#TotalTox2024

Join us for the ultimate virtual toxicology learning experience with the 2024 ACMT Total Tox Course | Live Event Package!

During this live, virtual event, earn valuable continuing education credits, learn from leading experts and peers, and enhance your clinical skills and preparedness for a wide range of toxicological emergencies. Included with your registration fee are up to 24.0 (8.0 per day) of continuing education credits for Physicians, Physician Assistants, Pharmacists, Nurses, and Nurse Practitioners. Learn from leading experts and peers, and enhance your clinical skills and preparedness for a wide range of toxicological emergencies. Secure your spot in the ACMT Total Tox Course today!

This course will focus on the follow medical toxicology topics:

Pharmaceuticals - Friday, 11/01/2024

Our first session will examine systematic approaches to managing poisoned patients, covering mechanisms of toxicity and treatment guidelines for substances like acetaminophen, NSAIDs, and SSRIs. Interactive case panels will allow you to apply theoretical knowledge to real-world scenarios, enhancing your clinical decision-making skills.

SUD & Emergency Preparedness - Friday, 11/08/2024

The first half of this session will cover substance use topics like opioid addiction, cannabis toxicity, and new substances. Experts will also discuss drug screen issues, pulmonary irritants, and the effects of mitochondrial asphyxiants on first responders to chemical suicides. We will conclude with a focus on disaster preparedness, including radiation types and symptom management, nerve agents, and a brief history of bioterrorism and identification of agents. Interactive case panels with expert speakers will focus on substance use disorder and disaster preparedness.

Non-Pharmaceuticals - Friday, 11/15/2024

The final session of the Total Tox Course will focus on the toxicology of plants and mushrooms, and reptile, marine, and arthropod envenomations. Experts will also cover anesthetic toxicity, malignant hyperthermia, and methemoglobinemia. Gain expertise in managing heavy metal poisoning and the complexities of ethanol and toxic alcohol intoxication. Participate in interactive case panels on novel treatments for critically ill patients and evaluation of an unknown potential toxicology issue, bringing together all your knowledge from the Total Tox Course.

Questions?

Please write to ACMT at events@acmt.net

Preliminary Agenda 

Session 1 - November 1, 2024

8:50 - 9:00 AM ET | Opening Remarks

9:00 - 9:45 AM ET
From Toxidromes to Activated Charcoal: A Rational Approach For Managing the Poisoned Patient
Ann Arens, MD Associate Professor of Emergency Medicine, University of Minnesota, Minneapolis, MN

Dr. Arens will identify the most common interventions performed in acute poisoning, and will examine a poisoned patient to identify what to look for in common poisonings. She will also discuss different treatment options for common toxidromes.

9:45 - 10:15 AM ET
Over-the-Counter Poisons #1: Acetaminophen
Neeraj Chhabra, MD, MSCR Medical Toxicologist & Emergency Medicine Physician, University of Illinois Chicago, Chicago, IL

Dr. Chhabra will discuss acetaminophen ingestions. He will explain how to recognize which patients require treatment and identify novel treatments for acetaminophen-related poisoning.

10:15 - 11:00 AM ET
Over-the-Counter Poisons #2: NSAIDS and ASA
Renee Petzel Gimbar, PharmD Clinical Associate Professor, University of Illinois Chicago College of Pharmacy, Chicago, IL

Dr. Petzel Gimbar will describe the treatment of NSAID poisoning, discuss the pathophysiology of salicylate poisoning, and examine the difference between treatment for NSAID and salicylate poisoning.

11:00 - 11:15 AM ET | Break - 15 min

11:15 - 11:30 AM ET
Case Review

Several speakers from previous lectures will return to review and discuss clinical cases.

11:30 - 12:00 PM ET

Over-the-Counter Poisons #3: Antihistamines & Antitussives
Michelle Hieger, DO Emergency Physician and Medical Toxicologist, WellSpan Health & VCU Health System, York, PA

Dr. Hieger will describe the action of antitussive medications and the pharmacology of antihistaminics with emphasis on clinical uses, adverse drug reactions and interactions. She will also identify major antihistamines used to treat breathing problems.

