Research Topics
| Geoffrey K IsbisterSummaryCountry: Australia Publications
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Publications
Suspected white-tail spider bite and necrotic ulcersG K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Newcastle Mater Misericordiae Hospital, Waratah, NSW 2298, Australia
Intern Med J 34:38-44. 2004..To describe the clinical features, investigation, diagnosis and treatment of ulcers attributed to white-tail (WT) spider bites or necrotic arachnidism...
Valproate overdose: a comparative cohort study of self poisoningsGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Level 5, Clinical Sciences Building, Newcastle Mater Misericordiae Hospital, Waratah, NSW 2298, Newcastle, Australia
Br J Clin Pharmacol 55:398-404. 2003..Based on individual case reports of massive overdoses, valproate is often regarded as having significant toxicity. This study aimed to describe the epidemiology of valproate poisoning and the spectrum of its clinical effects...
Nefazodone poisoning: toxicokinetics and toxicodynamics using continuous data collectionGeoffrey K Isbister
University of Newcastle, Newcastle, Australia
J Toxicol Clin Toxicol 41:167-73. 2003..Bradycardia, hypotension, and drowsiness are the most significant effects and are maximal in the first 12 hours when parent and metabolite concentrations are high...
Australian scorpion stings: a prospective study of definite stingsGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Newcastle Mater Misericordiae Hospital, Clinical Sciences Building, Level 5 Edith Street, Waratah, NSW 2298, Australia
Toxicon 41:877-83. 2003..This differs from other parts of the world, where severe envenoming is reported. The major clinical effect is severe pain, consistent with other scorpion stings. Most stings occurred indoors and at night...
Antivenom treatment in arachnidismGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle and Newcastle Mater Misericordiae Hospital, Newcastle, NSW, Australia
J Toxicol Clin Toxicol 41:291-300. 2003..Although envenomation from arthropods is common, no antivenoms exist for these, excepting Lonomia caterpillars in South America, and Ixodes paralysis ticks in Australia...
Feasibility of prehospital treatment with activated charcoal: Who could we treat, who should we treat?G K Isbister
Newcastle Mater Misericordiae Hospital, University of Newcastle, Waratah, Australia
Emerg Med J 20:375-8. 2003..To investigate the feasibility and potential risk benefit of prehospital administration of activated charcoal...
Bupropion overdose: QTc prolongation and its clinical significanceGeoffrey K Isbister
University of Newcastle, Waratah, Australia
Ann Pharmacother 37:999-1002. 2003..To investigate the cardiotoxicity of bupropion hydrochloride in deliberate self-poisoning...
Latrodectism: a prospective cohort study of bites by formally identified redback spidersGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Level 5, Clinical Sciences Building, Newcastle Mater Misericordiae Hospital, Waratah, NSW 2298
Med J Aust 179:88-91. 2003..To determine the spectrum of severity and early diagnostic predictors of redback spider bites (Latrodectus hasselti), and to examine the effect of intramuscular redback antivenom...
A prospective study of definite bites by spiders of the family Sparassidae (huntsmen spiders) with identification to species levelGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Clinical Toxicologist and Emergency Physician, Newcastle Mater Misericordiae Hospital, Level 5, Clinical Sciences Building Edith St, Waratah, NSW 2298, Australia
Toxicon 42:163-71. 2003..The mechanism of effects appeared to be trauma rather than envenoming. There were no major differences between genera, and Neosparassus spp. did not cause major effects...
White-tail spider bite: a prospective study of 130 definite bites by Lampona speciesGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Level 5, Clinical Sciences Building, Newcastle Mater Misericordiae Hospital, Waratah, NSW 2298, Australia
Med J Aust 179:199-202. 2003..To investigate the circumstances and clinical effects of bites by white-tail spiders, including the two species Lampona cylindrata and L. murina commonly encountered by humans, and the incidence of necrotic lesions...
