Professor Geoff Isbister

Professor Geoff Isbister

Professor

School of Medicine and Public Health

Snakes alive

Clinical researcher Dr Geoff Isbister courts controversy as he challenges time-honoured beliefs about the treatments given to envenomed patients.

Dr Geoff Isbister 

Dr Geoff Isbister doesn't take himself too seriously. The good-humoured researcher admits he originally chose a career in medicine because he thought it could fund his musical interests. Laughing about a 'joke' piece he published in The Lancet, Geoff also recounts a time when he became the terror of Australia Post after receiving hundreds of dead spiders in the mail.

Such easy conversation and quick wit belie the fact this ambitious academic is deadly serious about studying deadly poisons.

"I'm an investigator and a busy clinician," he says.

"My mission is simple – I want to better understand the pathophysiology of envenomation in patients."

"I also want to generate evidence regarding the efficacy of both conventional and new treatments."

Despite the controversy surrounding his work, the National Health and Medical Research Council Senior Research Fellow has affected major changes in the way spider and snakebites are managed in Australia. Using science as a weapon, Geoff is cutting a swathe through long held beliefs, myths and unquestioned conventions, leaving disbelief, derision and ultimately, more efficient practice, in his wake. 

The spark that drives

Having always possessed a veracious appetite for knowledge, Geoff initially combined a degree in science and medicine so he could better understand the chemical and biological machinations behind clinical practice. Coming to the end of his undergraduate study, the unconventional researcher worked with a local GP in country NSW, where snakebites and their treatment immediately captured his interest.

"I found them fascinating," he recalls.

After completing a stint as an emergency physician in Darwin and Sydney, Geoff returned to Newcastle in 2000 to work in toxicology.

"The thing about medical specialties is that you deal with one part of the body and nothing else," he explains.

"But drugs, bites and stings affect every part of the body, and that's what I was interested in."

"Newcastle has the best known toxicology unit in the world."

The Great Australian bite

With the urban setting of Sydney's Royal Prince Alfred Hospital seriously limiting his opportunities to investigate snakebites, Geoff turned to documenting spider bites for his doctoral thesis. Recruiting 750 participants, this was his first multicentre study of toxinology treatments.

"I debunked the myth that whitetail spider bites cause ulceration and necrosis," Geoff divulges.

"My work also informed the development of definitive and simplified treatment protocol for all Australian spider bites in clinical practice."

Intrigued by the information gleaned during his spider bite research, Geoff took to reviewing the clinical delivery of redback spider anti-venom. Initially undertaking a study comparing intramuscular to intravenous delivery of existing antivenom to redback bite victims, he was surprised to discover no difference in recovery time or self-reported pain between delivery options. A placebo randomised control study followed, which replicated the findings.

"The evidence was quite startling," he says.

"It was published in the Redback Spider Antivenom Evaluation (RAVE II) Study and has changed clinical practice related to the administration of redback antivenom."

Shedding old skin

Geoff is a main driver behind the Australian Snakebite Project (ASP), a multicentre project collecting data on presumed and definite snakebite victims in more than 150 hospitals across the country. Like the spider study before it, collating a mass of clinical information on snakebite cases has created a complete picture of the symptoms of envenomation. It's also provided evidence to change practice around the administration of escalating dosages of antivenom.

"We showed continual delivery of antivenom over the course of snakebite treatments is redundant," he claims.

Working with his colleagues from the Clinical Toxicology Research Group at the Mater, Geoff is undertaking studies of snake envenomation in Sri Lanka. There, it is possible to recruit thousands of cases per year.

He's also working with a PhD student to convert what is currently an expensive, lab-based process into an affordable bedside diagnostic kit that identifies enzymes found in snake venom.

"The most common bedside test is a clotting test," Geoff explains.

"That's fine if the snake causes clotting problems, but there's no way to know if the patient is going to develop paralysis, say from a krait bite."

"The only way you know they've got neurotoxicity is when they've got it, and then it's too late."

"So rather than giving antivenom to everyone who comes in, this method allows us to test for this enzyme in the patient's blood and give the antivenom within an hour or two to prevent paralysis occurring."

Keeping them safe

As well as being a prolific researcher, Geoff is also a working clinician, overseeing the treatment of 800 - 1000 patients with two other clinical toxicologists, who are admitted to the Mater for pharmaceutical overdose treatment each year.

Geoff is also one of a handful of toxicologists working for the NSW Poisons Centre. When rostered on, he can field up to 10 calls a night from physicians needing advice for the treatment of patients in other hospitals.

"My research into pharmaceutical overdose is less about treatment and more about risk assessment and understanding how drug overdoses affect the body," Geoff notes.  

"The team at the Mater has changed clinical practice through the creation of the QT nomogram, which is a way to assess risks related to abnormal electrical changes in the heart caused by dosages of particular drugs."

A greater understanding of risks related to the QT interval (interval seen in an electrocardiogram test of the heart function) has similarly informed a study into the sedation of violent or aggressive patients presenting at the Mater's Emergency Department. Initially run at the Mater, the DORM study has since been extended to one thousand patients across six emergency hospitals.

"The protocols and treatments identified in the trial have been adopted by hospitals nationwide," Geoff advises.

"These decrease the risk of violence to staff and other patients."

Snakes in the grass

Geoff isn't concerned about his detractors. He blames misunderstandings and blind belief in untested anecdotal evidence for the negative sentiment created by his findings on the effectiveness of antivenom.

"Most people would strongly believe that antivenom is a magic bullet," he says.

"Even when there are no trials or evidence to support it, they believe it works."

The risk of severe allergic reaction, and exorbitant costs are two factors Geoff cites as motivators for further assessment of the effectiveness of antivenoms.

"There is no question about whether antivenoms are efficacious," he declares.

"But we need to understand, on an antivenom by antivenom basis, a creature by creature basis, if they actually change the course of the envenomation, how much we need to administer, and when."

Laughing as he sums up his life's work, the head of the University of Newcastle's Clinical Toxicology Research Group notes the hypotheses he develops at the beginning of studies are most often proven wrong – even though he is staunchly defensive of his previous research.

"The moment I am not able to accept that I'm wrong is the moment I will pack up and stop doing research," he promises.

"There's been very few studies where I have gotten the results I want and that's what makes it interesting."

"I also like that my work is controversial, because that's what makes it fun."

Dr Geoff Isbister

Snakes alive

Clinical researcher Dr Geoff Isbister courts controversy as he challenges time-honoured beliefs about the treatments given to envenomed patients.

Read more

Career Summary

Biography

Dr Isbister is a clinician researcher in clinical toxicology and his research has focused on understanding poisoning and envenoming in patients and undertaking studies to determine the effectiveness of antidotes and antivenoms in treatment of these conditions. He heads the Clinical Toxicology Research Group at the University. He has published over 220 original research publications and holds an NHMRC Senior Research Fellowship as well as being Chief Investigator on an NHMRC Program Grant. The benefits of the research include improving our understanding of the pathophysiology of both envenomation and poisoning. Much of his research challenges long held views about the treatment of poisoned and envenomed patients, including whether antivenom works. He has made clinicians re-look at what evidence there is for various treatments and why we use these treatments.

His first study of spider bite showed that the majority of spider bites cause minor effects, and the major effects only occurred with funnel-web spider bites and redback spider bites. The research also debunked the myth of the Whitetail Spider, showing that severe ulceration of the skin was due to a variety of causes but not spider bite. Other studies of bites and stings by venomous creatures, including scorpions, insects, marine animals and continues with snake bites in a national snake bite study formed the basis of his Doctor of Medicine titled: Data collection in clinical toxinology: debunking myths and developing diagnostic approaches to bites and stings
 

Research Expertise
Ongoing major areas of research include: 1) Clinical Toxinology: observational and interventional studies in envenomed patients; this includes the Australian Snakebite Project ASP. The study has changed the way antivenom is dosed, decreasing the dose used and demonstrating the efficacy of antivenom. This study continues now investigating other treatments for snake bite and is funded by the NHMRC. A recent randomised controlled trial of fresh frozen plasma for snake bite coagulopathy has shown the benefits and risks of such a treatment. A similar study has been completed in Sri Lanka in 2011 to 2015. The clinical toxicology research group laboratory based at the Calvary Mater Newcastle undertakes assays for venoms, toxins and antivenom in human blood, with very low limits of detection allowing their use in clinical and forensic cases. He recently published a multicentre study, the Redback Spider Antivenom Evaluation (RAVE II) Study, that found that antivenom did not improve the pain or effects of redback spider envenomation. This was a controversial finding that challenges the current use of antivenom and has been featured on Catalyst in Feb 2015. A previous study established hot water as a safe and easily applied treatment for blue bottle stings which changed the Australian Resuscitation Councils recommendations on the first aid treatment and was awarded the Medical Journal of Australia and Wyeth Australia award for best research published in the journal in 2006. He published a commissioned review on scorpion envenomation in the New England Journal of Medicine in 2014 2)Clinical toxicology including modelling and simulation: This is multicentre research into the pharmacokinetics and pharmacodynamics of drugs in overdose with patient blood samples and clinical data to develop clinical guidelines for treatment using novel drug modeling and simulation techniques. These studies of treatments for drug overdose have rationalized the treatment for particular drug overdoses streamlining the care for patients. This includes research into the effects of drugs on the electrocardiogram and the effect on the QT interval which is associated with fatal arrhythmias, developing a risk assessment tool (QT nomogram). He has recently published several reviews and a commentary on drug-induced QT prolongation. Other projects include prospective studies of overdose patients which with NHMRC Program funding has become the Australian Toxicology Monitoring (ATOM) study, including studies of paracetamol, digoxins and anticoagulants. His group and collaborators have published on the relative toxicity of psychotropic medications, one of these publications is now highly cited comparing newer antidepressants toxicity. There is ongoing research on serotonin toxicity and a study that developed new diagnostic criteria for serotonin toxicity. This work has changed our understanding and approach to the treatment of serotonin toxicity over the last 5 years. 3) Acute behavioural Disturbance: He has coordinated research on the sedation of violent and aggressive patients in the health care setting, with a focus on drug and alcohol induced delirium in the emergency department. This has resulted in a number of publications in Annals of Emergency Medicine and the British Journal of Psychiatry demonstrating the safety and benefits of droperidol, challenging the FDA black

Teaching Expertise
Clinical pharmacology, clinical toxicology and emergency medicine to undergraduates and post-graduates.






Qualifications

  • Doctor of Medicine, University of New South Wales
  • Bachelor of Science, University of New South Wales
  • Bachelor of Medicine & Surgery, University of New South Wales

Keywords

  • Clinical Toxicology
  • Clinical Toxinology
  • Emergency Medicine
  • Pharmacokinetics and pharmacodynamics
  • Toxinology

Fields of Research

Code Description Percentage
110299 Cardiorespiratory Medicine and Haematology not elsewhere classified 45
111799 Public Health and Health Services not elsewhere classified 20
111599 Pharmacology and Pharmaceutical Sciences not elsewhere classified 35

Professional Experience

UON Appointment

Title Organisation / Department
Professor University of Newcastle
School of Medicine and Public Health
Australia

Academic appointment

Dates Title Organisation / Department
1/01/2010 - 1/12/2013 Fellow - NHMRC University of Newcastle
School of Medicine and Public Health
Australia
1/01/2007 -  Honourary Associate Professor, Department of Pharmacology Monash University
Department of Pharmacology
Australia

Membership

Dates Title Organisation / Department
1/06/2003 - 1/06/2015 Member, Drug Committee The Children's Hospital at Westmead
Australia

Professional appointment

Dates Title Organisation / Department
1/01/2007 -  Senior Staff Specialist, Clinical Toxicology and Emergency Medicine Calvary Mater Newcastle
Australia
1/01/2003 -  Visiting Medical Officer NSW Poisons Information Centre, The Children's Hospital at Westmead
Australia
1/06/2002 -  Honourary Consultant and Clinical Toxicologist Queensland Poisons Information Centre, Lady Cliento Hospital
Australia

Awards

Award

Year Award
2015 John Gilroy Potts Award, Australasian College for Emergency Medicine - best refereed paper contributing to emergency medicine in 2014
John Gilroy Potts Foundation
2014 John Gilroy Potts Award, Australasian College for Emergency Medicine – best refereed paper contributing to emergency medicine in 2013
John Gilroy Potts Foundation
2013 Vice-Chancellor's Awards for Research Excellence, Faculty of Health, University of Newcastle
Faculty of Health, University of Newcastle
2013 Australian Society of Clinical and Experimental Pharamcology and Toxicology Achievement Award
Australian Society of Clinical and Experiemtnal Pharmacology and Toxicology

Professional

Year Award
2014 Fellow of the European Association of Poison Centres and Clinical Toxicologists
European Association of Poisons Centres and Clinical Toxocologists
Edit

Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Chapter (7 outputs)

Year Citation Altmetrics Link
2015 Isbister GK, 'Spider Bite', Textbook of Adult Emergency Medicine, Elsevier Health Sciences, Edinburgh 1043-1046 (2015) [B2]
2015 Isbister GK, 'Snakebite', Textbook of Adult Emergency Medicine, Elsevier Health Sciences, Edinburgh 1034-1039 (2015) [B2]
2013 Isbister GK, Page CB, 'Beta blocker and calcium antagonist poisoning', Oxford Textbook of Critical Care, Oxford University Press, United Kingdom . (2013)
2012 Vajjah P, Isbister GK, Duffull SB, 'Introduction to pharmacokinetics in clinical toxicology', Computational Toxicology, Springer Science+Business Media, New York 289-312 (2012) [B1]
2011 Isbister GK, 'Trauma and Envenomations from Marine Fauna', Tintinalli's Emergency Medicine: A Comprehensive Study Guide, McGraw Hill, New York Ch207 (2011)
2004 Isbister GK, 'Marine Envenomation and Poisoning', Medical Toxicology, Lippincott Williams & Wilkins, Philadelphia, PA 1621-1644 (2004)
2004 Isbister GK, 'Other Arthropods', Medical Toxicology, Lippincott Williams & Wilkins, Philadelphia, PA 1606-1620 (2004)
Show 4 more chapters

Journal article (411 outputs)

Year Citation Altmetrics Link
2016 Isbister GK, Ang K, Gorman K, Cooper J, Mostafa A, Roberts MS, 'Zero-order metoprolol pharmacokinetics after therapeutic doses: severe toxicity and cardiogenic shock', Clinical Toxicology, 1-5 (2016)

© 2016 Informa UK Limited, trading as Taylor & Francis GroupObjective: Acute beta-blocker overdose can cause severe cardiac dysfunction. Chronic toxicity is rare but potentially ... [more]

© 2016 Informa UK Limited, trading as Taylor & Francis GroupObjective: Acute beta-blocker overdose can cause severe cardiac dysfunction. Chronic toxicity is rare but potentially severe. We report therapeutic dosing of metoprolol resulting in unusual pharmacokinetics and toxicity, given high-dose insulin therapy for treatment. Case details: A 90-year-old female presented with hypotension, tachycardia and severe cardiac dysfunction after commencing a rapidly increasing metoprolol dose of 250¿mg split daily. She was admitted to intensive care and given high-dose insulin therapy (10¿U/kg/h), noradrenaline, adrenaline and dobutamine for severe cardiac dysfunction (cardiac index, 0.76¿L/min/m2). She developed acute renal failure, ischaemic hepatitis and disseminated intravascular coagulopathy. Inotropes and high-dose insulin were weaned over four days with complete recovery. Metoprolol was quantified with liquid chromatography-tandem mass spectrometry and concentration-time data were analysed using MONOLIX® vs 4.3 (www.lixoft.com). Admission metoprolol concentration was 2.39¿µg/mL (therapeutic reference range: 0.035¿0.5¿µg/mL). Data best fitted a one compartmental model with Michaelis¿Menten kinetics and zero order elimination at high concentrations. Final parameter estimates were V, 63.4¿L, maximum rate [Vm], 9.57¿mg¿h-1, Michaelis constant [Km], 1.97¿mg¿L-1. Predicted elimination half-life decreased from 20¿h over time until there was first order elimination with a half-life 9¿h. Conclusion: The time course of cardiac dysfunction was longer than acute overdose but consistent with prolonged zero order elimination of metoprolol, suggesting the patient was a poor CYP2D6 metaboliser. High-dose insulin euglycaemia appeared to be effective in combination with vasoconstrictors/inotropes.

DOI 10.1080/15563650.2016.1209768
Co-authors Joyce Cooper
2016 Isbister GK, Buckley NA, 'Good clinical guidelines must define the setting, patients and evidence: Benzodiazepines versus droperidol for acute behavioural disturbance in the emergency department.', Aust N Z J Psychiatry, (2016)
DOI 10.1177/0004867416659543
2016 Isbister GK, Gault A, Tasoulis T, O'Leary MA, 'A definite bite by the Ornamental Snake (Denisonia maculata) causing mild envenoming', CLINICAL TOXICOLOGY, 54 241-244 (2016)
2016 Miller M, O'Leary MA, Isbister GK, 'Towards rationalisation of antivenom use in funnel-web spider envenoming: enzyme immunoassays for venom concentrations', CLINICAL TOXICOLOGY, 54 245-251 (2016)
2016 Jones L, Isbister G, Chesher D, Gillett M, 'Pneumatic tube transport of blood-stained cerebrospinal fluid specimens has no clinically relevant effect on rates of haemolysis compared to manual transport', Annals of Clinical Biochemistry, 53 168-173 (2016)

© 2015, The Author(s) 2015.Background: Pneumatic tube transport of pathology specimens from the emergency department to the laboratory for analysis is a widely used practice. Whe... [more]

© 2015, The Author(s) 2015.Background: Pneumatic tube transport of pathology specimens from the emergency department to the laboratory for analysis is a widely used practice. When compared to manual specimen transport, it results in savings in both time and labour. Sampling of cerebrospinal fluid still forms part of the workup of patients with suspected subarachnoid haemorrhage. There are claims in the literature that transport of cerebrospinal fluid samples by pneumatic tube results in excess haemolysis, which interferes with cerebrospinal fluid analysis for the presence of bilirubin. The aim of our study was to ascertain whether pneumatic tube transport of blood-stained cerebrospinal fluid to the laboratory, results in clinically significantly higher levels of haemolysis compared with manual transport of the same specimens. Methods: Stored cerebrospinal fluid was spiked with varying amounts of red blood cells creating 72 specimens of varying red cell concentration. Half of these specimens were transported to the laboratory manually while the other half were sent by pneumatic tube transport. The rates of haemolysis were compared between the pneumatic tube and manual transport samples. Results: There was no clinically significant difference in the rates of haemolysis between the samples transported to the laboratory by pneumatic tube compared with those moved manually. Conclusions: Pneumatic tube transport of cerebrospinal fluid to the laboratory is not associated with clinically significantly higher rates of haemolysis when compared to manual transport.

DOI 10.1177/0004563215593562
2016 Maduwage KP, Scorgie FE, Lincz LF, O'Leary MA, Isbister GK, 'Procoagulant snake venoms have differential effects in animal plasmas: Implications for antivenom testing in animal models', Thrombosis Research, 137 174-177 (2016) [C1]

© 2015 Elsevier Ltd. All rights reserved.Background Animal models are used to test toxic effects of snake venoms/toxins and the antivenom required to neutralise them. However, ve... [more]

© 2015 Elsevier Ltd. All rights reserved.Background Animal models are used to test toxic effects of snake venoms/toxins and the antivenom required to neutralise them. However, venoms that cause clinically relevant coagulopathy in humans may have differential effects in animals. We aimed to investigate the effect of different procoagulant snake venoms on various animal plasmas. Methods Prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and D-dimer levels were measured in seven animal plasmas (human, rabbit, cat, Guinea pig, pig, cow and rat). In vitro clotting times were then used to calculate the effective concentration (EC50) in each plasma for four snake venoms with different procoagulant toxins: Pseudonaja textilis, Daboia russelli, Echis carinatus and Calloselasma rhodostoma. Results Compared to human, PT and aPTT were similar for rat, rabbit and pig, but double for cat and cow, while Guinea pig had similar aPTT but double PT. Fibrinogen and D-dimer levels were similar for all species. Human and rabbit plasmas had the lowest EC50 for P. textilis (0.1 and 0.4 µg/ml), D. russelli (0.4 and 0.1 µg/ml), E. carinatus (0.6 and 0.1 µg/ml) venoms respectively, while cat plasma had the lowest EC50 for C. rhodostoma (11 µg/ml) venom. Cow, rat, pig and Guinea pig plasmas were highly resistant to all four venoms with EC50 10-fold that of human. Conclusions Different animal plasmas have varying susceptibility to procoagulant venoms, and excepting rabbits, animal models are not appropriate to test procoagulant activity. In vitro assays on human plasma should instead be adopted for this purpose.

