North American Congress of Clinical Toxicology

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					       North American
         Congress of
      Clinical Toxicology
          Organized By: American Academy of Clinical Toxicology

                      Las Vegas, NV • OctOber 1-6, 2012




Sponsored By:
• American Academy of Clinical Toxicology
• American Association of Poison Control Centers


Annual Meeting of:
• American Academy of Clinical Toxicology
• American Association of Poison Control Centers
• American College of Medical Toxicology
• Canadian Association of Poison Control Centres
• European Association of Poisons Centres and Clinical Toxicologists   NACCT
                                 North American Congress of Clinical Toxicology


    Meeting Announcement                                                Nacct Opening Day
    The American Academy of Clinical Toxicology and the                 Wednesday, October 3rd
    American Association of Poison Control Centers are                  Keynote Presentation
    pleased to announce that the North American Congress
    of Clinical Toxicology 2012 and associated pre-meeting                                   Partnership Opportunities for
    functions will be held at The Cosmopolitan of Las Vegas                                  Poison Centers and Public Health
    located in Las Vegas, NV; October 1-6, 2012.                                             Speaker: James S. Blumenstock, M.A.
                                                                                            	Chief	Program	Officer
    This annual conference allows an opportunity for physicians,
                                                                                             Public Health Practice
    pharmacists, nurses, and scientists from around the world
                                                                                             Association of State and Territorial
    to participate in the sharing of knowledge on a wide variety
                                                                                             Health	Officials	(ASTHO)
    of clinical toxicology topics and issues. In addition, there will
    be multiple original research papers presented, a number of         Jim Blumenstock holds the position of Chief Program Officer
    symposia, as well as other traditional and novel continuing         for Public Health Practice for the Association of State and
    education sessions.                                                 Territorial Health Officials (ASTHO). His portfolio includes
                                                                        the state public health practice program areas of infectious
                                                                        and emerging diseases, immunization, environmental
    general Objectives:                                                 health, public health preparedness and security (including
     Identify the acute and/or chronic toxic effects of various        pandemic influenza preparedness), and public health law.
      drugs, chemicals and biologicals.                                 Jim also serves as a member of the Association’s Executive
     Utilize research data to determine new approaches                 Management Team responsible for enterprise-wide strategic
      to the prevention, assessment, and treatment of                   planning, administrative services, member support, and
      poisoning victims.                                                public health advocacy. In recent years he has worked closely
                                                                        with the American Association of Poison Control Centers on
     Compare and contrast approaches to the treatment of               issues of preparedness and response to radiological events.
      poisoned patients.
                                                                        Prior to his arrival at ASTHO on November 1, 2005, Jim
     Identify the principles of assessing the severity and             was the Deputy Commissioner of Health for the New Jersey
      predicting the outcome of poisonings.                             Department of Health and Senior Services where he retired
     Define innovations in the responsibilities and functions          after almost 32 years of career public health service. In this
      of poison centers.                                                capacity, he had executive oversight responsibilities for a
                                                                        department branch of over 650 staff, an operating budget
     Identify the principles involved in the laboratory                of approximately $125 million, which was comprised of the
      evaluation of poisonings.                                         Division of Public Health and Environmental Laboratories;
     Identify the risks and treatment of occupational and              Division of Epidemiology, Occupational and Environmental
      environmental hazards to humans.                                  Health; Division of Local Health Practice and Regional Systems
                                                                        Development; Division of Health Emergency Preparedness
                    The Online Library                                  and Response, and the Office of Animal Welfare. During his
                                                                        tenure, Jim also represented the Department on a number of
         The Online Library is a convenient, easy-to-access
         format that is available from anywhere on a 24/7 basis.        boards, councils and commissions including the NJ Domestic
                                                                        Security Preparedness Task Force.
         The Library Features:
         • Search by conference name, presentation subject              Jim received his Bachelor of Science degree in Environmental
           or speaker.                                                  Science from Rutgers University in 1973 and a Master of Arts
         • Download the presentation audio to your mobile               degree in Health Sciences Administration from Jersey City
           media player.                                                State College in 1977.
         • Take notes during the presentations and store
           them for later reference.
         • Plus much more….                                                            Corporate Sponsors
         Conference Registrants:
         As a conference registrant, you have complimentary                   A special thank you to the following companies:
         access to the recorded presentations from the
         conference sessions for which you registered.                                btg International, Inc.
         Approximately 3 weeks after the conference, you will
         receive an email notifying you that the actual audio                      Cumberland Pharmaceuticals
         presentation recorded at the live conference and                   McNeil Specialty Consumer Pharmaceuticals
         PowerPoint slides are available for access in the
         Online Library.