12:00 - 12:45 PM ET
The Ins and Outs of Ups and Downs #1: Tricyclic Antidepressants & Antipsychotics
J.J. Rasimas, MD, PhD, FAACT, FACLP, FACMT, FACPsych Professor of Psychiatry & Emergency Medicine, University of Minnesota & Penn State College of Medicine, Minneapolis, MN

Dr. Rasimas will explain the pharmacologic, toxicity, and treatment differences between Tricyclic Antidepressants and Antipsychotics. He will discuss "typical" vs. "atypical" antipsychotics and describe the overlapping features of Serotonin Syndrome, Anticholinergic Syndrome, and NMS produced by TCAs and Antipsychotics.

12:45 - 1:15 PM ET
The Ins and Outs of Ups and Downs #2: SSRIs and Lithium
Katherine Katzung, MD, FACEP, FASAM Director of Addiction & Toxicology Program & Emergency Care Physician, Abbott Northwestern Hospital & Emergency Care Consultants, Minneapolis, MN

Dr. Katzung will identify unique concerns of specific antidepressants in overdose and compare differences in acute vs. chronic lithium toxicity. She will also discuss drug discontinuation syndrome as it applies to SSRIs & atypical antidepressants.

1:15 - 1:45 PM ET | Break - 30 min

1:45 - 2:15 PM ET
Beta Blockers and Calcium Channel Blockers: When the Antagonists Become Antagonistic
Katherine Katzung, MD, FACEP, FASAM Director of Addiction & Toxicology Program & Emergency Care Physician, Abbott Northwestern Hospital & Emergency Care Consultants, Minneapolis, MN

Dr. Katzung will return after the break to examine treatment options focusing on high-dose insulin vs vasopressor controversy and discuss mechanisms of toxicity, clinical manifestations, and updates on optimal therapy for beta-adrenergic blocking drugs and calcium channel antagonists drugs.

2:15 - 2:30 PM ET
Case Review

Several speakers from previous lectures return to review clinical cases.

2:30 - 3:00 PM ET
Drug-Induced Dysrhythmias: When You Can't Control the Rhythm
William "Russ" Kerns, II, MD, FACMT, FACEP Emeritus Professor of Emergency Medicine, Carolinas Medical Center, Charlotte, NC

Dr. Kerns will examine optimal treatment of drug-induced dysrhythmias and discuss how the optimal management of drug-induced dysrhythmias differs from AHA ACLS algorithms.

3:00 - 3:45 PM ET
Anticoagulants and Antithrombotics: When You Can't Control the Bleeding
Nena Bowman, PharmD, DABAT Director of Vaccine Operations, Vaccine Preventable Diseases and Immunization Program, Tennessee Department of Health, Nashville, TN

Dr. Bowman will identify appropriate uses of reversal agents for common anticoagulants and summarize the latest data in NOAC trials. She also will review the mechanism of action, indications, contraindications, adverse reactions, and common drug interactions of warfarin.

4:45 - 4:00 PM ET | Break - 15 min

4:00 - 4:30 PM ET
Out of Balance: Toxicity of Endocrine Agents
Charles McKay, MD, FACMT Associate Medical Director, CT Poison Control Center, University of Connecticut School of Medicine, Farmington, CT

Dr. McKay will examine management issues with overdose of endocrine drugs, and discuss endocrine clues and mimics and endocrine function impact of ‘non-endocrine’ medications.

4:30 - 5:00 PM ET
Anticonvulsants: When the Level Makes You Unsteady
Daniel J. Sessions, MD Medical Toxicologist, Ochsner Medical Center, New Orleans, LA

Dr. Sessions will identify treatment options for anticonvulsant toxicity, examine laboratory testing is required for toxicity from anticonvulsant agents, and discuss the toxicity of common anticonvulsants.

5:00 - 5:30 PM ET
Antimicrobials & Antivirals: When the Cure Becomes Toxic
Maryann Amirshahi, PharmD, MD, MPH, PhD, FACMT Emergency Medicine Attending Physician and Associate Professor Of Emergency Medicine, MedStar Washington Hospital Center & Georgetown University Hospital, Washington, D.C.

Dr. Amirshahi will discuss the mechanism of action of the five major classes of antimicrobials. She will describe the potential toxicities of commonly prescribed antimicrobial treatments and assess the likelihood of a cross-reaction between penicillin and cephalosporin.

Session 2 - November 8, 2024

8:50 - 9:00 AM ET | Opening Remarks

9:00 - 9:45 AM ET
The New Dangers of Opioid Addiction
Lewis Nelson, MD, FACEP Chair of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ

Dr. Nelson will describe opioid use disorder and explain how to initiate treatment for opioid use disorders. He will also highlight harm reduction efforts that can reduce the adverse consequences of opioid use.

