Department of Medical Toxicology

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Faculty & Staff

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Meghan Spyres, MD

Associate Professor of Emergency Medicine
Associate Medical Director, Banner Poison and Drug Information Center

Board Certifications Emergency Medicine
Medical Toxicology
Fellowship University of Arizona College of Medicine - Phoenix
Residency Bellevue/New York University

Recent Publications

Peer-Reviewed Research Articles

  1. Spyres MB, Padilla GK, Gerkin RD(1)(2), et al.Late hemotoxicity following North American rattlesnake envenomation treated with crotalidae immune F(ab')(2) (equine) antivenom and crotalidae immune polyvalent Fab (ovine) antivenom reported to the North American Snakebite Sub-registry. Clin Toxicol (Phila). 2022 Mar 9:1-5. doi: 10.1080/15563650.2022.2042550.
  2. Ruha AM, Padilla-Jones A, Canning J, Spyres MB, Curry SC. Early Experience with Crotalidae Immune F(ab')(2) Antivenom to Treat Arizona Rattlesnake Envenomations. J Med Toxicol. 2021; Oct 19. doi: 10.1007/s13181-021-00859-y.
  3. Spyres MB, Aldy K, Farrugia LA, Kang AM, et al. Toxicology Investigators Consortium Study Group.The Toxicology Investigators Consortium 2020 Annual Report. J Med Toxicol. 2021; Sep 17:1-30. doi: 10.1007/s13181-021-00854-3.
  4. Crow EM, Spyres MB, Boley SP, Levine ML, Stellpflug SJ. Delayed peaks in acetaminophen overdose with concomitant abdominal trauma. Clin Toxicol. 2020; 30:1-4. PMID 32349551
  5. Spyres MB, O'Connor AD. Periorbital edema mimicking an allergic reaction after black widow envonomation. Wilderness Environ Med. 2020; 31(1):116-118. PMID 32192283
  6. Spyres MB et al. The Toxicology Investigators Consortium Case Registry-the 2018 Annual Report. J Med Toxicol. 2019. (doi: 10.1007/s13181-019-00736-9)
  7. Spyres MB, Moore EC, Ruha AM, O'Connor AD. Moving Towards Gender Equality in Medical Toxicology. J Med Toxicol. 2019. (doi: 10.1007/s13181-019-00737-8)
  8. Levine M, Pizon A, Beuhler M, et al. Exploratory ingestions of novel anticoagulants and antiplatelets: What is the risk? Pediatr Emerg Care. 2018. doi: 10.1097/PEC.0000000000001616.
  9. Chai PR, Ruha AM, Wong KE, et al. The virtual toxicology journal club: the dissemination and discussion of noteworthy manuscripts using twitter. J Med Toxicol. 2018. (doi: 10.1007/s13181-018-0670-8)
  10. Levine M, Offerman S, Vohra R, et al. Assessing the effect of a medical toxicologist in the care of rattlesnake-envenomated patients. Acad Emerg Med. 2018. (doi: 10.1111/acem.13401)
  11. Spyres MB, Skolnik AB, Moore EC, Gerkin RD, Padilla-Jones A, Ruha AM. Comparison of antivenom dosing strategies for rattlesnake envenomation. Crit Care Med. 2018. (doi: 10.1097/CCM.0000000000003079)
  12. Levine ML, Beuhler MC, Pizon A, et al. Assessing bleeding risk in patients with intentional overdoses of novel antiplatelet and anticoagulant medications. Ann Emerg Med. 2017. (doi:
  13. Ruha AM, Kleinschmidt K, Green Spencer, et al. The epidemiology, clinical course, and management of snakebites in the North American snakebite registry. J Med Tox. 2017. (doi: 10.1007/s13181-017-0633-5)
  14. Spyres MB, Ruha AM, Kleinschmidt K, Vohra R et al. Epidemiology and clinical outcomes of snakebite in the elderly: A ToxIC database sudy. Clin Tox. 2017. (doi: 10.1080/15563650)
  15. Spyres MB, O'Connor AD, Gerkin RD. Limitations of the evidence supporting use of undetectable acetaminophen levels obtained <4 hours post-ingestion to rule out toxicity. Clin Toxicol. 2017;55:366.
  16. Levine M, Spyres M. Fire-related inhalational injury. N Eng J Med. 2016;375:1905.
  17. Jang DH, Greenwood JC, Spyres MB, Eckmann DM. Measurement of mitochondrial respiration and motility in acute care sepsis, trauma, and poisoning. J Intensive Care Med. 2017;32:86-94.
  18. Spyres MB, Oakley E, Graeme KA. Ultrasound to evaluate effectiveness of hyperbaric oxygen therapy. Intern Emerg Med. 2016.
  19. Spyres MB, Ruha AM, Seifert S, et al. Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry. J Med Toxicol. 2016

Case Reports

  1. Spyres MB, Van Wijk XMR, Lapoint J, Levine M. Two cases of severe opiate toxicity after ingestion of poppy seed tea. Toxicology Communications. 2018. (doi: 10.1080/24734306.2018.1540178)

Book Chapters

  1. Spyres MB, Jang D. "Amphetamines" in Goldfrank's Toxicologic Emergencies 10e, 2019.
  2. Spyres M, Curry S. "Salicylates" in Critical Care Toxicology, the Diagnosis and Management of Critically Poisoned Patients 2e, 2017. (doi:10.1007/978-3-319-20790-2_11-1)
  3. Spyres M, Curry S. "Sodium Nitroprusside" in Critical Care Toxicology, the Diagnosis and Management of Critically Poisoned Patients 2e, 2017. (doi:10.1007/978-3-319-20790-2_10-1)
  4. Curry S, Spyres M. "Cyanide: Hydrogen Cyanide, Inorganic Cyanide Salts, and Nitriles" in Critical Care Toxicology, the Diagnosis and Management of Critically Poisoned Patients 2e, 2017. (doi:10.1007/978-3-319-20790-2_101-1)
  5. Spyres MB "Snake bite to the hand" in Case Studies in Medical Toxicology. Ed Dye LR, Murphy C, Calello DP, Levine MD, Skolnik A. Springer. 2017.