SalioSAM/toxsample11 huggingface dataset:
Poisoning cause: MILD TO MODERATE Yohimbine toxicity
Toxic dose : SPI Triage Threshold for Emergency Room Referral:
Age Bracket: 6 months - 64 years:Refer to ER if ingested amount is greater than 0.05 mg/kg body weight OR total ingested amount exceeds 22 mg.
Age Bracket: 65 years - 79 years:Refer to ER if ingested amount is greater than 0.05 mg/kg body weight OR total ingested amount exceeds 16.2 mg.
Management: Treatment is symptomatic and supportive. Monitor vital signs and mental status. Initially treat anxiety/agitation with benzodiazepines as indicated. Sedation with benzodiazepines may be helpful in agitated patients with hypertension and tachycardia. A) Monitor vital signs and mental status. 
B) Routine laboratory studies are not needed unless otherwise clinically indicated. 
C) Monitor fluid status and electrolytes in patients that develop significant vomiting and/or diarrhea. 
D) Obtain a baseline ECG and consider continuous cardiac monitoring as indicated in symptomatic patients. 
E) Monitor renal function as necessary following a significant exposure. 
F) Toxic serum concentrations can be measured but may not be readily available.
Poisoning cause: Severe Yohimbine toxicity
Toxic dose : Cases of severe toxicity and fatality have been reported with acute ingestions ranging from 3 g to 5 g. Chronic use can also lead to fatal outcomes.
Management: Treatment is symptomatic and supportive. Initially treat seizures with IV benzodiazepines; barbiturates or propofol may be needed if seizures persist or recur.A) Monitor vital signs and mental status. 
B) Routine laboratory studies are not needed unless otherwise clinically indicated. 
C) Monitor fluid status and electrolytes in patients that develop significant vomiting and/or diarrhea. 
D) Obtain a baseline ECG and consider continuous cardiac monitoring as indicated in symptomatic patients. 
E) Monitor renal function as necessary following a significant exposure. 
F) Toxic serum concentrations can be measured but may not be readily available.
Poisoning cause: MILD TO MODERATE Oxybutynin toxicity
Toxic dose : Triage to ER if Oxybutynin ingested amount meets these criteria: Age Bracket Amount 6 months - 4 years >0 mg 5 years - 17 years >5 mg 18 years - 64 years >10 mg 65 years - 79 years >2.5 mg
Poisoning cause: Severe Oxybutynin toxicity
Poisoning cause: MILD TO MODERATE  methocarbamol( Robaxin ) toxicity
Toxic dose : criteria for triage to the ER following Methocarbamol ingestion:
For individuals weighing less than 50 kg, triage to the ER if the ingested amount is greater than 750 mg.
For individuals weighing 50 kg or more, triage to the ER if the ingested amount is greater than 3000 mg.
Management: For mild to moderate exposures, good symptomatic and supportive care is the only necessary treatment. While decontamination may decrease the absorption of these drugs, it may not be necessary as most patients require little more than supportive care.
Clinical effect 1: CNS depression
Clinical effect 2: Nystagmus
Clinical effect 3: Mydriasis
Clinical effect 4: Blurred vision
Clinical effect 5: Tachycardia
Clinical effect 6: Mild hypotension
Clinical effect 7: Nausea
Clinical effect 8: Vomiting
Clinical effect 9: Dry mouth
Clinical effect 10: Lethargy
Clinical effect 11: Euphoria
Clinical effect 12: Confusion
Clinical effect 13: Incoordination
Clinical effect 14: Hallucinations
Clinical effect 15: Ataxia
Clinical effect 16: Muscle weakness
Poisoning cause: SEVERE methocarbamol( Robaxin ) toxicity
Management: For severe toxicity, administer intravenous fluids and vasopressors for hypotension, and endotracheal intubation and mechanical ventilation for severe CNS and respiratory depression. For seizures, administer benzodiazepines initially and add propofol or phenobarbital if seizures persist.