Acute conjunctival inflammation following contact with squashed spider contentsGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, and Newcastle Mater Misericordiae Hospital, Waratah, New South Wales, Australia
Am J Ophthalmol 136:563-4. 2003..To report the effects to the eye following contact with spider contents...
Moclobemide poisoning: toxicokinetics and occurrence of serotonin toxicityGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Newcastle, Australia
Br J Clin Pharmacol 56:441-50. 2003..To investigate the spectrum of toxicity of moclobemide overdose, the occurrence of serotonin toxicity, and to estimate toxicokinetic parameters...
Presumed Angel's trumpet (Brugmansia) poisoning: clinical effects and epidemiologyGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Department of Clinical Toxicology and Pharmacology, Newcastle Mater Misericordiae Hospital, Newcastle, New South Wales, Australia
Emerg Med (Fremantle) 15:376-82. 2003..To investigate the pattern and epidemiology of anticholinergic plant poisoning, and to characterize its time course and clinical features...
Intentional warfarin overdoseGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Newcastle, New South Wales, Australia
Ther Drug Monit 25:715-22. 2003..Titrating intravenous vitamin K with doses of 0.5 to 2.0 mg when INR > 5 is appropriate to reduce INR without causing warfarin resistance. The high-risk group must be kept anticoagulated, and warfarin resistance avoided...
Suspected snakebite: one year prospective study of emergency department presentationsGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle and Newcastle Mater Misericordiae Hospital, Newcastle, New South Wales, Australia
Emerg Med (Fremantle) 15:160-9. 2003..Snakebite is an uncommon, but potentially life-threatening condition. The more common clinical scenario is suspected snake-bite. Our aim was to characterise the epidemiology, diagnosis and management of patients with suspected snakebites...
Bites by spiders of the family Theraphosidae in humans and caninesGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Waratah, NSW 2298, Australia
Toxicon 41:519-24. 2003..Bites by these spiders are unlikely to cause major problems in humans. The study also demonstrates that the venom is far more toxic to canines...
Clinical effects of bites from formally identified spiders in tropical Northern TerritoryG K Isbister
Royal Darwin Hospital, Darwin, NT
Med J Aust 174:79-82. 2001..To determine the types of spiders causing bites and the clinical effects of their bites in tropical Northern Territory (north of the town of Katherine)...
Envenomation by the billygoat plum stinging caterpillar (Thosea penthima)G K Isbister
Royal Darwin Hospital, Darwin, NT
Med J Aust 173:654-5. 2000..Pain radiated up the arm and there was severe "crushing" chest pain lasting four hours. The local pain persisted for 10 hours and required opiate analgesia...
Paracetamol overdose in a preterm neonateG K Isbister
Royal Darwin Hospital, Northern Territory, Australia
Arch Dis Child Fetal Neonatal Ed 85:F70-2. 2001..Treatment includes N-acetylcysteine and supportive care, with activated charcoal for oral poisoning...
Venomous fish stings in tropical northern AustraliaG K Isbister
Royal Darwin Hospital, Darwin, Northern Territory, Australia
Am J Emerg Med 19:561-5. 2001..Stingray injuries should be explored and debrided with large wounds, while other stings only need appropriate cleaning. The routine use of antibiotics is not recommended...
Two cases of bites by the black-bellied swamp snake (Hemiaspis signata)Geoffrey K Isbister
Department of Clinical Toxicology and Pharmacology, Newcastle Mater Misericordiae Hospital, Locked Bag 7, Hunter Region Main Centre, Newcastle, NSW 2310, Australia
Toxicon 40:317-9. 2002..These cases indicate the potential for coagulopathy and local symptoms following bites by large specimens of H. signata in young children...
Treatment of anticholinergic-induced ileus with neostigmineG K Isbister
Department of Clinical Toxicology and Pharmacology, Newcastle Mater Hospital, Newcastle, New South Wales, Australia
Ann Emerg Med 38:689-93. 2001....
