SalioSAM/toxsample11 huggingface dataset:
Poisoning cause: Mild to Moderate Dermal Toothpaste or Fluoride Exposure
Management: Patients should be treated in a stepwise manner based on their response to therapy. The initial treatment for pain from dermal exposure is topical calcium. One method for making a gel is to mix calcium gluconate with methylcellulose or water-soluble lubricant in a 1:2 ratio. Apply the gel to the affected areas as frequently as needed to relieve symptoms. If the patient has pain despite topical therapy, extremity burns can be treated with a regional infusion of 40 mL of 2.5% calcium gluconate solution using a Bier block. If this is not successful, an intra-arterial infusion of 40 mL of 2.5% calcium gluconate can be performed. If the area affected is not on an extremity, inject 0.3 to 0.5 mL/cm(2) of 2.5% calcium gluconate into the region. 
Clinical effect 1: Slow-developing pain
Clinical effect 2: Initially normal-appearing tissue
Clinical effect 3: Severe pain
Clinical effect 4: Skin hyperemia
Clinical effect 5: Blanching
Clinical effect 6: Coagulative necrosis
Poisoning cause: SYSTEMIC Fluoride POISONING
Toxic dose : Vomiting and abdominal pain are common with ingestions of 3 to 5 mg/kg of elemental fluoride. Hypocalcemia and muscular symptoms may appear with 5 to 10 mg/kg. 
Management: Early administration of high doses of calcium salts and magnesium may be life-saving. Administer sufficient calcium to maintain serum concentrations in the high-normal range.
Clinical effect 1: Acute lung injury
Clinical effect 2: Muscle weakness
Clinical effect 3: Muscle spasm
Clinical effect 4: Respiratory arrest
Clinical effect 5: Dysrhythmia
Clinical effect 6: Acute lung injury
Poisoning cause: MILD TO MODERATE Salicylate TOXICITY
Toxic dose : The acute ingestion of more than 150 mg/kg or 6.5 g of aspirin equivalent, whichever is less. For oil of wintergreen (98% methyl salicylate), greater than a lick or taste by children under 6 years of age or greater than 4 mL by patients 6 years of age and older may cause toxicity and requires referral to an emergency department for evaluation.
B) FATALITIES: As little as 5 mL of oil of wintergreen has resulted in pediatric deaths.
Toxic serum or urine levels: Over 30 mg/dL 
Management: An initial salicylate level should be obtained and repeated every 1 to 2 hours until a clear peak and decline in concentration is observed. Concentrations greater than 30 mg/dL and rising should be treated with urine alkalinization. The presence of a large anion gap metabolic acidosis or altered mental status indicates a more severe poisoning. 
Clinical effect 1: Abdominal pain
Clinical effect 2: Tinnitus
Clinical effect 3: Hyperventilation/tachypnea
Clinical effect 4: Respiratory alkalosis
Poisoning cause: Severe Acute Salicylate Toxicity
Toxic dose :  The acute ingestion of greather than 150 mg/kg or 6.5 g of aspirin equivalent, whichever is less. For oil of wintergreen (98% methyl salicylate), greater than a lick or taste by children under 6 years of age or greater than 4 mL by patients 6 years of age and older may cause toxicity and requires referral to an emergency department for evaluation.
B) FATALITIES: As little as 5 mL of oil of wintergreen has resulted in pediatric deaths.
Toxic serum or urine levels: Over 30 mg/dL 
Management: Patients with severe poisoning should be continued on urine alkalinization. Hemodialysis should be strongly considered. Relative indications for hemodialysis include: renal failure, congestive heart failure, altered mental status, seizures, evidence of cerebral edema, worsening acidosis despite adequate resuscitation, persistently rising salicylate concentrations despite adequate treatment (greater than 50 to 60 mg/dL in a chronic poisoning or levels greater than 90 to 100 mg/dL in an acute Overdose). Patients with an altered mental status may have cerebral edema. Obtain a head CT. Mannitol can be given for cerebral edema. Severely ill patients may require respiratory support and intubation. Maintain preintubation minute ventilation at the same high respiratory rate because once the patient's respiratory drive is removed metabolic acidosis may worsen. 
