Department of Medical Toxicology


Recent Selected Peer-Reviewed Publications (Previous 5 Years)


  1. Woolbright BL et al. Generation of Pro- and Anti-Inflammatory Mediators after Acetaminophen Overdose in Surviving and Non-Surviving Patients. Toxicol Lett. 2022 Jul 26:S0378-4274(22)00968-7. doi: 10.1016/j.toxlet.2022.07.813.
  2. Cohen N et al. Predictors of severe outcome following opioid intoxication in children. Clin Toxicol (Phila). 2022 Jun;60(6):702-707. doi: 10.1080/15563650.2022.2038188.
  3. 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.
  4. Ghallab et al. Interruption of bile acid uptake by hepatocytes after acetaminophen overdose ameliorates hepatotoxicity. J Hepatol. 2022 Feb 4:S0168-8278(22)00062-9. doi: 10.1016/j.jhep.2022.01.020.
  5. Akakpo JY, Ramachandran A, Curry SC et al. Comparing N-acetylcysteine and 4-methylpyrazole as antidotes for acetaminophen overdose. Arch Toxicol. 2022 Jan 3. doi: 10.1007/s00204-021-03211-z.


  1. 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.
  2. 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.
  3. Graff J, Thompson MG, Berriochoa Z, Kuhn B, Ruha AM, Lipinski C. Chloroquine Ingestion to Prevent SARS-CoV-2 Infection: A Report of Two Cases. Clin Pract Cases Emerg Med. 2021 May;5(2):234-238. doi: 10.5811/cpcem.2021.3.51329.
  4. Akakpo JY, Jaeschke MW, Ramachandran A, Curry SC, Rumack BH, Jaeschke H. Delayed administration of N-acetylcysteine blunts recovery after an acetaminophen overdose unlike 4-methylpyrazole. Arch Toxicol. 2021 Aug 22. doi: 10.1007/s00204-021-03142-9.


  1. Akakpo JY, Ramachandran A, Orhan H, Curry SC, Rumack BH, Jaeschke H. 4-methylpyrazole protects against acetaminophen-induced acute kidney injury. Toxicol Appl Pharmacol. 2020 Nov 3:115317. doi: 10.1016/j.taap.2020.115317
  2. Malashock HR, Yeung C, Roberts AR, Snow JW, Gerkin RD, O'Connor AD. Pediatric Methamphetamine Toxicity: Clinical Manifestations and Therapeutic Use of Antipsychotics-One Institution's Experience. J Med Toxicol. 2021 Jan 13. doi: 10.1007/s13181-020-00821-4
  3. Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Brooks DE, et al. 2019 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 37th Annual Report. Clin Toxicol (Phila). 2020 Dec;58(12):1360-1541. doi: 10.1080/15563650.2020.1834219.
  4. Greene S, Ruha AM, Campleman S, et al. Epidemiology, Clinical Features, and Management of Texas Coral Snake (Micrurus tener) Envenomations Reported to the North American Snakebite Registry. J Med Toxicol. 2020 Aug 14. doi: 10.1007/s13181-020-00806-3.
  5. Levine M, Ruha AM, Wolk B, Caravati M, Brent J, Campleman S, Wax P; ToxIC North American Snakebite Study Group. When It Comes to Snakebites, Kids Are Little Adults: a Comparison of Adults and Children with Rattlesnake Bites. J Med Toxicol. 2020 May 11. doi: 10.1007/s13181-020-00776-6. [Epub ahead of print]
  6. Offerman S, Gosen J, Thomas SH, Padilla-Jones A, Ruha AM, Levine M. (2020). Buproprion associated seizures following acute overdose: who develops late seizures. Clin Toxicol (Phila). 2020 Mar 26:1-7. doi: 10.1080/15563650.2020.1742919. [Epub ahead of print]
  7. Heise CW, Gallo T, Curry SC, Woosley RL. (2020). Identification of populations likely to benefit from pharmacogenomic testing. Pharmacogenet Genomics. 2020 Mar 23. doi: 10.1097/FPC.0000000000000400. [Epub ahead of print]