Citalopram-induced bradycardia and presyncopeG K Isbister
Department of Clinical Toxicology and Pharmacology, Newcastle Mater Misericordiae Hospital, Locked Bag 7, Hunter Region Mail Centre, NSW 2310, Newcastle, Australia
Ann Pharmacother 35:1552-5. 2001....
Failure of intramuscular antivenom in Red-back spider envenomingGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Level 5, Clinical Sciences Building, Newcastle Mater Hospital, Edith St, Waratah NSW 2298, Australia
Emerg Med (Fremantle) 14:436-9. 2002..Controlled studies should be undertaken to establish the effectiveness of intravenous and intramuscular Red-back antivenom...
Puffer fish poisoning: a potentially life-threatening conditionGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Newcastle Mater Misericordiae Hospital, Waratah, NSW
Med J Aust 177:650-3. 2002..Symptoms of poisoning may include paralysis, respiratory failure, numbness, paraesthesia, nausea and ataxia. Health professionals should be aware of the condition so as to institute early and appropriate management...
A prospective study of 750 definite spider bites, with expert spider identificationG K Isbister
Discipline of Clinical Pharmacology, Level 5, Clinical Sciences Building, University of Newcastle, Newcastle Mater Misericordiae Hospital, Waratah NSW 2298, Sydney, Australia
QJM 95:723-31. 2002..Clinical experience and small studies suggest otherwise, but this has not been confirmed by prospective studies of bites by identified spiders...
Acute allergic reaction following contact with a spiderGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Newcastle Mater Misericordiae Hospital, Level 5, Clinical Sciences Building, Edith Street, Waratah, NSW 2298, Australia
Toxicon 40:1495-7. 2002..He recovered within 6 h and had no further problems. The early allergic reaction in this case was most likely the result of contact with the spider...
Data collection in clinical toxinology: debunking myths and developing diagnostic algorithmsGeoffrey K Isbister
University of Newcastle, Newcastle Mater Misericordiae Hospital, Waratah, New South Wales, Australia
J Toxicol Clin Toxicol 40:231-7. 2002....
Delayed asystolic cardiac arrest after diltiazem overdose; resuscitation with high dose intravenous calciumG K Isbister
Discipline of Clinical Pharmacology, University of Newcastle and Department of Clinical Toxicology and Pharmacology, Newcastle Mater Misericordiae Hospital, Waratah, NSW, Australia
Emerg Med J 19:355-7. 2002..It should be considered early in cases of cardiac arrest after diltiazem overdose. The case also highlights the problems with delayed toxicity when whole bowel irrigation is not administered...
Randomized controlled trial of intramuscular droperidol versus midazolam for violence and acute behavioral disturbance: the DORM studyGeoffrey K Isbister
Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Newcastle, New South Wales, Australia
Ann Emerg Med 56:392-401.e1. 2010..We determine whether droperidol, midazolam, or the combination is more effective for intramuscular sedation in violent and acute behavioral disturbance in the emergency department (ED)...
Relative toxicity of selective serotonin reuptake inhibitors (SSRIs) in overdoseGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Newcastle Mater Misericordiae Hospital, Waratah, New South Wales, Australia
J Toxicol Clin Toxicol 42:277-85. 2004..Objective: To determine the effect of SSRIs in overdose, as a group, and the relative toxicity of five different SSRIs...
Amisulpride overdose is frequently associated with QT prolongation and torsades de pointesGeoffrey K Isbister
Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle Hospital, University of Newcastle, Newcastle, Australia
J Clin Psychopharmacol 30:391-5. 2010..Amisulpride overdose commonly causes QT prolongation, bradycardia, and hypotension. Torsades de pointes occurred commonly enough to suggest that amisulpride is highly cardiotoxic in overdose...
Aspiration pneumonitis in an overdose population: frequency, predictors, and outcomesGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Australia
Crit Care Med 32:88-93. 2004..Patients with aspiration pneumonitis have a significantly increased mortality and length of stay in the hospital...
Antivenom efficacy or effectiveness: the Australian experienceGeoffrey K Isbister
Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Newcastle, New South Wales, Australia
Toxicology 268:148-54. 2010....