Clinical effect 1: Acidosis
Clinical effect 2: Hyperpnea
Clinical effect 3: Diaphoresis
Clinical effect 4: Fever/hyperthermia
Clinical effect 5: CNS depression
Clinical effect 6: Seizure
Clinical effect 7: Coma
Clinical effect 8: Cerebral edema
Clinical effect 9: Pulmonary edema
Clinical effect 10: Death
Poisoning cause: Severe Chronic Salicylate Toxicity
Toxic dose : Ingestions of greater than 100 mg/kg/day Over 2 days may produce toxicity. 
Toxic serum or urine levels: Over 30 mg/dL 
Management: Patients with severe poisoning should be continued on urine alkalinization. Hemodialysis should be strongly considered. Relative indications for hemodialysis include: renal failure, congestive heart failure, altered mental status, seizures, evidence of cerebral edema, worsening acidosis despite adequate resuscitation, persistently rising salicylate concentrations despite adequate treatment (greater than 50 to 60 mg/dL in a chronic poisoning or levels greater than 90 to 100 mg/dL in an acute Overdose). Patients with an altered mental status may have cerebral edema. Obtain a head CT. Mannitol can be given for cerebral edema. Severely ill patients may require respiratory support and intubation. Maintain preintubation minute ventilation at the same high respiratory rate because once the patient's respiratory drive is removed metabolic acidosis may worsen. 
Clinical effect 1: Confusion
Clinical effect 2: Delirium
Clinical effect 3: Agitation/Irritability/Restlessness
Clinical effect 4: Coagulopathy
Clinical effect 5: Mild Elevation of serum transaminase (Alt,Ast<100)
Clinical effect 6: Bilirubin increased
Clinical effect 7: Other LFTs abnormality
Clinical effect 8: Dysrhythmia
Poisoning cause: Mild to Moderate Doxylamine Toxicity
Toxic dose : Over 4 mg/kg in children. toxic range in adults: >75–125 mg
Management: The majority of antihistamine Overdoses requires only supportive care; give activated charcoal if patient presents shortly after ingestion; sedate with benzodiazepines for agitation and delirium. Tachycardia is generally mild and well tolerated, and does not usually require specific treatment. Physostigmine can be used to establish a diagnosis, it may also help avoid an invasive, costly work-up, but should only be given in a setting where intensive monitoring and resuscitation are available. It should NOT be given if there is a history or ECG (QRS widening) evidence that suggests a tricyclic antidepressant poisoning
Clinical effect 1: Drowsiness/lethargy
Clinical effect 2: Anticholinergic symptoms
Clinical effect 3: Mydriasis
Clinical effect 4: Flushing
Clinical effect 5: Fever/hyperthermia
Clinical effect 6: Dry mouth
Clinical effect 7: Decreased bowel sounds
Clinical effect 8: Tachycardia
Clinical effect 9: Hypertension
Clinical effect 10: Nausea
Clinical effect 11: Vomiting
Clinical effect 12: Agitation/Irritability/Restlessness
Clinical effect 13: Confusion
Clinical effect 14: Hallucinations
Poisoning cause: Severe Doxylamine Toxicity
Toxic dose : Over 4 mg/kg in children. toxic range in adults: >75–125 mg
Management: Orotracheal intubation for airway protection should be performed early. Gastric lavage may be of benefit, if the patient presents soon after a large ingestion; administer activated charcoal as well. GI decontamination should be performed only in patients who can protect their airway or who are intubated. Severe delirium may develop and require large doses of benzodiazepines for sedation. Seizures (may rarely progress to status epilepticus) may require aggressive use of benzodiazepines, propofol and/or barbiturates. Monitor for QRS widening and ventricular dysrhythmias; treat with intravenous sodium bicarbonate (1 to 2 mEq/kg IV bolus starting dose, titrate to blood pH 7.45 to 7.55), or lidocaine if sodium bicarbonate unsuccessful. Monitor core temperature and treat hyperthermia with aggressive benzodiazepine sedation to control agitation and external cooling. Clinical manifestations may be prolonged due to delayed absorption in the setting of an anticholinergic ileus.