Clinical effect 1: Coma
Clinical effect 2: shock
Clinical effect 3: respiratory depression
Clinical effect 4: seizures
Poisoning cause: MILD TO MODERATE Chlorzoxazone toxicity
Toxic dose : 6 months - 79 years	>10.7 mg/kg OR >750 mg
Management: For mild to moderate exposures, good symptomatic and supportive care is the only necessary treatment. While decontamination may decrease the absorption of these drugs, it may not be necessary as most patients require little more than supportive care
Poisoning cause:  SEVERE Chlorzoxazone toxicity
Toxic dose : An adult developed severe symptoms after ingesting 10 g.
Management: for severe toxicity, administer intravenous fluids and vasopressors for hypotension, and endotracheal intubation and mechanical ventilation for severe CNS and respiratory depression. For seizures, administer benzodiazepines initially and add propofol or phenobarbital if seizures persist.
Poisoning cause: MILD TO MODERATE Carisoprodol toxicity
Toxic dose : Triage to ER if ingested amount meets these criteria:
6 months - 5 years	>100 mg,
6 years - 79 years	>700 mg
Management: For mild to moderate exposures, good symptomatic and supportive care is the only necessary treatment. While decontamination may decrease the absorption of these drugs, it may not be necessary as most patients require little more than supportive car
Clinical effect 1: Blurred Vision
Clinical effect 2: Tachycardia
Clinical effect 3: Mild Hypotension
Clinical effect 4: Nausea
Clinical effect 5: Vomiting
Clinical effect 6: Dry Mouth
Clinical effect 7: Lethargy
Clinical effect 8: Euphoria
Clinical effect 9: Confusion
Clinical effect 10: Incoordination
Clinical effect 11: Hallucinations
Clinical effect 12: Ataxia
Clinical effect 13: Muscle Weakness
Clinical effect 14: Anticholinergic Symptoms
Clinical effect 15: Serotonin Syndrome
Clinical effect 16: CNS  Depression 
Clinical effect 17: Nystagmus
Clinical effect 18: Mydriasis
Clinical effect 19: Blurred Vision
Clinical effect 20: Anticholinergic symptoms
Poisoning cause: SEVERE Carisoprodol toxicity
Management: For severe toxicity, administer intravenous fluids and vasopressors for hypotension, and endotracheal intubation and mechanical ventilation for severe CNS and respiratory depression. For seizures, administer benzodiazepines initially and add propofol or phenobarbital if seizures persist.
Clinical effect 1: Coma
Clinical effect 2: shock
Clinical effect 3: respiratory depression
Clinical effect 4: seizures
Clinical effect 5: Anticholinergic symptoms
Poisoning cause: MILD TO MODERATE chlorpromazine toxicity
Toxic dose : 6 months - 11 months	>20 mg
1 year - 4 years	>50 mg
5 years - 6 years	>100 mg
7 years - 14 years	>150 mg
15 years - 64 years	>200 mg
65 years - 79 years	>50 mg
Management:  In mild to moderate toxicity, supportive care is the mainstay of treatment. Treat extrapyramidal effects with anticholinergics (diphenhydramine 25 to 50 mg IV or orally, or benztropine 1 to 2 mg IV or orally) or benzodiazepines (diazepam 5 mg IV or orally or lorazepam 2 mg IV). Treat agitation with benzodiazepines. If urinary retention is severe, insert a Foley catheter.
Poisoning cause: SEVERE chlorpromazine toxicity
Toxic dose : Serious CNS depression and hypotension may occur after ingestion of 200–1000 mg of chlorpromazine in children or 3–5 g in adults.
Management: Patients with severe CNS depression require endotracheal intubation. Treat hypotension initially with IV 0.9% saline, add vasopressors (norepinephrine preferred) if hypotension persists. Control seizures with benzodiazepines, add propofol or barbiturates, if seizures persist. Treat QRS widening with sodium bicarbonate (1 to 2 mEq/kg IV bolus, repeat as necessary, monitor blood gases, maintain pH 7.45 to 7.55). Unstable ventricular dysrhythmias require cardioversion. Treat torsades de pointes with magnesium, overdrive pacing. For neuroleptic malignant syndrome, initial treatment involves the use of intravenous benzodiazepines. Other potential treatments include external cooling, intravenous dantrolene, and oral bromocriptine. Neuromuscular paralysis and endotracheal intubation may be necessary in severe cases. Treat rhabdomyolysis with early aggressive fluid replacement. Consider the use of physostigmine for anticholinergic manifestations, but the vast majority of patients will improve with simple supportive care alone.