  1. Kang AM, Padilla-Jones A, Fisher ES , Akakpo JY, Jaeschke H, Rumack BH, Gerkin RD, Curry SC. (2019). The Effect of 4-Methylpyrazole on Oxidative Metabolism of Acetaminophen in Human Volunteers. J Med Toxicol. 2019 Nov. doi: 10.1007/s13181-019-00740-z.
  2. Claudius IA, Jontz A, Levine M, LoVecchio F, Dabrowski P, Kreisler R. Marijuana self-report compared with testing in trauma patients before and after legalization. Clin Toxicol (Phila). 2019 Nov 23:1-3. doi: 10.1080/15563650.2019.1693045. [Epub ahead of print]
  3. Gummin DD, Mowry JB, Spyker DA, Brooks DE, Beuhler MC, Rivers LJ, Hashem HA, Ryan ML. 2018 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 36th Annual Report. Clin Toxicol (Phila). 2019 Nov 21:1-194. doi: 10.1080/15563650.2019.1677022. [Epub ahead of print]
  4. Spyres MB, Farrugia LA, Kang AM, Calello DP, Campleman SL, Pizon A, Wiegand T, Kao L, Riley B, Li S, Wax PM, Brent J, Toxicology Investigators Consortium Study Group. The Toxicology Investigators Consortium Case Registry-the 2018 Annual Report. J Med Toxicol. 2019. In press
  5. Kang AM and Fisher ES. Thromboelastography with Platelet Studies (TEGĀ® with PlateletMappingĀ®) After Rattlesnake Envenomation in the Southwestern United States Demonstrates Inhibition of ADP-Induced Platelet Activation As Well As Clot Lysis. J Med Toxicol.. 2019. doi:10.1007/s13181-019-00729-8.
  6. Fisher ES and Curry SC. Evaluation and treatment of acetaminophen toxicity. Adv Pharmacol. 2019;85:263-272. doi: 10.1016/bs.apha.2018.12.004
  7. Domanski K, Kleinschmidt KC, Greene S, Ruha AM, et al. Cottonmouth snake bites reported to the ToxIC North American snakebite registry 2013-2017. Clin Toxicol (Phila). 2019 Jun 13:1-5. doi: 10.1080/15563650.2019.1627367.
  8. Curry SC, Padilla-Jones A, Ruha AM, O'Connor AD, Kang AM, Wilkins DG, Jaeschke H, Wilhelms K, Gerkin RD, Acetaminophen Adduct Study Group. The Relationship Between Circulating Acetaminophen-Protein Adduct Concentrations and Alanine Aminotransferase Activities in Patients With and Without Acetaminophen Overdose and Toxicity. J Med Toxicol. 2019 Apr 12. doi: 10.1007/s13181-019-00705-2. [Epub ahead of print]
  9. Moore EC, Porter LM, Ruha AM. Rattlesnake venom-induced recurrent coagulopathy in first trimester pregnant women - Two Cases. Toxicon. 2019 Mar 14. doi: 10.1016/j.toxicon.2019.03.006. [Epub ahead of print]
  10. Quan D, LoVecchio F, Bhattarai B, Flores M, Frechette A, Sinha M. Comparing clinical outcomes between two scorpion antivenom dosing strategies in children. Clin Toxicol (Phila). 2019 Sep 2;57(9)760-64. doi: 10.1080/15563650.2018.1551546.