Human anti-snake venom IgG antibodies in a previously bitten snake-handler, but no protection against local envenomingGeoffrey K Isbister
Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle Hospital, New South Wales, Australia
Toxicon 55:646-9. 2010..However, despite the presence of antibodies to death adder venom and free venom not being detected, the patient still developed significant local myotoxicity...
Funnel-web spider bite: a systematic review of recorded clinical casesGeoffrey K Isbister
Menzies School of Health Research, Charles Darwin University, Darwin, NT
Med J Aust 182:407-11. 2005..To investigate species-specific envenoming rates and spectrum of severity of funnel-web spider bites, and the efficacy and adverse effects of funnel-web spider antivenom...
The impact of a standardised intramuscular sedation protocol for acute behavioural disturbance in the emergency departmentLeonie A Calver
Discipline of Clinical Pharmacology, University of Newcastle, New South Wales, Australia
BMC Emerg Med 10:14. 2010..Acute behavioural disturbance (ABD) is an increasing problem in emergency departments. This study aimed to determine the impact of a structured intramuscular (IM) sedation protocol on the duration of ABD in the emergency department...
Current use of Australian snake antivenoms and frequency of immediate-type hypersensitivity reactions and anaphylaxisGeoffrey K Isbister
Menzies School of Health Research, Charles Darwin University, Darwin, NT
Med J Aust 188:473-6. 2008..To investigate current use of Australian snake antivenoms and the frequency and severity of immediate-type hypersensitivity reactions...
Activated charcoal decreases the risk of QT prolongation after citalopram overdoseGeoffrey K Isbister
Menzies School of Health Research, Charles Darwin University, Darwin, Australia
Ann Emerg Med 50:593-600, 600.e1-46. 2007..We determine whether single-dose activated charcoal (SDAC) administration after citalopram overdose reduces the proportion of patients developing abnormal QT prolongation...
Digital Holter measurement of QT prolongation in ziprasidone overdoseIngrid Berling
Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Newcastle, Australia
Clin Toxicol (Phila) 49:694-6. 2011..We report a case of ziprasidone overdose with QT prolongation, demonstrating different methods of measuring the QT interval...
Endogenous thrombin potential as a novel method for the characterization of procoagulant snake venoms and the efficacy of antivenomGeoffrey K Isbister
Faculty of Health, University of Newcastle, Newcastle, New South Wales, Australia
Toxicon 56:75-85. 2010..ETP is a useful assay to investigate mechanisms of other procoagulant venoms and is a robust method of assessing antivenom efficacy...
Sedation assessment tool to score acute behavioural disturbance in the emergency departmentLeonie A Calver
Discipline of Clinical Pharmacology, Faculty of Health, University of Newcastle, Newcastle, New South Wales, Australia
Emerg Med Australas 23:732-40. 2011..The objective of the study was to evaluate the effectiveness of the sedation assessment tool (SAT) in assessing patient response to treatment for acute behavioural disturbance (ABD)...
Quetiapine overdose: predicting intubation, duration of ventilation, cardiac monitoring and the effect of activated charcoalGeoffrey K Isbister
aDepartment of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle Hospital, Newcastle, Australia
Int Clin Psychopharmacol 24:174-80. 2009..SDAC seems to have only modest effects on outcomes but may be considered within 2 h for large ingestions. Electrocardiogram monitoring is unlikely to be necessary...
Inter-rater reliability of manual QT measurement and prediction of abnormal QT,HR pairsGeoffrey K Isbister
Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle Hospital, Waratah, NSW, Australia geoffrey isbister menzies edu au
Clin Toxicol (Phila) 47:884-8. 2009..To assess interobserver agreement when trained healthcare staff measure the QT interval using a standardized approach across a range of QT lengths...