Clinical effect 1: Agitated delirium
Clinical effect 2: Psychosis
Clinical effect 3: Seizure
Clinical effect 4: Coma
Clinical effect 5: Hypotension
Clinical effect 6: QRS widening
Clinical effect 7: Ventricular dysrhythmia
Clinical effect 8: Torsade de pointes
Clinical effect 9: Rhabdomyolysis
Clinical effect 10: Renal failure
Clinical effect 11: Agitation/Irritability/Restlessness
Poisoning cause: MILD TO MODERATE Chlorpheniramine TOXICITY
Toxic dose : 6 months - 23 months:	>0.5 mg/kg,
2 years - 5 years:	>4 mg,
6 years - 11 years:	>12 mg,
12 years - 79 years:	>24 mg
Management: The majority of antihistamine Overdoses requires only supportive care; give activated charcoal if patient presents shortly after ingestion; sedate with benzodiazepines for agitation and delirium. Tachycardia is generally mild and well tolerated, and does not usually require specific treatment. Physostigmine can be used to establish a diagnosis, it may also help avoid an invasive, costly work-up, but should only be given in a setting where intensive monitoring and resuscitation are available. It should NOT be given if there is a history or ECG (QRS widening) evidence that suggests a tricyclic antidepressant poisoning.
Clinical effect 1: Drowsiness/lethargy
Clinical effect 2: Anticholinergic symptoms
Clinical effect 3: Mydriasis
Clinical effect 4: Flushing
Clinical effect 5: Fever/hyperthermia
Clinical effect 6: Dry mouth
Clinical effect 7: Decreased bowel sounds
Clinical effect 8: Tachycardia
Clinical effect 9: Hypertension
Clinical effect 10: Nausea
Clinical effect 11: Vomiting
Clinical effect 12: Agitation/Irritability/Restlessness
Clinical effect 13: Confusion
Clinical effect 14: Hallucinations
Poisoning cause: SEVERE Chlorpheniramine TOXICITY
Toxic dose : 6 months - 23 months:	>0.5 mg/kg,
2 years - 5 years:	>4 mg,
6 years - 11 years:	>12 mg,
12 years - 79 years:	>40 mg
Management: Orotracheal intubation for airway protection should be performed early. Gastric lavage may be of benefit, if the patient presents soon after a large ingestion; administer activated charcoal as well. GI decontamination should be performed only in patients who can protect their airway or who are intubated. Severe delirium may develop and require large doses of benzodiazepines for sedation. Seizures (may rarely progress to status epilepticus) may require aggressive use of benzodiazepines, propofol and/or barbiturates. Monitor for QRS widening and ventricular dysrhythmias; treat with intravenous sodium bicarbonate (1 to 2 mEq/kg IV bolus starting dose, titrate to blood pH 7.45 to 7.55), or lidocaine if sodium bicarbonate unsuccessful. Monitor core temperature and treat hyperthermia with aggressive benzodiazepine sedation to control agitation and external cooling. Clinical manifestations may be prolonged due to delayed absorption in the setting of an anticholinergic ileus.
Clinical effect 1: Agitated delirium
Clinical effect 2: Psychosis
Clinical effect 3: Seizure
Clinical effect 4: Coma
Clinical effect 5: Hypotension
Clinical effect 6: QRS widening
Clinical effect 7: Ventricular dysrhythmia
Clinical effect 8: Torsade de pointes
Clinical effect 9: Rhabdomyolysis
Clinical effect 10: Renal failure
Clinical effect 11: Agitation/Irritability/Restlessness
Poisoning cause: MILD TO MODERATE Diphenhydramine TOXICITY
Toxic dose : Over 7.5 mg/kg in children. toxic range in adults:> 75–250 mg
Management: The majority of antihistamine Overdoses requires only supportive care; give activated charcoal if patient presents shortly after ingestion; sedate with benzodiazepines for agitation and delirium. Tachycardia is generally mild and well tolerated, and does not usually require specific treatment. Physostigmine can be used to establish a diagnosis, it may also help avoid an invasive, costly work-up, but should only be given in a setting where intensive monitoring and resuscitation are available. It should NOT be given if there is a history or ECG (QRS widening) evidence that suggests a tricyclic antidepressant poisoning.