2                  Register Today at www.clintox.org • Follow us on Facebook and Twitter (#NACCT12)
the 2012 congress                                                                Pre-Meeting activities
The 2012 Congress will offer multiple clinical toxicology                        Monday, October 1
symposia, presentation of original research as posters and                       ACMT Pre-Meeting Symposium
platforms, and scheduled special interest and committee                          • Vanity and Vice: Toxicology in the Sin City
group meetings. Selected topics include:
                                                                                 Tuesday, October 2
 Arsenic toxicity in West Bengal                                                AACT Pre-Meeting Symposium
 Snake venoms and medication development                                        • Advanced Antidotes: a full day presymposium on
                                                                                   recent advances and emerging treatments for a large
 Clinical toxicology response following nuclear power                             variety of toxicologic emergencies.
  plant disasters
 Drug metabolism in therapeutic hypothermia
 Contaminants in neutraceutical products
                                                                                 special Opportunities for 2012
 Intersection of pediatric and forensic toxicology                                H
                                                                                 •		 osted	by	the	AACT	Acute	&	Intensive	Care	SIG:
 Application of evidence based practice in clinical                               Use of a Simulation Center for Clinical Toxicology
  toxicology                                                                       Training
                                                                                  Using a simulation mannequin, meeting attendees
 Integration of electrocardiograph (ECG) interpretation                          will be given the opportunity to observe and/
  with management decisions in the poisoned patient                               or participate in using a simulator for toxicology
                                                                                  education:
                                                                                  An experienced technologist from Medical Education
Accreditation                                                                     Technologies, Inc. will be on-site to demonstrate the
                                                                                  use of a simulator in clinical toxicology education. The
This activity has been planned and implemented in accordance
                                                                                  simulation center will be open throughout the meeting.
with the Essential Areas and Policies of the Accreditation
                                                                                  The Simulation Center will be available:
Council for Continuing Medical Education through the joint
sponsorship of the American Academy of Clinical Toxicology,                       Wednesday, October 3rd:                 3:15 pm to 4:15 pm
and the American Association of Poison Control Centers.                           Thursday, October 4th:                  2:45 pm to 3:45 pm
Participating organizations include the American College of                                                               4:00 pm to 5:00 pm
Medical Toxicology, Canadian Association of Poison Control                        Friday, October 5th:                    10:30 am to 11:30 am
Centres, and European Association of Poisons Centres and                                                                  1:00 pm to 2:00 pm
Clinical Toxicologists. The American Academy of Clinical                                                                  5:00 pm to 6:00 pm
Toxicology is accredited by the ACCME to provide continuing                       ACPE	Program	Number:	0225-9999-12-233-L04-P	(A)/1.0	credit
medical education for physicians.                                                •	Toxicology	History	Room
                                                                                   Posters featuring toxicology history, made available by
     American Academy of Clinical Toxicology Inc., is                              the Toxicology History Association, will be on display.
     accredited by the Accreditation Council for Pharmacy
Education as a provider of continuing pharmacy education.                        •	Featured	Topic	Day	–	Friday,	October	5th	
                                                                                  On Friday, October 5th, three symposia will highlight
Disclosure
                                                                                  the field of environment toxicology:
It is the policy of the American Academy of Clinical Toxicology to ensure
balance, independence, objectivity and scientific rigor in all its educational    1. Arsenic Toxicity in West Bengal
activities. All faculty, authors, editors and planning committee members are      2. Dealing With the Aftermath of a Nuclear Power Plant
required to disclose all relevant financial relationships with any commercial
interest producing health care goods or services consumed by, or used on
                                                                                     Disaster
patients, with the exemption of non-profit or government organizations and        3. A Case Discussion of Pediatric Environmental Exposures
non-health care related companies.
                                                                                  Running concurrently will be two symposia
Physicians, Pharmacists, Nurses, and Certified Health Education Specialists       highlighting	the	field	of	envenomation	science:
should refer to page 15 for CE credit details.
                                                                                  Topics covered will include medication development
                                                                                  from venoms, management of venomous snakebites in
                                                                                  Thailand, the development of novel snake antivenoms,
                                                                                  and common misconceptions in the management of
                                                                                  snake envenomation in Taiwan.



           Internet Café and wireless Internet access throughout all sessions

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    Continuing Education Sessions
                                                                                                                       Credit Hours*
    Session                                                                          ACPE Program Number               RPh      MD              RN

    October 1, 2012
     8:00 am – 5:00 pm ACMT Pre-Meeting Symposium: Vanity and Vice:                  0225-9999-12-200-L04-P (K)         8.0         8.0         8.0
                         Toxicology in the Sin City
    October 2, 2012
     8:00 am – 5:00 pm AACT Pre-Meeting Symposium: Advanced Antidotes                0225-9999-12-201-L04-P (K)         8.0         8.0         8.0
     5:30 pm – 7:30 pm ACMT Clinical Pathophysiology Competition (CPS)               0225-9999-12-202-L04-P (K)         2.0         2.0         2.0

    October 3, 2012
     7:30 am – 9:00 am Keynote Symposium:Partnership Opportunities for               0225-9999-12-203-L04-P (K)         1.0         1.0         1.0
                         Poison Centers and Public Health
     9:00 am – 4:30 pm Exhibits / Poster Session I
    10:00 am – 11:30 am	 ACMT	Scientific	Symposium:	Hypothermia	and	Toxicology	 0225-9999-12-204-L04-P (K)              1.0         1.0         1.0
    11:30 am – 1:00 pm ACMT Fellows in Training Roundtable:The Development of                                           1.5
                         an Inpatient Medical Toxicology Service
     1:00 pm – 3:00 pm Platform Session I                                            0225-9999-12-205-L04-P (K)         2.0         2.0         2.0
     3:15 pm – 4:45 pm CAPCC Symposium: Controversies in the Use of                  0225-9999-12-207-L04-P (K)         1.5         1.5         1.5
                         Hemodialysis in Poisoned Patients
     3:15 pm – 4:45 pm AAPCC Veterinary Symposium: One World, One Health:            0225-9999-12-206-L04-P (K)         1.5         1.5         1.5
                         Veterinary and Human Crossroads
     5:00 pm – 6:00 pm AACT SIG Toxicological Historical Society                     0225-9999-12-208-L04-P (K)         1.0         1.0         1.0
     6:00 pm – 7:30 pm Opening Reception

    October 4, 2012
     9:00 am – 4:00 pm Exhibits / Poster Session II
     8:00 am – 9:30 am AAPCC Symposium                                               0225-9999-12-209-L04-P (K)         1.5         1.5         1.5
    10:30 am – 11:30 am AACT Career Achievement Award                                0225-9999-12-210-L04-P (K)         1.0         1.0         1.0
    11:30 am – 1:00 pm Lunch Break
     1:00 pm – 2:30 pm EAPCCT Symposium: Acute Assessment of the                     0225-9999-12-212-L04-P (K)         1.5         1.5         1.5
                         Poisoned Patient
     1:00 pm – 2:30 pm   AACT Trainees Research Symposium                            0225-9999-12-211-L04-P (K)         1.5         1.5         1.5
     2:45 pm – 3:45 pm   Platform Session II                                         0225-9999-12-214-L04-P (K)         1.0         1.0         1.0
     2:45 pm – 3:45 pm   AACT Herbal SIG Symposium: Contaminants                     0225-9999-12-213-L04-P (K)         1.0         1.0         1.0
                         in Herbals, Supplements, & Other Products
     4:00 pm – 5:00 pm   AACT Articles You May Have Missed Symposium                 0225-9999-12-215-L04-P (K)         1.0         1.0         1.0
     4:00 pm – 5:00 pm   AAPCC SPI Poison Center Best Practices Symposium            0225-9999-12-216-L04-P (K)         1.0         1.0         1.0
     6:30 pm – 8:30 pm   AACT Reception
K = Knowledge-based activity; A = Application-based activity