  1. Bennett BK, Boesen KJ, Welch SA, Kang AM. Study of factors contributing to scorpion envenomation in Arizona. J Med Toxicol. 2018; [Epub ahead of print]. Doi: 10.1007/s13181-018-0690-4.
  2. Gummin DD, Mowry JB, Spyker DA, Brooks DE, Osterthaler KM, Banner W. 2017 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 35th Annual Report. Clin Toxicol (Phila). 2018 Dec 21:1-203. doi: 10.1080/15563650.2018.1533727. [Epub ahead of print]
  3. Gallo T, Curry SC, Padilla-Jones A, Heise CW, Ramos KS, Woosley RL, Raschke RA. A Computerized Scoring System to Improve Assessment of Heparin-induced Thrombocytopenia Risk. J Thromb Haemost. 2018 Dec 14. doi: 10.1111/jth.14359. [Epub ahead of print]
  4. Levine M, Pizon A, Beuhler M, Cantrell FL, LoVecchio F, Spyres M, Skolnik AB, Brooks DE. Exploratory Ingestions of Novel Anticoagulants and Antiplatelets: What Is the Risk? Pediatr Emerg Care. 2018 Nov 19. doi: 10.1097/PEC.0000000000001616.
  5. Duan L, Ramachandran A, Akakpo JY, Weemhoff JL, Curry SC, Jaeschke H. Role of extracellular vesicles in release of protein adducts after acetaminophen-induced liver injury in mice and humans. Toxicol Lett. 2018 Nov 14. pii: S0378-4274(18)32002-2. doi: 10.1016/j.toxlet.2018.11.005.
  6. Kang AM. Substances involved in suicidal poisonings in the United States. Suicide Life Threat Behav. In press.
  7. Kleinschmidt K, Ruha AM, Campleman S, Brent J, Wax P. Acute adverse events associated with the administration of Crotalidae polyvalent immune Fab antivenom within the North American Snakebite Registry. Clin Toxicol (Phila). 2018 Apr 24:1-6. doi: 10.1080/15563650.2018.1464175. [Epub ahead of print]
  8. Spyres MB, Skolnik A, Moore E, et al. Comparison of antivenom dosing strategies for rattlesnake envenomation. Crit Care Med. 2018 Mar 7. doi: 10.1097/CCM.0000000000003079.
  9. 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 Mar 2. doi: 10.1111/acem.13401. [Epub ahead of print]
  10. Enfield B, Brooks DE, Welch S, et al. Human plant exposures reported to a regional (Southwestern) poison control center over 8 years. J Med Toxicol. 2018.


  1. Raschke RA, Groves RH, Khurana HS, et al. A quality improvement project to improve the Medicare and Medicaid Services (CMS) sepsis bundle compliance rate in a large healthcare system. BMJ Open Qual. 2017 Oct 21;6(2):e000080. doi: 10.1136/bmjoq-2017-000080
  2. Gummin DD, Mowry JB, Spyker DA, Brooks DE, et al. 2016 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 34th Annual Report. Clin Toxicol (Phila). 2017;55(10):1072-252.
  3. Kang AM and Brooks DE. Geographic distribution of scorpion exposures in the United States, 2010-2015. Am J Public Health. 2017; 107(12):e1-e6. Doi: 10.2105/AJPH.2017.304094.
  4. Heise CW, Ruha AM, Padilla-Jones A, et al. Clinical predictors of tissue necrosis following rattlesnake envenomation. Clin Toxicol (Phila). 2017;1-4. doi:10.1080/15563650.2017.1371311. [Epub ahead of print]
  5. Farrugia LA, Rhyee SH, Calello DP, et al. The Toxicology Investigators Consortium Case Registry-the 2016 Experience. J Med Toxicol. 2017; 13:203-26. doi: 10.1007/s13181-017-0627-3.
  6. O'Connor AD, Padilla-Jones A, Ruha MR. Severe bark scorpion envenomation in adults. Clin Toxicol (Phila). 2017 Jul 28:1-5. doi: 10.1080/15563650.2017.1353095. [Epub ahead of print]
  7. Spyres MB, Ruha AM, Kleinschmidt K, Vohra R, Smith E, Padilla-Jones A. Epidemiology and clinical outcomes of snakebite in the elderly: a ToxIC database study. Clin Toxicol (Phila). 2017 Jul 13:1-5. doi: 10.1080/15563650.2017.1342829. [Epub ahead of print]
  8. Raschke RA, Gallo T, Curry SC, et al. Clinical effectiveness of a Bayesian algorithm for the diagnosis and management of heparin-induced thrombocytopenia. J Thromb Haemost. 2017; 15(8):1640-5. doi: 10.1111/jth.13758
  9. Heise CW, Malashock H, Brooks DE. A review of vilazodone exposures with focus on serotonin syndrome effects. Clin Toxicol (Phila). 2017:1. doi: 10.1080/15563650.2017.1332369.
  10. Kang AM and Brooks DE. Nationwide scorpion exposures reported to US poison control centers from 2005 to 2015. J Med Toxicol. 2017; 13(2):158-65. Doi: 10.1007/s13181-016-0594-0.
  11. Coorg V, Levitan RD, Gerkin RD, et al. Clinical Presentation and Outcomes Associated with Different Treatment Modalities for Pediatric Bark Scorpion Envenomation. J Med Toxicol. 2017; 13(1):66-70. doi:10.1007/s13181-016-0575-3.
  12. Weemhoff JL, Woolbright BL, Jenkins RE, et al. Plasma biomarkers to study mechanisms of liver injury in patients with hypoxic hepatitis. Liver Int. 2017; 37:377-384. doi:10.1111/liv.13202.