Clinical effect 1: Drowsiness/lethargy
Clinical effect 2: Anticholinergic symptoms
Clinical effect 3: Mydriasis
Clinical effect 4: Flushing
Clinical effect 5: Fever/hyperthermia
Clinical effect 6: Dry mouth
Clinical effect 7: Decreased bowel sounds
Clinical effect 8: Tachycardia
Clinical effect 9: Hypertension
Clinical effect 10: Nausea
Clinical effect 11: Vomiting
Clinical effect 12: Agitation/Irritability/Restlessness
Clinical effect 13: Confusion
Clinical effect 14: Hallucinations
Poisoning cause: SEVERE Diphenhydramine TOXICITY
Toxic dose : Over 7.5 mg/kg in children. toxic range in adults:> 75–250 mg
Management: Orotracheal intubation for airway protection should be performed early. Gastric lavage may be of benefit, if the patient presents soon after a large ingestion; administer activated charcoal as well. GI decontamination should be performed only in patients who can protect their airway or who are intubated. Severe delirium may develop and require large doses of benzodiazepines for sedation. Seizures (may rarely progress to status epilepticus) may require aggressive use of benzodiazepines, propofol and/or barbiturates. Monitor for QRS widening and ventricular dysrhythmias; treat with intravenous sodium bicarbonate (1 to 2 mEq/kg IV bolus starting dose, titrate to blood pH 7.45 to 7.55), or lidocaine if sodium bicarbonate unsuccessful. Monitor core temperature and treat hyperthermia with aggressive benzodiazepine sedation to control agitation and external cooling. Clinical manifestations may be prolonged due to delayed absorption in the setting of an anticholinergic ileus
Clinical effect 1: Agitated delirium
Clinical effect 2: Psychosis
Clinical effect 3: Seizure
Clinical effect 4: Coma
Clinical effect 5: Hypotension
Clinical effect 6: QRS widening
Clinical effect 7: Ventricular dysrhythmia
Clinical effect 8: Torsade de pointes
Clinical effect 9: Rhabdomyolysis
Clinical effect 10: Renal failure
Clinical effect 11: Agitation/Irritability/Restlessness
Poisoning cause: MILD TO MODERATE Hydroxyzine( Vistaril) TOXICITY
Toxic dose : In children:Over 7.5 mg/kg.Given that the usual single adult dose of hydroxyzine is listed as 25–50 mg, the toxic dose could be estimated as ranging from 75 mg (3 times the lower end of the usual dose) to 250 mg (5 times the higher end of the usual dose) for an adult.
Management: The majority of antihistamine Overdoses requires only supportive care; give activated charcoal if patient presents shortly after ingestion; sedate with benzodiazepines for agitation and delirium. Tachycardia is generally mild and well tolerated, and does not usually require specific treatment. Physostigmine can be used to establish a diagnosis, it may also help avoid an invasive, costly work-up, but should only be given in a setting where intensive monitoring and resuscitation are available. It should NOT be given if there is a history or ECG (QRS widening) evidence that suggests a tricyclic antidepressant poisoning.
Clinical effect 1: Drowsiness/lethargy
Clinical effect 2: Anticholinergic symptoms
Clinical effect 3: Mydriasis
Clinical effect 4: Flushing
Clinical effect 5: Fever/hyperthermia
Clinical effect 6: Dry mouth
Clinical effect 7: Decreased bowel sounds
Clinical effect 8: Tachycardia
Clinical effect 9: Hypertension
Clinical effect 10: Nausea
Clinical effect 11: Vomiting
Clinical effect 12: Agitation/Irritability/Restlessness
Clinical effect 13: Confusion
Clinical effect 14: Hallucinations
Poisoning cause: SEVERE HHydroxyzine( Vistaril)  TOXICITY
Toxic dose : In children:Over 7.5 mg/kg.Given that the usual single adult dose of hydroxyzine is listed as 25–50 mg, the toxic dose could be estimated as ranging from 75 mg (3 times the lower end of the usual dose) to 250 mg (5 times the higher end of the usual dose) for an adult.