Poisoning cause: MILD TO MODERATE isopropanol toxicity
Toxic dose : 	>300 mg/kg based on one reference and also other references suggested  Toxic oral dose is about 0.5 to 1 mL/kg of rubbing alcohol (70% isopropyl alcohol)
Management: treatment is symptomatic and supportive care. A) Monitor vital signs and mental status.
B) Obtain a metabolic panel, serum isopropyl alcohol and acetone concentrations. Ketonemia and ketonuria may present within 1 to 3 hours of ingestion, but acidosis is NOT expected. Isopropanol elevates measured serum osmolality. 
C) Monitor for evidence of hemorrhagic gastritis (hemoccult stools, gastroccult emesis, hematocrit).
Poisoning cause: SEVERE isopropanol toxicity
Toxic dose : Fatalities have occurred in adults with ingestions of as little as 240 mL
Management: Treatment is symptomatic and supportive care. Critically ill patients will need emergent management of airway, breathing, and circulation. CNS depression may require intubation, and alcohol-induced vasodilation and vomiting may lead to hypotension requiring fluid resuscitation, and rarely vasopressors. 
2) Metabolites of methanol and ethylene glycol can cause metabolic acidosis. Although isopropyl alcohol is metabolized to acetone and does not usually cause metabolic acidosis, metabolic acidosis can occur in patients who drink isopropyl alcohol, experience decreased caloric intake, and develop alcoholic ketoacidosis. Chronic ethanol abusers may present with alcoholic ketoacidosis after a sudden reduction of caloric intake. Patients with alcoholic ketoacidosis and isopropyl alcohol intoxication may be misdiagnosed with ethanol, methanol, or ethylene glycol intoxication. Fomepizole reduces the clearance of isopropyl alcohol and prolongs its effects; therefore, it is contraindicated in patients with isopropyl alcohol intoxication. Hemodialysis could be considered in extreme cases; however, most patients should improve with supportive care. Dialysis should be considered when levels are extremely high (eg, greater than 500 to 600 mg/dL).Obtain a metabolic panel, serum isopropyl alcohol and acetone concentrations. Ketonemia and ketonuria may present within 1 to 3 hours of ingestion, but acidosis is NOT expected. Isopropanol elevates measured serum osmolality. 
C) Monitor for evidence of hemorrhagic gastritis (hemoccult stools, gastroccult emesis, hematocrit). A) Monitor vital signs and mental status.
B) Obtain a metabolic panel, serum isopropyl alcohol and acetone concentrations. Ketonemia and ketonuria may present within 1 to 3 hours of ingestion, but acidosis is NOT expected. Isopropanol elevates measured serum osmolality. 
C) Monitor for evidence of hemorrhagic gastritis (hemoccult stools, gastroccult emesis, hematocrit).
Poisoning cause: MILD TO MODERATE Acetone toxicity
Management: MANAGEMENT OF MILD TO MODERATE POISONING
1) Generally requires no specific intervention. Administer intravenous fluids and antiemetics as necessary.
Poisoning cause: SEVERE Acetone toxicity
Management: Administer intravenous 0.9% saline for hypotension or persistent tachycardia. Endotracheal intubation and mechanical ventilation may be required in patients with CNS or respiratory depression. Evaluate for gastrointestinal bleeding after large ingestion.
Poisoning cause: MILD TO MODERATE  Paliperidone (Invega) toxicity
Toxic dose : For patients aged 6 months to 11 years: Triage to the emergency room (ER) if the ingested amount is greater than 12 mg.
For patients aged 12 years to 64 years: Triage to the ER if the ingested amount is greater than 24 mg.