DOI 10.1016/j.thromres.2015.12.002
Citations Scopus - 2Web of Science - 2
Co-authors Lisa Lincz
2016 Lim AY, Singh PN, Isbister GK, 'Severe rhabdomyolysis from red-bellied black snake (Pseudechis porphyriacus) envenoming despite antivenom.', Toxicon, 117 46-48 (2016)
DOI 10.1016/j.toxicon.2016.03.016
2016 Silva A, Maduwage K, Sedgwick M, Pilapitiya S, Weerawansa P, Dahanayaka NJ, et al., 'Neurotoxicity in Russell's viper (Daboia russelii) envenoming in Sri Lanka: a clinical and neurophysiological study.', Clin Toxicol (Phila), 54 411-419 (2016)
DOI 10.3109/15563650.2016.1143556
Citations Web of Science - 1
2016 de Boer A, Cohen AF, Ferro A, Flockhart DA, Gilchrist A, Isbister G, et al., 'Editors' Report for 2015, December 2015.', Br J Clin Pharmacol, 81 6-7 (2016) [O1]
DOI 10.1111/bcp.12865
2016 Foo LK, Duffull SB, Calver L, Schneider J, Isbister GK, 'Population pharmacokinetics of intramuscular droperidol in acutely agitated patients.', Br J Clin Pharmacol, (2016)
DOI 10.1111/bcp.13093
Co-authors Jennifer Schneider
2016 Chan BS, Chiew A, Isbister GK, O'Leary M, Buckley NA, 'Authors' responses to letter to the editor re: "Efficacy and effectiveness of anti-digoxin antibodies in chronic digoxin poisonings from the DORA study (ATOM-1)".', Clin Toxicol (Phila), 1 (2016)
DOI 10.1080/15563650.2016.1214278
2016 Berling I, Buckley NA, Isbister GK, 'The antipsychotic story: changes in prescriptions and overdose without better safety.', Br J Clin Pharmacol, 82 249-254 (2016)
DOI 10.1111/bcp.12927
2016 Isbister GK, Downes MA, McNamara K, Berling I, Whyte IM, Page CB, 'A prospective observational study of a novel 2-phase infusion protocol for the administration of acetylcysteine in paracetamol poisoning', Clinical Toxicology, 54 120-126 (2016) [C1]

© 2015 Taylor & Francis.Context: The current 3-phase acetylcysteine infusion for paracetamol poisoning delivers half the dose over 15-60 min and frequently results in adverse rea... [more]

© 2015 Taylor & Francis.Context: The current 3-phase acetylcysteine infusion for paracetamol poisoning delivers half the dose over 15-60 min and frequently results in adverse reactions. Objective: We aimed to determine adverse reaction frequency with a modified 2-phase infusion protocol with a longer initial infusion. Materials and methods: A prospective observational study of a modified 2-phase acetylcysteine protocol was undertaken at two hospitals. Acetylcysteine was commenced on admission and ceased if paracetamol concentrations were low-risk (below the nomogram line). The first infusion was 200 mg/kg over 4-9 h based on ingestion time or 4 h for staggered/chronic ingestions. The second infusion was 100 mg/kg over 16 h. Pre-defined outcomes were frequency of adverse reactions (systemic hypersensitivity reactions or gastrointestinal); proportion with alanine transaminase (ALT) > 1000 U/L or abnormal ALT. Results: 654 paracetamol poisonings were treated with the new protocol; median age 29 y (15-98 y); 453 females; 576 acute and 78 staggered/chronic ingestions. In 420 (64%) acetylcysteine was stopped for low-risk paracetamol concentrations. An adverse reaction occurred in 229/654 admissions (35%; 95% CI: 31-39%): 173 (26.5%; 95% CI: 23-30%) only gastrointestinal, 50 (8%; 95% CI: 6-10%) skin only systemic hypersensitivity reactions; and three severe anaphylaxis (0.5%; 95% CI: 0.1-1.5%; all hypotension). Adverse reactions occurred in 111/231 (48%) receiving full treatment compared to 116/420 (28%) in whom the infusion was stopped early (absolute difference 20%; 95% CI: 13-28%; p < 0.0001). In 200 overdoses < 10 g, one had toxic paracetamol concentrations, but 53 developed reactions. Sixteen patients had an ALT > 1000 U/L and 24 an abnormal ALT attributable to paracetamol; all but one had treatment commenced >12 h post-ingestion. Conclusion: A 2-phase acetylcysteine infusion protocol results in a fewer reactions in patients with toxic paracetamol concentrations, but is not justified in patients with low-risk paracetamol concentrations.

DOI 10.3109/15563650.2015.1115057
Citations Scopus - 2
2016 Isbister GK, Calver LA, Downes MA, Page CB, 'Ketamine as Rescue Treatment for Difficult-to-Sedate Severe Acute Behavioral Disturbance in the Emergency Department', Annals of Emergency Medicine, 67 581-587e1 (2016)

© 2016 American College of Emergency Physicians.Study objective We investigate the effectiveness and safety of ketamine to sedate patients with severe acute behavioral disturbanc... [more]

© 2016 American College of Emergency Physicians.Study objective We investigate the effectiveness and safety of ketamine to sedate patients with severe acute behavioral disturbance who have failed previous attempts at sedation. Methods This was a prospective study of patients given ketamine for sedation who had failed previous sedation attempts. Patients with severe acute behavioral disturbance requiring parenteral sedation were treated with a standardized sedation protocol including droperidol. Demographics, drug dose, observations, and adverse effects were recorded. The primary outcome was the number of patients who failed to sedate within 120 minutes of ketamine administration or requiring further sedation within 1 hour. Results Forty-nine patients from 2 hospitals were administered rescue ketamine during 27 months; median age was 37 years (range 20-82 years); 28 were men. Police were involved with 20 patients. Previous sedation included droperidol (10 mg; 1), droperidol (10+10 mg; 33), droperidol (10+10+5 mg; 1), droperidol (10+10+10 mg; 11), and combinations of droperidol and benzodiazepines (2) and midazolam alone (1). The median dose of ketamine was 300 mg (range 50 to 500 mg). Five patients (10%; 95% confidence interval 4% to 23%) were not sedated within 120 minutes or required additional sedation within 1 hour. Four of 5 patients received 200 mg or less. Median time to sedation postketamine was 20 minutes (interquartile range 10 to 30 minutes; 2 to 500 minutes). Three patients (6%) had adverse effects, 2 had vomiting, and a third had a transient oxygen desaturation to 90% after ketamine that responded to oxygen. Conclusion Ketamine appeared effective and did not cause obvious harm in this small sample and is a potential option for patients who have failed previous attempts at sedation. A dose of 4 to 5 mg/kg is suggested, and doses less than 200 mg are associated with treatment failure.

DOI 10.1016/j.annemergmed.2015.11.028
Citations Scopus - 3Web of Science - 3
2016 Silva A, Maduwage K, Sedgwick M, Pilapitiya S, Weerawansa P, Dahanayaka NJ, et al., 'Neuromuscular Effects of Common Krait (Bungarus caeruleus) Envenoming in Sri Lanka.', PLoS Negl Trop Dis, 10 e0004368 (2016)
DOI 10.1371/journal.pntd.0004368
Citations Scopus - 1Web of Science - 1
2016 Cohen A, Pattanaik S, Kumar P, Bies RR, de Boer A, Ferro A, et al., 'Organised crime against the academic peer review system.', Br J Clin Pharmacol, 81 1012-1017 (2016)
DOI 10.1111/bcp.12992
2016 Maduwage KP, O Leary MA, Silva A, Isbister GK, 'Detection of snake venom in post-antivenom samples by dissociation treatment followed by Enzyme Immunoassay', Toxins, 8 (2016)

© 2016 by the authors; licensee MDPI, Basel, Switzerland.Venom detection is crucial for confirmation of envenomation and snake type in snake-bite patients. Enzyme immunoassay (EI... [more]

© 2016 by the authors; licensee MDPI, Basel, Switzerland.Venom detection is crucial for confirmation of envenomation and snake type in snake-bite patients. Enzyme immunoassay (EIA) is used to detect venom, but antivenom in samples prevents venom detection. We aimed to detect snake venom in post-antivenom samples after dissociating venom-antivenom complexes with glycine-HCl (pH 2.2) and heating for 30 min at 950 C. Serum samples underwent dissociation treatment and then Russell¿s viper venom or Australian elapid venom measured by EIA. In confirmed Russell¿s viper bites with venom detected pre-antivenom (positive controls), no venom was detected in untreated post-antivenom samples, but was after dissociation treatment. In 104 non-envenomed patients (negative controls), no venom was detected after dissociation treatment. In suspected Russell¿s viper bites, ten patients with no pre-antivenom samples had venom detected in post-antivenom samples after dissociation treatment. In 20 patients with no venom detected pre-antivenom, 13 had venom detected post-antivenom after dissociation treatment. In another 85 suspected Russell¿s viper bites with no venom detected pre-antivenom, 50 had venom detected after dissociation treatment. Dissociation treatment was also successful for Australian snake envenomation including taipan, mulga, tiger snake and brown snake. Snake venom can be detected by EIA in post-antivenom samples after dissociation treatment allowing confirmation of diagnosis of envenomation post-antivenom.

DOI 10.3390/toxins8050130
2016 Buckley NA, Dawson AH, Juurlink DN, Isbister GK, 'Who gets antidotes? choosing the chosen few', British Journal of Clinical Pharmacology, 81 402-407 (2016) [C1]

© 2016 The British Pharmacological Society.An understanding of mechanisms, potential benefits and risks of antidotes is essential for clinicians who manage poisoned patients. Of ... [more]

© 2016 The British Pharmacological Society.An understanding of mechanisms, potential benefits and risks of antidotes is essential for clinicians who manage poisoned patients. Of the dozens of antidotes currently available, only a few are regularly used. These include activated charcoal, acetylcysteine, naloxone, sodium bicarbonate, atropine, flumazenil, therapeutic antibodies and various vitamins. Even then, most are used in a minority of poisonings. There is little randomized trial evidence to support the use of most antidotes. Consequently, decisions about when to use them are often based on a mechanistic understanding of the poisoning and the expected influence of the antidote on the patient's clinical course. For some antidotes, such as atropine and insulin, the doses employed can be orders of magnitude higher than standard dosing. Importantly, most poisoned patients who reach hospital can recover with supportive care alone. In low risk patients, the routine use of even low risk antidotes such as activated charcoal is unwarranted. In more serious poisonings, decisions regarding antidote use are generally guided by a risk/benefit assessment based on low quality evidence.

DOI 10.1111/bcp.12894
2016 Buckley NA, Dawson AH, Isbister GK, 'Treatments for paracetamol poisoning', BMJ (Online), 353 (2016)
DOI 10.1136/bmj.i2579
Citations Scopus - 2
2016 Isbister GK, Buckley NA, 'Therapeutics in clinical toxicology: in the absence of strong evidence how do we choose between antidotes, supportive care and masterful inactivity.', Br J Clin Pharmacol, 81 408-411 (2016)
DOI 10.1111/bcp.12819
2016 Silva A, Kuruppu S, Othman I, Goode RJA, Hodgson WC, Isbister GK, 'Neurotoxicity in Sri Lankan Russell¿s Viper (Daboia russelii) Envenoming is Primarily due to U1-viperitoxin-Dr1a, a Pre-Synaptic Neurotoxin', Neurotoxicity Research, 1-9 (2016)

© 2016 Springer Science+Business Media New YorkRussell¿s vipers are snakes of major medical importance in Asia. Russell¿s viper (Daboia russelii) envenoming in Sri Lanka and So... [more]

© 2016 Springer Science+Business Media New YorkRussell¿s vipers are snakes of major medical importance in Asia. Russell¿s viper (Daboia russelii) envenoming in Sri Lanka and South India leads to a unique, mild neuromuscular paralysis, not seen in other parts of the world where the snake is found. This study aimed to identify and pharmacologically characterise the major neurotoxic components of Sri Lankan Russell¿s viper venom. Venom was fractionated using size exclusion chromatography and reverse-phase high-performance liquid chromatography (RP-HPLC). In vitro neurotoxicities of the venoms, fractions and isolated toxins were measured using chick biventer and rat hemidiaphragm preparations. A phospholipase A2 (PLA2) toxin, U1-viperitoxin-Dr1a (13.6 kDa), which constitutes 19.2 % of the crude venom, was isolated and purified using HPLC. U1-viperitoxin-Dr1a produced concentration-dependent in vitro neurotoxicity abolishing indirect twitches in the chick biventer nerve-muscle preparation, with a t90 of 55 ± 7 min only at 1 µM. The toxin did not abolish responses to acetylcholine and carbachol indicating pre-synaptic neurotoxicity. Venom, in the absence of U1-viperitoxin-Dr1a, did not induce in vitro neurotoxicity. Indian polyvalent antivenom, at the recommended concentration, only partially prevented the neurotoxic effects of U1-viperitoxin-Dr1a. Liquid chromatography mass spectrometry analysis confirmed that U1-viperitoxin-Dr1a was the basic S-type PLA2 toxin previously identified from this venom (NCBI¿GI: 298351762; SwissProt: P86368). The present study demonstrates that neurotoxicity following Sri Lankan Russell¿s viper envenoming is primarily due to the pre-synaptic neurotoxin U1-viperitoxin-Dr1a. Mild neurotoxicity observed in severely envenomed Sri Lankan Russell¿s viper bites is most likely due to the low potency of U1-viperitoxin-Dr1a, despite its high relative abundance in the venom.

DOI 10.1007/s12640-016-9650-4
2016 Wong LY, Wong A, Robertson T, Burns K, Roberts M, Isbister GK, 'Severe Hypertension and Bradycardia Secondary to Midodrine Overdose.', J Med Toxicol, (2016)
DOI 10.1007/s13181-016-0574-4
2016 Ediriweera DS, Kasturiratne A, Pathmeswaran A, Gunawardena NK, Wijayawickrama BA, Jayamanne SF, et al., 'Mapping the Risk of Snakebite in Sri Lanka - A National Survey with Geospatial Analysis.', PLoS Negl Trop Dis, 10 e0004813 (2016)
DOI 10.1371/journal.pntd.0004813
2016 Chan BS, Isbister GK, O Leary M, Chiew A, Buckley NA, 'Efficacy and effectiveness of anti-digoxin antibodies in chronic digoxin poisonings from the DORA study (ATOM-1)', Clinical Toxicology, 54 488-494 (2016) [C1]

© 2016 Informa UK Limited, trading as Taylor & Francis Group.abstract: Context: We hypothesized that in chronic digoxin toxicity, anti-digoxin antibodies (Fab) would be efficacio... [more]

© 2016 Informa UK Limited, trading as Taylor & Francis Group.abstract: Context: We hypothesized that in chronic digoxin toxicity, anti-digoxin antibodies (Fab) would be efficacious in binding digoxin, but this may not translate into improved clinical outcomes. Objective: This study aims to investigate changes in free digoxin concentrations and clinical effects on heart rate and potassium concentrations in chronic digoxin poisoning when anti-digoxin Fab are given. Materials and methods: This is a prospective observational study. Patients were recruited if they have been treated with anti-digoxin Fab for chronic digoxin poisoning. Data was entered into a standardised prospective form, supplemented with medical records. Their serum or plasma was collected, analysed for free and bound digoxin and free anti-digoxin Fab concentrations. Results: From September 2013 to February 2015, 36 patients (median age, 78 years; 22 females) were recruited from 18 hospitals. Median heart rate (HR) was 49 beats/min. Initial median digoxin and potassium concentrations were 4.7 nmol/L (3.6 µg/L) (range: 2.3¿11.2 nmol/L) and 5.3 mmol/L (range: 2.9¿9.2 mmol/L) respectively. Beta-blockers (n = 18), calcium antagonists (n = 6), spironolactone and/or angiotensin blocking agents (n = 24) were also used concomitantly. Renal impairment and gastrointestinal symptoms were present in 31 (86%) and 22 (63%) patients respectively. Five patients died from conditions unrelated to digoxin toxicity. Median change in HR was 8 beats/min post-Fab with no effect on blood pressure; they were 4, 10 and 17 beats/min for the 1, 2 and =3 vials of anti-digoxin Fab groups respectively. Concomitant treatments with potassium lowering agents (12/36) and inotropic drugs (7/36) were used. Gastrointestinal effects resolved in all 22 patients. The median decrease for potassium was 0.3 mmol/L. Digoxin concentration reduced from 3.8 to 0 nmol/L post-Fab. There was a rebound observed in the free digoxin concentration in 25 patients but none had associated clinical deterioration. Conclusions: One to two vials of anti-digoxin Fab initially bound all free digoxin confirming Fab efficacy. However, this was associated with only a moderate improvement in HR and potassium, suggesting bradyarrhythmia and hyperkalaemia may be from other co-morbidities.

DOI 10.1080/15563650.2016.1175620
2016 Isbister GK, Calver L, Downes MA, Page CB, 'In reply.', Ann Emerg Med, 67 146-147 (2016)
DOI 10.1016/j.annemergmed.2015.09.029
2016 Cooper JM, Brown JA, Cairns R, Isbister GK, 'Desvenlafaxine overdose and the occurrence of serotonin toxicity, seizures and cardiovascular effects.', Clin Toxicol (Phila), 1-7 (2016)
DOI 10.1080/15563650.2016.1223847
Co-authors Joyce Cooper
2016 Ryan NM, Kearney RT, Brown SGA, Isbister GK, 'Incidence of serum sickness after the administration of Australian snake antivenom (ASP-22)', Clinical Toxicology, 54 27-33 (2016) [C1]

© 2015 Taylor & Francis.Context: Serum sickness is a delayed immune reaction resulting from the injection of foreign protein or serum. Antivenom is known to cause serum sickness ... [more]

© 2015 Taylor & Francis.Context: Serum sickness is a delayed immune reaction resulting from the injection of foreign protein or serum. Antivenom is known to cause serum sickness but the incidence and characteristics are poorly defined. Objective: To investigate the incidence and clinical features of serum sickness following the administration of Australian snake antivenoms. Materials and methods: This was a prospective cohort study of patients recruited to the Australian Snakebite Project who received snake antivenom from November 2012 to March 2014. Demographics, clinical information, laboratory tests and antivenom treatment were recorded prospectively. Patients administered antivenom were followed up at 7-10 days and 6 weeks post-antivenom. The primary outcome was the proportion with serum sickness, pre-defined as three or more of: fever, erythematous rash/urticaria, myalgia/arthralgia, headache, malaise, nausea/vomiting 5-20 days post-antivenom. Results: During the 16-month period, 138 patients received antivenom. 23 were not followed up (unable to contact, tourist, child, bee sting) and 6 died in hospital. Of 109 patients followed up, the commonest reason for antivenom was venom induced consumption coagulopathy in 77 patients. An acute systemic hypersensitivity reaction occurred post-antivenom in 25 (23%) and 8 (7%) were severe with hypotension. Serum sickness occurred in 32/109 (29%) patients, including 15/37 (41%) given tiger snake, 6/15 (40%) given polyvalent and 4/23 (17%) given brown snake antivenom. There was no association between the volume of antivenom and serum sickness, p = 0.18. The commonest effects were lethargy, headache, muscle/joint aches and fever. Discussion: The incidence of serum sickness after snake antivenom in Australia was higher than earlier investigations which failed to define symptoms or follow-up patients, but similar to more recent studies of antivenoms in the United States. Conclusion: Serum sickness is common with Australian snake antivenom but does not appear to be predictable based on the volume of antivenom administered.