9:45 - 10:15 AM ET
Management Options for Opioid Use Disorder
Rachel Wightman, MD, FACMT Assistant Professor of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI

Dr. Wightman will review the misuse, abuse, & criteria for diagnosing opioid use disorder. She will identify psychosocial treatments for opioid use disorder and describe the medication-assisted treatments for Buprenorphine, Methadone, and Naltrexone.

10:15 - 10:45 AM ET
Cannabis & Cannabis Toxicity
Mark Neavyn, MD, FACMT Medical Director & Emergency Medicine Physician, Northern New England Poison Center & Maine Medical Center, Portland, ME

Dr. Neavyn will examine the symptoms of cannabis toxicity and describe the treatment approach to cannabis toxicity.

10:45 - 11:00 AM ET | Break (15 min)

11:00 - 11:15 AM ET
What's New in Your Neighborhood?
Stephanie Weiss, MD, PhD Staff Clinician, Translational Addiction Medicine Branch, National Institute on Drug Abuse, Baltimore, MD

Dr. Weiss will discuss the epidemiology of new fentalogues and explain how to initiate treatment for fentanyl-related overdose.

11:15 - 12:00 PM ET
Case Review

Several speakers from previous lectures return to review clinical cases

12:00 - 12:30 PM ET
Drug Screen Pitfalls
Paul M. Wax, MD, FACMT Executive Director, American College of Medical Toxicology (ACMT), Phoenix, AZ

Dr. Wax will Identify toxicology tests available in the ED. He will discuss which tests should be requested in specific situations and describe how test ordering changes treatment outcomes.

12:30 - 1:00 PM ET | Break (30 min)

1:00 - 1:45 PM ET
Inhaled Toxicants: Simple Asphyxiants & Respiratory Irritants
Charles McKay, MD, FACMT Associate Medical Director, CT Poison Control Center, University of Connecticut School of Medicine, Farmington, CT

Dr. McKay will discuss the role of water solubility in the clinical presentation of pulmonary irritants and describe the clinical presentation of pulmonary irritants.

1:45 - 2:15 PM ET
Chemical Suicide & Mitochondrial Asphyxiants
Paul M. Wax, MD, FACMT Executive Director, American College of Medical Toxicology (ACMT), Phoenix, AZ

Dr. Wax will return to examine the sources and uses of chemical asphyxiants, their basic mechanisms of toxicity, and their clinical presentations. He will identify the differences between simple asphyxiants and chemical asphyxiants and compare therapies used to treat asphyxiant poisoning.

2:15 - 2:45 PM ET
Carbon Monoxide Poisoning: High Flow Oxygen or the Hyperbaric Chamber
Kelly Johnson-Arbor, MD, FACEP, FUHM, FACMT Medical Director, National Capital Poison Center & MedStar Georgetown University Hospital, Washington, DC

Dr. Johnson-Arbor will identify different types of radiation, describe the consequences of exposure to radiation, and discuss the diagnosis and management of radiation casualties and radiation mass casualty events.

2:45 - 3:15 PM ET
Disaster Preparedness #1: Radiation Events
Joseph K. Maddry, Lt Col, USAF, MC, FS, MD, FACMT Deputy Commander, Department of Emergency Medicine, US Army Institute of Surgical Research, Houston, TX

Dr. Maddry will discuss the diagnosis and management of radiation casualties and radiation mass casualty events. He will also identify different types of radiation and describe the consequences of exposure to radiation.

3:15 - 3:30 PM ET | Break (15 min)

3:30 - 4:00 PM ET
Disaster Preparedness #2: Organophosphates & New Agents
Christina Hantsch, MD, FACEP, FACMT, FAACT Emergency Physician and Medical Toxicologist, Loyola University Chicago Stritch School of Medicine Maywood, IL

Dr. Hantsch will discuss management options for patients with organophosphate insecticide or nerve agent toxicity and explain cholinergic toxidrome. She will list specific organophosphate insecticides and chemical weapon nerve agents.

4:00 - 4:45 PM ET
Disaster Preparedness #3: Other Chemical & Biological Terrorism
Aaron Frey, DO Emergency Medicine Attending Physician and Medical Toxicology Fellow, Richmond Emergency Physicians, Inc. & University of Virginia, Richmond, VA

Dr. Frey will examine the diagnosis and management of casualties resulting from terrorism and mass casualty events and discuss the history of bioterrorism as a tool for warfare. He will explain and evaluate the agents used in bioterrorist events.