Population pharmacokinetics of intravenous, intramuscular, and intranasal naloxone in human volunteersJonathonm Dowling
Clinical and Experimental Toxicology Unit, Prince of Wales Hospital and Prince of Wales Clinical School, University of NSW, Sydney, Australia
Ther Drug Monit 30:490-6. 2008..Intranasal naloxone had poor bioavailability compared with intramuscular. Combined intravenous and intramuscular administration may be a useful alternative to naloxone infusions...
Risperidone overdose causes extrapyramidal effects but not cardiac toxicityColin B Page
Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle Hospital, Newcastle, New South Wales, Australia
J Clin Psychopharmacol 30:387-90. 2010..The aim of this study was to describe the clinical and electrocardiographic features of risperidone overdose, including the frequency of dystonic reactions...
Spider biteGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Newcastle, NSW, Australia
Lancet 378:2039-47. 2011..Antivenoms are an important treatment for spider envenomation but have been less successful than have those for snake envenomation, with concerns about their effectiveness for both latrodectism and loxoscelism...
Efficacy of antivenom against the procoagulant effect of Australian brown snake (Pseudonaja sp.) venom: in vivo and in vitro studiesGeoffrey K Isbister
Tropical Toxinology Unit, Menzies School of Health Research, Charles Darwin University, Darwin, NSW, Australia
Toxicon 49:57-67. 2007..One vial of antivenom appears to be sufficient to bind and neutralise all venom in patients with severe brown snake envenoming...
An examination of the activity of expired and mistreated commercial Australian antivenomsMargaret A O'Leary
Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle Hospital, Newcastle, New South Wales, Australia
Trans R Soc Trop Med Hyg 103:937-42. 2009..CSL antivenoms are more robust than indicated on their label and maintain useful activity long past their nominated expiry dates...
Antivenom, anecdotes and evidenceGeoffrey K Isbister
Emergency Department, Newcastle Mater Misericordiae Hospital, NSW
Med J Aust 181:685-6. 2004
Cross-neutralisation of Australian brown and tiger snake venoms with commercial antivenoms: Cross-reactivity or antivenom mixtures?Margaret A O'Leary
Department of Clinical Toxicology and Pharmacology, Newcastle Mater Hospital, Newcastle, NSW, Australia
Toxicon 50:206-13. 2007..Single-polyvalent antivenom for brown snake and tiger snake may be feasible in the future...
Tiger snake (Notechis spp) envenoming: Australian Snakebite Project (ASP-13)Geoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Newcastle, NSW
Med J Aust 197:173-7. 2012..To describe the clinical syndrome associated with definite tiger snake (Notechis spp) envenoming and to examine the ability of tiger snake antivenom (TSAV) to bind free venom in vivo...
Clinically applicable laboratory end-points for treating snakebite coagulopathyGeoffrey K Isbister
Tropical Toxinology Unit, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
Pathology 38:568-72. 2006..To determine which coagulation tests best reflect the return of clotting function after snakebite venom induced consumptive coagulopathy (VICC)...
Cross-neutralisation of Australian brown snake, taipan and death adder venoms by monovalent antibodiesGeoffrey K Isbister
Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle Hospital, Newcastle, New South Wales, Australia
Vaccine 28:798-802. 2010..However, they did cross-neutralise the procoagulant effects of both procoagulant venoms. This supports the idea of developing antivenoms against groups of snake toxins rather than individual snake venoms...
Effects of envenoming by comb-footed spiders of the genera Steatoda and Achaearanea (family Theridiidae: Araneae) in AustraliaGeoffrey K Isbister
University of Newcastle, Newcastle, Australia
J Toxicol Clin Toxicol 41:809-19. 2003..The family Theridiidae (comb-footed spiders) contains the well-known and medically important widow spider group (Latrodectus spp.). Little is known about the effects of envenoming by other common members of this family...
Baclofen overdose: defining the spectrum of toxicityNicola Y Leung
Department of Clinical Toxicology and Pharmacology, Newcastle Mater Misericordiae Hospital, Waratah, New South Wales, Australia
Emerg Med Australas 18:77-82. 2006..Doses greater than 200 mg were predictive of patients developing delirium, coma and seizures, requiring long hospital admissions and ICU admission...