DOI 10.3109/15563650.2015.1101771
Co-authors Nicole Ryan
2016 Klein-Schwartz W, Stassinos GL, Isbister GK, 'Treatment of sulfonylurea and insulin overdose', British Journal of Clinical Pharmacology, 81 496-504 (2016) [C1]

© 2015 The British Pharmacological Society.The most common toxicity associated with sulfonylureas and insulin is hypoglycaemia. The article reviews existing evidence to better gu... [more]

© 2015 The British Pharmacological Society.The most common toxicity associated with sulfonylureas and insulin is hypoglycaemia. The article reviews existing evidence to better guide hypoglycaemia management. Sulfonylureas and insulin have narrow therapeutic indices. Small doses can cause hypoglycaemia, which may be delayed and persistent. All children and adults with intentional overdoses need to be referred for medical assessment and treatment. Unintentional supratherapeutic ingestions can be initially managed at home but if symptomatic or if there is persistent hypoglycaemia require medical referral. Patients often require intensive care and prolonged observation periods. Blood glucose concentrations should be assessed frequently. Asymptomatic children with unintentional sulfonylurea ingestions should be observed for 12 h, except if this would lead to discharge at night when they should be kept until the morning. Prophylactic intravenous dextrose is not recommended. The goal of therapy is to restore and maintain euglycaemia for the duration of the drug's toxic effect. Enteral feeding is recommended in patients who are alert and able to tolerate oral intake. Once insulin or sulfonylurea-induced hypoglycaemia has developed, it should be initially treated with an intravenous dextrose bolus. Following this the mainstay of therapy for insulin-induced hypoglycaemia is intravenous dextrose infusion to maintain the blood glucose concentration between 5.5 and 11 mmol l-1. After sulfonylurea-induced hypoglycaemia is initially corrected with intravenous dextrose, the main treatment is octreotide which is administered to prevent insulin secretion and maintain euglycaemia. The observation period varies depending on drug, product formulation and dose. A general guideline is to observe for 12 h after discontinuation of intravenous dextrose and, if applicable, octreotide.

DOI 10.1111/bcp.12822
Citations Scopus - 2Web of Science - 2
2016 Page CB, Mostafa A, Saiao A, Grice JE, Roberts MS, Isbister GK, 'Cardiovascular toxicity with levetiracetam overdose.', Clin Toxicol (Phila), 54 152-154 (2016)
DOI 10.3109/15563650.2015.1115054
2016 Scott AJ, Dunlop AJ, Brown A, Sadler C, Isbister GK, 'The prevalence of QT prolongation in a population of patients with substance use disorders.', Drug Alcohol Rev, (2016)
DOI 10.1111/dar.12415
Co-authors Adrian Dunlop
2016 Maduwage K, Silva A, O'Leary MA, Hodgson WC, Isbister GK, 'Efficacy of Indian polyvalent snake antivenoms against Sri Lankan snake venoms: lethality studies or clinically focussed in vitro studies.', Sci Rep, 6 26778 (2016)
DOI 10.1038/srep26778
2016 Cowan T, Foster R, Isbister GK, 'Acute and chronic oesophageal injury following caustic ingestions in a 25-year cohort', CLINICAL TOXICOLOGY, 54 376-377 (2016)
2016 Jayaweera DS, Islam SAKM, Gunja N, Cowie C, Poojara L, Roberts MS, Isbister GK, 'Severe poisoning after ingestion of chloroform', CLINICAL TOXICOLOGY, 54 420-420 (2016)
2016 Downes M, Bastick M, Cowie C, Roberts MS, Isbister GK, 'Methyl ethyl ketone peroxide toxicity treated with acetylcysteine', CLINICAL TOXICOLOGY, 54 420-420 (2016)
2016 Page CB, Rosek T, Roberts MS, Isbister GK, 'Severe toxicity with triclopyr overdose: a case report', CLINICAL TOXICOLOGY, 54 421-421 (2016)
2016 Chiew AL, Isbister GK, Page CB, Buckley NA, 'Massive paracetamol overdose: an observational study', CLINICAL TOXICOLOGY, 54 429-429 (2016)
2016 Wong LY, Wong AY, Rozek T, Roberts MS, Isbister GK, 'Severe hypertension and bradycardia secondary to midodrine overdose', CLINICAL TOXICOLOGY, 54 438-438 (2016)
2016 Twaddell S, Whyte IM, Isbister GK, 'Use of octreotide as a novel treatment for insulin overdose in a non-diabetic patient', CLINICAL TOXICOLOGY, 54 446-447 (2016)
2016 Chiew AL, James LP, Letzig LG, Isbister GK, Buckley NA, 'Paracetamol-protein adducts following acute paracetamol overdose', CLINICAL TOXICOLOGY, 54 472-472 (2016)
2016 Johnston C, Ryan NM, Isbister GK, 'Sea snake envenoming in Australia causes myotoxicity, local effects and non-specific systemic symptoms (ASP-24)', CLINICAL TOXICOLOGY, 54 511-511 (2016)
Co-authors Nicole Ryan
2016 Buckley NA, Dawson AH, Isbister GK, 'Authors' reply to Thomas and colleagues', BMJ (Online), 353 (2016) [C3]
DOI 10.1136/bmj.i3461
2016 Chiew A, Raos MP, Isbister GK, 'Sub-mammary injection of ropivacaine resulting in severe toxicity with seizures.', Emerg Med Australas, 28 246-247 (2016)
DOI 10.1111/1742-6723.12539
2015 Isbister GK, 'Risk assessment of drug-induced QT prolongation.', Australian prescriber, 38 20-24 (2015) [C1]
Citations Scopus - 5
2015 Michael AP, Mostafa A, Cooper JM, Grice J, Roberts MS, Isbister GK, 'Erratum: The pharmacokinetics and pharmacodynamics of severe aldicarb toxicity after overdose (Clinical Toxicology (2015) (1-3))', Clinical Toxicology, 53 788 (2015) [O1]
DOI 10.3109/15563650.2015.1063280
Co-authors Joyce Cooper
2015 Maduwage K, Buckley NA, de Silva HJ, Lalloo DG, Isbister GK, 'Snake antivenom for snake venom induced consumption coagulopathy', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2015) [C1]
DOI 10.1002/14651858.CD011428.pub2
Citations Scopus - 3
2015 Calver L, Drinkwater V, Gupta R, Page CB, Isbister GK, 'Droperidol V. haloperidol for sedation of aggressive behaviour in acute mental health: randomised controlled trial', BRITISH JOURNAL OF PSYCHIATRY, 206 223-228 (2015) [C1]
DOI 10.1192/bjp.bp.114.150227
Citations Scopus - 2Web of Science - 2
2015 Calver L, Page CB, Downes MA, Chan B, Kinnear F, Wheatley L, et al., 'The Safety and Effectiveness of Droperidol for Sedation of Acute Behavioral Disturbance in the Emergency Department', Annals of Emergency Medicine, (2015) [C1]

Study objective: We investigate the safety and effectiveness of droperidol for sedation of acute behavioral disturbance in the emergency department (ED). Methods: This was a prosp... [more]

Study objective: We investigate the safety and effectiveness of droperidol for sedation of acute behavioral disturbance in the emergency department (ED). Methods: This was a prospective observational study in 6 EDs (August 2009 to April 2013). Adult patients requiring parenteral sedation for acute behavioral disturbance received droperidol 10 mg. If this did not sedate the patient within 15 minutes, further sedation was allowed but droperidol 10 mg was recommended as part of a sedation protocol. The primary outcome was the proportion of patients with an abnormal QT interval, defined by the at-risk line on the QT nomogram. Secondary outcomes were effectiveness determined by the time to sedation measured on the Sedation Assessment Tool, use of additional sedation, adverse events, and injury to staff or patients. Results: There were 1,009 patients with an ECG performed within 2 hours of droperidol administration, with a median dose of 10 mg (interquartile range [IQR]10 to 17.5 mg). Thirteen of the 1,009 patients had an abnormal QT (1.3%; 95% confidence interval 0.7% to 2.3%), but 7 of these had another cause attributed for prolonged QT (methadone, escitalopram, amiodarone, or preexisting). In 1,403 patients sedated with a median total dose of droperidol of 10 mg (IQR 10 to 20 mg), the median time to sedation was 20 minutes (IQR 10 to 30 minutes) and 97% were sedated within 120 minutes. Additional sedation was required for 435 patients (31.0%; 95% confidence interval 28.6% to 33.5%). Adverse events occurred in 70 patients (5%) and oversedation without complications in 109 (8%), the latter more common for patients receiving benzodiazepines as additional sedation (16/109 [15%]). There were no cases of torsades de pointes. Injuries occurred in 34 staff members and 4 patients. Conclusion: The study supports the use of high-dose droperidol as a safe sedating agent for patients with acute behavioral disturbance in the ED. There is no evidence of increased risk for QT prolongation with the doses used in this study.

DOI 10.1016/j.annemergmed.2015.03.016
Citations Scopus - 7Web of Science - 6
2015 Page CB, Isbister GK, Buckley NA, Fatovich DM, Brown SGA, 'In reply', Annals of Emergency Medicine, 65 124-125 (2015) [C3]
DOI 10.1016/j.annemergmed.2014.08.021
Citations Scopus - 1Web of Science - 1
2015 Berling I, Isbister G, 'Marine envenomations', Australian Family Physician, 44 28-32 (2015) [C2]

Background: Marine stings are common but most are minor and do not require medical intervention. Severe and systemic marine envenoming is uncommon, but includes box jellyfish stin... [more]

Background: Marine stings are common but most are minor and do not require medical intervention. Severe and systemic marine envenoming is uncommon, but includes box jellyfish stings, Irukandji syndrome, major stingray trauma and blue-ringed octopus envenoming. Almost all marine injuries are caused by jellyfish stings, and penetrating injuries from spiny fish, stingrays or sea urchins. Objective: This article describes the presentation and management of marine envenomations and injuries that may occur in Australia. Discussion: First aid for jellyfish includes tentacle removal, application of vinegar for box jellyfish, and hot water immersion (45°C for 20 min) for bluebottle jellyfish stings. Basic life support is essential for severe marine envenomings that result in cardiac collapse or paralysis. Irukandji syndrome causes severe generalised pain, autonomic excess and minimal local pain, which may require large amounts of analgesia, and, uncommonly, myocardial depression and pulmonary oedema occur. Penetrating marine injuries can cause significant trauma depending on location of the injury. Large and unclean wounds may have delayed healing and secondary infection if not adequately irrigated, debrided and observed.

Citations Scopus - 2Web of Science - 2
2015 Berling I, Isbister GK, 'Hematologic effects and complications of snake envenoming', Transfusion Medicine Reviews, 29 82-89 (2015) [C1]

© 2015.Hematologic abnormalities are the most common effects of snake envenoming globally. Venom-induced consumption coagulopathy (VICC) is the commonest and most important. Othe... [more]

© 2015.Hematologic abnormalities are the most common effects of snake envenoming globally. Venom-induced consumption coagulopathy (VICC) is the commonest and most important. Other hematologic abnormalities are an anticoagulant coagulopathy and thrombotic microangiopathy. Venom-induced consumption coagulopathy is a venom-induced activation of the clotting pathway by procoagulant toxins, resulting in clotting factor consumption and coagulopathy. The type of procoagulant toxin differs between snakes and can activate prothrombin, factor X, and factor V or consume fibrinogen. The most useful investigation in VICC is a prothrombin time/international normalized ratio. The d-dimer may assist in early diagnosis, but fibrinogen levels often add little in the clinical setting. Bedside investigations would be ideal, but point-of-care testing international normalized ratio and whole blood clotting tests have been shown to be unreliable in VICC. The major complication of VICC is hemorrhage, including intracranial hemorrhage which is often fatal. The role of antivenom in VICC is controversial and may only be beneficial for some types of snakes including Echis spp where the duration of abnormal clotting is reduced from more than a week to 24 to 48 hours. In contrast, antivenom does not appear to speed the recovery of VICC in Australian snake envenoming. Other treatments for VICC include factor replacement, observation and prevention of trauma, and heparin. An Australian study showed that fresh-frozen plasma speeds recovery of VICC, but early use may increase consumption. There is no evidence to support heparin.

DOI 10.1016/j.tmrv.2014.09.005
Citations Scopus - 4Web of Science - 4
2015 Chiew AL, Isbister GK, Duffull SB, Buckley NA, 'Evidence for the changing regimens of acetylcysteine', British Journal of Clinical Pharmacology, (2015) [C1]

© 2015 The British Pharmacological Society. Paracetamol overdose prior to the introduction of acetylcysteine was associated with significant morbidity. Acetylcysteine is now the ... [more]

© 2015 The British Pharmacological Society. Paracetamol overdose prior to the introduction of acetylcysteine was associated with significant morbidity. Acetylcysteine is now the mainstay of treatment for paracetamol poisoning and has effectively reduced rates of hepatotoxicity and death. The current three-bag intravenous regimen with an initial high loading dose was empirically derived four decades ago and has not changed since. This regimen is associated with a high rate of adverse effects due mainly to the high initial peak acetylcysteine concentration. Furthermore, there are concerns that the acetylcysteine concentration is not adequate for 'massive' overdoses and that the dose and duration may need to be altered. Various novel regimens have been proposed, looking to address these issues. Many of these modified regimens aim to decrease the rate of adverse reactions by slowing the loading dose and thereby decrease the peak concentration. We used a published population pharmacokinetic model of acetylcysteine to simulate these modified regimens. We determined mean peak and 20 h acetylcysteine concentrations and area under the under the plasma concentration-time curve to compare these regimens. Those regimens that resulted in a lower peak acetylcysteine concentration have been shown in studies to have a lower rate of adverse events. However, these studies were too small to show whether they are as effective as the traditional regimen. Further research is still needed to determine the optimum dose and duration of acetylcysteine that results in the fewest side-effects and treatment failures. Indeed, a more patient-tailored approach might be required, whereby the dose and duration are altered depending on the paracetamol dose ingested or paracetamol concentrations.

DOI 10.1111/bcp.12789
Citations Scopus - 2Web of Science - 5
2015 Isbister GK, Sellors KV, Beckmann U, Chiew AL, Downes MA, Berling I, 'Catecholamine-induced cardiomyopathy resulting from life-threatening funnel-web spider envenoming', Medical Journal of Australia, 203 302-304.e1 (2015) [C3]
DOI 10.5694/mja15.00279
2015 Isbister GK, 'How do we assess whether the QT interval is abnormal: Myths, formulae and fixed opinion', CLINICAL TOXICOLOGY, 53 189-191 (2015) [C3]
DOI 10.3109/15563650.2015.1014044
Citations Scopus - 3Web of Science - 3
2015 Isbister GK, Maduwage K, Scorgie FE, Shahmy S, Mohamed F, Abeysinghe C, et al., 'Venom concentrations and clotting factor levels in a prospective cohort of russell¿s viper bites with coagulopathy', PLoS Neglected Tropical Diseases, 9 (2015) [C1]

© 2015 Isbister et al.Background Russell¿s viper envenoming is a major problem in South Asia and causes venom induced consumption coagulopathy. This study aimed to investigate t... [more]

© 2015 Isbister et al.Background Russell¿s viper envenoming is a major problem in South Asia and causes venom induced consumption coagulopathy. This study aimed to investigate the kinetics and dynamics of venom and clotting function in Russell¿s viper envenoming. Methodology/Principal Findings In a prospective cohort of 146 patients with Russell¿s viper envenoming, we measured venom concentrations, international normalised ratio [INR], prothrombin time (PT), activated partial thromboplastin time (aPTT), coagulation factors I, II, V, VII, VIII, IX and X, and von Willebrand factor antigen. The median age was 39y (16¿82y) and 111 were male. The median peak INR was 6.8 (interquartile range[IQR]:3.7 to >13), associated with low fibrinogen [median,<0.01g/L;IQR:<0.01¿0.9g/L), low factor V levels [median,<5%;IQR:<5¿4%], low factor VIII levels [median,40%;IQR:12¿79%] and low factor X levels [median,48%; IQR:29¿67%]. There were smaller reductions in factors II, IX and VII over time. All factors recovered over 48h post-antivenom. The median INR remained >3 at 6h post-antivenom but had reduced to <2, by 24h. The aPTT had also returned to close to normal (<50sec) at 24h. Factor VII, VIII and IX levels were unusually high pre-antivenom, median peak concentrations of 393%, 307% and 468% respectively. Pre-antivenom venom concentrations and the INR (r = 0.20, p = 0.02) and aPTT (r = 0.19, p = 0.03) were correlated (non-parametric Spearman analysis). Conclusions Russell¿s viper coagulopathy results in prolonged aPTT, INR, low fibrinogen, factors V, VIII and X which recover over 48h. Severity of clotting abnormalities was associated with venom concentrations.

DOI 10.1371/journal.pntd.0003968
Co-authors Lisa Lincz
2015 Berling I, Buckley NA, Mostafa A, Downes MA, Grice J, Medley G, et al., '2-Methyl-4-chlorophenoxyacetic acid and bromoxynil herbicide death', Clinical Toxicology, 53 486-488 (2015) [C3]

Copyright © 2015 Informa Healthcare USA, Inc.Case report. We report a fatal case of a 37 year old gentleman who ingested a MCPA/bromoxynil co-formulation herbicide. Although clin... [more]

Copyright © 2015 Informa Healthcare USA, Inc.Case report. We report a fatal case of a 37 year old gentleman who ingested a MCPA/bromoxynil co-formulation herbicide. Although clinically well on initial examination, our patient declined dramatically over his 18 h admission with increasing CO2 production, hyperthermia and metabolic derangement to eventually die from cardiac asystole 20 h post ingestion. Two hours after ingestion the MCPA concentration was 83.9 µg/mL and bromoxynil concentration was 137 µg/mL. Discussion. The patients' mechanism of death appeared to be uncoupling of oxidative phosphorylation, excess CO2 production and hyperthermia. There is limited knowledge on the acute toxicity of these herbicides, in particular bromoxynil, and this case highlights the relentless progression of severe toxicity in humans.

DOI 10.3109/15563650.2015.1030025
Citations Scopus - 1Web of Science - 1
2015 Isbister GK, Maduwage K, Saiao A, Buckley NA, Jayamanne SF, Seyed S, et al., 'Population pharmacokinetics of an Indian F(ab')2 snake antivenom in patients with Russell's viper (Daboia russelii) bites', PLoS Neglected Tropical Diseases, 9 1-13 (2015) [C1]
DOI 10.1371/journal.pntd.0003873
Citations Scopus - 1Web of Science - 1
Co-authors Alexandre Mendes
2015 McNamara K, Isbister GK, 'Hyperlactataemia and clinical severity of acute metformin overdose', INTERNAL MEDICINE JOURNAL, 45 402-408 (2015) [C1]
DOI 10.1111/imj.12713
2015 Chaisakul J, Isbister GK, O'Leary MA, Parkington HC, Smith AI, Hodgson WC, Kuruppu S, 'Prothrombin activator-like toxin appears to mediate cardiovascular collapse following envenoming by Pseudonaja textilis', Toxicon, 102 48-54 (2015) [C1]

© 2015 Elsevier Ltd. All rights reserved.Brown snake (Pseudonaja spp.)-induced early cardiovascular collapse is a life-threatening medical emergency in Australia. We have previou... [more]

© 2015 Elsevier Ltd. All rights reserved.Brown snake (Pseudonaja spp.)-induced early cardiovascular collapse is a life-threatening medical emergency in Australia. We have previously shown that this effect can be mimicked in animals and is mediated via the release of endogenous mediators. In the present study, we aimed to purify and characterize the component in Pseudonaja textilis venom which induces cardiovascular collapse following envenoming. The component (fraction 3) was isolated using a combination of techniques including hydroxyapatite and reverse phase chromatography. Fraction 3 (10 or 20 µg/kg, i.v.) produced a rapid decrease in mean arterial pressure (MAP) followed by cardiovascular collapse. Fraction 3-induced early collapse was abolished by prior administration of smaller priming doses of fraction 3 (i.e. 2 and 5 µg/kg, i.v.) or heparin (300 units/kg, i.v.). P. textilis whole venom (1 and 3 µg/ml), but not fraction 3 (1 or 3 µg/ml), induced endothelium-dependent relaxation in isolated rat mesenteric arteries. SDS-PAGE gel indicated the presence of 9-10 protein bands of fraction 3. Using proteomic based analysis some protein bands of fraction 3 were identified as subunits of venom prothrombin activator, pseutarin C of P. textilis venom. Our results conclude that prothrombin activator-like toxin is likely to be a contributor to the rapid collapse induced by P. textilis venom.