Management: Orotracheal intubation for airway protection should be performed early. Gastric lavage may be of benefit, if the patient presents soon after a large ingestion; administer activated charcoal as well. GI decontamination should be performed only in patients who can protect their airway or who are intubated. Severe delirium may develop and require large doses of benzodiazepines for sedation. Seizures (may rarely progress to status epilepticus) may require aggressive use of benzodiazepines, propofol and/or barbiturates. Monitor for QRS widening and ventricular dysrhythmias; treat with intravenous sodium bicarbonate (1 to 2 mEq/kg IV bolus starting dose, titrate to blood pH 7.45 to 7.55), or lidocaine if sodium bicarbonate unsuccessful. Monitor core temperature and treat hyperthermia with aggressive benzodiazepine sedation to control agitation and external cooling. Clinical manifestations may be prolonged due to delayed absorption in the setting of an anticholinergic ileus. OBSERVATION CRITERIA of Hydroxyzine TOXICITY: Patients with deliberate ingestions and symptomatic patients should be sent to a health care facility for observation for 6 to 8 hours. A patient with a deliberate Overdose requires a psychiatric evaluation prior to discharge.
Clinical effect 1: Agitated delirium
Clinical effect 2: Psychosis
Clinical effect 3: Seizure
Clinical effect 4: Coma
Clinical effect 5: Hypotension
Clinical effect 6: QRS widening
Clinical effect 7: Ventricular dysrhythmia
Clinical effect 8: Torsade de pointes
Clinical effect 9: Rhabdomyolysis
Clinical effect 10: Renal failure
Clinical effect 11: Agitation/Irritability/Restlessness
Poisoning cause: MILD TO MODERATE Cetirizine TOXICITY
Toxic dose : 6 months - 79 years  doses more than >6 mg/kg OR >150 mg. 
Management: The majority of antihistamine Overdoses requires only supportive care; give activated charcoal if patient presents shortly after ingestion; sedate with benzodiazepines for agitation and delirium. Tachycardia is generally mild and well tolerated, and does not usually require specific treatment. Physostigmine can be used to establish a diagnosis, it may also help avoid an invasive, costly work-up, but should only be given in a setting where intensive monitoring and resuscitation are available. It should NOT be given if there is a history or ECG (QRS widening) evidence that suggests a tricyclic antidepressant poisoning.
Clinical effect 1: Drowsiness/lethargy
Clinical effect 2: Anticholinergic symptoms
Clinical effect 3: Mydriasis
Clinical effect 4: Flushing
Clinical effect 5: Fever/hyperthermia
Clinical effect 6: Dry mouth
Clinical effect 7: Decreased bowel sounds
Clinical effect 8: Tachycardia
Clinical effect 9: Hypertension
Clinical effect 10: Nausea
Clinical effect 11: Vomiting
Clinical effect 12: Agitation/Irritability/Restlessness
Clinical effect 13: Confusion
Clinical effect 14: Hallucinations
Poisoning cause: SEVERE Cetirizine TOXICITY
Toxic dose : 6 months - 79 years  doses more than >6 mg/kg OR >150 mg.