    The AACT reserves the right to adjust the maximum number of hours available pending changes in the program schedule.
    NOTE: Shaded areas indicate concurrent sessions.
         AACT      = American Academy of Clinical Toxicology            CAPCC    =   Canadian Association of Poison Control Centres
         AAPCC     = American Association of Poison Control Centers     EAPCCT   =   European Association of Poisons Centres and Clinical Toxicologists
         ABAT      = American Board of Applied Toxicology               SPI      =   Specialist in Poison Information
4        ACMT      = American College of Medical Toxicology             SIG      =   Special Interest Group
         APAMT	    =		 Asia	Pacific	Association	of	Medical	Toxicology   WMD      =   Weapons of Mass Destruction
                                                                                                                               Credit Hours*
Session                                                                                     ACPE Program Number                RPh      MD             RN

October 5, 2012
  8:00 am – 9:30 am AACT Scientific Symposium: Poison in the Well:                           0225-9999-12-217-L04-P (K)         1.5        1.5          1.5
                          Exposure, Consequences, and Remediation of Arsenic
                          in Bangladesh
  9:00 am – 3:45 pm Exhibits / Poster Session III
 10:30 am – 11:30 am Platform Session III                                                    0225-9999-12-219-L04-P (K)         1.0        1.0          1.0
 10:30 am – 11:30 am AACT Radiation/Food Safety SIG Symposium: Role                          0225-9999-12-218-L04-P (K)         1.0        1.0          1.0
                          of the Toxicologist in the Aftermath of a Nuclear Power
                          Plant Disaster
 11:30 am – 1:00 pm ACMT Fellows In Training Luncheon:Core Knowledge in                                                         1.5
                          Occupational Toxicology
  1:00 pm – 2:00 pm Platform Session IV                                                      0225-9999-12-220-L04-P (K)         1.0        1.0          1.0
  1:00 pm – 2:00 pm AACT Envenomation SIG Symposium: Medications                             0225-9999-12-221-L04-P (K)         1.0        1.0          1.0
                          Developed From Venoms
  2:00 pm – 3:30 pm ABAT Symposium: Evidenced-Based Practice                                 0225-9999-12-222-L04-P (K)         1.5        1.5          1.5
                          and the Treatment of Rhabdomyolysis
  2:00 pm – 3:30 pm APAMT Symposium: Snake Envenomation in Asia                              0225-9999-12-223-L04-P (K)         1.5        1.5          1.5
  3:45 pm – 4:45 pm AACT Forensics/Pediatric SIG Symposium:
                          The Intersection of Pediatric & Forensic Toxicology                0225-9999-12-225-L04-P (K)         1.0        1.0          1.0
  3:45 pm – 4:45 pm ACMT Ellenhorn Award                                                     0225-9999-12-224-L04-P (K)         1.0        1.0          1.0
  5:00 pm – 6:00 pm AAPCC SPI Clinical Practice Symposium: Pediatric                         0225-9999-12-226-L04-P (K)         1.0        1.0          1.0
                          Environmental Exposures and Cases
  7:00 pm – 9:00 pm SPI Awards/Quiz Bowl

October 6, 2012
  7:00 am – 11:00 am Exhibits / Poster Session IV
  8:00 am – 9:30 am ACMT Practice Symposium: Telemedicine                                    0225-9999-12-227-L04-P (K)         1.0        1.0          1.0
                          and the Practice of Medical Toxicology
  8:00 am – 9:30 am AAPCC Public Education Committee Symposium:                              0225-9999-12-228-L04-P (K)         1.0        1.0          1.0
                          Ways to Partner with 911 to Increase Call Volume
 10:30 am – 11:30 am AAPCC SPI Roundtable Symposium                                          0225-9999-12-229-L04-P (K)         1.0        1.0          1.0
 10:30 am – 11:30 am AACT Year in Toxicology Symposium                                       0225-9999-12-230-L04-P (K)         1.0        1.0          1.0
 11:30 am – 12:30 pm AACT Acute and Intensive Care Symposium                                 0225-9999-12-231-L04-P (K)         1.0        1.0          1.0
 11:30 am – 12:30 pm AACT Occupational/Environmental SIG Symposium:
                          Inhalational Toxicology of Manufactured Nanoparticles              0225-9999-12-232-L04-P (K)         1.0        1.0          1.0
                             Maximum Hours                                                                                    40.5        43.5         40.5*
*Application for nursing credits has been submitted to the California Board of Nursing. Credit hours are preliminary, and subject to final approval.
K = Knowledge-based activity; A = Application-based activity




    The AACT reserves the right to adjust the maximum number of hours available pending changes in the program schedule.
    NOTE: Shaded areas indicate concurrent sessions.
           AACT       =   American Academy of Clinical Toxicology                 CAPCC      =   Canadian Association of Poison Control Centres
           AAPCC      =   American Association of Poison Control Centers          EAPCCT     =   European Association of Poisons Centres and Clinical Toxicologists
           ABAT       =   American Board of Applied Toxicology                    SPI        =   Specialist in Poison Information
           ACMT       =   American College of Medical Toxicology                  SIG        =   Special Interest Group                                           5
           APAMT      =   Asia Pacific Association of Medical Toxicology          WMD        =   Weapons of Mass Destruction
    acMt Pre-Meeting symposium
    Monday • October 1, 2012

    Vanity and Vice: Toxicology in the Sin City
    This symposium will begin by examining the toxicologic underpinnings of various methods to look younger, last longer, and
    get stronger. The primary focus will be on the basic science behind these “therapies” and the evidence supporting potential
    approaches to treatment. The second half of the symposium will delve into debauchery - the sordid world of gambling
    addiction, celebrity drug abuse, addiction and detoxification, as well as the benefits and risks of public health measures to
    ameliorate the epidemic of opioid overdose.