For patients aged 65 years to 79 years: Triage to the ER if the ingested amount is greater than 12 mg.
Management: Management will primarily be symptomatic and supportive. Manage mild hypotension with IV fluids.
Poisoning cause: SEVERE Paliperidone (Invega)  toxicity
Toxic dose : For patients aged 6 months to 11 years: Triage to the emergency room (ER) if the ingested amount is greater than 12 mg.
For patients aged 12 years to 64 years: Triage to the ER if the ingested amount is greater than 24 mg.
For patients aged 65 years to 79 years: Triage to the ER if the ingested amount is greater than 12 mg.
Management: Treat hypotension with IV fluids and pressors (norepinephrine preferred) if needed. Manage severe extrapyramidal symptoms with anticholinergics and/or benzodiazepines. Although rare, treat neuroleptic malignant syndrome with benzodiazepines, as well as cooling and supportive measures; consider bromocriptine and dantrolene in severe cases. Prolonged QT may occur with paliperidone overdose. Institute continuous cardiac monitoring and obtain an ECGs to evaluate for evidence of dysrhythmias. If antiarrhythmic therapy is administered, disopyramide, procainamide, and quinidine carry a theoretical hazard of additive QT-prolonged effects when administered in patients with an acute overdose of paliperidone.A)  Monitor vital signs and mental status.
B)  Monitor fluid and electrolyte status in patients with significant vomiting and/or diarrhea.
C)  Monitor CBC.
D)  Institute continuous cardiac monitoring and obtain serial ECGs to evaluate for evidence of QT prolongation.
Clinical effect 1: Extrapyramidal symptoms
Clinical effect 2: Gait unsteadiness
Clinical effect 3: Tachycardia
Clinical effect 4: Hypotension
Clinical effect 5: Drowsiness/sedation
Clinical effect 6: Tremor
Clinical effect 7: Dystonia
Clinical effect 8: Dizziness
Clinical effect 9: Agitation
Clinical effect 10: Muscle rigidity
Clinical effect 11: Prolonged QT
Clinical effect 12: Torsades de pointes
Clinical effect 13: Ventricular fibrillation
Poisoning cause: MILD TO MODERATE Phentermine toxicity
Toxic dose : For patients weighing less than 50 kg:Triage to ER if the ingested amount of Phentermine is greater than 3 mg/kg OR more than 45 mg.
For patients weighing 50 kg or more:Triage to ER if the ingested amount of Phentermine is more than 90 mg.
Management: Most amphetamine related toxicity may be safely managed with supportive care that includes monitoring airway, breathing, and circulation, and control of agitation with benzodiazepines. Intravenous fluids may be needed for mild dehydration and mild hypotension, and sedation for agitation. Charcoal may be indicated if recent ingestion, airway controlled, and low seizure risk. Monitor vital signs (including core temperature) and mental status.
B) Serum concentrations of amphetamine and related agents are not readily available or clinically useful.
C) Urine toxicology screens may detect amphetamines as a class, but do not distinguish between pharmaceutical and illicit forms. False positive amphetamine results may occur after exposure to over-the-counter cold preparations containing ephedrine or pseudoephedrine.
D) No specific lab work is needed in patients with mild clinical signs and symptoms.
E) In patients with severe toxicity, monitor serum electrolytes, CK, renal function, and troponin.
F) Obtain an ECG and institute continuous cardiac monitoring.
G) Consider chest radiograph or CT to exclude pneumothorax or aortic dissection as clinically indicated.
H) Consider a brain CT to exclude traumatic injury or cerebrovascular accident as clinically indicated.
Poisoning cause: Severe Phentermine toxicity
Toxic dose : For patients weighing less than 50 kg:Triage to ER if the ingested amount of Phentermine is greater than 3 mg/kg OR more than 45 mg.
For patients weighing 50 kg or more:Triage to ER if the ingested amount of Phentermine is more than 90 mg.