4:45 - 5:30 PM ET
Case Review

Several speakers from previous lectures return to review clinical cases.

Session 3 - November 15, 2024

8:50 - 9:00 AM ET | Opening Remarks

9:00 - 9:30 AM ET
Hospital Hazards #1: Anesthetic Toxicity & Malignant Hyperthermia
Shaun D. Carstairs, MD, FACMT Medical Toxicologist, 98point6, Inc., Seattle, WA

Dr. Carstairs will discuss the history and pharmacology of local anesthetics and the unique characteristics and common clinical use for each prototypical local anesthetic. He will assess the most commonly caused several complications of local anesthetics and identifies general thermoregulatory principles. He will also review the following hyperthermic syndromes & discusses treatment options: Serotonin Syndrome, Neuroleptic Malignant Syndrome, and Malignant Hyperthermia.

9:30 - 10:00 AM ET
Hospital Hazards #2: Methemoglobinemia
Andrea Carlson, MD Emergency Medicine Physician, Advocate Christ Medical Center, Oak Lawn, IL

Dr. Carlson will discuss the common agents causing Methemoglobinemia. She will identify methemoglobinemia mechanisms of toxicity and describe the best practices in clinical management of methemoglobinemia.

10:00 - 10:30 AM ET
Heavy Metals In the ED: Lead, Arsenic & Mercury
Evan Schwarz, MD, FACMT, FASAM, FACEP Medical Toxicology Fellowship Director, University of California, Los Angeles, Los Angeles, CA

Dr. Schwarz will review the signs and symptoms of lead toxicity. He will discuss the role of chelation in heavy metal toxicity and compare and contrast the toxicity caused by different forms of mercury.

10:30 - 10:45 AM ET | Break (15 min)

10:45 - 11:45 AM ET
Case Panel: Novel Treatments for the Crashing Patient

Several speakers from previous lectures will return to review clinical cases.

11:45 - 12:30 PM ET
Ethanol Intoxication: Too Much Of a Good Thing
Anthony Pizon, MD, FACMT Chief of Medical Toxicology Division, Professor of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA

Dr. Pizon will examine the prevalence of ethanol AUD in patients presenting to the Emergency Department. He will also discuss the genetic vs. environmental factors for ethanol AUD and assess the most critical laboratory tests for symptomatic patients who have suspected ethanol intoxication.

12:30 - 1:15 PM ET
When It's Not Ethanol: Demystifying Toxic Alcohols
Bram Dolcourt, MD Clinical Assistant Professor Department of Emergency Medicine, Wayne State University, Detroit, MI

Dr. Dolcourt will describe toxicity & time course of methanol (MeOH) and ethylene glycol (EthGly) exposures, identify two stand-in tests for MeOH and EthGly, noting limitations, and present a rationale for treatment with ethanol, fomepizole, and/or hemodialysis.

1:15 - 1:45 PM ET | Break (30 min)

1:45 - 2:15 PM ET
Ethanol Withdrawal: When the Good Times End
Jerrold Blair Leikin, MD, FACP, FACEP, FACMT, FAACT, FACOEM, FASAM Adjunct Clinical Professor Division of Environmental and Occupational Health Sciences & Professor of Medicine, University of Illinois Chicago and Rosalind Franklin University of Medicine & Science, North Chicago, IL

Dr. Leikin will discuss appropriate treatment so that complications are prevented. He will examine alcohol withdrawal symptoms and describe the principles of detoxification.

2:15 - 2:45 PM ET
Don't Touch That! Marine, Arthropod & Reptile Envenomations
Michael Levine, MD, FACMT Associate Professor of Emergency Medicine, University of California Los Angeles, Los Angeles, CA

Dr. Levine will identify various toxic envenomations and describe the characterization of Black Widow envenomation and management options. He will also discuss management options for pit viper envenomations.

2:45 - 3:15 PM ET
The Toxic Yard
Fiona Garlich Horner, MD Head of Toxicology & Assistant Professor of Clinical Emergency Medicine, LAC+USC Medical Center & University of Southern California Keck School of Medicine, Los Angeles, CA

Dr. Garlich Horner will examine different classes of plant derived toxins and their effects on humans and identify hazards of different mushrooms and clinical toxidromes associated with mushrooms.

3:15 - 3:45 PM ET
The Toxic House
Ashley Haynes, MD, FACEP Medical Director, Addiction Toxicology of Kansas, Wichita, KS

Dr. Haynes will discuss common household exposures and their implications and review the toxicity of common household cleaners and toys.