    Objectives
    At the end of the Pre-Meeting Symposium, the learner will be able to:
    1.      Review the epidemiology of systemic disease associated with breast implants.
    2.      Distinguish between local complications and systemic disease associated with breast implants.
    3.      Describe the history of tumescently administered lidocaine.
    4.      Discuss how the pharmacology of tumescent lidocaine differs from other routes of delivery and the potential
            toxicological consequences.
    5.      Discuss the diversion of research grade Botulinum toxin, the mechanism of toxicity and management of BoTox
            overdose.
    6.      Discuss the risks and controversies surrounding the injection of silicone, Non Animal Stabilized Hyaluronic Acid
            (NASHA), calcium hydroxyl apatite, polymethyl-methacrylate (PMMA), and other foreign substances for cosmetic
            purposes.
    7.      Describe mechanisms of toxicity from anabolic/androgenic steroid abuse.
    8.      Discuss other novel compounds that may be abused as anabolic agents, including pathophysiology and review of
            existing scientific evidence.
    9.      Explain the mechanisms behind the most common sexual performance enhancers.
    10. Assess the most appropriate management approach for sexual performance enhancer toxicity based upon the
        mechanism of drug action.
    11. Review the psychosocial complexities associated with celebrity drug abuse and poisoning.
    12. Discuss the literature surrounding highly publicized celebrity poisonings as it pertains to the practice of medical
        toxicology.
    13. Review the pathophysiology of gambling addiction, including the role of dopamine agonism in inducing impulse
        control disorders.
    14. Review the mechanism of and scientific evidence to support pharmacological treatment options for gambling
        addiction.
    15. Review the pharmacologic treatment of substance abuse.
    16. Describe the neurobiological mechanism of drug addiction.
    17. Discuss recent proposed legislation aimed at preventing morbidity from opiate overdose, and whether this will likely
        worsen or improve the epidemic of prescription opioid abuse.
    18. List the arguments for and against public health measures such as use of naloxone by non-medical personnel and
        supervised injection sites.
     Moderators:
                          Diane P. Calello, MD                                                Keenan Bora, MD
                             Medical Toxicologist                                   Assistant Professor of Emergency Medicine
             New Jersey Poison Information and Education System                               and Medical Toxicologist
                     Department of Emergency Medicine                     Children’s Hospital of Michigan Regional Poison Control Center
         Morristown Medical Center and Emergency Medical Associates                 Wayne State University School of Medicine


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topics to be covered:
 Introduction: Hedonism and the Medical Toxicologist        A Toxicologist’s Perspective on Addiction and
  Diane P. Calello, MD: Medical Toxicologist, New             Detox
  Jersey Poison Information and Education System;             Heath A. Joliff, DO: Fellowship Director, Medical
  Department of Emergency Medicine, Morristown                Toxicology, Associate Professor of Emergency
  Medical Center and Emergency Medical Associates             Medicine, The Ohio State University Medical Center
 Silicone, Science and Silliness: The                       Opioid Overdose Prevention Panel Discussion:
  Pseudoscientific	Saga	of	Breast	Implants	and	the	           Harm Reduction vs. Do No Harm
  Women Who Need Them                                         Lewis Nelson, MD: President, American College of
  Jeffrey Brent, M.D., Ph.D: Clinical Professor of            Medical Toxicology, Professor of Emergency Medicine,
  Medicine and Pediatrics, University of Colorado School      New York University School of Medicine, Director,
  of Medicine, Clinical Professor of Environmental and        Fellowship in Medical Toxicology, New York City
  Occupational Health, Colorado School of Public Health       Poison Control Center
 Nip Tuck Tox: High Dose Tumescent Anesthetics               Heath A. Joliff, DO: Fellowship Director, Medical
  Under the Knife                                             Toxicology, Associate Professor of Emergency
  Rama Rao, MD: Director, Medical Toxicology,                 Medicine, The Ohio State University Medical Center
  Assistant Professor of Emergency Medicine, New York         Craig Smollin, MD: Assistant Clinical Professor
  Presbyterian Hospital: Weill Cornell Medical Center         of Emergency Medicine, UCSF and San Francisco
                                                              General Hospital, Associate Medical Director,
 From Botox to Bootleg Beauty: Toxic Injectables             California Poison Control Center, San Francisco
  S. Eliza Halcomb, MD: Chief, Section of Medical             Division, Fellowship Director, Medical Toxicology
  Toxicology, Assistant Professor of Emergency                Fellowship Program, UCSF
  Medicine, Washington University School of Medicine          Chuck McKay, MD: Associate Professor of
 What Charles Atlas Never Told Me: Anabolics for the         Emergency Medicine, Director of Toxicology
  Next	Generation                                             Fellowship, University of Connecticut School
  Matthew Hedge, MD: Assistant Professor of                   of Medicine, Associate Medical Director of the
  Emergency Medicine, Wayne State University School           Connecticut Poison Control Center, National
  of Medicine                                                 Coordinator, ACMT-ATSDR Regional Consultation
                                                              Network
 Mechanisms of Sexual Performance Enhancers:
  Getting	Up	and	Keeping	Up	with	the	Latest	
  Developments
  G.	Patrick	Daubert,	MD:	KPNC Regional Toxicology
  Service, Department of Emergency Medicine, Kaiser
  Permanente, South Sacramento Medical Center
 Celebrity Toxicology: What Happens in Vegas
  Sometimes Leaves Vegas
  Sean M. Bryant, MD: Associate Professor of
  Emergency Medicine, Rush Medical College, Cook
  County Hospital (Stroger); Assistant Fellowship
  Director, Toxicon Consortium; Associate Medical
  Director, Illinois Poison Center, LCDR, US Navy
  Reserve MC, 4th MD, DET 5
 Addicted	to	Gambling?	Bet	on	Dopamine!
  Shan Yin, MD, MPH: Assistant Professor of Pediatrics,
  University of Cincinnati School of Medicine, Cincinnati
  Children’s Hospital, Division of Emergency Medicine,
  Medical Director, Cincinnati Drug and Poison
  Information Center