Management: Severe agitation requires aggressive treatment to avoid malignant hypertension, rhabdomyolysis, hyperthermia, and seizures. Large doses of benzodiazepines may be needed. Hyperthermia should be aggressively managed with evaporative or immersive cooling measures. Severe hyperthermia may require intubation and paralysis. For tachycardia, treat with intravenous fluids, sedation. Rhabdomyolysis is best treated with adequate 0.9% normal saline; monitor CK, electrolytes, and creatinine. Diuretics and urinary alkalinization are not recommended. Ventricular dysrhythmias should be treated with standard ACLS protocols. Coronary vasospasm can be treated with vasodilators (eg, nitrates and alpha-adrenergic receptor antagonists). Treat severe hypotension with IV 0.9% NaCl at 10 to 20 mL/kg. Add vasopressors (eg, norepinephrine) if unresponsive to fluids.      Monitor vital signs (including core temperature) and mental status.
B) Serum concentrations of amphetamine and related agents are not readily available or clinically useful.
C) Urine toxicology screens may detect amphetamines as a class, but do not distinguish between pharmaceutical and illicit forms. False positive amphetamine results may occur after exposure to over-the-counter cold preparations containing ephedrine or pseudoephedrine.
D) No specific lab work is needed in patients with mild clinical signs and symptoms.
E) In patients with severe toxicity, monitor serum electrolytes, CK, renal function, and troponin.
F) Obtain an ECG and institute continuous cardiac monitoring.
G) Consider chest radiograph or CT to exclude pneumothorax or aortic dissection as clinically indicated.
H) Consider a brain CT to exclude traumatic injury or cerebrovascular accident as clinically indicated.
Poisoning cause: MILD TO MODERATE  buprenorphine toxicity
Toxic dose : Ages 6 months to 5 years:Triage to ER if any amount is ingested (>0 mg).
Ages 6 years to 12 years:Triage to ER if more than 1 mg is ingested.
Ages 13 years to 18 years:Triage to ER if more than 3 mg is ingested.
Ages 19 years to 64 years:Triage to ER if more than 4 mg is ingested.
Ages 65 years to 79 years:Triage to ER if more than 3 mg is ingested.
Management:  Monitor vital signs, respiratory effort, and mental status.
Routine urine toxicology opioid assays generally do not detect buprenorphine.For patients who have CNS depression without airway compromise or respiratory depression, close monitoring and supplemental oxygen and supportive care is usually all that is required. Manage mild hypotension with IV fluids.
Poisoning cause: Severe buprenorphine toxicity
Toxic dose : Ages 6 months to 5 years:Triage to ER if any amount is ingested (>0 mg).
Ages 6 years to 12 years:Triage to ER if more than 1 mg is ingested.
Ages 13 years to 18 years:Triage to ER if more than 3 mg is ingested.
Ages 19 years to 64 years:Triage to ER if more than 4 mg is ingested.
Ages 65 years to 79 years:Triage to ER if more than 3 mg is ingested.
Management: A) Monitor vital signs, respiratory effort, and mental status.
B) Monitor blood gases, serum electrolytes, and renal function in patients with severe poisoning.
C) Obtain a chest x-ray in patients with clinical evidence of pulmonary edema.
D) Routine urine toxicology opioid assays generally do not detect buprenorphine.      E)Supportive care (intravenous crystalloid, supplemental oxygen, and assisted ventilation), may be required. Naloxone can be given for respiratory depression in order to eliminate the need for intubation. Treat severe hypotension with IV 0.9% NaCl at 10 to 20 mL/kg. Add vasopressors (eg, norepinephrine) if unresponsive to fluids.
Poisoning cause: MILD TO MODERATE Hydrogen Peroxide toxicity
Toxic dose : 	>0 mL
Management:   No routine laboratory tests are needed when a small amount of 3% hydrogen peroxide is ingested.
 Patients with any symptoms of oral or gastrointestinal tract injury should undergo endoscopy.