Management: Orotracheal intubation for airway protection should be performed early. Gastric lavage may be of benefit, if the patient presents soon after a large ingestion; administer activated charcoal as well. GI decontamination should be performed only in patients who can protect their airway or who are intubated. Severe delirium may develop and require large doses of benzodiazepines for sedation. Seizures (may rarely progress to status epilepticus) may require aggressive use of benzodiazepines, propofol and/or barbiturates. Monitor for QRS widening and ventricular dysrhythmias; treat with intravenous sodium bicarbonate (1 to 2 mEq/kg IV bolus starting dose, titrate to blood pH 7.45 to 7.55), or lidocaine if sodium bicarbonate unsuccessful. Monitor core temperature and treat hyperthermia with aggressive benzodiazepine sedation to control agitation and external cooling. Clinical manifestations may be prolonged due to delayed absorption in the setting of an anticholinergic ileus. OBSERVATION CRITERIA of Cetirizine TOXICITY: Patients with deliberate ingestions and symptomatic patients should be sent to a health care facility for observation for 6 to 8 hours. A patient with a deliberate Overdose requires a psychiatric evaluation prior to discharge
Clinical effect 1: Agitated delirium
Clinical effect 2: Psychosis
Clinical effect 3: Seizure
Clinical effect 4: Coma
Clinical effect 5: Hypotension
Clinical effect 6: QRS widening
Clinical effect 7: Ventricular dysrhythmia
Clinical effect 8: Torsade de pointes
Clinical effect 9: Rhabdomyolysis
Clinical effect 10: Renal failure
Clinical effect 11: Agitation/Irritability/Restlessness
Poisoning cause: MILD TO MODERATE Levocetirizine TOXICITY
Toxic dose : Over 300 mg
Management: The majority of antihistamine Overdoses requires only supportive care; give activated charcoal if patient presents shortly after ingestion; sedate with benzodiazepines for agitation and delirium. Tachycardia is generally mild and well tolerated, and does not usually require specific treatment. Physostigmine can be used to establish a diagnosis, it may also help avoid an invasive, costly work-up, but should only be given in a setting where intensive monitoring and resuscitation are available. It should NOT be given if there is a history or ECG (QRS widening) evidence that suggests a tricyclic antidepressant poisoning.
Clinical effect 1: Drowsiness/lethargy
Clinical effect 2: Anticholinergic symptoms
Clinical effect 3: Mydriasis
Clinical effect 4: Flushing
Clinical effect 5: Fever/hyperthermia
Clinical effect 6: Dry mouth
Clinical effect 7: Decreased bowel sounds
Clinical effect 8: Tachycardia
Clinical effect 9: Hypertension
Clinical effect 10: Nausea
Clinical effect 11: Vomiting
Clinical effect 12: Agitation/Irritability/Restlessness
Clinical effect 13: Confusion
Clinical effect 14: Hallucinations
Poisoning cause: SEVERE Levocetirizine TOXICITY
Toxic dose : Over 300 mg
Management: Orotracheal intubation for airway protection should be performed early. Gastric lavage may be of benefit, if the patient presents soon after a large ingestion; administer activated charcoal as well. GI decontamination should be performed only in patients who can protect their airway or who are intubated. Severe delirium may develop and require large doses of benzodiazepines for sedation. Seizures (may rarely progress to status epilepticus) may require aggressive use of benzodiazepines, propofol and/or barbiturates. Monitor for QRS widening and ventricular dysrhythmias; treat with intravenous sodium bicarbonate (1 to 2 mEq/kg IV bolus starting dose, titrate to blood pH 7.45 to 7.55), or lidocaine if sodium bicarbonate unsuccessful. Monitor core temperature and treat hyperthermia with aggressive benzodiazepine sedation to control agitation and external cooling. Clinical manifestations may be prolonged due to delayed absorption in the setting of an anticholinergic ileus. OBSERVATION CRITERIA of Levocetirizine TOXICITY: Patients with deliberate ingestions and symptomatic patients should be sent to a health care facility for observation for 6 to 8 hours. A patient with a deliberate Overdose requires a psychiatric evaluation prior to discharge.
Clinical effect 1: Agitated delirium
Clinical effect 2: Psychosis
Clinical effect 3: Seizure
Clinical effect 4: Coma
Clinical effect 5: Hypotension
Clinical effect 6: QRS widening
Clinical effect 7: Ventricular dysrhythmia
Clinical effect 8: Torsade de pointes
Clinical effect 9: Rhabdomyolysis
Clinical effect 10: Renal failure
Clinical effect 11: Agitation/Irritability/Restlessness