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    aact Pre-Meeting symposium
    Tuesday • October 2, 2012

    Advanced Antidotes:
    A full day presymposium on recent advances and emerging treatments for a large variety of
    toxicologic emergencies.
    Antidotes play a critical role in the reversal of life-threatening toxicity from a select group of poisonings. Over recent years,
    there have been a number of substantial innovations in antidote development that have revolutionized patient care. This
    symposium examines new antidotes, new uses for old antidotes, and antidotes in development to provide the participant
    with the most recent knowledge and tools necessary to improve patient care.


    Objectives
    At the end of the Pre-Meeting Symposium, the learner will be able to:
    1.    Review experimental findings around newer lipid based detoxification remedies.
    2.    State the clinical evidence regarding efficacy of antivenom in scorpion envenomation.
    3.    Describe current clinical practice in scorpion envenomation treatment in primary and tertiary care settings.
    4.    Discuss the role of dextrazoxane in extravasation incident.
    5.    Describe the mechanism of action 5FU and analogs and the rationalle for uridine triacetate therapy.
    6.    Understand the role of glucarpidase in folate antagonist toxicity.
    7.    Understand the pathophysiology of ACE inhibitor angioedema.
    8.    Discuss the role of icatibant in ACE inhbitor angioedema.
    9.    Recognize the mechanism by which various drugs and toxins produce microvesicular steatosis.
    10. Discuss the rationale for administering intravenous carnitine when treating patients with microvesicular steatotic
        syndromes.
    11. Describe the evidence for nitric oxide as a contributor to drug-induced vasodilatory shock.
    12. Explain the evidence to support the use of methylene blue in drug-induced vasodilatory shock.
    13. Describe new methods to assess cyanide poisoning.
    14. Discuss new antidotes for cyanide poisoning.
    15. Describe the role of factor replacement in anticoagulant overdose.
    16. Understand the future of aptamer technology in anticoagulant therapy and overdose.
    17. Understanding the latest recommendations for active acute kidney injury prevention in contrast exposure.
    18. Discuss the potential use of renal replacement therapy in contrast nephropathy.

     Moderators:


                       Robert S. Hoffman, MD                                              Kirk Cumpston, DO
                       Director, NYC Poison Center                                Medical Director, Virginia Poison Center
         Associate Professor of Emergency Medicine and Medicine            Assistant Professor Virginia Commonwealth University
                  New York University School of Medicine                                    School of Medicine
              Attending Physician, Bellevue Hospital Center




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topics to be covered:
 Lipid Emulsion 2.0
  Grant	Cave,	MD,	FACEM,	FCICM:	Clinical Head of
  Emergency Medicine, Hutt Hospital, New Zealand
  Intensivist, Tamworth Rural Referral Hospital, Australia
 Scorpion Antivenom
  Leslie Boyer, MD, FACMT: Director, VIPER Institute
  Associate Professor, Pathology Associate Professor,
  Pediatrics Associate Professor, BIO5 Institute University of
  Arizona Tucson, Arizona, USA
 New Antidotes for Chemotherapeutic Toxicity
  Silas Smith, MD, FACEP: Assistant Professor of
  Emergency Medicine New York University School of
  Medicine New York, New York, USA Attending Physician
  New York University Langone Medical Center and Bellevue
  Hospital Center New York, New York, USA
 Icatibant for Ace Inhibitor Angioedema
  Kirk Cumpston, DO, FACEP, FACMT: Assistant Professor
  Division of Clinical Toxicology Department of Emergency
  Medicine, Medical Director of the Virginia Poison Center
  Medical College of Virginia Hospital Virginia Commonwealth
  University Health System Richmond, VA, USA
 Pathogenesis of Hepatic Microvesicular Steatotic
  Syndromes and Role of Carnitine Therapy
  Steven Curry, MD, FACCT, FRCP Edin: Director,
  Department of Medical Toxicology Banner Good Samaritan
  Medical Center, Professor of Medicine University of Arizona
  College of Medicine, Phoenix, AZ, USA
 Methylene Blue for Drug Induced Cardiovascular
  Shock
  David Jang, MD: Assistant Professor Department of
  Emergency Medicine/Medical Toxicology New York University
  School of Medicine, Masters of Science Degree in Clinical
  Investigation Clinical and Translational Science Institute
 New Cyanide Antidotes and New Methods to
  Diagnose Cyanide Poisoning
  Gerry	Boss,	MD:	Professor of Medicine University of
  California, San Diego La Jolla, CA, USA.
  C
 	 ontrast	Nephropathy:	What’s	Good	on	the	Menu	
  Today?
  	Marc	Ghannoum,	MD: Associate Professor of Medicine
  University of Montreal Department Chief, Nephrology
  Verdun Hospital, Montreal Montreal, Canada
 Stopping Bleeding from New Anticoagulants
  Robert S. Hoffman, MD, FAACT, FACMT, FRCP Edin:
  Director, NYC Poison Center Associate Professor of
  Emergency Medicine and Medicine NYU SOM New York,
  NY, USA, Attending Physician Bellevue Hospital Center
  New York, NY, USA


          Register Today at	www.clintox.org		•		Follow us on Facebook and Twitter (#NACCT12)   9
 AAPCC Public Education Committee Track
 October 3-6, 2012

