Hypothermia
Clinical effect 5: Hypotension
Clinical effect 6: Renal failure
Clinical effect 7: Ventricular dysrhythmia
Clinical effect 8: Respiratory depression
Poisoning cause: Mild to Moderate Pramoxine toxicity
Toxic dose : Over 150 mg (child), 11 mg/kg (child), 250 mg (adult
Management: •Supportive care is the primary approach.
•Paresthesias and paralysis usually resolve.
•Anxiety can be addressed with benzodiazepines.
Clinical effect 1: Drowsiness/lethargy
Clinical effect 2: Headache
Clinical effect 3: Paresthesia
Clinical effect 4: Euphoria
Clinical effect 5: Anxiety
Clinical effect 6: Confusion
Clinical effect 7: Tremors
Clinical effect 8: Hallucinations
Clinical effect 10: Temporary paralysis
Poisoning cause: Severe Pramoxine toxicity
Toxic dose : Over 150 mg (child), 11 mg/kg (child), 250 mg (adult
Management: •Severe cases need standard supportive care.
•Includes intubation, ventilation, fluids, pressors, benzodiazepines.
•Early intravenous lipid therapy for ventricular dysrhythmias or hypotension.                                                                                                                   Methylene Blue as an Antidote for Methemoglobinemia:
Use: Treats methemoglobinemia, especially when levels are above 20-30% or in patients with other underlying conditions.
Initial Dose: 1 mg/kg IV for both adults and children, administered Over 5 to 30 minutes.
Repeat Dose: If symptoms persist or methemoglobin levels remain high (above 30%), another dose of up to 1 mg/kg may be given after 1 hour.
Availability:
50 mg/10 mL (0.5% solution) single-dose ampules.
10 mg/1 mL (1% solution) vials.
Efficacy: Usually effective shortly after administration if diagnosis is accurate. If no improvement, consider other causes or treatments.
Alternate Routes: Can be given via intraosseous infusion if IV is not feasible. Avoid subcutaneous or intrathecal routes.
Neonates: The dosage is 0.3 to 1 mg/kg.
Clinical effect 1: Hypotension
Clinical effect 2: Conduction disturbances/AV block
Clinical effect 3: Bradycardia
Clinical effect 4: QRS widening
Clinical effect 5: Dysrhythmia
Clinical effect 6: Asystole
Clinical effect 7: Respiratory depression
Clinical effect 8: Respiratory arrest
Clinical effect 9: Methemoglobinemia
Clinical effect 10: Seizure
Poisoning cause: Rapid IV Pramoxine
Toxic dose : Over 150 mg (child), 11 mg/kg (child), 250 mg (adult
Management: •Severe cases need standard supportive care.
•Includes intubation, ventilation, fluids, pressors, benzodiazepines.
•Early intravenous lipid therapy for ventricular dysrhythmias or hypotension.                                                                                                                   Methylene Blue as an Antidote for Methemoglobinemia:
Use: Treats methemoglobinemia, especially when levels are above 20-30% or in patients with other underlying conditions.
Initial Dose: 1 mg/kg IV for both adults and children, administered Over 5 to 30 minutes.
Repeat Dose: If symptoms persist or methemoglobin levels remain high (above 30%), another dose of up to 1 mg/kg may be given after 1 hour.
Availability:
50 mg/10 mL (0.5% solution) single-dose ampules.
10 mg/1 mL (1% solution) vials.
Efficacy: Usually effective shortly after administration if diagnosis is accurate. If no improvement, consider other causes or treatments.
Alternate Routes: Can be given via intraosseous infusion if IV is not feasible. Avoid subcutaneous or intrathecal routes.
Neonates: The dosage is 0.3 to 1 mg/kg.
Clinical effect 1: Seizure
Clinical effect 2: Coma
Poisoning cause: Pramoxine Inhalation
Toxic dose : Over 150 mg (child), 11 mg/kg (child), 250 mg (adult
Management: Treat Methemoglobinemia if happened
Clinical effect 1: Methemoglobinemia
Poisoning cause: MILD TO MODERATE Visine (tetrahydrozoline) TOXICITY
Toxic dose : Over 1 -2 mg
Management: •Supportive care is the primary approach. •Peripheral alpha effects may cause vasoconstriction and agitation. •Generally, these effects do not require specific therapy.
Clinical effect 1: Tachycardia
Clinical effect 2: Agitation/Irritability/Restlessness
Clinical effect 3: Pallor
Clinical effect 4: Diaphoresis
Clinical effect 5: Drowsiness/lethargy
Clinical effect 6: Ataxia
Poisoning cause: SEVERE Visine (tetrahydrozoline) TOXICITY
Toxic dose : Over 2 mg
Management: •Supportive care is the mainstay. •Central alpha effects are prominent. •Concerns include CNS depression, respiratory depression, and loss of airway reflexes. •Administer supplemental oxygen as needed. •Intubation might be necessary for severely depressed children. •Hypotension usually responds to IV fluids; vasopressors might be needed rarely. •Naloxone's efficacy for imidazoline poisoning is uncertain and not routinely recommended.
Clinical effect 1: Coma
Clinical effect 2: Hypotension
Clinical effect 3: Hypertension
Clinical effect 4: Bradycardia
Clinical effect 5: Respiratory depression
Clinical effect 6: Respiratory arrest
Clinical effect 7: Hypothermia
Clinical effect 8: Hyporeflexia