DOI 10.1016/j.toxicon.2015.05.001
2015 Berling I, Brown SGA, Miteff F, Levi C, Isbister GK, 'Intracranial haemorrhages associated with venom induced consumption coagulopathy in Australian snakebites (ASP-21)', Toxicon, 102 8-13 (2015) [C1]

© 2015 Published by Elsevier Ltd. All rights reserved.Intracranial haemorrhage (ICH) is a rare life-threatening consequence of venom induced consumption coagulopathy in snake-bit... [more]

© 2015 Published by Elsevier Ltd. All rights reserved.Intracranial haemorrhage (ICH) is a rare life-threatening consequence of venom induced consumption coagulopathy in snake-bite. It is unclear why certain patients haemorrhage. We aimed to investigate ICH in snake envenoming. Cases of venom-induced consumption coagulopathy from July 2005-June 2014 were identified from the Australian Snakebite Project, a prospective multicentre cohort of snake-bites. Cases with venom-induced consumption coagulopathy were extracted with data on the snake-bite, clinical effects, laboratory investigations, treatment and outcomes. 552 cases had venom-induced consumption coagulopathy; median age, 40 y (2-87 y), 417 (76%) males, 253 (46%) from brown snakes and 17 died (3%). There were 6/552 (1%) cases of ICH; median age, 71 y (59-80 y), three males and five from brown snakes. All received antivenom and five died. All six had a history of hypertension. Time to onset of clinical effects consistent with ICH was 8-12 h in four cases, and within 3 h in two. Difficult to manage hypertension and vomiting were common. One patient had a normal cerebral CT on presentation and after the onset of focal neurological effects a repeat CT showed an ICH. ICH is rare in snake-bite with only 1% of patients with coagulopathy developing one. Older age and hypertension were associated with ICH.

DOI 10.1016/j.toxicon.2015.05.012
Co-authors Chris Levi
2015 Miller M, O Leary MA, Isbister GK, 'Towards rationalisation of antivenom use in funnel-web spider envenoming: enzyme immunoassays for venom concentrations', Clinical Toxicology, 1-7 (2015) [C1]

© 2015 Taylor & Francis Context: Funnel-web spider (Atrax and Hadronyche spp.) envenoming is rare but causes severe neuromuscular, autonomic, and cardiac effects. A rabbit-derive... [more]

© 2015 Taylor & Francis Context: Funnel-web spider (Atrax and Hadronyche spp.) envenoming is rare but causes severe neuromuscular, autonomic, and cardiac effects. A rabbit-derived IgG antivenom is available, but venom detection in patients has not been reported. Objective: To use serial venom and antivenom concentrations to better define envenoming and antivenom effectiveness. Materials and methods: Serum was collected from nine patients with suspected funnel-web spider bites and clinical effects were recorded. Venom-specific enzyme immunoassays were developed to measure funnel-web spider venom and antivenom concentrations. Goat anti-rabbit whole serum was coupled to UltraLink resin and added to samples to remove bound venom and measure free venom. Antivenom efficacy was defined as antivenom binding all free venom and antivenom effectiveness as resolution of clinical features. Results: Venom was detectable in samples from six of nine patients. In three patients without venom detected, there were only moderate effects, which did not completely respond to antivenom in all cases and no spider was identified. In five of six cases, a male Atrax spp. (Sydney funnel-web) spider was identified. Three patients had moderate envenoming which responded to antivenom. Three patients had severe envenoming and developed catecholamine-induced myocarditis and acute pulmonary oedema. Although cholinergic and non-specific clinical features appeared to respond to antivenom, myocarditis and pulmonary oedema lasted 2¿4 days. Median venom concentration pre-antivenom in five patients with samples was 5.6 ng/ml (3¿35 ng/ml), and immediately post-antivenom decreased to a median of 0 ng/ml (0¿1.8 ng/ml). Post-antivenom venom concentrations decreased when bound venom was removed; median, 0 ng/ml (0¿0.9 ng/ml), indicating that most venom detected post-antivenom was bound. There was recurrence of venom and clinical features in one patient when a pressure bandage was removed. Conclusions: Detection of venom in suspected funnel-web spider bites identified definite cases with characteristic envenoming and a spider was identified. Measurement of venom concentrations pre- and post-antivenom demonstrated that venom was bound by antivenom, but in severe cases cardiac toxicity was not reversed.

DOI 10.3109/15563650.2015.1122794
2015 Cooper JM, Duffull SB, Saiao AS, Isbister GK, 'The pharmacokinetics of sertraline in overdose and the effect of activated charcoal', British Journal of Clinical Pharmacology, 79 307-315 (2015) [C1]

Aims To investigate the pharmacokinetics (PK) of sertraline in overdose and the effect of single dose activated charcoal (SDAC). Methods Patients presenting to a toxicology unit w... [more]

Aims To investigate the pharmacokinetics (PK) of sertraline in overdose and the effect of single dose activated charcoal (SDAC). Methods Patients presenting to a toxicology unit with sertraline overdoses had demographic and clinical information recorded, and serial serum collected for measurement of sertraline concentrations. Monolix® version 4.2 was used to develop a population PK model of sertraline overdose and the effect of SDAC. Uncertainty in dose time was accounted for by shifting dose time using lag time with between subject variability (BSV). BSV on relative fraction absorbed was used to model uncertainty in dose. Results There were 77 timed sertraline concentrations measured in 28 patients with sertraline overdoses with a median dose of 1550 mg (250-5000 mg). SDAC was given to seven patients between 1.5 and 4 h post-overdose. A one compartment model with lag time of 1 h and first order input and elimination adequately described the data. Including BSV on both lag time and relative fraction absorbed improved the model. The population PK parameter estimates for absorption rate constant, volume of distribution and clearance were 0.895 h-1, 5340 l and 130 l h-1, respectively. The calculated half-life of sertraline following overdose was 28 h (IQR 19.4-30.6h). When given up to 4 h post-overdose, SDAC significantly increased the clearance of sertraline by a factor of 1.9, decreased the area under the curve and decreased the maximum plasma concentration (Cmax). Conclusions Sertraline had linear kinetics in overdose with parameter values similar to those in therapeutic use. SDAC is effective in increasing clearance when given 1.5 to 4 h post-overdose.

DOI 10.1111/bcp.12500
Citations Scopus - 2Web of Science - 2
Co-authors Joyce Cooper
2015 Chiew AL, Fountain JS, Graudins A, Isbister GK, Reith D, Buckley NA, 'Summary statement: New guidelines for the management of paracetamol poisoning in Australia and New Zealand', Medical Journal of Australia, 203 215-218 (2015) [C3]
DOI 10.5694/mja15.00614
Citations Scopus - 2Web of Science - 3
2015 Isbister GK, Bies R, 'Pharmacometrics: So much mathematics and why planes achieve their destinations with almost perfect results ...', British Journal of Clinical Pharmacology, 79 1-3 (2015) [C3]
DOI 10.1111/bcp.12514
2015 Gulati A, Faed JM, Isbister GK, Duffull SB, 'Application of Adaptive DP-optimality to Design a Pilot Study for a Clotting Time Test for Enoxaparin', Pharmaceutical Research, 32 3391-3402 (2015) [C1]

© 2015 Springer Science+Business Media New York.Purpose: Dosing of enoxaparin, like other anticoagulants, may result in bleeding following excessive doses and clot formation if t... [more]

© 2015 Springer Science+Business Media New York.Purpose: Dosing of enoxaparin, like other anticoagulants, may result in bleeding following excessive doses and clot formation if the dose is too low. We recently showed that a factor Xa based clotting time test could potentially assess the effect of enoxaparin on the clotting system. However, the test did not perform well in subsequent individuals and effectiveness of an exogenous phospholipid, Actin FS, in reducing the variability in the clotting time was assessed. The aim of this work was to conduct an adaptive pilot study to determine the range of concentrations of Xa and Actin FS to take forward into a proof-of-concept study. Methods: A nonlinear parametric function was developed to describe the response surface over the factors of interest. An adaptive method was used to estimate the parameters using a D-optimal design criterion. In order to provide a reasonable probability of observing a success of the clotting time test, a P-optimal design criterion was incorporated using a loss function to describe the hybrid DP-optimality. Results: The use of adaptive DP-optimality method resulted in an efficient estimation of model parameters using data from only 6 healthy volunteers. The use of response surface modelling identified a range of sets of Xa and Actin FS concentrations, any of which could be used for the proof-of-concept study. Conclusions: This study shows that parsimonious adaptive DP-optimal designs may provide both precise parameter estimates for response surface modelling as well as clinical confidence in the potential benefits of the study.

DOI 10.1007/s11095-015-1715-1
2015 O'Leary MA, Maduwage K, Isbister GK, 'Detection of venom after antivenom administration is largely due to bound venom', Toxicon, 93 112-118 (2015) [C1]
DOI 10.1016/j.toxicon.2014.11.221
Citations Scopus - 5Web of Science - 4
2015 Ryan NM, Isbister GK, 'Tramadol overdose causes seizures and respiratory depression but serotonin toxicity appears unlikely', Clinical Toxicology, 53 545-550 (2015) [C1]

© 2015 Informa Healthcare USA, Inc.Context. Tramadol is a commonly used centrally acting analgesic associated with seizures and suspected to cause serotonin toxicity in overdose.... [more]

© 2015 Informa Healthcare USA, Inc.Context. Tramadol is a commonly used centrally acting analgesic associated with seizures and suspected to cause serotonin toxicity in overdose. Objective. This study sought to investigate the effects of tramadol overdose, and included evaluation for serotonin toxicity based on the Hunter Serotonin Toxicity Criteria where the seven clinical features of spontaneous clonus, inducible clonus, ocular clonus, agitation, diaphoresis, tremor and hyperreflexia are examined for in all patients taking serotonergic medications; seizures and central nervous system depression. Materials and methods. This was an observational cases series based on a retrospective review of tramadol overdoses (> 400 mg) admitted to a tertiary toxicology unit from November 2000 to June 2013. Demographic details, information on ingestion (dose and co-ingestants), clinical effects, complications (seizures, serotonin toxicity and cardiovascular effects) and intensive care unit (ICU) admission were extracted from a clinical database. Results. There were 71 cases of tramadol overdose (median age: 41 years, range: 17-69 years; and median ingested dose: 1000 mg, interquartile range [IQR]: 800-2000 mg). Seizures were dose related and occurred in 8 patients, one of them co-ingested a benzodiazepine compared with 16 patients without seizures. There were no cases of serotonin toxicity meeting the Hunter Serotonin Toxicity Criteria. Tachycardia occurred in 27 and mild hypertension occurred in 32. The Glasgow Coma Score was < 15 in 29 and < 9 in 5 patients; three co-ingested tricyclic antidepressants and two tramadol alone (3000 mg and 900 mg). Respiratory depression occurred in 13, median dose: 2500 (IQR: 1600-3000) mg which was significantly different (p = 0.003) to patients without respiratory depression, median dose: 1000 (IQR: 750-1475) mg. Eight patients were admitted to ICU, five due to co-ingestant toxicity and three for respiratory depression. Discussion. Tramadol overdose was associated with a significant risk of seizures and respiratory depression in more severe cases, both which appear to be related to the ingested dose. There were no cases of serotonin toxicity, while opioid-like effects and adrenergic effects were prominent. Conclusion. Tramadol overdose is associated with seizures and respiratory depression, but is unlikely to cause serotonin toxicity.

DOI 10.3109/15563650.2015.1036279
Citations Scopus - 6Web of Science - 3
Co-authors Nicole Ryan
2015 Michael AP, Mostafa A, Cooper JM, Grice J, Roberts MS, Isbister GK, 'The pharmacokinetics and pharmacodynamics of severe aldicarb toxicity after overdose', Clinical Toxicology, 53 633-635 (2015) [C1]

© 2015 Informa Healthcare USA, Inc.Objective. To describe the clinical effects, pharmacokinetics, and pharmacodynamics of plasma and acetylcholinesterase in an aldicarb overdose.... [more]

© 2015 Informa Healthcare USA, Inc.Objective. To describe the clinical effects, pharmacokinetics, and pharmacodynamics of plasma and acetylcholinesterase in an aldicarb overdose. Case Report. A 57-year-old female was found unconscious and incontinent of urine after ingesting aldicarb. She was bradycardic, hypotensive, hypersalivating, clammy, had small pupils, and generalized weakness. She was intubated, ventilated, and treated with large atropine doses (50 mg and 20 mg/h infusion) and adrenaline. She improved hemodynamically over 24 h, but remained comatose for another 24 h, before recovering without sequela. Aldicarb concentration at admission was 2.18 µg/ml and concentration-time data best fitted a two compartmental model with first order absorption and a time of ingestion 4.5 h preadmission. The half-life of distribution was 0.4 h and half-life of elimination, 13 h. Plasma cholinesterase concentration at admission was 0.3 kU/L (Reference range[RR]:4.3-10.6 kU/L) and red cell cholinesterase was 10 U/gHb (RR:38-66 U/gHb). The IC50 was 0.15 µg/ml and 0.26 µg/ml for plasma and red cell cholinesterase, respectively. Discussion. Aldicarb poisoning causes rapid onset severe toxicity with muscarinic and nicotinic excess, seizures, and decreased consciousness. Cholinesterases rapidly recover once aldicarb concentrations decrease and precede clinical recovery.

DOI 10.3109/15563650.2015.1054504
Co-authors Joyce Cooper
2015 Skinner K, Saiao A, Mostafa A, Soderstrom J, Medley G, Roberts MS, Isbister GK, 'Isoniazid poisoning: Pharmacokinetics and effect of hemodialysis in a massive ingestion', HEMODIALYSIS INTERNATIONAL, 19 E37-E40 (2015) [C1]
DOI 10.1111/hdi.12293
Citations Web of Science - 2
2015 Buckley NA, Whyte IM, Dawson AH, Isbister GK, 'A prospective cohort study of trends in selfpoisoning, newcastle, Australia, 1987¿2012: Plus ça change, plus c¿est la même chose', Medical Journal of Australia, 202 438-443 (2015) [C1]

© 2015, Australasian Medical Publishing Co. Ltd. All Rights Reserved.Objective: To examine inhospital mortality and morbidity associated with self-poisoning with different drug c... [more]

© 2015, Australasian Medical Publishing Co. Ltd. All Rights Reserved.Objective: To examine inhospital mortality and morbidity associated with self-poisoning with different drug classes over an extended period. Design, setting and participants: A prospective cohort study over 26 years (1987¿2012) with limited follow-up of patients presenting consecutively to a primary and tertiary referral toxicology centre covering Newcastle, Lake Macquarie and Port Stephens, Australia. Main outcome measures: Hospital length of stay, types of drugs ingested, intensive care unit (ICU) admission, requirement for ventilation, inhospital deaths and rates of antidepressant drug use in Australia. Results: Over the study period, there were 17 266 admissions of patients poisoned by 34 342 substances (16 723 drugs available only on prescription). The median length of stay was 16 hours, 12.2% of patients (2101/17 266) were admitted to an ICU, 7.4% (1281/17 266) were ventilated and 78 (0.45%) died in hospital. Patient demographics, social and psychiatric factors remained stable over the 26-year period, but case fatality decreased (from 0.77% [15/1955] to 0.17% [7/4060]) as did ICU admissions (19.2% [376/1955] to 6.9% [280/4060]), ventilation (13.7% [268/1955] to 4.8% [193/4060]) and LOS. The most frequently ingested substances were alcohol, benzodiazepines, paracetamol, antidepressants and antipsychotics. There was a substantial fall in some highly toxic drugs (tricyclic antidepressants, barbiturates, conventional antipsychotics and theophylline), but increases in less toxic selective serotonin reuptake inhibitors, serotonin¿noradrenaline reuptake inhibitors and paracetamol. A greater than sixfold increase in community antidepressant use was accompanied by only minor changes in overall and antidepressant selfpoisoning rates. Conclusion: Over two decades, there were decreases in poisonings by many highly toxic drugs which were associated with substantial reductions in morbidity and inhospital deaths. Despite massive increases in the number of antidepressant prescriptions, neither rates of self-harm nor the proportion of antidepressant poisonings increased markedly.

DOI 10.5694/mja14.01116
Citations Scopus - 7Web of Science - 5
2015 Berling I, Isbister G, 'Marine envenomations Reply', AUSTRALIAN FAMILY PHYSICIAN, 44 168-168 (2015) [C3]
2015 Downes MA, Berling IL, Mostafa A, Grice J, Roberts MS, Isbister GK, 'Acute behavioural disturbance associated with phenibut purchased via an internet supplier', Clinical Toxicology, 53 636-638 (2015) [C1]

© 2015 Informa Healthcare USA, Inc.Context. Toxicity from recreational substances marketed for other purposes is a well-documented clinical entity. We present two cases of phenib... [more]

© 2015 Informa Healthcare USA, Inc.Context. Toxicity from recreational substances marketed for other purposes is a well-documented clinical entity. We present two cases of phenibut toxicity procured via the internet. Case Details. A 20-year-old female presented to the emergency department (ED) having used phenibut the prior day. The main finding was a decreased level of consciousness, however when roused she became delirious. Supportive care only was required with no specific intervention. The patient made a full recovery over a 24-hour period and admitted to use of phenibut purchased online. Plasma phenibut concentration was 29.7 µg/ml. A 38-year-old male presented to ED with an agitated delirium. The prior evening he had used tetrahydrocannabinol or THC, alcohol and phenibut, the latter purchased via the internet. His behavioural state had a suboptimal response to parenteral sedation. He was subsequently intubated for airway protection in the context of ongoing sedation to optimally manage his behavioural state. Post extubation the next morning he admitted using phenibut. Plasma phenibut concentration was 36.5 µg/ml. Discussion. Altered mental status was the predominant manifestation of phenibut toxicity in these cases. Clinicians to be aware of how phenibut toxicity may present as the internet has widened access to such substances.

DOI 10.3109/15563650.2015.1059945
Citations Web of Science - 1
2015 Wijesinghe CA, Williams SS, Kasturiratne A, Dolawaththa N, Wimalaratne P, Wijewickrema B, et al., 'A Randomized Controlled Trial of a Brief Intervention for Delayed Psychological Effects in Snakebite Victims.', PLoS Neglected Tropical Diseases, 9 1-12 (2015) [C1]
DOI 10.1371/journal.pntd.0003989
2015 Ryan NM, Downes MA, Isbister GK, 'Clinical features of serum sickness after Australian snake antivenom', Toxicon, 108 181-183 (2015) [C3]

© 2015 Elsevier Ltd. All rights reserved.Serum sickness is a delayed immune reaction in which the immune system responds to a protein in antiserum as a potentially harmful substa... [more]

© 2015 Elsevier Ltd. All rights reserved.Serum sickness is a delayed immune reaction in which the immune system responds to a protein in antiserum as a potentially harmful substance and mounts an IgG-mediated antibody response. A 32 year-old female patient had systemic envenoming following a bite by a red-bellied black snake (Pseudechis porphyriacus). She was treated with Tiger snake antivenom and recovered over 24 h and did not develop myotoxicity. She then presented with local pain, itching and swelling, which was partially treated with antihistamines. Eleven days after the bite she presented again with symptoms of worsening serum sickness including rash on the upper legs, joint and muscle pain in arms, ankles and knees, and nausea. The patient was prescribed five days of prednisone 50 mg/day, antihistamine 10 mg/day and analgesia 1000 mg/day and improved over 2 days. She had no further problems on follow up at 4 months. This case highlights that serum sickness can cause significant effects after the treatment of snake envenoming. It develops 5-14 days after antivenom administration and has characteristic clinical and laboratory features. Severe cases of serum sickness can result in morbidity but it appears to respond well to corticosteroid treatment.