  1. Spyres MB, Ruha AM, Seifert S, et al (2016). Occupational Snake Bites: a Prospective Case Series of Patients Reported to the ToxIC North American Snakebite Registry. J Med Toxicol. Dec;12(4):365-369.
  2. Heise CW and Brooks DE (2016). Ayahuasca Exposure: Descriptive Analysis of Calls to US Poison Control Centers from 2005 to 2015. J Med Toxicol. 1-4. doi:10.1007/s13181-016-0593-1.
  3. Mowry JB, Spyker DA, Brooks DE et al. Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 33rd Annual Report. Clin Toxicol (Phila). 2016 Dec;54(10):924-1109
  4. Lasoff DR, Ruha AM, Curry SC, Koh C, Clark RF (2016). A new F(ab')(2) antivenom for the treatment of crotaline envenomation in children. Am J Emerg Med. Oct;34(10):2003-2006. doi: 10.1016/j.ajem.2016.07.061.
  5. Heise CW, Skolnik AB, Raschke RA, et al. Two Cases of Refractory Cardiogenic Shock Secondary to Bupropion Successfully Treated with Veno-Arterial Extracorporeal Membrane Oxygenation. J Med Toxicol. 2016 Sep;12(3):301-4. doi: 10.1007/s13181-016-0539-7.
  6. Farrugia LA, Rhyee SH, Campleman SL, et al (2016). The Toxicology Investigators Consortium Case Registry-the 2015 Experience. J Med Toxicol. Sep;12(3):224-47. doi: 10.1007/s13181-016-0580-6.
  7. Thomas KC, Wilkins DG, Curry SC, et al. Detection of Acetaminophen-Protein Adducts in Decedents with Suspected Opioid-Acetaminophen Combination Product Overdose. J Forensic Sci. 2016;61:1301-6. doi:10.1111/1556-4029.13169.
  8. Levine M, O'Connor AD, Padilla-Jones A and Gerkin RD. Comparison of prothrombin time and aspartate aminotransferase in predicting hepatotoxicity after acetaminophen overdose. J Med Toxicol. 2016;12:100-6. doi:10.1007/s13181-015-0504-x.
  9. Spyres MB, Oakley E, Graeme KA. Ultrasound to evaluate effectiveness of hyperbaric oxygen therapy. Intern Emerg Med. 2016 Jul 28.
  10. Kang AM and Brooks DE. US poison control center calls for infants 6 months of age and younger. Pediatrics. 2016; 137(2): e20151865. Doi: 10.1542/peds.2015-1865.