 An ECG and continuous cardiac monitoring may reveal signs of gas embolization. Desaturation on pulse oximetry, hemodynamic instability, and neurologic deficit may be indicative of gas embolus, and at that time an arterial blood gas would be indicated.Treatment is symptomatic and supportive. Water can be administered to dilute the solution in the case of ingestion. Gastric distention may be relieved by insertion of a nasogastric tube and suction. A careful examination should be done to detect any gas formation. Ocular exposure to 3% solution usually requires only thorough irrigation.
Poisoning cause: Severe Hydrogen Peroxide toxicity
Toxic dose : 	>0 mL
Management: A)  No routine laboratory tests are needed when a small amount of 3% hydrogen peroxide is ingested.
B)  After a high-volume or high-concentration ingestion, patients should be evaluated for caustic injury and for oxygen embolism.
C)  Patients with any symptoms of oral or gastrointestinal tract injury should undergo endoscopy.
D)  Any patient with symptoms of cerebral oxygen embolism should have a head CT.
E)  Echocardiography or chest CT with contrast may demonstrate oxygen in the right ventricle.
F)  Abdominal and upright chest radiograph may reveal radiolucent gas in the gastrointestinal tract, right ventricle, mediastinum, or the portal venous system.
G)  An ECG and continuous cardiac monitoring may reveal signs of gas embolization. Desaturation on pulse oximetry, hemodynamic instability, and neurologic deficit may be indicative of gas embolus, and at that time an arterial blood gas would be indicated.Upper airway injury may require intubation. Patients may require resuscitation for burns. Endoscopy should be performed to assess gastrointestinal tract injury if the patient is symptomatic or if higher concentration ingestion is suspected. Obtain surgical consult for patients with evidence of gastrointestinal tract perforation. If the patient has significant symptoms of oxygen embolism (such as CNS effects), place the patient in Trendelenburg position and consider treatment with hyperbaric oxygen. Treat seizures with IV benzodiazepines or barbiturates. Ocular exposure to high concentrations warrants slit lamp examination and ophthalmologic consultation.
Poisoning cause: MILD TO MODERATE tamsulosin toxicity
Toxic dose : 6 months - 4 years	>0.2 mg  tamsulosin,
5 years - 14 years	>0.4 mg  tamsulosin,
15 years - 79 years	>0.8 mg  tamsulosin
Management: Hypotension usually responds to IV fluids.
Poisoning cause: Severe tamsulosin toxicity
Toxic dose : 6 months - 4 years	>0.2 mg  tamsulosin,
5 years - 14 years	>0.4 mg  tamsulosin,
15 years - 79 years	>0.8 mg  tamsulosin
Management: Hypotension that does not respond to IV fluids should be treated with adrenergic vasopressors such as phenylephrine or norepinephrine. Intubate patients with significant CNS depression. Treat seizures with benzodiazepines; add propofol or barbiturates if seizures persist or recur.
Poisoning cause: Mild to Moderate Cannabinoids and Analogs (Pharmaceuticals) toxicity
Toxic dose : 1.delta-8 THC (Pharmaceuticals)6 months - 79 years:	>0.6 mg/kg OR >75 mg.   2.tetra-hydrocannabinol (delta 9 THC):6 months - 5 years:	>0.2 mg/kg,
6 years - 12 years:	>0.3 mg/kg,
13 years - 79 years:	>0.4 mg/kg
Management: A) No specific laboratory studies are needed in most patients. Obtain specific laboratory studies based on symptoms observed in the patient, since the constituents of many of these products may contain multiple chemicals unrelated to the reported synthetic cannabinoid consumed. 
B) THC homologs are not structurally related to delta-9 tetrahydrocannabinol, the active ingredient in marijuana and are, therefore, undetectable via routine toxicologic screening methods (ie, urine). 
C) Monitor fluid and electrolyte status in symptomatic patients. Mild hypokalemia and severe vomiting have been rarely reported following inhalational exposure to these compounds.
D) Obtain a baseline ECG and institute continuous cardiac monitoring for tachycardia or altered cardiac rhythm.For mild and moderate toxicity, treatment consists primarily of supportive care. Most patients do not require any specific treatment and, especially with an inhalational exposure, symptoms should resolve in a few hours.