DOI 10.1016/j.toxicon.2015.10.012
Co-authors Nicole Ryan
2015 Isbister GK, Poklis A, Poklis JL, Grice J, 'Beware of blotting paper hallucinogens: Severe toxicity with NBOMes', Medical Journal of Australia, 203 266-267e.1 (2015) [C3]
DOI 10.5694/mja15.00650
Citations Scopus - 1
2015 Berling I, Isbister GK, 'The Half RR Rule: A Poor Rule of Thumb and Not a Risk Assessment Tool for QT Interval Prolongation', Academic Emergency Medicine, (2015) [C1]

Objectives: Measuring the QT interval on an electrocardiogram (ECG) is integral to risk assessment of Torsade de Pointes (TdP). This study aimed to investigate the accuracy of the... [more]

Objectives: Measuring the QT interval on an electrocardiogram (ECG) is integral to risk assessment of Torsade de Pointes (TdP). This study aimed to investigate the accuracy of the 1/2 RR rule as a risk assessment tool for drug-induced TdP, comparing it to the QT nomogram, Bazett's corrected QT (QTcB), and Fridericia's corrected QT (QTcF). Methods: The authors calculated sensitivity and specificity of the 1/2 RR rule using a published data set of 129 cases of drug-induced TdP and 316 controls (noncardiotoxic overdoses), compared to the QT nomogram, QTcB > 500 msec and QTcF > 500 msec. To further determine the value of the 1/2 RR rule, its observed positive, and negative agreement were calculated when compared to the QT nomogram for determining an abnormal QT in eight samples of different drugs in overdose. Results: The sensitivity and specificity of the 1/2 RR rule were 88% (95% confidence interval [CI] = 80% to 93%) and 53% (95% CI = 47% to 58%), respectively, compared to the QT nomogram (sensitivity = 97%, 95% CI = 92% to 99%; specificity = 99%, 95% CI = 97% to 100%). It was also less sensitive than QTcB > 500 msec and had a lower specificity than QTcB > 500 msec and QTcF > 500 msec. In drug overdose patients, the 1/2 RR rule had poor observed agreement averaging 41%, which was mainly due to poor positive agreement, except for amisulpride where there was good agreement. Conclusions: The 1/2 RR rule was not as sensitive as the QT nomogram or QTcB > 500 msec for drug-induced TdP. It had poor positive agreement in almost all overdose patients, resulting in over half of patients receiving unnecessary cardiac monitoring and repeat ECGs.

DOI 10.1111/acem.12752
Citations Scopus - 1Web of Science - 1
2015 Isbister GK, Page CB, 'Brown snake envenoming: Why are we left in the dark?', Clinical Toxicology, 53 925 (2015) [C3]
DOI 10.3109/15563650.2015.1096366
Citations Scopus - 1
2015 Berling I, Isbister GK, 'In reply', Annals of Emergency Medicine, 66 216-217 (2015) [C3]
DOI 10.1016/j.annemergmed.2015.04.017
2014 Chiew AL, Isbister GK, 'A coagulopathic dilemma: snakes or genes.', Lancet, 383 2184 (2014) [C3]
DOI 10.1016/S0140-6736(14)60690-5
2014 Isbister GK, Bawaskar HS, 'Scorpion envenomation.', N Engl J Med, 371 457-463 (2014) [C1]
DOI 10.1056/NEJMra1401108
Citations Scopus - 10Web of Science - 29
2014 van Helden DF, Thomas PA, Dosen PJ, Imtiaz MS, Laver DR, Isbister GK, 'Pharmacological approaches that slow lymphatic flow as a snakebite first aid.', PLoS Negl Trop Dis, 8 e2722 (2014) [C1]
DOI 10.1371/journal.pntd.0002722
Citations Scopus - 3Web of Science - 3
Co-authors Derek Laver, Dirk Vanhelden
2014 Maduwage K, O'Leary MA, Scorgie FE, Shahmy S, Mohamed F, Abeysinghe C, et al., 'Detection of venom after antivenom is not associated with persistent coagulopathy in a prospective cohort of Russell's viper (Daboia russelii) envenomings.', PLoS Negl Trop Dis, 8 e3304 (2014) [C1]
DOI 10.1371/journal.pntd.0003304
Citations Scopus - 4Web of Science - 4
Co-authors Lisa Lincz
2014 Lincz LF, Scorgie FE, Johnston CI, O'Leary M, Prasad R, Seldon M, et al., 'Comparative sensitivity of commercially available aPTT reagents to mulga snake (Pseudechis australis) venom.', Pathology, 46 444-449 (2014) [C1]
DOI 10.1097/PAT.0000000000000120
Citations Scopus - 3Web of Science - 3
Co-authors Lisa Lincz
2014 Maduwage K, O'Leary MA, Isbister GK, 'Diagnosis of snake envenomation using a simple phospholipase A2 assay.', Sci Rep, 4 4827 (2014) [C1]
DOI 10.1038/srep04827
Citations Scopus - 1Web of Science - 1
2014 Isbister GK, Bawaskar HS, Brown SGA, 'Scorpion Envenomation REPLY', NEW ENGLAND JOURNAL OF MEDICINE, 371 1559-1560 (2014) [C3]
Citations Scopus - 24Web of Science - 1
2014 Isbister GK, Maduwage K, Page CB, 'Antivenom cross neutralisation in a suspected Asian pit viper envenoming causing severe coagulopathy.', Toxicon, 90 286-290 (2014) [C1]
DOI 10.1016/j.toxicon.2014.08.071
Citations Scopus - 2Web of Science - 2
2014 Chaisakul J, Isbister GK, Tare M, Parkington HC, Hodgson WC, 'Hypotensive and vascular relaxant effects of phospholipase A toxins from Papuan taipan (Oxyuranus scutellatus) venom', European Journal of Pharmacology, 723 227-233 (2014) [C1]
DOI 10.1016/j.ejphar.2013.11.028
Citations Scopus - 3Web of Science - 3
2014 Brinkman DL, Konstantakopoulos N, McInerney BV, Mulvenna J, Seymour JE, Isbister GK, Hodgson WC, 'Chironex fleckeri ( Box Jellyfish) Venom Proteins EXPANSION OF A CNIDARIAN TOXIN FAMILY THAT ELICITS VARIABLE CYTOLYTIC AND CARDIOVASCULAR EFFECTS*', JOURNAL OF BIOLOGICAL CHEMISTRY, 289 4798-4812 (2014) [C1]
DOI 10.1074/jbc.M113.534149
Citations Scopus - 14Web of Science - 12
2014 O'Leary MA, Isbister GK, 'Detection of venom-antivenom (VAV) immunocomplexes in vitro as a measure of antivenom efficacy', TOXICON, 77 125-132 (2014) [C1]
DOI 10.1016/j.toxicon.2013.11.001
Citations Scopus - 6Web of Science - 6
2014 Isbister GK, Page CB, Buckley NA, Fatovich DM, Pascu O, MacDonald SPJ, et al., 'Randomized controlled trial of intravenous antivenom versus placebo for latrodectism: The second redback antivenom evaluation (RAVE-II) study', Annals of Emergency Medicine, 64 620-628 (2014) [C1]

© 2014 American College of Emergency Physicians.Study objective Latrodectism is the most important spider envenomation syndrome worldwide. There remains considerable controversy ... [more]

© 2014 American College of Emergency Physicians.Study objective Latrodectism is the most important spider envenomation syndrome worldwide. There remains considerable controversy over antivenom treatment. We aimed to investigate whether antivenom resulted in resolution of pain and systemic effects in patients with latrodectism who received standardized analgesia.Methods In a multicenter randomized placebo-controlled trial of redback spider antivenom for latrodectism, 224 patients (>7 years) with a redback spider bite and severe pain, with or without systemic effects, were randomized to receive normal saline solution (placebo) or antivenom after receiving standardized analgesia. The primary outcome was a clinically significant reduction in pain 2 hours after trial medication compared with baseline. A second primary outcome for the subgroup with systemic features of envenomation was resolution of systemic features at 2 hours. Secondary outcomes were improved pain at 4 and 24 hours, resolution of systemic features at 4 hours, administration of opioid analgesics or unblinded antivenom after 2 hours, and adverse reactions.Results Two hours after treatment, 26 of 112 patients (23%) from the placebo arm had a clinically significant improvement in pain versus 38 of 112 (34%) from the antivenom arm (difference in favor of antivenom 10.7%; 95% confidence interval -1.1% to 22.6%; P=.10). Systemic effects resolved after 2 hours in 9 of 41 patients (22%) in the placebo arm and 9 of 35 (26%) in the antivenom arm (difference 3.8%; 95% confidence interval -15% to 23%; P=.79). There was no significant difference in any secondary outcome between antivenom and placebo. Acute systemic hypersensitivity reactions occurred in 4 of 112 patients (3.6%) receiving antivenom.Conclusion The addition of antivenom to standardized analgesia in patients with latrodectism did not significantly improve pain or systemic effects.

DOI 10.1016/j.annemergmed.2014.06.006
Citations Scopus - 6Web of Science - 7
2014 Berling I, Isbister GK, 'Prolonged QT Risk Assessment in Antipsychotic Overdose Usingthe QT Nomogram', Annals of Emergency Medicine, (2014) [C1]

Study objective: Antipsychotic drugs are frequently reported to cause QT prolongation and torsade de pointes. We aim to investigate the potential risk of torsade de pointes in ant... [more]

Study objective: Antipsychotic drugs are frequently reported to cause QT prolongation and torsade de pointes. We aim to investigate the potential risk of torsade de pointes in antipsychotic overdose by assessing the QT interval with the QT nomogram. Methods: All presentations to a toxicology service between January 1987 and May 2013 were reviewed. Admissions with single ingestions of an antipsychotic greater than maximum daily dose were extracted. Demographics, dose, ECG, and outcomes (arrhythmias and death) were obtained. QT intervals in multiple leads were manually measured and the median taken. QT-heart rate (QT-HR) pairs were plotted on the QT nomogram and defined as prolonged if above the abnormal line. The QTcF (Fridericia's HR correction) was calculated and compared with dose. Results: From 2,356 antipsychotic overdoses, 494 were included. There were no abnormal QT-HR pairs in 4 aripiprazole, 31 pericyazine, 14 trifluoperazine, and 7 haloperidol overdoses. Abnormal QT intervals occurred in 9 of 16 amisulpride overdoses (56%; 95% confidence interval [CI] 31% to 79%), 16 of 57 thioridazine overdoses (28%; 95% CI 17% to 42%), and 5 of 29 chlorpromazine overdoses (17%; 95% CI 7% to 36%). Abnormal QT intervals occurred in 5 of 41 risperidone overdoses (12%; 95% CI 5% to 27%), 10 of 202 quetiapine overdoses (5%; 95% CI 3% to 9%), and 2 of 76 olanzapine overdoses (3%; 95% CI 0.5% to 10%), but there was no correlation between dose and QTcF, and most abnormal QT intervals were at fast HR. An additional 186 single antipsychotic ingestions with noncardiotoxic coingestants had similar proportions of abnormal QT. There was 1 case of torsade de pointes in a thioridazine overdose. Conclusion: There appeared to be significant risk of QT prolongation with amisulpride and thioridazine overdoses. Although there were abnormal QT intervals for quetiapine, olanzapine, and risperidone overdoses, they were associated with tachycardia and not dose dependent, and so were unlikely to be associated with increased torsade de pointes risk.

DOI 10.1016/j.annemergmed.2014.12.005
Citations Scopus - 6Web of Science - 4
2014 Cooper JM, Newby DA, Whyte IM, Carter G, Jones AL, Isbister GK, 'Serotonin toxicity from antidepressant overdose and its association with the T102C polymorphism of the 5-HT receptor', Pharmacogenomics J, (2014) [C1]
DOI 10.1038/tpj.2013.47
Citations Scopus - 1
Co-authors Joyce Cooper, David Newby, Gregory Carter
2014 Berling I, Isbister GK, 'Mirtazapine overdose is unlikely to cause major toxicity', CLINICAL TOXICOLOGY, 52 20-24 (2014) [C1]
DOI 10.3109/15563650.2013.859264
Citations Scopus - 5Web of Science - 5
2014 Hart AJ, Hodgson WC, O'Leary M, Isbister GK, 'Pharmacokinetics and pharmacodynamics of the myotoxic venom of Pseudechis australis (mulga snake) in the anesthetised rat', CLINICAL TOXICOLOGY, 52 604-610 (2014) [C1]
DOI 10.3109/15563650.2014.914526
Citations Scopus - 1Web of Science - 1
2014 Buckley NA, Dawson AH, Isbister GK, 'Serotonin syndrome', Praxis, 103 1031-1041 (2014) [C3]
2014 Brown SGA, Isbister GK, 'Clinical research is a priority for emergency medicine but how do we make it happen, and do it well?', EMERGENCY MEDICINE AUSTRALASIA, 26 14-18 (2014) [C1]
DOI 10.1111/1742-6723.12179
Citations Scopus - 1Web of Science - 1
2014 Buckley NA, Dawson AH, Isbister GK, 'PRACTICE POINTER Serotonin syndrome', BMJ-BRITISH MEDICAL JOURNAL, 348 (2014) [C3]
DOI 10.1136/bmj.g1626
Citations Scopus - 21Web of Science - 14
2014 Maduwage K, Isbister GK, 'Current Treatment for Venom-Induced Consumption Coagulopathy Resulting from Snakebite', PLoS Neglected Tropical Diseases, 8 (2014) [C1]

© 2014 Maduwage, Isbister.Venomous snakebite is considered the single most important cause of human injury from venomous animals worldwide. Coagulopathy is one of the commonest i... [more]

© 2014 Maduwage, Isbister.Venomous snakebite is considered the single most important cause of human injury from venomous animals worldwide. Coagulopathy is one of the commonest important systemic clinical syndromes and can be complicated by serious and life-threatening haemorrhage. Venom-induced consumption coagulopathy (VICC) is the commonest coagulopathy resulting from snakebite and occurs in envenoming by Viperid snakes, certain elapids, including Australian elapids, and a few Colubrid (rear fang) snakes. Procoagulant toxins activate the clotting pathway, causing a broad range of factor deficiencies depending on the particular procoagulant toxin in the snake venom. Diagnosis and monitoring of coagulopathy is problematic, particularly in resource-poor countries where further research is required to develop more reliable, cheap clotting tests. MEDLINE and EMBASE up to September 2013 were searched to identify clinical studies of snake envenoming with VICC. The UniPort database was searched for coagulant snake toxins. Despite preclinical studies demonstrating antivenom binding toxins (efficacy), there was less evidence to support clinical effectiveness of antivenom for VICC. There were no placebo-controlled trials of antivenom for VICC. There were 25 randomised comparative trials of antivenom for VICC, which compared two different antivenoms (ten studies), three different antivenoms (four), two or three different doses or repeat doses of antivenom (five), heparin treatment and antivenom (five), and intravenous immunoglobulin treatment and antivenom (one). There were 13 studies that compared two groups in which there was no randomisation, including studies with historical controls. There have been numerous observational studies of antivenom in VICC but with no comparison group. Most of the controlled trials were small, did not use the same method for assessing coagulopathy, varied the dose of antivenom, and did not provide complete details of the study design (primary outcomes, randomisation, and allocation concealment). Non-randomised trials including comparison groups without antivenom showed that antivenom was effective for some snakes (e.g., Echis), but not others (e.g., Australasian elapids). Antivenom is the major treatment for VICC, but there is currently little high-quality evidence to support effectiveness. Antivenom is not risk free, and adverse reactions can be quite common and potentially severe. Studies of heparin did not demonstrate it improved outcomes in VICC. Fresh frozen plasma appeared to speed the recovery of coagulopathy and should be considered in bleeding patients.

DOI 10.1371/journal.pntd.0003220
Citations Scopus - 9Web of Science - 9
2014 Calver L, Isbister GK, 'High dose droperidol and QT prolongation: analysis of continuous 12-lead recordings.', Br J Clin Pharmacol, 77 880-886 (2014) [C1]
DOI 10.1111/bcp.12272
Citations Scopus - 6Web of Science - 4
2014 Gulati A, Isbister GK, Duffull SB, 'Scale reduction of a systems coagulation model with an application to modeling pharmacokinetic-pharmacodynamic data.', CPT Pharmacometrics Syst Pharmacol, 3 e90 (2014) [C1]
DOI 10.1038/psp.2013.67
2014 Downes MA, Calver LA, Isbister GK, 'Intralipid therapy does not improve level of consciousness in overdoses with sedating drugs: a case series.', Emerg Med Australas, 26 286-290 (2014) [C1]
DOI 10.1111/1742-6723.12237
Citations Scopus - 5Web of Science - 4
2013 Isbister GK, Buckley NA, Brown SGA, 'Tiger snake (Notechis spp) envenoming: Australian Snakebite Project (ASP-13) REPLY', MEDICAL JOURNAL OF AUSTRALIA, 198 194-195 (2013) [C3]
DOI 10.5694/mja12.11690
Citations Scopus - 1Web of Science - 1
2013 Allen GE, Wilson SK, Isbister GK, 'Paroplocephalus envenoming: a previously unrecognised highly venomous snake in Australia', MEDICAL JOURNAL OF AUSTRALIA, 199 792-793 (2013) [C3]
DOI 10.5694/mja13.10985
2013 Isbister GK, Brown SGA, Page CB, McCoubrie DL, Greene SL, Buckley NA, 'Snakebite in Australia: A practical approach to diagnosis and treatment', Medical Journal of Australia, 199 763-768 (2013) [C1]

Snakebite is a potential medical emergency and must receive high-priority assessment and treatment, even in patients who initially appear well. Patients should be treated in hospi... [more]

Snakebite is a potential medical emergency and must receive high-priority assessment and treatment, even in patients who initially appear well. Patients should be treated in hospitals with onsite laboratory facilities, appropriate antivenom stocks and a clinician capable of treating complications such as anaphylaxis. All patients with suspected snakebite should be admitted to a suitable clinical unit, such as an emergency short-stay unit, for at least 12 hours after the bite. Serial blood testing (activated partial thromboplastin time, international normalised ratio and creatine kinase level) and neurological examinations should be done for all patients. Most snakebites will not result in significant envenoming and do not require antivenom. Antivenom should be administered as soon as there is evidence of envenoming. Evidence of systemic envenoming includes venom-induced consumption coagulopathy, sudden collapse, myotoxicity, neurotoxicity, thrombotic microangiopathy and renal impairment. Venomous snake groups each cause a characteristic clinical syndrome, which can be used in combination with local geographical distribution information to determine the probable snake involved and appropriate antivenom to use. The Snake Venom Detection Kit may assist in regions where the range of possible snakes is too broad to allow the use of monovalent antivenoms. When the snake identification remains unclear, two monovalent antivenoms (eg, brown snake and tiger snake antivenom) that cover possible snakes, or a polyvalent antivenom, can be used. One vial of the relevant antivenom is sufficient to bind all circulating venom. However, recovery may be delayed as many clinical and laboratory effects of venom are not immediately reversible. For expert advice on envenoming, contact the National Poisons Information Centre on 13 11 26.