3:45 - 4:00 PM ET | Break (20 min)

4:00 - 4:30 PM ET
The Toxic Cabinet
Stephen Wood, MS, ACNP-BC, FEWM Acute Care Nurse Practitioner & Director of Advanced Practice Providers, St. Elizabeth’s Medical Center, Brighton, MA

Nurse Practitioner Wood will review toxicity of essential oils and examine the risks associated with the use of dietary supplements.

4:30 - 5:00 PM ET
The Toxic Garage
Andrew King, MD Associate Professor in the Department of Emergency Medicine & Medical Director, Wayne State University School of Medicine & Michigan Poison and Drug Information Center, Detroit, MI

Dr. King will discuss common toxins and exposures of chemicals commonly found in the garage. He will also review toxicity and management of chemicals and other substances commonly found in the garage.

5:00 - 5:30 PM ET
Case Panel

Several speakers from previous lectures will return to review clinical cases.

Registration Rates

Registration includes:

• Access to all three sessions of the live virtual event on November 1, 8, 15, 2024
• Access to the on-demand recording for 90 days after the event
• Access to the Speaker slides
• 24.0 Continuing Education Certificate. Available credits: Continuing Medical Education (CME), Continuing Nursing Education (CNE), Continuing Pharmacy Education (CPE), Continuing Medical Education for Physician Associate (AAPA CME), and Continuing Education for Nurse Practitioners (AANP CE).

Are you a member of any of the following organizations: AAEM, AAENP, APC, APAMT, EAPCCT, SOT, MENATOX? You may be eligible for a registration discount! Please email us at events@acmt.net for more information.

Member Rates

Non-Member Rates

ACMT Membership

ACMT Members receive a discounted rate. Interested in becoming an ACMT Member? Contact our Membership Team at membership@acmt.net. Learn more at: www.acmt.net/membership

Group Discounts Available

Is your hospital or medical group interested in enrolling multiple employees in our course? We offer special discounts for organizations with multiple participants. Contact us at events@acmt.net for more details!

Refunds and Cancellations

• Cancellations made 15 days or more in advance of the event date will receive a full refund less a 8% processing fee.
• Cancellations made within 14 days of the event date will not receive a refund.

All cancellation requests must be made in writing and emailed to: events@acmt.net. No telephone cancellations will be accepted. A refund that results from a cancellation or change to your registration will be returned to the original payer and in the original method of payment. 

Pending review, limited exceptions will be made based on need and circumstance (family emergency, for example) and must be submitted in writing to events@acmt.net. For these instances, the full registration fee, minus a 8% processing fee, will be refunded. Because each exception must undergo a review and approval process, we ask in advance for your patience.

Questions?

For any questions, please email us at events@acmt.net.

Continuing Education

CE credit provided by AKH Inc., Advancing Knowledge in Healthcare. 

In support of improving patient care, this activity has been planned and implemented by AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

This activity was planned by and for the healthcare team, and learners will receive 8.0 Interprofessional Continuing Education (IPCE) credit for learning and change. 

Physicians
AKH Inc., Advancing Knowledge in Healthcare designates this live activity for a maximum of 8.0 AMA PRA Category 1 Credit(s)™ per session. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses
Credit being awarded: 8.0 ANCC contact hours per session.

Nurse Practitioners

This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners (AANP) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT).   AKH Inc., Advancing Knowledge in Healthcare is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 030803. This activity is approved for 8.0 contact hour(s) per session (which includes 8.0 hour(s) of pharmacology per session).

Physician Associate

AKH Inc., Advancing Knowledge in Healthcare has been authorized by the American Academy of Physician Associates (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 8.0 AAPA Category 1 CME credits per session. 

PAs should only claim credit commensurate with the extent of their participation.

Pharmacists
AKH Inc., Advancing Knowledge in Healthcare designates this continuing education activity for 8.0 contact hours per session.

Commercial Support
This activity is supported from an independent medical education grant from BTG international lnc.,

Disclosures
It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The author must disclose to the participants any significant relationships with ineligible companies whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are mitigated by AKH prior to accreditation of the activity. AKH planners and reviewers have no relevant financial relationships to disclose.

Disclosure of Unlabeled Use and Investigational Product
This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer
This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participants misunderstanding of the content. If you would like to opt out from future communications from AKH please send an email to optout@akhcme.com with your information with "Opt Out" in the subject line.