 Description:                                                      Highlights:
 The Public Education Committee Track at the North                  True	Colors™	Workshop	– Learn valuable strategies
 American Congress of Clinical Toxicology brings together            for communicating with one’s boss, co-worker, and
 public health educators from all over the United States and         clients. True Colors™ is a model for understanding
 Canada. Attendees have diverse backgrounds and areas                yourself and others based on your personality
 of expertise, including certified health educators, specialists     temperament.
 in poison information, emergency medical services (EMS)
 professionals, and marketing professionals. The audience           Prescription	Drug	Abuse	Panel	– A panel of experts
 is small enough to have meaningful interaction with both            who incorporate drug abuse education into their poison
 presenters and participants while networking and building           prevention programs will share their successes and
 lasting partnerships with others who share your goals and           failures in tackling this dynamic, deadly, and growing
 challenges.                                                         problem.
 Attendees of this track will learn about evidenced-based            S
                                                                    	 ocial	Media	– Social media is the fastest growing
 strategies targeted at specific audiences and best practices        vehicle to reach the masses. In this session,
 in public health education with a focus on poison safety            participants will learn how to leverage this tool, identify
 programs. This track runs concurrently with the clinical            useful measurement methods, and most importantly,
 toxicology education sessions of the main congress,                 get a better understanding of social media return on
 October 3-6, 2012.                                                  investment.
 audience:                                                          Herbals,	Dietary	Supplements,	and	OTC’s	–
 Poison center educators, health educators, childhood injury         Although the study of herbs as medicine dates back
 prevention specialists, CHES-eligible participants.                 thousands of years, they are not safe for everyone.
                                                                     Many herbals pose significant threats. Participants will
 ceU:                                                                learn steps to avoid toxicity and drug interactions with
                                                                     herbal and dietary supplement usage.
 Application for CHES/MCHES Category I continuing education
 contact hours (CECH) has been made to the National                 Partnering	with	911	to	Increase	Call	Volume	– As
 Commission for Health Education Credentialing, Inc.                 part of the main educational sessions at NAACT, the




10              Register Today at	www.clintox.org		•		Follow us on Facebook and Twitter (#NACCT12)
   educators will host a symposium in which a panel of
   veteran educators will share ways to partner with EMS                    bring your lunch and join a
   and 911 centers to increase collaboration resulting in
   increased number of calls to poison centers.                             “lunch-and-learn” program
 	 rogram	Design	and	Implementation	– Whether
  P                                                                            for Poison Specialists!
  the goal is to design programs for poison safety,
  disaster preparedness, or childhood vaccinations,                     Friday • October 5th: 12:00 to 1:30 pm
  this session will equip the participant with tools to
  start off on the right foot. Program strategies, health
                                                                         Working Your Way Through the CSPI
  education theories, and methods to pilot programs in
  the community will be reviewed.                                              Examination Process
 	 oisons	in	Pop	Culture	– Find a seat early! This
  P                                                                     Leslie Sandler from the AAPCC Central
  popular session filled with great music and interesting               Office will cover topics including:
  trivia is presented game show style geared for
                                                                       What to expect at the test site
  audience interaction. The audience is split into teams
  that compete for bragging rights. If you know what                   Testing tips
  poison killed Michael Jackson, Janis Joplin, and Elvis,              Dealing with test anxiety
  there is a team that desperately needs you! If you
  don’t know, you will by the time you leave.                          Where	to	find	study	materials
 Swap	and	Share	– Have a great idea? Need a
                                                                       List of topics that may need more preparation
  great idea? Swap and Share is a session in which                     Q/A
  educators share their most successful projects from
  the previous year.




                                        Post-Meeting activity
                                        Advanced	Hazmat	Life	Support	(AHLS)
                                        Saturday,	Sunday,	&	Monday;	October	6th	–	8th
                                        Provider	&	Instructor	Course
                                        Register online at www.ahls.org or call	(520)	626-2305	today!




         Register Today at	www.clintox.org		•		Follow us on Facebook and Twitter (#NACCT12)                             11
 V iva Las Vegas …
 It’s impossible to resist the excitement of the neon lights,   Don’t miss the new CityCenter complex located in the
 the shrieks of delight from jackpot winners, and the glitz     heart of The Strip, a blend of sleek architecture and public
 and glamour of the hotels on the strip. A Disneyland for       miniparks, with walkways and art throughout. You’ll
 adults?	You	bet	…	and	Las	Vegas	is	so	much	more!	Dine	         find	luxury	hotels,	a	casino	and	Crystals, a three-story
 at restaurants inspired by the world’s greatest collection     retail center whose shape resembles the multi-faceted
 of	 chefs–Wolfgang Puck, Emeril Lagasse, Bobby Flay            surface of a quartz crystal. Add to your enjoyment by
 and Thomas Keller, just to name a few. Treat yourself to       experiencing Viva Elvis, the latest Cirque du Soleil tribute
 a	world-class	show,	including	a	choice	of	five	Cirque du       to the life and music of “The King.”
 Soleil productions, Disney’s The Lion King, the Blue Man
 Group, Phantom-The Las Vegas Spectacular and Jersey            There’s never a dull moment in Las Vegas. Watch the
 Boys. Make sure to also consider the variety of well-          volcano erupt at the Mirage, don’t miss the rousing pirate
 known headliners from the worlds of music, comedy and          battle at Treasure Island, marvel at the dancing waters
 magic performing during your stay.                             display at the Bellagio, take a romantic gondola ride




12             Register Today at	www.clintox.org		•		Follow us on Facebook and Twitter (#NACCT12)
through the canals of the Venetian or dine at the top of      Vegas on the Eiffel Tower ride. And right outside the
the Eiffel Tower at Paris. For a break from The Strip, take   doors, see all “the Strip” has to offer.
a day trip to Hoover Dam where you’ll be impressed with
the power of the mighty Colorado River.                       World-class dining, internationally-known boutiques,
                                                              award-winning golf courses, savvy nightclubs and
Experience all your fantasies of Paris right in the heart     European-style spas are calling you to this glittering city,
of	Las	Vegas!	From	guest	rooms	with	a	European	flair	to	      known	as	“Vegas!”		Join	your	colleagues	for	“Advances	
great	entertainment,	fine	French	cuisine,	sidewalk	cafes	     In Health Care for Women Over 40” and enjoy all of the
and even the Eiffel Tower, the Paris Las Vegas has all        fun in the city that never sleeps. For more information,
the passion, excitement and ambiance of Europe’s most         call the Las Vegas Convention and Visitors Authority at
romantic city. Enjoy the charming atmosphere of the           (702)	892-7575 or go online to www.visitlasvegas.com.
European village and mall, the lively casino, the dueling
pianos at Napoleon’s, and a breathtaking view of Las