Developing a decision tree algorithm for the diagnosis of suspected spider bitesGeoffrey K Isbister
Emergency Department, Newcastle Mater Misericordiae Hospital, Newcastle, New South Wales, Australia
Emerg Med Australas 16:161-6. 2004....
Clinical consequences of spider bites: recent advances in our understandingGeoffrey K Isbister
Emergency Department, Newcastle Mater Misericordiae Hospital and the University of Newcastle, Newcastle, NSW 2298, Australia
Toxicon 43:477-92. 2004..Most spiders only cause minor effects, including a large number of groups that have been implicated in necrotic arachnidism...
Quetiapine poisoning: a case seriesCorrine R Balit
New South Wales Poisons Information Centre, The Children's Hospital at Westmead, Sydney, Australia
Ann Emerg Med 42:751-8. 2003....
Indications for single-dose activated charcoal administration in acute overdoseGeoffrey K Isbister
Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle and Discipline of Clinical Pharmacology, University of Newcastle, New South Wales, Australia
Curr Opin Crit Care 17:351-7. 2011..There has been a significant decrease in the use of single-dose activated charcoal (SDAC) in recent years based on little new evidence and possibly because the overall mortality in overdose patients is low...
Prospective study of definite caterpillar exposuresCorrine R Balit
NSW Poisons Information Centre, The Children s Hospital, Westmead, Corner Hawkesbury Rd and Hainsworth Street, Locked Bag 4001, Westmead, Sydney, NSW 2145, Australia
Toxicon 42:657-62. 2003..This is the first prospective study of caterpillar exposures within Australia and demonstrates that exposures can result in a variety of reactions depending on the family and species involved...
A turbidimetric assay for the measurement of clotting times of procoagulant venoms in plasmaMargaret A O'Leary
Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle Hospital, Newcastle, New South Wales, Australia
J Pharmacol Toxicol Methods 61:27-31. 2010..Assessment of the procoagulant effect of snake venoms is important for understanding their effects. The aim of this study was to develop a simple automated method to measure clotting times to assess procoagulant venoms...
Investigating pressure bandaging for snakebite in a simulated setting: bandage type, training and the effect of transportElizabeth Canale
Tropical Toxinology Program, Menzies School of Health Research, Charles Darwin University, and Northern Territory Clinical School, Royal Darwin Hospital, Darwin, Northern Territory, Australia
Emerg Med Australas 21:184-90. 2009..The clinical evidence base for the use of pressure bandaging in snakebite is limited. We aimed to investigate if pressure bandages (PB) generated and maintained presumptive optimal pressures in a simulated setting...
Arsenic trioxide poisoning: a description of two acute overdosesGeoffrey K Isbister
Discipline of Clinical Pharmacology, University of Newcastle, Newcastle, NSW, Australia
Hum Exp Toxicol 23:359-64. 2004..Arsenic quantification in blood, urine and faeces suggested that enhanced gastrointestinal decontamination was minimally effective for decontamination and that DMSA for at least two weeks was required...
Black house spiders are unlikely culprits in necrotic arachnidism: a prospective studyG K Isbister
Clinical Envenoming Research Group, University of Newcastle and Newcastle Mater Misericordiae Hospital, Newcastle, Australia
Intern Med J 34:287-9. 2004..5% confidence interval 0-14%). Black house spiders (Badumna spp.) are unlikely to cause necrosis, contrary to reports of suspected bites. Patients can be reassured and do not require any further investigation or treatment...
Prospective cohort study of definite spider bites in Australian childrenG K Isbister
Clinical Envenoming Research Group, University of Newcastle, and Newcastle Mater Misericordiae Hospital, Newcastle, New South Wales, Australia
J Paediatr Child Health 40:360-4. 2004..To describe the clinical effects of spider bites in a paediatric population and compare to bites in an adult population...