DOI 10.5694/mja12.11172
Citations Scopus - 15Web of Science - 14
2013 Maduwage K, Isbister GK, Silva A, Bowatta S, Mendis S, Gawarammana I, 'Epidemiology and clinical effects of hump-nosed pit viper (Genus: Hypnale) envenoming in Sri Lanka', TOXICON, 61 11-15 (2013) [C1]
DOI 10.1016/j.toxicon.2012.10.013
Citations Scopus - 13Web of Science - 11
2013 Gulati A, Isbister GK, Duffull SB, 'Effect of Australian elapid venoms on blood coagulation: Australian Snakebite Project (ASP-17)', TOXICON, 61 94-104 (2013) [C1]
DOI 10.1016/j.toxicon.2012.11.001
Citations Scopus - 5Web of Science - 3
2013 Hart AJ, Isbister GK, Hodgson WC, 'In vitro neurotoxic effects of Pseudechis spp. venoms: A comparison of avian and murine skeletal muscle preparations', TOXICON, 63 112-115 (2013) [C1]
DOI 10.1016/j.toxicon.2012.12.002
Citations Scopus - 3Web of Science - 3
2013 Barber CM, Isbister GK, Hodgson WC, 'Alpha neurotoxins', Toxicon, 66 47-58 (2013) [C1]
DOI 10.1016/j.toxicon.2013.01.019
Citations Scopus - 26Web of Science - 25
2013 O'Rourke KM, Correlje E, Martin CL, Robertson JD, Isbister GK, 'Point-of-care derived INR does not reliably detect significant coagulopathy following Australian snakebite', Thrombosis Research, 132 610-613 (2013) [C1]
DOI 10.1016/j.thromres.2013.09.004
Citations Scopus - 1Web of Science - 1
2013 Brown SGA, Stone SF, Fatovich DM, Burrows SA, Holdgate A, Celenza A, et al., 'Anaphylaxis: Clinical patterns, mediator release, and severity', JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 132 1141-1149 (2013) [C1]
DOI 10.1016/j.jaci.2013.06.015
Citations Scopus - 49Web of Science - 40
2013 Brown SGA, Stone SF, Fatovich DM, Isbister GK, 'Reply', Journal of Allergy and Clinical Immunology, 132 1457 (2013) [C3]
DOI 10.1016/j.jaci.2013.09.013)
2013 Isbister GK, Page CB, 'Drug induced QT prolongation: the measurement and assessment of the QT interval in clinical practice', BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 76 48-57 (2013) [C1]
DOI 10.1111/bcp.12040
Citations Scopus - 33Web of Science - 24
2013 Chaisakul J, Isbister GK, Kuruppu S, Konstantakopoulos N, Hodgson WC, 'An examination of cardiovascular collapse induced by eastern brown snake (Pseudonaja textilis) venom', Toxicology Letters, 221 205-211 (2013) [C1]
DOI 10.1016/j.toxlet.2013.06.235
Citations Scopus - 2Web of Science - 1
2013 Hart AJ, Isbister GK, O'Donnell P, Williamson NA, Hodgson WC, 'Species differences in the neuromuscular activity of post-synaptic neurotoxins from two Australian black snakes (Pseudechis porphyriacus and Pseudechis colletti)', Toxicology Letters, 219 262-268 (2013) [C1]
DOI 10.1016/j.toxlet.2013.03.026
Citations Scopus - 3Web of Science - 3
2013 Calver L, Isbister GK, 'Parenteral sedation of elderly patients with acute behavioral disturbance in the ED', AMERICAN JOURNAL OF EMERGENCY MEDICINE, 31 970-973 (2013) [C1]
DOI 10.1016/j.ajem.2013.03.026
Citations Scopus - 3Web of Science - 2
2013 O'Leary MA, Maduwage K, Isbister GK, 'Use of immunoturbidimetry to detect venom-antivenom binding using snake venoms', JOURNAL OF PHARMACOLOGICAL AND TOXICOLOGICAL METHODS, 67 177-181 (2013) [C1]
DOI 10.1016/j.vascn.2013.02.004
Citations Scopus - 2Web of Science - 1
2013 Berling I, Whyte IM, Isbister GK, 'Oxycodone overdose causes naloxone responsive coma and QT prolongation', QJM-AN INTERNATIONAL JOURNAL OF MEDICINE, 106 35-41 (2013) [C1]
DOI 10.1093/qjmed/hcs176
Citations Scopus - 9Web of Science - 9
2013 Isbister GK, Maduwage K, Shahmy S, Mohamed F, Abeysinghe C, Karunathilake H, et al., 'Diagnostic 20-min whole blood clotting test in Russell's viper envenoming delays antivenom administration', QJM-AN INTERNATIONAL JOURNAL OF MEDICINE, 106 925-932 (2013) [C1]
DOI 10.1093/qjmed/hct102
Citations Scopus - 15Web of Science - 10
2013 Li L, McGee RG, Isbister G, Webster AC, 'Interventions for the symptoms and signs resulting from jellyfish stings', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2013) [C1]
DOI 10.1002/14651858.CD009688.pub2
Citations Scopus - 4
2013 Calver L, Drinkwater V, Isbister GK, 'A prospective study of high dose sedation for rapid tranquilisation of acute behavioural disturbance in an acute mental health unit', BMC PSYCHIATRY, 13 (2013) [C1]
DOI 10.1186/1471-244X-13-225
Citations Scopus - 3Web of Science - 2
2013 Isbister GK, Buckley NA, Page CB, Scorgie FE, Lincz LF, Seldon M, Brown SGA, 'A randomized controlled trial of fresh frozen plasma for treating venom-induced consumption coagulopathy in cases of Australian snakebite (ASP-18)', Journal of Thrombosis and Haemostasis, 11 1310-1318 (2013) [C1]
DOI 10.1111/jth.12218
Citations Scopus - 11Web of Science - 11
Co-authors Lisa Lincz
2013 Johnston CI, Brown SGA, O'Leary MA, Currie BJ, Greenberg R, Taylor M, et al., 'Mulga snake (Pseudechis australis) envenoming: a spectrum of myotoxicity, anticoagulant coagulopathy, haemolysis and the role of early antivenom therapy - Australian Snakebite Project (ASP-19)', CLINICAL TOXICOLOGY, 51 417-424 (2013) [C1]
DOI 10.3109/15563650.2013.787535
Citations Scopus - 14Web of Science - 12
2013 Maduwage K, Scorgie FE, Silva A, Shahmy S, Mohamed F, Abeysinghe C, et al., 'Hump-nosed pit viper (Hypnale hypnale) envenoming causes mild coagulopathy with incomplete clotting factor consumption', CLINICAL TOXICOLOGY, 51 527-531 (2013) [C1]
DOI 10.3109/15563650.2013.811589
Citations Scopus - 8Web of Science - 8
Co-authors Lisa Lincz
2013 Isbister GK, Duffull SB, 'When is research clinical advice? Interpreting an exploratory study of paracetamol overdose', Clinical Toxicology, 51 1242 (2013) [C3]
DOI 10.3109/15563650.2013.857780
2013 Isbister GK, Duffull SB, 'Understanding probability and exposure in paracetamol overdose risk assessment', Clinical Toxicology, 51 1240 (2013) [C3]
DOI 10.3109/15563650.2013.851391
Citations Scopus - 1Web of Science - 1
2013 Duffull SB, Isbister GK, 'Predicting the requirement for N-acetylcysteine in paracetamol poisoning from reported dose', Clinical Toxicology, 51 772-776 (2013) [C1]
DOI 10.3109/15563650.2013.830733
Citations Scopus - 12Web of Science - 12
2013 Cubitt M, Armstrong J, McCoubrie D, White J, Williams V, Isbister GK, 'Point-of-care testing in snakebite: An envenomed case with false negative coagulation studies', EMERGENCY MEDICINE AUSTRALASIA, 25 372-373 (2013) [C3]
DOI 10.1111/1742-6723.12089
Citations Scopus - 4Web of Science - 3
2013 Kornhauser R, Isbister GK, O'Leary MA, Mirtschin P, Dunstan N, Hodgson WC, 'Cross-Neutralisation of the Neurotoxic Effects of Egyptian Cobra Venom with Commercial Tiger Snake Antivenom', BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY, 112 138-143 (2013) [C1]
DOI 10.1111/j.1742-7843.2012.00925.x
Citations Scopus - 9Web of Science - 8
2013 Chaisakul J, Parkington HC, Isbister GK, Konstantakopoulos N, Hodgson WC, 'Differential Myotoxic and Cytotoxic Activities of Pre-synaptic Neurotoxins from Papuan Taipan (Oxyuranus scutellatus) and Irian Jayan Death Adder (Acanthophis rugosus) Venoms', BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY, 112 325-334 (2013) [C1]
DOI 10.1111/bcpt.12048
Citations Scopus - 2Web of Science - 2
2013 Stone SF, Isbister GK, Shahmy S, Mohamed F, Abeysinghe C, Karunathilake H, et al., 'Immune Response to Snake Envenoming and Treatment with Antivenom; Complement Activation, Cytokine Production and Mast Cell Degranulation', PLOS NEGLECTED TROPICAL DISEASES, 7 (2013) [C1]
DOI 10.1371/journal.pntd.0002326
Citations Scopus - 12Web of Science - 11
2012 Allen G, O'Leary MA, Brown SGA, Buckley NA, Isbister GK, 'Clinical Effects and Antivenom Dosing in Brown Snake (Pseudonaja spp.) Envenoming - Australian Snakebite Project (ASP-14)', CLINICAL TOXICOLOGY, 50 280-281 (2012)
2012 Buckley NA, Isbister GK, 'Review: Application of heat or hot water reduces pain from jellyfish stings', Annals of Internal Medicine, 157 JC6-JC12 (2012) [C3]
2012 Isbister GK, O'Leary MA, Elliott M, Brown SGA, 'Tiger snake (Notechis spp) envenoming: Australian Snakebite Project (ASP-13)', Medical Journal of Australia, 197 173-177 (2012) [C1]
Citations Scopus - 17Web of Science - 16
2012 Hill DJ, Lowe AJ, Hosking C, Bennett CM, Allen KJ, Axelrad C, et al., 'Reply', Journal of Allergy and Clinical Immunology, 129 262.e2-263.e2 (2012) [C3]
2012 Van Gorp F, Duffull S, Hackett LP, Isbister GK, 'Population pharmacokinetics and pharmacodynamics of escitalopram in overdose and the effect of activated charcoal', British Journal of Clinical Pharmacology, 73 402-410 (2012) [C1]
Citations Scopus - 10Web of Science - 8
2012 Vajjah P, Isbister GK, Duffull SB, 'Introduction to pharmacokinetics in clinical toxicology', Methods in Molecular Biology, 929 289-312 (2012)

In clinical toxicology, a better understanding of the pharmacokinetics of the drugs may be useful in both risk assessment and formulating treatment guidelines for patients. Pharma... [more]

In clinical toxicology, a better understanding of the pharmacokinetics of the drugs may be useful in both risk assessment and formulating treatment guidelines for patients. Pharmacokinetics describes the time course of drug concentrations and is a driver for the time course of drug effects. In this chapter pharmacokinetics is described from a mathematical modeling perspective as applied to clinical toxicology. The pharmacokinetics of drugs are described using a combination of input and disposition (distribution and elimination) phases. A description of the time course of the input and disposition of drugs in overdose provides a basis for understanding the time course of effects of drugs in overdose. Relevant clinical toxicology examples are provided to explain various pharmacokinetic principles. Throughout this chapter we have taken a pragmatic approach to understanding and interpreting the time course of drug effects. © 2012 Springer Science+Business Media, LLC.

DOI 10.1007/978-1-62703-50-2_12
Citations Scopus - 2
2012 Barber CM, Isbister GK, Hodgson WC, 'Solving the 'Brown snake paradox': In vitro characterisation of Australasian snake presynaptic neurotoxin activity', Toxicology Letters, 210 318-323 (2012) [C1]
Citations Scopus - 16Web of Science - 14
2012 Chaisakul J, Isbister GK, Konstantakopoulos N, Tare M, Parkington HC, Hodgson WC, 'In vivo and in vitro cardiovascular effects of Papuan taipan (Oxyuranus scutellatus) venom: Exploring ' sudden collapse'', Toxicology Letters, 213 243-248 (2012) [C1]
Citations Scopus - 5Web of Science - 4
2012 Gulati A, Faed JM, Isbister GK, Duffull SB, 'Development and evaluation of a prototype of a novel clotting time test to monitor Enoxaparin', Pharmaceutical Research, 29 225-235 (2012) [C1]
Citations Scopus - 6Web of Science - 4
2012 Isbister GK, Prior F, Kilham HA, 'Restricting cough and cold medicines in children', Journal of Paediatrics and Child Health, 48 91-98 (2012) [C1]
Citations Scopus - 15Web of Science - 10
2012 Isbister GK, Brown SGA, 'Bites in Australian snake handlers-Australian snakebite project (ASP-15)', QJM, 105 1089-1095 (2012) [C1]
DOI 10.1093/qjmed/hcs132
Citations Scopus - 9Web of Science - 8
2012 Calver L, Isbister GK, 'Dexmedetomidine in the emergency department: Assessing safety and effectiveness in difficult-to-sedate acute behavioural disturbance', Emergency Medicine Journal, 29 915-918 (2012) [C1]
Citations Scopus - 2Web of Science - 2
2012 Berling I, Anscombe M, Isbister GK, 'Intravenous paracetamol toxicity in a malnourished child', Clinical Toxicology, 50 74-76 (2012) [C3]
Citations Scopus - 7Web of Science - 5
2012 Pycroft K, Fry BG, Isbister GK, Kuruppu S, Lawrence J, Smith AI, Hodgson WC, 'Toxinology of venoms from five Australian lesser known elapid snakes', Basic & Clinical Pharmacology & Toxicology, 111 268-274 (2012) [C1]
Citations Scopus - 6Web of Science - 6
2012 Calver L, Dunlop AJ, Isbister GK, 'Individual patient assessment of methadone-induced QT prolongation with digital holter recording', Journal of Addiction Medicine, 6 92-93 (2012) [C3]
Citations Scopus - 3Web of Science - 3
Co-authors Adrian Dunlop
2012 Isbister GK, Shahmy S, Mohamed F, Abeysinghe C, Karunathilake H, Ariaratnam A, 'A randomised controlled trial of two infusion rates to decrease reactions to Antivenom', PLOS One, 7 1-6 (2012) [C1]
Citations Scopus - 26Web of Science - 22
2012 Allen GE, Brown SGA, Buckley NA, O'Leary MA, Page CB, Currie BJ, et al., 'Clinical effects and antivenom dosing in brown snake (Pseudonaja spp.) envenoming: Australian Snakebite Project (ASP-14)', PLoS One, 7 e53188 (2012) [C1]
Citations Web of Science - 23
2012 Johnston CI, O'Leary MA, Brown SGA, Currie BJ, Halkidis L, Whitaker R, et al., 'Death Adder envenoming causes neurotoxicity not reversed by antivenom - Australian Snakebite Project (ASP-16)', PLoS Neglected Tropical Diseases, 6 1-8 (2012) [C1]
Citations Scopus - 10Web of Science - 9
2011 Isbister GK, Page CB, 'Early endoscopy or CT in caustic injuries: A re-evaluation of clinical practice', Clinical Toxicology, 49 641-642 (2011) [C3]
DOI 10.3109/15563650.2011.604035
Citations Scopus - 2Web of Science - 3
2011 Shen F, Coulter CV, Isbister GK, Duffull SB, 'A dosing regimen for immediate N-acetylcysteine treatment for acute paracetamol overdose', Clinical Toxicology, 49 643-647 (2011) [C1]
DOI 10.3109/15563650.2011.604034
Citations Scopus - 11Web of Science - 11
2011 Berling I, Isbister GK, Calver L, Clunas S, 'Digital Holter measurement of QT prolongation in ziprasidone overdose', Clinical Toxicology, 49 694-696 (2011) [C3]
DOI 10.3109/15563650.2011.597035
Citations Scopus - 5Web of Science - 6
2011 Coulter CV, Farquhar SE, McSherry CM, Isbister GK, Duffull SB, 'Methanol and ethylene glycol acute poisonings - Predictors of mortality', Clinical Toxicology, 49 900-906 (2011) [C1]
DOI 10.3109/15563650.2011.630320
Citations Scopus - 19Web of Science - 16
2011 Calver L, Stokes BJ, Isbister GK, 'Sedation assessment tool to score acute behavioural disturbance in the emergency department', Emergency Medicine Australasia, 23 732-740 (2011) [C1]
Citations Scopus - 8Web of Science - 8
2011 Maduwage K, Hodgson WC, Konstantakopoulos N, O'Leary MA, Gawarammana I, Isbister GK, 'The in vitro toxicity of venoms from South Asian hump-nosed pit vipers (Viperidae: Hypnale)', Journal of Venom Research, 2 17-23 (2011) [C1]
2011 Joy JP, Coulter CV, Duffull SB, Isbister GK, 'Prediction of Torsade de Pointes from the QT Interval: Analysis of a case series of Amisulpride overdoses', Clinical Pharmacology and Therapeutics, 90 243-245 (2011) [C1]
DOI 10.1038/clpt.2011.107
Citations Scopus - 11Web of Science - 8
2011 Page CB, Wilson PA, Foy A, Downes MA, Whyte IM, Isbister GK, 'Life-threatening hypokalaemia associated with ibuprofen-induced renal tubular acidosis', Medical Journal of Australia, 194 613-614 (2011) [C3]
Citations Scopus - 4Web of Science - 1
2011 Lane J, O'Leary MA, Isbister GK, 'Coagulant effects of black snake (Pseudechis spp.) venoms and in-vitro efficacy of commercial antivenom', Toxicon, 58 239-246 (2011) [C1]
Citations Scopus - 7Web of Science - 7
2011 Isbister GK, White J, Currie BJ, O'Leary MA, Brown SGA, 'Clinical effects and treatment of envenoming by Hoplocephalus spp. snakes in Australia: Australian Snakebite Project (ASP-12)', Toxicon, 58 634-640 (2011) [C1]
DOI 10.1016/j.toxicon.2011.09.013
Citations Scopus - 12Web of Science - 12
2011 Isbister GK, Fan HW, 'Spider bite', The Lancet, 378 2039-2047 (2011) [C1]
Citations Scopus - 32Web of Science - 27
2011 Kumar VVP, Isbister GK, Duffull SB, 'The effect of decontamination procedures on the pharmacodynamics of venlafaxine in overdose', British Journal of Clinical Pharmacology, 72 125-132 (2011) [C1]
DOI 10.1111/j.1365-2125.2011.03934.x
Citations Scopus - 8Web of Science - 8
2011 Casamento AJ, Isbister GK, 'Thrombotic microangiopathy in two tiger snake envenomations', Anaesthesia and Intensive Care, 39 1124-1127 (2011) [C3]
Citations Scopus - 6Web of Science - 5
2011 Coulter CV, Isbister GK, Duffull SB, 'The pharmacokinetics of methanol in the presence of ethanol: A case study', Clinical Pharmacokinetics, 50 245-251 (2011) [C1]
Citations Scopus - 6Web of Science - 5
2011 Isbister GK, Calver L, 'Managing aggressive and violent patients', Australian Prescriber, 34 National Prescribing Service (2011) [C3]
2011 Isbister GK, Calver L, 'Hyperferritinaemia without positive HFE gene mutation', Australian Prescriber, 34 166-167 (2011) [C3]
2011 Kalam Y, Isbister GK, Mirtschin P, Hodgson WC, Konstantakopoulos N, 'Validation of a cell-based assay to differentiate between the cytotoxic effects of elapid snake venoms', Journal of Pharmacological and Toxicological Methods, 63 137-142 (2011) [C1]
DOI 10.1016/j.vascn.2010.09.001
Citations Scopus - 10Web of Science - 7
2011 Isbister GK, Kumar VVP, 'Indications for single-dose activated charcoal administration in acute overdose', Current Opinion in Critical Care, 17 351-357 (2011) [C2]
DOI 10.1097/MCC.0b013e328348bf59
Citations Scopus - 14Web of Science - 12
2011 Saul ME, Thomas PA, Dosen PJ, Isbister GK, O'Leary MA, Whyte IM, et al., 'A pharmacological approach to first aid treatment for snakebite', Nature Medicine, 17 809-811 (2011) [C1]
DOI 10.1038/nm.2382
Citations Scopus - 19Web of Science - 18
Co-authors Sally Mcfadden, Dirk Vanhelden
2011 Buckley NA, Juurlink DN, Isbister GK, Bennett MH, Lavonas EJ, 'Hyperbaric oxygen for carbon monoxide poisoning', Cochrane Database of Systematic Reviews, - 41 (2011) [C1]
DOI 10.1002/14651858.CD002041.pub3
Citations Scopus - 20Web of Science - 34
2010 Isbister GK, 'Pharmacokinetic-pharmacodynamic modeling in overdose patients - Is it worth the trouble?', CLINICAL TOXICOLOGY, 48 896-897 (2010) [C1]
DOI 10.3109/15563650.2010.533680
Citations Scopus - 3Web of Science - 3
2010 Calver L, Downes M, Page C, Bryant JL, Isbister G, 'Randomised controlled trial of intramuscular droperidol versus midazolam for acute behavioural disturbance - The DORM study', INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, 19 A6-A6 (2010)
2010 Isbister GK, Scorgie FE, O'Leary MA, Seldon M, Brown SGA, Lincz L, 'Factor deficiencies in venom-induced consumption coagulopathy resulting from Australian elapid envenomation: Australian Snakebite Project (ASP-10)', Journal of Thrombosis and Haemostasis, 8 2504-2513 (2010) [C1]
DOI 10.1111/j.1538-7836.2010.04050.x
Citations Scopus - 26Web of Science - 24
Co-authors Lisa Lincz
2010 Ireland G, Brown SGA, Buckley NA, Stormer J, Currie BJ, White J, et al., 'Changes in serial laboratory test results in snakebite patients: When can we safely exclude envenoming?', Medical Journal of Australia, 193 285-290 (2010) [C1]
Citations Scopus - 11Web of Science - 10
2010 Churchman A, O'Leary MA, Buckley NA, Page CB, Tankel A, Gavaghan C, et al., 'Clinical effects of red-bellied black snake (Pseudechis porphyriacus) envenoming and correlation with venom concentrations: Australian Snakebite Project (ASP-11)', Medical Journal of Australia, 193 696-700 (2010) [C1]
Citations Scopus - 24Web of Science - 24
2010 Kulawickrama S, O'Leary MA, Hodgson WC, Brown SGA, Jacoby T, Davern K, Isbister GK, 'Development of a sensitive enzyme immunoassay for measuring taipan venom in serum', Toxicon, 55 1510-1518 (2010) [C1]
DOI 10.1016/j.toxicon.2010.03.003
Citations Scopus - 46Web of Science - 42
2010 Isbister GK, Woods D, Alley S, O'Leary MA, Seldon M, Lincz L, 'Endogenous thrombin potential as a novel method for the characterization of procoagulant snake venoms and the efficacy of antivenom', Toxicon, 56 75-85 (2010) [C1]
DOI 10.1016/j.toxicon.2010.03.013
Citations Scopus - 18Web of Science - 17
Co-authors Lisa Lincz
2010 Isbister GK, Halkidis L, O'Leary MA, Whitaker R, Cullen P, Mulcahy R, et al., 'Human anti-snake venom IgG antibodies in a previously bitten snake-handler, but no protection against local envenoming', Toxicon, 55 646-649 (2010) [C1]
DOI 10.1016/j.toxicon.2009.07.034
Citations Scopus - 8Web of Science - 7
2010 Isbister GK, 'Snakebite doesn't cause disseminated intravascular coagulation: Coagulopathy and thrombotic microangiopathy in snake envenoming', Seminars in Thrombosis and Hemostasis, 36 444-451 (2010) [C1]
DOI 10.1055/s-0030-1254053
Citations Scopus - 40Web of Science - 30
2010 Isbister GK, 'How do we use drug concentration data to improve the treatment of overdose patients?', Therapeutic Drug Monitoring, 32 300-304 (2010) [C1]
DOI 10.1097/FTD.0b013e3181dca280
Citations Scopus - 8Web of Science - 7
2010 Isbister GK, Calver L, Page CB, Stokes BJ, Bryant J, Downes MA, 'Randomized controlled trial of intramuscular droperidol versus midazolam for violence and acute behavioral disturbance: The DORM Study', Annals of Emergency Medicine, 56 392-401 (2010) [C1]
DOI 10.1016/j.annemergmed.2010.05.037
Citations Web of Science - 27
2010 Isbister GK, 'In reply', Annals of Emergency Medicine, 55 129-130 (2010) [C3]
2010 Isbister GK, O'Leary MA, Hagan J, Nichols KL, Jacoby T, Davern K, et al., 'Cross-neutralisation of Australian brown snake, taipan and death adder venoms by monovalent antibodies', Vaccine, 28 798-802 (2010) [C1]
DOI 10.1016/j.vaccine.2009.10.055
Citations Scopus - 20Web of Science - 18
Co-authors Jennifer Schneider
2010 Page CB, Calver L, Isbister GK, 'Risperidone overdose causes extrapyramidal effects but not cardiac toxicity', Journal of Clinical Psychopharmacology, 30 387-395 (2010) [C1]
DOI 10.1097/JCP.0b013e3181e5f7a5
Citations Scopus - 16Web of Science - 15
2010 Isbister GK, Balit CR, Macleod D, Duffull SB, 'Amisulpride overdose is frequently associated with QT prolongation and torsades de pointes', Journal of Clinical Psychopharmacology, 30 391-395 (2010) [C1]
DOI 10.1097/JCP.0b013e3181e5c14c
Citations Scopus - 24
2010 Isbister GK, 'Antivenom efficacy or effectiveness: The Australian experience', Toxicology, 268 148-154 (2010) [C1]
DOI 10.1016/j.tox.2009.09.013
Citations Scopus - 23Web of Science - 21
2010 Winter KL, Isbister GK, McGowan S, Konstantakopoulos N, Seymour JE, Hodgson WC, 'A pharmacological and biochemical examination of the geographical variation of Chironex fleckeri venom', Toxicology Letters, 192 419-424 (2010) [C1]
DOI 10.1016/j.toxlet.2009.11.019
Citations Scopus - 12Web of Science - 10
2010 O'Leary MA, Isbister GK, 'A turbidimetric assay for the measurement of clotting times of procoagulant venoms in plasma', Journal of Pharmacological and Toxicological Methods, 61 27-31 (2010) [C1]
DOI 10.1016/j.vascn.2009.06.004
Citations Scopus - 17Web of Science - 17
2010 Calver L, Downes MA, Page CB, Bryant J, Isbister GK, 'The impact of a standardised intramuscular sedation protocol for acute behavioural disturbance in the emergency department', BMC Emergency Medicine, 10 1-7 (2010) [C1]
DOI 10.1186/1471-227X-10-14
Citations Scopus - 9
2009 Hodgson WC, Isbister GK, 'The application of toxins and venoms to cardiovascular drug discovery', CURRENT OPINION IN PHARMACOLOGY, 9 173-176 (2009) [C3]
DOI 10.1016/j.coph.2008.11.007
Citations Scopus - 23Web of Science - 20
2009 Isbister GK, Calver L, Van Gorp F, Stokes BJ, Page CB, 'Inter-rater reliability of manual QT measurement and prediction of abnormal QT,HR pairs', Clinical Toxicology, 47 884-888 (2009) [C1]
DOI 10.3109/15563650903333820
Citations Scopus - 14Web of Science - 15
2009 Page CB, Hacket LP, Isbister GK, 'The Use of High-Dose insulin-glucose euglycemia in beta-blocker overdose: A case report', Journal of Medical Toxicology, 5 139-143 (2009) [C1]

