Green Snake

Medical toxicology is a unique subspecialty focusing on the diagnosis, management, and prevention of poisoned patient. The Office of Medical Toxicology’s mission is three-fold:

1. To provide expertise in the clinical care of the poisoned patient.

2. To provide medical education to all learners at UAB on treating toxicology emergencies.

3. To provide medical toxicology backup for Alabama’s only poison control center at the Alabama Poison Information Center at Children’s of Alabama.

Follow us on twitter @UABTOX

Clinical Care

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The office of medical toxicology runs an active 24/7 inpatient consultation service. Intoxicated and envenomated patients, medical mysteries, and industrial exposures are among the frequent utilization of the service. Emergency medicine residents and medical students enrolled in the medical toxicology course take an active role in the hands-on management of these frequently complicated and critical patients.

Medical Education

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Every two weeks there is a medical toxicology elective offered to senior medical students, pharmacy students, and medical residents. These students are mentored by Emergency Medicine Residents on the rotation. The course focuses on care of the poisoned patient through treating patients at the bedside at UAB hospital, didactics focusing on critical care toxicity, simulations in managing the intoxicated patient, and regional field trips to identify poisonous plants, mushrooms, and snakes of Alabama. The course is tailored to provide a broad application for participants interested in all fields of medicine. At the completion of the course, students will have a better understanding of the pharmacology, management, and application of antidotes to treat these patients.

Medical education is further enhanced through monthly lectures to the entire emergency medicine residency and faculty at the department’s grand rounds series as well as participation in educational training for first and second year medical students.

Poison Center

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The Office of Medical Toxicology plays an integral component of the Alabama Poison Information Center at Children’s of Alabama. The center handles over 100,000 calls per year ranging from unintentional pediatric exposures, intentional overdoses requiring intensive care and monitoring, therapeutic errors, and envenomations. Medical toxicologists take poison center call and provide medical backup to all health care facilities in the state of Alabama. Rotators through the medical toxicology elective are encouraged to listen in to calls coming through the center and help look up information to improve the care of these poisoned patients.

About Us

Dr. William Rushton MD | FACEP FACMT
William Rushton is an associate professor, practicing Emergency Medicine physician and Medical Toxicology. After finishing medical school at Georgetown University, he pursued residency (Emergency Medicine), chief residency, and fellowship (Medical Toxicology) at the University of Virginia Medical Center. He moved to UAB in summer 2015 to found the medical toxicology program. He has published on trends in toxicology including changing patterns of drug abuse, limits in testing, novel approaches to snake envenomation, and emerging drugs of abuse. He currently is the medical director of the Alabama Poison Information Center and the director of the Office of Medical Toxicology. Dr. Rushton is board certified in Emergency Medicine and medical toxicology.

Dr Sukhsant Atti MD
Dr Atti is an assistant professor in Emergency Medicine and a toxicologist at the Alabama Poison Information Center. She pursued medical training at St. George University School of Medicine and Emergency Medicine residency at Newark Beth Israel Medical Center. She has completed fellowships in both Disaster Medicine (Beth Israel Deaconess Medical Center) and Medical Toxicology (Emory University and CDC). She has published on mass casualty incidents, radiation poisoning, and heavy metal toxicity. Dr Atti joined the UAB Tox faculty in summer, 2020. She is the course director of the medical toxicology rotation for medical students and emergency medicine residents.

Dr Ann Slattery DrPH, RN, RPh | DABAT
Ann Slattery is the director of the Alabama Poison Information Center at Children's of Alabama. She is also an adjunct professor at the McWhorter School of Pharmacy. Dr Slattery graduated Samford with both her Nursing and Pharmacy degrees. She graduated from UAB with her masters and doctorate in Environmental Health and Toxicology. She completed a fellowship at the CDC in the Agency of Toxic Substances and Diseases Registry. She is a boarded clinical toxicologist with the American Board of Applied Toxicology. She is also an Adjunct Professor at McWhorter School of Pharmacy, a past Editor for Lexi-Comp (2007-2019) and a current editor for the American College of Clinical Pharmacology Pediatric Pharmacy Review and Recertification Course.

Dr Jessica Rivera Pescatore PharmD | BCPS, DABAT
Jessica Rivera Pescatore is a practicing emergency medicine pharmacist and clinical toxicologist. After obtaining her PharmD at the University of Florida, she completed a pharmacy practice residency at Lakeland Regional Health. From there she pursued clinical toxicology training and completed a 2-year fellowship with the Florida/US Virgin Islands Poison Information Center at UF Health Jacksonville, after which she became a Diplomate of the American Board of Applied Toxicology. She accepted a position at UAB in 2016 and has been collaborating with the Office of Medical Toxicology and Alabama Poison Information Center since; providing education to residents and clinical toxicology consultation. Her interests include envenomations, antidotes, and trends of abuse. She is an active advocate for antidote stewardship and responsible use at UAB.

Dr Justin Arnold DO | FACEP FACMT
Dr Arnold is an adjunct faculty with the Office of Medical Toxicology. He completed his medical toxicology fellowship at Emory/CDC and is currently the Medical Director of the Florida Poison Information Center Tampa. He acts as a visiting lecturer and a co-research collaborator with UAB Toxicology. Research interests include toxicosurveillance, emerging drugs of abuse, and poison center leadership.