Pharmacokinetics of quetiapine in overdose and the effect of activated charcoalG K Isbister
Department of Clinical Toxicology and Pharmacology, Newcastle Mater Hospital, Newcastle and Tropical Toxinology Unit, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
Clin Pharmacol Ther 81:821-7. 2007..9-8.4 h). Charcoal was estimated to reduce fraction absorbed by 35%. Co-ingested CYP3A4 inhibitors appeared to decrease clearance and CYP3A4 inducers increase clearance. Charcoal administration may be beneficial after quetiapine overdose...
Prospective study of jellyfish stings from tropical Australia, including the major box jellyfish Chironex fleckeriG K Isbister
Royal Darwin Hospital, Darwin, NT
Med J Aust 175:652-5. 2001..fleckeri, severe envenomation was rare. There was a strong association between clinical features and sticky-tape identification of nematocysts. Delayed hypersensitivity was common after C. fleckeri stings...
Promethazine overdose: clinical effects, predicting delirium and the effect of charcoalC B Page
Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, NSW 2310, Australia
QJM 102:123-31. 2009..The aim of this study was to describe the clinical effects of promethazine in overdose and explore the relationship between delirium and possible predictor variables...
The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicityE J C Dunkley
School of Medical Practice and Population Health, University of Newcastle, Newcastle, NSW, Australia
QJM 96:635-42. 2003..75%) and more specific (97% vs. 96%) than Sternbach's criteria. DISCUSSION:These redefined criteria for serotonin toxicity should be more sensitive to serotonin toxicity and less likely to yield false positives...
Thrombotic microangiopathy from Australian brown snake (Pseudonaja) envenomingG K Isbister
Tropical Toxinology Unit, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
Intern Med J 37:523-8. 2007..A proportion of cases go on to develop thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic haemolytic anaemia (MAHA) and acute renal failure (ARF)...
Collett's snake (Pseudechis colletti) envenoming in snake handlersG K Isbister
Department of Clinical Toxicology, Newcastle Mater Hospital, Edith St, Waratah NSW 2298, Australia
QJM 99:109-15. 2006..There are no reports of bites occurring in the wild, and bites were previously thought to cause only minor effects. They are a popular snake among zoos and exotic snake keepers...
A randomised controlled trial of intramuscular vs. intravenous antivenom for latrodectism--the RAVE studyG K Isbister
Menzies School of Health Research, Charles Darwin University, Darwin, Australia
QJM 101:557-65. 2008..Widow spider-bite causes latrodectism and is associated with significant morbidity worldwide. Antivenom is given by both the intravenous (IV) and intramuscular (IM) routes and it is unclear which is more effective...
Acute myocardial injury caused by Sydney funnel-web spider (Atrax robustus) envenomingG K Isbister
Newcastle Mater Misericordiae Hospital, Waratah, New South Wales
Anaesth Intensive Care 31:672-4. 2003..The mechanism by which funnel-web spider envenomation caused myocardial injury is unclear but follow-up nuclear studies in the patient demonstrated that she had minimal atherosclerotic disease...
QTc abnormalities in deliberate self-poisoning with moclobemideM A Downes
Department of Clinical Toxicology and Pharmacology, Newcastle Mater Hospital, New South Wales, Australia
Intern Med J 35:388-91. 2005..Several medications have been found to prolong the QT interval in overdose. This can predispose to torsade de pointes-type ventricular tachycardia...
Scorpion stings in Australia: five definite stings and a reviewG K Isbister
Newcastle Mater Misericordiae Hospital, Newcastle, New South Wales, Australia
Intern Med J 34:427-30. 2004..The stings from Australian buthid scorpions cause more severe effects than from the larger species in the families Urodacidae (genus Urodacus) and Liochelidae (genus Liocheles)...
Failure of antivenom to improve recovery in Australian snakebite coagulopathyG K Isbister
Tropical Toxinology Unit, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
QJM 102:563-8. 2009..Venom-induced consumption coagulopathy (VICC) is an important feature of snake envenoming...