The management of life-threatening beta-blocker toxicity and its associated low cardiac output state is clinically challenging. Previous case reports and case series describe the ... [more]

The management of life-threatening beta-blocker toxicity and its associated low cardiac output state is clinically challenging. Previous case reports and case series describe the use of hyperinsulinemia/euglycemia therapy in mono-ingestions of calcium channel blockers and mixed ingestions, including calcium channel and beta-blockers. In this case report we describe the use of high-dose insulin (10 IU/kg per hour) in a case of massive metoprolol ingestion (5 g) in which hypotension was unresponsive to conventional therapies. Although the metoprolol concentrations measured in plasma were approximately 100-200 times therapeutic concentrations, the pharmacokinetics appeared to be similar to therapeutic metoprolol dosing.

DOI 10.1007/BF03161225
Citations Scopus - 18
2009 Canale E, Isbister GK, Currie BJ, 'Investigating pressure bandaging for snakebite in a simulated setting: Bandage type, training and the effect of transport', EMERGENCY MEDICINE AUSTRALASIA, 21 184-190 (2009) [C1]
DOI 10.1111/j.1742-6723.2009.01180.x
Citations Scopus - 17Web of Science - 12
2009 Downes MA, Healy P, Page CB, Bryant J, Isbister GK, 'Structured team approach to the agitated patient in the emergency department', Emergency Medicine Australasia, 21 196-202 (2009) [C1]
DOI 10.1111/j.1742-6723.2009.01182.x
Citations Scopus - 22Web of Science - 18
2009 Loten C, Isbister GK, Jamcotchian MA, Hullick C, McElduff P, Attia JR, Marley J, 'Adverse outcomes following emergency department discharge of patients with possible acute coronary syndrome', Emergency Medicine Australasia, 21 455-464 (2009) [C1]
DOI 10.1111/j.1742-6723.2009.01229.x
Citations Scopus - 7Web of Science - 6
Co-authors John Attia
2009 Clunas S, Whitaker R, Ritchie N, Upton J, Isbister GK, 'Reviewing deaths in the emergency department: Deaths in the department or deaths within 48 h', Emergency Medicine Australasia, 21 117-123 (2009) [C1]
DOI 10.1111/j.1742-6723.2009.01166.x
Citations Scopus - 3Web of Science - 3
2009 Gildenhuys J, Lee M, Isbister GK, 'Does implementation of a paediatric asthma clinical practice guideline worksheet change clinical practice?', International Journal of Emergency Medicine, 2 33-39 (2009) [C1]
DOI 10.1007/s12245-008-0063-x
Citations Scopus - 12
2009 Isbister GK, Scorgie FE, Seldon MR, Lincz L, 'Clinical relevance of brown snake (Pseudonaja spp) factor V escaping hemostatic regulation', Blood, 114 2563 (2009) [C3]
DOI 10.1182/blood-2009-06-227306
Citations Scopus - 1
Co-authors Lisa Lincz
2009 Wajima T, Isbister GK, Duffull SB, 'A comprehensive model for the humoral coagulation network in humans', Clinical Pharmacology & Therapeutics, 86 290-298 (2009) [C1]
DOI 10.1038/clpt.2009.87
Citations Scopus - 31Web of Science - 24
2009 Kumar VVP, Oscarsson S, Friberg LE, Isbister GK, Hackett LP, Duffull SB, 'The effect of decontamination procedures on the pharmacokinetics of venlafaxine in overdose', Clinical Pharmacology and Therapeutics, 86 403-410 (2009) [C1]
DOI 10.1038/clpt.2009.114
2009 Gan M, O'Leary MA, Brown SGA, Jacoby T, Spain D, Tankel A, et al., 'Envenoming by the rough-scaled snake (Tropidechis carinatus): a series of confirmed cases', MEDICAL JOURNAL OF AUSTRALIA, 191 183-186 (2009) [C1]
Citations Scopus - 14Web of Science - 14
2009 Calver LA, Stokes BJ, Isbister GK, 'The dark side of the moon', Medical Journal of Australia, 191 692-694 (2009) [C1]
Citations Scopus - 6Web of Science - 4
2009 O'Leary MA, Kornhauser RS, Hodgson WC, Isbister GK, 'An examination of the activity of expired and mistreated commercial Australian antivenoms', TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, 103 937-942 (2009) [C1]
DOI 10.1016/j.trstmh.2008.11.011
Citations Scopus - 8Web of Science - 6
2009 O'Leary MA, Isbister GK, 'Commercial monovalent antivenoms in Australia are polyvalent', Toxicon, 54 192-195 (2009) [C1]
DOI 10.1016/j.toxicon.2009.04.004
Citations Scopus - 20Web of Science - 18
2009 Konstantakopoulos N, Isbister GK, Seymour JE, Hodgson WC, 'A cell-based assay for screening of antidotes to, and antivenom against Chironex fleckeri (box jellyfish) venom', Journal of Pharmacological and Toxicological Methods, 59 166-170 (2009) [C1]
DOI 10.1016/j.vascn.2009.02.003
Citations Scopus - 19
2009 Stone SF, Cotterell C, Isbister GK, Holdgate A, Brown SGA, Emergency Department Anaphylaxis Investigators, 'Elevated serum cytokines during human anaphylaxis: Identification of potential mediators of acute allergic reactions', Journal of Allergy and Clinical Immunology, 124 786-792 (2009) [C1]
DOI 10.1016/j.jaci.2009.07.055
Citations Scopus - 51Web of Science - 47
2009 Isbister GK, 'Procoagulant Snake Toxins: Laboratory Studies, Diagnosis, and Understanding Snakebite Coagulopathy', SEMINARS IN THROMBOSIS AND HEMOSTASIS, 35 93-103 (2009) [C1]
DOI 10.1055/s-0029-1214152
Citations Scopus - 36Web of Science - 33
2009 Van Gorp F, Whyte IM, Isbister GK, 'Clinical and ECG effects of escitalopram overdose', Annals of Emergency Medicine, 54 404-408 (2009) [C1]
DOI 10.1016/j.annemergmed.2009.04.016
Citations Scopus - 29Web of Science - 27
2009 Isbister GK, Duffull SB, 'Quetiapine overdose: Predicting intubation, duration of ventilation, cardiac monitoring and the effect of activated charcoal', International Clinical Psychopharmacology, 24 174-180 (2009) [C1]
DOI 10.1097/yic.0b013e32832bb078
Citations Scopus - 23Web of Science - 22
2009 Isbister GK, 'Electrocardiogram changes and arrhythmias in venlafaxine overdose', British Journal of Clinical Pharmacology, 67 572-576 (2009) [C1]
DOI 10.1111/j.1365-2125.2009.03382.x
Citations Scopus - 27Web of Science - 25
2009 Brown SGA, Caruso N, Borland ML, McCoubrie DL, Celenza A, Isbister GK, 'Clotting factor replacement and recovery from snake venom-induced consumptive coagulopathy', INTENSIVE CARE MEDICINE, 35 1532-1538 (2009) [C1]
DOI 10.1007/s00134-009-1556-7
Citations Scopus - 18Web of Science - 12
2009 Winter KL, Isbister GK, Jacoby T, Seymour JE, Hodgson WC, 'An in vivo comparison of the efficacy of CSL box jellyfish antivenom with antibodies raised against nematocyst-derived Chironex fleckeri venom', TOXICOLOGY LETTERS, 187 94-98 (2009) [C1]
DOI 10.1016/j.toxlet.2009.02.008
Citations Scopus - 12Web of Science - 12
2009 Isbister GK, 'Commentary: Treating redback spider envenoming - the evidence, the interpretation and current thinking', JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 45 477-477 (2009) [C3]
2009 Page CB, Duffull SB, Whyte IM, Isbister GK, 'Promethazine overdose: Clinical effects, predicting delirium and the effect of charcoal', QJM - An International Journal of Medicine, 102 123-131 (2009) [C1]
DOI 10.1093/qjmed/hcn153
Citations Scopus - 17Web of Science - 15
2009 Isbister GK, Duffull SB, Brown SGA, 'Failure of antivenom to improve recovery in Australian snakebite coagulopathy', QJM-AN INTERNATIONAL JOURNAL OF MEDICINE, 102 563-568 (2009) [C1]
DOI 10.1093/qjmed/hcp081
Citations Scopus - 37Web of Science - 29
2008 Kuruppu S, Smith AI, Isbister GK, Hodgson WC, 'Neurotoxins from Australo-Papuan elapids: A biochemical and pharmacological perspective', CRITICAL REVIEWS IN TOXICOLOGY, 38 73-86 (2008) [C3]
DOI 10.1080/10408440701703964
Citations Scopus - 19Web of Science - 19
2008 Isbister GK, Brown SGA, Miller M, Tankel A, MacDonald E, Stokes BJ, et al., 'A randomised controlled trial of intramuscular vs. intravenous antivenom for latrodectism: The RAVE study', QJM, 101 557-565 (2008) [C1]
DOI 10.1093/qjmed/hcn048
Citations Scopus - 17Web of Science - 17
2008 Page C, Isbister G, 'Dolasetron and QT interval', EMERGENCY MEDICINE JOURNAL, 25 706-706 (2008) [C3]
Citations Scopus - 1
2008 Knott JC, Isbister GK, 'Sedation of agitated patients in the emergency department', EMERGENCY MEDICINE AUSTRALASIA, 20 97-100 (2008) [C3]
DOI 10.1111/j.1742-6723.2008.01063.x
Citations Scopus - 9Web of Science - 7
2008 Currie BJ, Canale E, Isbister GK, 'Effectiveness of pressure-immobilization first aid for snakebite requires further study', EMERGENCY MEDICINE AUSTRALASIA, 20 267-270 (2008) [C1]
DOI 10.1111/j.1742-6723.2008.01093.x
Citations Scopus - 10Web of Science - 11
2008 Chan AS, Isbister GK, Kirkpatrick CM, Duffull SB, 'Assessing risk of a prolonged QT interval-a survey of emergency physicians.', International journal of emergency medicine, 1 35-41 (2008) [C2]
2008 Isbister GK, Burns J, Prior F, Ouvrier RA, 'Safety of nitrous oxide administration in patients with Charcot-Marie-Tooth disease', JOURNAL OF THE NEUROLOGICAL SCIENCES, 268 160-162 (2008) [C1]
DOI 10.1016/j.jns.2007.12.004
Citations Scopus - 3Web of Science - 1
2008 Isbister GK, Brown SG, MacDonald E, White J, Currie BJ, 'Current use of Australian snake antivenoms and frequency of immediate-type hypersensitivity reactions and anaphylaxis', MEDICAL JOURNAL OF AUSTRALIA, 188 473-476 (2008) [C1]
Citations Scopus - 56Web of Science - 47
2008 Herzig V, Khalife AA, Chong Y, Isbister GK, Currie BJ, Churchill TB, et al., 'Intersexual variations in Northern (Missulena pruinosa) and Eastern (M-bradleyi) mouse spider venom', TOXICON, 51 1167-1177 (2008) [C1]
DOI 10.1016/j.toxicon.2008.02.001
Citations Scopus - 15Web of Science - 17
2008 Tanos PP, Isbister GK, Lalloo DG, Kirkpatrick CMJ, Duffull SB, 'A model for venom-induced consumptive coagulopathy in snake bite', TOXICON, 52 769-780 (2008) [C1]
DOI 10.1016/j.toxicon.2008.08.013
Citations Scopus - 23Web of Science - 20
2008 Vetter RS, Isbister GK, 'Medical aspects of spider bites', ANNUAL REVIEW OF ENTOMOLOGY, 53 409-429 (2008) [C3]
DOI 10.1146/annurev.ento.53.103106.093503
Citations Scopus - 66Web of Science - 51
2008 Dowling J, Isbister GK, Kirkpatrick CMJ, Naidoo D, Graudins A, 'Population pharmacokinetics of intravenous, intramuscular, and intranasal naloxone in human volunteers', THERAPEUTIC DRUG MONITORING, 30 490-496 (2008) [C1]
Citations Scopus - 24Web of Science - 21
2008 Downes M, Page C, Isbister G, 'Response to "Use of Lipid Emulsion in the Resuscitation of a Patient With Prolonged Cardiovascular Collapse After Overdose of Bupropion and Lamotrigine"', ANNALS OF EMERGENCY MEDICINE, 51 794-795 (2008) [C3]
DOI 10.1016/i.annemergmed.2007.11.042
Citations Scopus - 6Web of Science - 3
2008 Isbister GK, Stokes BJ, Buckle NA, Duffull SB, 'Effect of activated charcoal on citalopram-induced QT prolongation - Reply', Annals of Emergency Medicine, 52 87-88 (2008) [C3]
DOI 10.1016/j.annemergmed.2007.11.046
2008 Isbister GK, O'Leary M, Miller MK, Brown SGA, Ramasamy S, James R, Schneider JJ, 'A comparison of serum antivenom concentrations after intravenous and intramuscular administration of redback (widow) spider antivenom', British Journal of Clinical Pharmacology, 65 139-143 (2008) [C1]
DOI 10.1111/j.1365-2125.2007.03004.x
Citations Scopus - 17Web of Science - 14
Co-authors Jennifer Schneider
2008 Isbister G, 'Marine animal injuries - Dr Geoffrey Isbister, comments', AUSTRALIAN PRESCRIBER, 31 32-32 (2008) [C3]
2008 Winter KL, Isbister GK, Schneider JJ, Konstantakopoulos N, Seymour JE, Hodgson WC, 'An examination of the cardiovascular effects of an 'Irukandji' jellyfish, Alatina nr mordens', Toxicology Letters, 179 118-123 (2008) [C1]
DOI 10.1016/j.toxlet.2008.04.011
Citations Scopus - 20Web of Science - 18
Co-authors Jennifer Schneider
2007 Isbister GK, 'Managing injuries by venomous sea creatures in Australia', Australian Prescriber, 30 117-121 (2007)

Marine injuries or stings are common, but the majority cause only minor effects and do not require medical intervention. Injuries from venomous marine creatures can be divided int... [more]

Marine injuries or stings are common, but the majority cause only minor effects and do not require medical intervention. Injuries from venomous marine creatures can be divided into jellyfish stings due to contact with nematocysts, and penetrating injuries from spiny fish, stingrays and sea urchins. Box jellyfish are the most dangerous and may cause severe and potentially life-threatening effects. First aid for jellyfish stings includes removal of the tentacles, and hot water immersion for bluebottles or vinegar for major box jellyfish. In addition to vinegar, major box jellyfish stings are treated with analgesia and local dressings. Early resuscitation is required in the rare severe cases. Irukandji syndrome causes severe generalised pain associated with autonomic effects with little local pain or reaction. Treatment is symptomatic but may require large amounts of analgesia. Spiny fish and stingrays cause a combination of traumatic injury and venom-mediated effects. First aid is hot water immersion and treatment includes analgesia, thorough wound cleaning and regular review for secondary infection. Stingray injuries can be associated with significant trauma and sometimes result in penetrating abdominal or thoracic injury.