         Register Today at	www.clintox.org		•		Follow us on Facebook and Twitter (#NACCT12)                              13
 registration Information
 Registration Fees •		 NACCT Main Congress 2012 • October 3-6, 2012
                                                                                EARLY BIRD                            ADVANCE                          REGULAR
                                                                                until 8/20                            8/20-9/10                        9/10-onsite
     General Registration                                                       $875                                  $995                             $1,095
     AACT, AAPCC, ACMT
     CAPCC, EAPCCT Members**                                                    $600                                  $680                             $820
     SPIs, Poison Center Educators                                              $400                                  $455                             $615
     Fellows-in-Training                                                        $400                                  $455                             $615
     Residents, Students                                                        $300                                  $350                             $395
     Active Duty Military Personnel***                                          $400                                  $455                             $615
     Guest ****                                                                 $ 50                                  $ 50                             $ 50
     CE Credit (MD, DO, Pharmacist, RN)                                         $175                                  $175                             $175

 Registration Fees •			Affiliated	Programs
     ACMT Pre-Meeting Symposium                                                                    AACT Pre-Meeting Symposium
     Monday, October 1                                                                             Tuesday, October 2
     General Registration        $300                                                              General Registration                                $300
     ACMT Members                $215                                                              AACT Members                :                       $215
     AACT Members                $270                                                              ACMT Members                                        $270
     SPIs/Fellows-in-Training    $215                                                              SPIs/Fellows-in-Training                            $215
     Residents, Students         $195                                                              Residents, Students                                 $195
     Continuing Education Credit $ 65                                                              Continuing Education Credit                         $ 65

 *Early Bird registration must be postmarked on or before August 20, 2012.
 **Must be a current member of any of these organizations prior to registering for NACCT. Contact Contemporary Forums if you are interested in becoming a member of a sponsoring
   organization.
 ***Military - Active members serving in the Army, Navy, Air Force, Marines, and Coast Guard of the United States of America.
 ****This charge allows participants’ guests to attend the opening reception.


  Tuition includes Online Library Access, Continental Breakfasts, Coffee Breaks and Opening Reception.
  To register
     Online - Go to www.clintox.org.
     Fax          - (800) 329-9923, Purchase Order, Visa, MasterCard or American Express only.
     Mail         - NACCT Attn: Registrar, 6377 Clark Ave., Suite 200, Dublin, CA 94568. Check payable to NACCT.
     Phone - Contemporary Forums Conference Management, (800) 377-7707,
             Monday-Friday, 8 am - 5 pm (Pacific Time)
  Access numbers for international registrants: Phone (925) 828-7100 • Fax (925) 828-2121
  Registration must include full payment in US Funds to be processed. A $30 fee is charged for any returned
   check or declined credit card.
  Purchase Orders: Purchase Orders must be received with registration by the conference date and include the P.O.
   number, invoice address, tuition, approval signature, and contact name, e-mail address and phone number.
  Confirmation of registration will be sent via email or mail.
  Cancellations received after August 20, 2012 will be assessed a $150 processing fee.
  Spouses and significant others may not attend the Opening Reception unless the Guest fee has been paid.
     If you have a disability requiring an auxiliary aid or special service while attending this meeting, please call
     (800) 377-7707, no later than September 17, 2012.


14                      Register Today at www.clintox.org. Follow us on Facebook and Twitter (#NACCT12)
Hotel Accommodations                                                      travel Information
 The conference will be held at The Cosmopolitan of                                   Contemporary Forums has a special discount
  Las Vegas, 3708 Las Vegas Blvd. South, Las Vegas, NV                                 agreement with United Airlines unavailable
  89109. A limited block of rooms is being held for you                                to the general public. To obtain these special
                                                                                       conference fares call the Special Meeting Desk
  and your guests at special group rates which will be in
                                                                          at (800) 521-4041, Account Code 510CW. Ticketing and
  effect, based on room availability, from September 30 to                payment can be done directly by you or through your travel
  October 8 for those wishing to extend their stay to enjoy               agent. To ensure the best flights and times, since seats are
  area activities or qualify for discount airfares.                       limited, make your reservations early. Fares are guaranteed
 Rates: $179 single/double                                               at the time of ticket purchase.
    Rates are per room and subject to prevailing state and local taxes.
 To obtain the special group rates, make your reservation                                      Arrangements have been made with
                                                                                                Hertz to be the official car rental agency
  early and before the “hotel room block release date”
                                                                                                for the NACCT Congress. Special
  which is August 30. Rooms may sell out before this                      rates will be in effect through-out the Congress as well
  date so be sure to make your reservation now. After the                 as one week before and after. To obtain the special
  release date, rooms and group rates may no longer be                    rates please call the Hertz Meeting Sales Desk at
  available so call the hotel regarding availability.                     (800) 654-2240 and refer to the NACCT Congress or meeting
 To reserve your room online, please visit www.clintox.org               CV #03000258.
  for details.
 For room reservations, call 1-(855) 435-0005 and inform
  them that you are attending the NACCT conference or
  give group code #SNACT2. Request a confirmation
  number and written confirmation of your reservation.
  Reservations must include a first night’s deposit.
 Contact the hotel regarding cancellation policy. For arrivals
  after 3 pm, call the hotel on the day of travel to reconfirm
  reservations.
 For additional hotel information, call The Cosmopolitan of
  Las Vegas at 1 (877) 551-7778 or (702) 698-7000 or visit
  www.cosmopolitanlasvegas.com.


