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Prescribing within clinical toxicology

MacVicar, Sonya; Osinski, Karen


Karen Osinski


In 2020, the first clinical toxicology advanced nurse practitioner and independent prescriber post was introduced in the United Kingdom. This article discusses the remit of clinical toxicology and the integration of nurse prescribing into this service by following a patient journey from admission to discharge. The case study describes an acute paracetamol poisoning presentation following intentional self-harm. Paracetamol is widely available and safe in therapeutic dosages; however, it is the drug most commonly taken in intentional overdose and the toxic effect can result in hepatic failure and fatality. The nurse prescriber conducted a holistic consultation, assessed pharmacological management and instigated timely treatment. Current research on the benefits and disadvantages of paracetamol antidote regimes are discussed. Long-term physical and mental wellbeing following intentional overdose require interprofessional liaison with access to psychological support, arranged prior to patient discharge.


MacVicar, S., & Osinski, K. (2020). Prescribing within clinical toxicology. Journal of Prescribing Practice, 2(12), 674-680.

Journal Article Type Article
Online Publication Date Dec 12, 2020
Publication Date Dec 2, 2020
Deposit Date Dec 14, 2020
Publicly Available Date Jan 5, 2021
Journal Journal of Prescribing Practice
Print ISSN 2631-8385
Electronic ISSN 2631-8393
Publisher Mark Allen Healthcare
Peer Reviewed Peer Reviewed
Volume 2
Issue 12
Pages 674-680
Keywords paracetamol, acetylcysteine, clinical toxicology, activated charcoal, SNAP regimen
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