Select Recent Publications

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Manuscripts

Rushton W, Rivera J, Brown J, Kurz M, Arnold J. Utilization of thromboelastograms in management of Crotalus adamanteus envenomation [published online ahead of print, 2020 July 4]. Clin Toxicol (Phila). 2020; DOI: 10.1080/15563650.2020.1788053

Rushton W, Whitworth B, Brown J, Kurz M, Rivera J. Characteristics of tianeptine effects reported to a poison control center: a growing threat to public health [published online ahead of print, 2020 Jun 18]. Clin Toxicol (Phila). 2020;1-6. doi:10.1080/15563650.2020.1781151

Rivera JV, Vance EG, Rushton WF, Arnold JK. Novel Psychoactive Substances and Trends of Abuse. Crit Care Nurs Q. 2017;40(4):374-382. doi:10.1097/CNQ.0000000000000174

Alabama ACEP Newsletters

Tianeptine: An Emerging Alabama Public Health Threat. Spring 2020.

A Hot Mistake! A Case Report of Severe Hyperthermia from Suspected Paramethoxyamphetamine Ingestion

Messy but Effective: Calcium Carbonate Treatment for Dermal Hydrofluoric Acid Burns

Purple Lips: A Case of Acne Treatment Gone Awry

National and International Abstracts

Cox C; Peterson C; Gaines L: Rushton W. A Prospective Observational Study Characterizing Lurasidone Toxicity. Presented at North American Congress of Clinical Toxicology. September 2020, San Francisco.

Pasquale M; Rushton W; Lustig M; Rivera J. Magnetic Resonance Imaging Features in Massive Paradichlorobenzene Poisoning. Presented at North American Congress of Clinical Toxicology. September 2020, San Francisco.

Edgar J; Rivera j; Rushton W. Successful Use of Buprenorphine/naloxone in the Treatment of Tianeptine Withdrawal. Presented at North American Congress of Clinical Toxicology. September 2020, San Francisco.

Rushton W; Tidwell D; Taylor R; Rodgers J; Dye D; Siler P. A retrospective study of observation times in a health care facility and 48-hour mortality after heroin overdose with naloxone rescue. Accepted at the European Association of Poisons Centres and Clinical Toxicologists. 2020, Tallinn, Estonia

Wallace D; Rushton W; Rivera, JV. Amitraz: An Unfamiliar Insecticide with Severe Toxicity. Accepted at the European Association of Poisons Centres and Clinical Toxicologists. 2020, Tallinn, Estonia

Rushton W; Brown J; Green EV; Rivera JV. Thromboelastogram use in Crotalus adamanteus envenomation. Accepted at the European Association of Poisons Centres and Clinical Toxicologists. 2020, Tallinn, Estonia

Rushton W; Read L; B Rozier; Harris K; Page D; Arnold J. Parental vs Enteral N-acetylcysteine in Adolescent Acetaminophen Poisoned Patients. Presented at the North American Congress of Clinical Toxicology, September 2019, Nashville TN. CLINICAL TOXICOLOGY 57 (10), 934-934 2019

Rushton W; Tomeny P; Arnold J. Delayed Ototoxicity Following a Fatal Ingestion of Diethylene Glycol. Presented at the North American Congress of Clinical Toxicology, September 2019, Nashville TN. CLINICAL TOXICOLOGY 57 (10), 935-935 2019

Rushton W; Rivera J; Farmer F; Dramatically Improved Hemodynamics following Hydroxocobalamin in Hypothermic Cardiac Arrest. Presented at the North American Congress of Clinical Toxicology, September 2019, Nashville TN. CLINICAL TOXICOLOGY 57 (10), 918-918 2019

Simpson A; Rinker J; Rushton W; Intravenous immunoglobulin (IVIG) use in subacute combined degeneration secondary to vitamin B12 deficiency from nitrous oxide abuse. Presented at International Congress of the European Association of Poisons Centres and Clinical Toxicologists. 2019, Naples Italy. CLINICAL TOXICOLOGY 57 (6), 502-503

Vance E; Arnold J; Rushton W; Supratherapeutic digoxin concentration without cardiac manifestations. Presented at International Congress of the European Association of Poisons Centres and Clinical Toxicologists. 2019, Naples Italy. CLINICAL TOXICOLOGY 57 (6), 574-575

Rushton W; Arnold J: Rivera J; Implementation of a protocol driven Crotalinae Envenomation Unit. Presented at International Congress of the European Association of Poisons Centres and Clinical Toxicologists. 2019, Naples Italy. CLINICAL TOXICOLOGY 57 (6), 505-505

Rushton, W; Rivera J; Kessler A; Arnold J.Neuropsychiatric changes associated with acute on chronic bromide toxicity from dextromethorphan abuse. Presented at the North American Congress of Clinical Toxicology, October 2018, Chicago.

Arnold J; Rushton W. Renal injury or lab error? Interpretation of renal function studies following a massive dosing error of Vitamin C in sepsis Presented at the North American Congress of Clinical Toxicology, October 2018, Chicago.

Arnold J, Rushton W. The mineral miracle disaster: accidental poisoning after use of 28% sodium chlorite solution resulting in methemoglobinemia and mild hemolytic anemia. Presented at the North American Congress of Clinical Toxicology, October 2018, Chicago.

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