Continuing Education Credit
This program was designed in accordance with the                          Pharmacists are encouraged to complete their e-profile at
Accreditation Council for Pharmacy Education Quality                      www.nabp.net in order to obtain their NABP e-Profile ID.
Criteria and the Essential Areas and Policies of the                      Please remember that you will need to submit the e-profile
Accreditation Council for Continuing Medical Education.                   ID and birth date (MMDD format) to receive credit at this
Application has been made to the National Commission for                  year’s meeting.
Health Education Credentialing, Inc. (NCHEC).

Physician                                                                 Nursing
                                                                          40.5 Continuing Education Contact Hours have been applied for.
The American Academy of Clinical Toxicology designates
this educational activity for a maximum of 43.5 AMA PRA                   Health Educators
Category 1 Credit(s)™. Physicians should only claim
credit commensurate with the extent of their participation                CHES Category I continuing education contact hours pending.
in the activity.
                                                                          requirements for successful completion
Pharmacy                                                                  To successfully complete the requirements for continuing
This Congress will have multiple ACPE Universal Program                   medical education (CME) credit, continuing pharmaceutical
numbers. Pharmacists can earn up to a maximum of 40.5                     education (CPE) credit, or continuing nursing education
continuing education credit hours. Pharmacists should                     credit, complete the following steps:
only claim credit commensurate with the extent of their                   1. Submit with your registration, the required Continuing
participation in the activity.                                               Education Credit fee.
NAACT will be utilizing CPE Monitor for tracking and reporting of         2. Complete an evaluation form for each session attended.
all ACPE-accredited continuing pharmacy education activities.                Please list your suggestions for topics for future meetings.

 (NOTE: Full CE credit cannot be claimed for all sessions within a concurrent (shaded) time block.).
 AACT reserves the right to adjust the maximum number of hours available as necessary pending change in the program schedule.

          Register Today at	www.clintox.org		•		Follow us on Facebook and Twitter (#NACCT12)                                             15
ONLINE	REGISTRATION	AVAILABLE




                                                                                                                                                                                                    U.S. POSTAGE PAID
                                                                                                                                                                                                       Permit No. 295
                                                                                                                                                                                                        NONPROFIT
Visit the American Academy of Clinical Toxicology website: www.clintox.org


 NACCT 2012 Registration Form
 Fax	(800)	329-9923	or	mail	this	form	with	full	payment	(U.S.	Funds)	to:	
 NACCT, Attn: Registrar, 6377 Clark Ave., Suite 200, Dublin, CA 94568




                                                                                                                                                                Please share with your colleagues
 or	call	(800)	377-7707

MEMBERSHIP STATUS Please check all that apply
Registration fees based on Membership and Position/Job Function
q AACT q AAPCC q ACMT q CAPCC q EAPCCT q EDUCATOR/SPI

DEGREE			                               POSITION/FUNCTION
q BS Pharm                              q Administrator/Managing Director
q DVM                                   q Clinical Toxicologist/Physician
q MD/DO                                 q Educator
q PA/ARNP                               q Fellow/Resident




                                                                                                                                                          American Academy of Clinical Toxicology
q PharmD                                q Poison Center Educator
q PhD                                   q SPI
q RN                                    q Student
q Other: ____________                   q Other: ____________


REGISTER	ME	FOR	
q ACMT Pre-Meeting Symposium - October 1                                                                                                                                                  6728 Old McLean Village Dr.

                                                                                                                                                                                                                        PDF
  q Speaker

q AACT Pre-Meeting Symposium - October 2
                                                                                                                                                                                          McLean, VA 22101

  q Speaker

q NACCT Main Congress - October 3-6
                                                                                                                                                                                                                        Code:



q AACT Reception - October 4
   (AACT Members only)
  If you are a Fellow, Resident or Student
  (checking the box below acknowledges current status)                                                                                                  PAYMENT SUMMARY                                                                  #073912
q I am currently enrolled in an active fellowship, resident program
  and/or medical school                                                                                                                                 Early Fee Postmark Deadline: August 20, 2012
                                                                                                                                                        Registration fees based on Membership and Position/Job Function
PLEASE PRINT CLEARLY                                                                                                                                    (See page 14)
                                                                                                                                                        ACMT Pre-Meeting Symposium (10/1)             $

                                                                                                                                                         ACMT CE Credit Fee $65                                                           $
First Name                                          Last Name
                                                                                                                                                        AACT Pre-Meeting Symposium (10/2)                                                 $

Place of Employment                                                                                                                                      AACT CE Credit Fee $65                                                           $

                                                                                                                                                        NACCT Main Congress (10/3-10/6)                                                   $

City                                                                    State                                                                            Main Congress CE Credit Fee $175                                                 $

                                                                                                                                                        Opening	Reception	Guest	Fee	(10/3)
                                                                                                                                                         $50 per guest, #____ of tickets                                                  $
*Attendee’s email: For confi rmation, receipt, access to presentation slides prior to conference,
access to your Certifi cate of Attendance and Online CE Library. Please print clearly and provide
your best email address as some emails are filtered and blocked.
                                                                                               OFFICE USE ONLY: C__________ D __________ E __________




                                                                                                                                                                                                                   TOTAL PAYMENT ENCLOSED $


Mailing Address                                                                                                                                         q Check/Money Order Payable to NACCT (U.S. Funds)
                                                                                                                                                        q Visa         q MasterCard           q AMEX

City                                                        State          Zip
                                                                                                                                                        Credit Card #


                                                                                                                                                        Exp. Date
Daytime Phone

SPECIAL	EVENT	GUEST                                                                                                                                     Print Cardholder’s Name

Congress attendees planning to bring a guest(s) to the Opening
Reception, October 3, must pay an event fee of $50 and provide                                                                                          Billing Address

name of guest(s) for identification badge:
                                                                                                                                                        City                                                                    State    Zip


                                                                                                                                                        Payer Email Address


                                                                                                                                                        Payer Phone #

				
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