Citations Scopus - 1
2007 Isbister GK, Friberg LE, Duffull SB, 'Reply to Dr. Megarbane et al. regarding "Pharmacokinetic/pharmacodynamic modelling of cardiac toxicity in venlafaxine overdose"', INTENSIVE CARE MEDICINE, 33 197-197 (2007)
DOI 10.1007/s00134-006-0418-9
Citations Web of Science - 1
2007 Isbister GK, Friberg LE, Duffull SB, 'Application of pharmacokinetic-pharmacodynamic modeling in management of QT abnormalities after citalopram overdose. Reply to A. Manini', INTENSIVE CARE MEDICINE, 33 739-739 (2007)
DOI 10.1007/s00134-006-0506-x
2007 Winter KL, Fernando R, Ramasamy S, Seymour JE, Isbister GK, Hodgson WC, 'The in vitro vascular effects of two chirodropid (Chironex fleckeri and Chiropsella bronzie) venoms', TOXICOLOGY LETTERS, 168 13-20 (2007)
DOI 10.1016/j.toxlet.2006.10.011
Citations Scopus - 23Web of Science - 23
2007 Balit CR, Gilmore SP, Isbister GK, 'Unintentional paediatric ingestions of angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists', JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 43 686-688 (2007)
DOI 10.1111/j.1440-1754.2007.01188.x
Citations Scopus - 3Web of Science - 5
2007 Ramjan KA, Williams AJ, Isbister GK, Elliott EJ, ''Red as a beet and blind as a bat' Anticholinergic delirium in adolescents: Lessons for the paediatrician', JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 43 779-780 (2007)
DOI 10.1111/j.1440-1754.2007.01220.x
Citations Scopus - 5Web of Science - 4
2007 Isbister GK, Little M, Cull G, McCoubrie D, Lawton P, Szabo F, et al., 'Thrombotic microangiopathy from Australian brown snake (Pseudonaia) envenoming', INTERNAL MEDICINE JOURNAL, 37 523-528 (2007)
DOI 10.1111/j.1445-5994.2007.01407.x
Citations Scopus - 27Web of Science - 22
2007 Isbister GK, 'Safety of i.v. administration of redback spider antivenom', INTERNAL MEDICINE JOURNAL, 37 820-U1 (2007)
DOI 10.1111/j.1445-5994.2007.01513.x
Citations Scopus - 6Web of Science - 6
2007 Chan A, Isbister GK, Kirkpatrick CMJ, Dufful SB, 'Drug-induced QT prolongation and torsades de pointes: evaluation of a QT nomogram', QJM-AN INTERNATIONAL JOURNAL OF MEDICINE, 100 609-615 (2007)
DOI 10.1093/qjmed/hcm072
Citations Scopus - 81Web of Science - 76
2007 Isbister GK, Mills K, Friberg LE, Hodge M, O'Connor E, Patel R, et al., 'Human methyl parathion poisoning', CLINICAL TOXICOLOGY, 45 956-960 (2007)
DOI 10.1080/15563650701232745
Citations Scopus - 11Web of Science - 8
2007 Isbister GK, Friberg LE, Hackett LP, Duffull SB, 'Pharmacokinetics of quetiapine in overdose and the effect of activated charcoal', CLINICAL PHARMACOLOGY & THERAPEUTICS, 81 821-827 (2007)
DOI 10.1038/sj.clpt.6100193
Citations Scopus - 33Web of Science - 33
2007 Jansen M, McLeod MG, White J, Isbister GK, 'Spotted black snake (Pseudechis guttatus) envenoming', Medical Journal of Australia, 186 41-42 (2007) [C1]
Citations Scopus - 4Web of Science - 3
2007 Isbister GK, Buckley NA, Whyte IM, 'Serotonin toxicity: a practical approach to diagnosis and treatment', Medical Journal of Australia, 187 361-365 (2007) [C1]
Citations Scopus - 107Web of Science - 69
2007 Brown SGA, Isbister GK, Stokes BJ, 'Route of administration of redback spider bite antivenom: Determining clinician beliefs to facilitate Bayesian analysis of a clinical trial', EMA - Emergency Medicine Australasia, 19 458-463 (2007) [C1]
DOI 10.1111/j.1742-6723.2007.01014.x
Citations Scopus - 2Web of Science - 3
2007 Winter KL, Isbister GK, Seymour JE, Hodgson WC, 'An in vivo examination of the stability of venom from the Australian box jellyfish Chironex fleckeri', TOXICON, 49 804-809 (2007)
DOI 10.1016/j.toxicon.2006.11.031
Citations Scopus - 17Web of Science - 17
2007 Isbister G, O'Leary M, Schneider JJ, Brown S, Currie B, 'Efficacy of antivenom against the procoagulant effect of Australian brown snake (Pseudonaja sp.) venom: In vivo and in vitro studies', Toxicon, 49 57-67 (2007) [C1]
DOI 10.1016/j.toxicon.2006.09.007
Citations Scopus - 30Web of Science - 27
Co-authors Jennifer Schneider
2007 O'Leary MA, Schneider JJ, Krishnan BP, Lavis C, McKendry A, Ong LK, Isbister GK, 'Cross-neutralisation of Australian brown and tiger snake venoms with commercial antivenoms: Cross-reactivity or antivenom mixtures?', Toxicon, 50 206-213 (2007) [C1]
DOI 10.1016/j.toxicon.2007.03.014
Citations Scopus - 17Web of Science - 12
Co-authors Jennifer Schneider, Linkooi Ong
2007 Isbister GK, Friberg LE, Stokes BJ, Buckley NA, Lee C, Gunja N, et al., 'Activated Charcoal Decreases the Risk of QT Prolongation After Citalopram Overdose', Annals of Emergency Medicine, 50 593.e46-600.e46 (2007) [C1]
DOI 10.1016/j.annemergmed.2007.03.009
Citations Scopus - 27Web of Science - 24
2007 Morgan M, Hackett LP, Isbister GK, 'Olanzapine overdose: a series of analytically confirmed cases', International Clinical Psychopharmacology, 22 183-186 (2007) [C1]
DOI 10.1097/YIC.0b013e32805aedf5
Citations Scopus - 18Web of Science - 17
2006 Isbister GK, Tankel AS, White J, Little M, Brown SGA, Spain DJ, et al., 'High rate of immediate systemic hypersensitivity reactions to tiger snake antivenom', MEDICAL JOURNAL OF AUSTRALIA, 184 419-420 (2006)
Citations Scopus - 4Web of Science - 4
2006 Isbister GK, Murray L, John S, Hackett LP, Haider T, O'Mullane P, et al., 'Amisulpride deliberate self-poisoning causing severe cardiac toxicity including QT prolongation and torsades de pointes', MEDICAL JOURNAL OF AUSTRALIA, 184 354-356 (2006)
Citations Scopus - 21Web of Science - 18
2006 Loten C, Stokes BJ, Worsley D, Seymour JE, Jiang S, Isbister GK, 'Randomised controlled trial of hot water (45 degrees C) immersion versus ice packs for pain relief in bluebottle stings', Medical Journal of Australia, 184 329-333 (2006) [C1]
Citations Scopus - 58Web of Science - 49
2006 Isbister GK, Williams V, Brown SGA, White J, Currie B, 'Clinically applicable laboratory end-points for treating snakebite coagulopathy', Pathology, 38 568-672 (2006) [C1]
DOI 10.1080/00313020601024045
Citations Scopus - 16Web of Science - 15
2006 Vetter RS, Isbister GK, 'Verified bites by the woodlouse spider, Dysdera crocata', TOXICON, 47 826-829 (2006)
DOI 10.1016/j.toxicon.2006.02.002
Citations Scopus - 5Web of Science - 6
2006 O'Leary MA, Isbister GK, Schneider JJ, Brown SGA, Currie BJ, 'Enzyme immunoassays in brown snake (Pseudonaja spp.) envenoming: Detecting venom, antivenom and venom-antivenom complexes', Toxicon, 48 4-11 (2006) [C1]
DOI 10.1016/j.toxicon.2006.04.001
Citations Scopus - 32Web of Science - 30
Co-authors Jennifer Schneider
2006 Friberg LE, Isbister GK, Duffull SB, 'Pharmacokinetic Pharmacodynamic Modelling of QT Interval Prolongation following Citalopram Overdoses', British Journal of Clinical Pharmacology, 61 177-190 (2006) [C1]
DOI 10.1111/j.1365-2125.2005.02546.x
Citations Scopus - 55Web of Science - 51
2006 Isbister GK, 'Snake bite: A current approach to management', Australian Prescriber, 29 125-129 (2006)

Snake envenoming is uncommon but potentially life-threatening. It is characterised by systemic effects including coagulopathy, neurotoxicity, myotoxicity and renal impairment. Pre... [more]

Snake envenoming is uncommon but potentially life-threatening. It is characterised by systemic effects including coagulopathy, neurotoxicity, myotoxicity and renal impairment. Pressure immobilisation bandaging is safe and appears to be effective first aid if applied correctly soon after the bite. Each Australian snake causes a characteristic clinical syndrome which can be used with information about the geographical distribution of snakes to determine which snake is involved when a patient is envenomed. Snake venom detection kits are available to help identify the causative snake. Antivenoms are available for the five major groups of snakes and are the mainstay of therapy in patients with systemic envenoming. Antivenom should be administered by slow intravenous infusion in a critical care area. Serious adverse reactions to antivenoms are uncommon.

Citations Scopus - 11
2006 Isbister GK, 'Spider bite: A current approach to management', Australian Prescriber, 29 156-158 (2006)

Although spider bite is common, most spider bites cause minor effects and do not require treatment. More significant effects result from redback and, less commonly, from funnel-we... [more]

Although spider bite is common, most spider bites cause minor effects and do not require treatment. More significant effects result from redback and, less commonly, from funnel-web spider bites. Redback spider envenoming causes local, radiating and regional pain, sometimes associated with local or regional diaphoresis, non-specific systemic features, and less commonly, other autonomic or neurological effects. Antivenom is recommended for severe or persistent pain and systemic effects. Funnel-web spider envenoming can rapidly cause life-threatening effects, but it can be treated effectively with antivenom. Envenoming is characterised by excessive autonomic activity, neuromuscular excitation and pulmonary oedema. Clinical effects attributed to suspected spider bites such as ulcers, should be thoroughly investigated for other causes including infectious, inflammatory, vascular and neoplastic conditions.

Citations Scopus - 2
2006 Isbister GK, Friberg LE, Duffull SB, 'Application of pharmacokinetic-pharmacodynamic modelling in management of QT abnormalities after citalopram overdose', Intensive Care Medicine, 32 1060-1065 (2006) [C1]
DOI 10.1007/s00134-006-0183-9
Citations Scopus - 33Web of Science - 29
2006 Balit CR, Lynch AM, Gilmore SP, Murray L, Isbister GK, 'Lignocaine and chlorhexidine toxicity in children resulting from mouth paint ingestion: a bottling problem', Journal of Paediatrics and Child Health, 42 350-353 (2006) [C1]
DOI 10.1111/j.1440-1754.2006.00871.x
Citations Scopus - 10Web of Science - 10
2006 Isbister GK, Hooper MR, Dowsett R, Maw G, Murray L, White J, 'Collett''s Snake (Pseudechis colletti) envenoming in snake handlers', QJM: an international journal of medicine, 99 109-115 (2006) [C1]
DOI 10.1093/qjmed/hcl007
Citations Scopus - 18Web of Science - 19
2006 Sibbritt DW, Isbister GK, Walker RJ, 'Emergency department performance indicators that encompass the patient journey', Quality Management in Health Care, 15 27-38 (2006) [C2]
Citations Scopus - 15
2006 Seifert SA, Keyler D, Isbister G, McNally J, Martin TG, 'ACMT Position Statement: Institutions housing venomous animals.', Journal of medical toxicology : official journal of the American College of Medical Toxicology, 2 118-119 (2006)
Citations Scopus - 3
2006 Isbister GK, 'Clinical trials in toxinology: More than a discussion between friends?', EMA - Emergency Medicine Australasia, 18 4-6 (2006)
DOI 10.1111/j.1742-6723.2006.00797.x
Citations Scopus - 2
2006 Leung NY, Whyte IM, Isbister GK, 'Baclofen overdose: Defining the spectrum of toxicity', EMA - Emergency Medicine Australasia, 18 77-82 (2006) [C1]
DOI 10.1111/j.1742-6723.2006.00805.x
Citations Scopus - 39
2006 Vetter RS, Isbister GK, Bush SP, Boutin LJ, 'Verified Bites By Yellow Sac Spiders (Genus Cheiracanthium) In The United States And Australia: Where Is The Necrosis?', American Journal of Tropical Medicine and Hygiene, 74 1043-1048 (2006) [C1]
Citations Scopus - 19Web of Science - 14
2005 Friberg LE, Isbister GK, Hackett LP, Duffull SB, 'The Population Pharmacokinetics of Citalopram after Deliberate Self-Poisoning: a Bayesian approach', Journal of Pharmacokinetics and Pharmacodynamics, 32 571-605 (2005) [C1]
DOI 10.1007/s10928-005-0022-6
Citations Scopus - 44Web of Science - 38
2005 Isbister GK, Balit CR, Kilham HA, 'Antipsychotic poisoning in young children: A systematic review', Drug Safety, 28 1029-1044 (2005)

The aim of this review was to determine the spectrum and severity of effects of unintentional antipsychotic poisoning in children. A computerised literature search of MEDLINE (196... [more]

The aim of this review was to determine the spectrum and severity of effects of unintentional antipsychotic poisoning in children. A computerised literature search of MEDLINE (1966 to February 2005) and EMBASE (1980 to February 2005) was undertaken. The Internet was searched using URL: www.google.com. The proceedings of the North American Congress of Clinical Toxicology (NACCT) and the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) were hand searched. All cases of unintentional antipsychotic (all classes) poisoning in children aged 0-6 years were included. The data extracted included the age, weight, antipsychotic, dose, clinical effects, treatment and outcomes. The toxic dose was estimated as the lowest dose causing objective adverse effects. Sixty-eight reports were identified. Few contained all of the required information. Most of the case series included multiple antipsychotics with limited information on individual drugs or all ages with limited paediatric information. For most antipsychotics the ingestion of one tablet caused symptoms that were sometimes severe and usually lasted from 1 to 3 days. Extrapyramidal symptoms (EPS) were often delayed for up to 12-24 hours. Chlorpromazine caused CNS depression, hypotension and miosis; EPS and cardiac effects were rare, and the toxic dose was estimated to be 15 mg/kg. Haloperidol caused drowsiness (rarely coma) and over one-half of patients had neuromuscular effects (mainly EPS), with a toxic dose estimated at 0.15 mg/kg. Thioridazine caused CNS depression and potentially cardiac effects, with a toxic dose of 1.4 mg/kg. Atypical antipsychotics caused significant CNS depression (except risperidone); EPS were less common. Toxic doses were clozapine 2.5 mg/kg, olanzapine 0.5 mg/kg and aripiprazole 3 mg/kg. EPS responded to anticholinergic drug treatment. In summary, unintentional antipsychotic ingestion in children can cause severe effects that last 1-3 days, often with one tablet. Children potentially ingesting a toxic dose or who are symptomatic should be considered for assessment in hospital. Most cases resolve with good supportive care. Toxic doses are only estimates that are based on limited data and should be used with caution until prospective studies are undertaken. © 2005 Adis Data Information BV. All rights reserved.

DOI 10.2165/00002018-200528110-00004
Citations Scopus - 16
2005 Isbister GK, White J, Currie BJ, Bush SP, Vetter RS, Warrell DA, 'Spider bites: Addressing mythology and poor evidence (letter)', American Journal of Tropical Medicine and Hygiene, 72 361-364 (2005) [C3]
Citations Scopus - 10Web of Science - 6
2005 Kuruppu S, Isbister GK, Hodgson WC, 'Phospholipase A2 dependent effects of the venom from the New Guinean small-eyed snake Micropechis ikaheka', Muscle and Nerve, 32 81-87 (2005) [C1]
DOI 10.1002/mus.20334
Citations Scopus - 4
2005 Isbister GK, Vetter RS, 'Loxoscelism and necrotic arachnidism: More myths and minor corrections (letter)', Annals of Emergency Medicine, 46 205-206 (2005) [C3]
Citations Scopus - 2Web of Science - 1
2005 Isbister GK, Buckley NA, 'The pathophysiology of serotonin toxicity in animals and humans - Implications for diagnosis and treatment', Clinical Neuropharmacology, 28 205-214 (2005) [C1]
Citations Scopus - 106Web of Science - 83
2005 Isbister GK, Seymour JS, Hodgson WC, 'The in Vivo Cardiovascular effects of the Lrukandji Jellyfish (Carukia barnesi) Nematocyst Venom and a Tentacle Extract in rats', Toxicology Letters, 155 135-141 (2005) [C1]
DOI 10.1016/j.toxlet.2004.09.004
Citations Scopus - 47Web of Science - 41
2005 Ramasamy S, Isbister GK, Seymour JS, Hodgson WC, 'Pharmacologically Distinct Cardiovascular Effects of Box Jellyfish (Chironex fleckeri) Venom and a Tentacle-only extract in rats', Toxicology Letters, 155 219-226 (2005) [C1]
DOI 10.1016/j.toxlet.2004.09.018
Citations Scopus - 42Web of Science - 41
2005 Kiernan MC, Isbister GK, Lin CSY, Burke D, Bostock H, 'Acute tetrodotoxin-induced neurotoxicity after ingestion of puffer fish', Annals of Neurology, 57 339-348 (2005) [C1]
DOI 10.1002/ana.20395
Citations Scopus - 106Web of Science - 94
2005 Thom SR, Buckley NA, Isbister GK, Juurlink DN, 'Hyperbaric oxygen therapy for carbon monoxide poisoning', Toxicological Reviews, 24 157-160 (2005)
DOI 10.2165/00139709-200524030-00006
Citations Scopus - 4
2005 Buckley NA, Isbister GK, Stokes BJ, Juurlink DN, 'Hyperbaric oxygen for carbon monoxide poisoning: A systematic review and critical analysis of the evidence', Toxicological Reviews, 24 75-92 (2005) [C1]
DOI 10.2165/00139709-200524020-00002
Citations Scopus - 57
2005 Isbister GK, Gray MR, Balit CR, Raven RJ, Stokes BJ, Porges K, et al., 'Funnel-web spider bite: a systematic review of recorded clinical cases', Medical Journal of Australia, 182 407-411 (2005) [C1]
Citations Scopus - 22Web of Science - 16
2005 Downes MA, Whyte IM, Isbister GK, 'QTc abnormalities in deliberate self-poisoning with moclobemide', Internal Medicine Journal, 35 388-391 (2005) [C1]
DOI 10.1111/j.1445-5994.2005.00850.x
Citations Scopus - 5Web of Science - 3
2005 Isbister GK, 'Snake antivenom research: the importance of case definition', EMERGENCY MEDICINE JOURNAL, 22 399-400 (2005)
DOI 10.1136/emj.2004.022251
Citations Scopus - 5Web of Science - 6
2005 Isbister GK, Kiernan MC, 'Neurotoxic Marine Poisoning', Lancet Neurology, 4 219-228 (2005) [C1]
DOI 10.1016/S1474-4422(05)70041-7
Citations Scopus - 116Web of Science - 82
2005 Gosselin S, Isbister GK, 'Re: Treatment of accidental intrathecal methotrexate overdose', JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 97 609-610 (2005)
DOI 10.1093/jnci/dji108
Citations Scopus - 3Web of Science - 2
2005 Little M, Isbister G, 'Big black spider bite from the desert region of Western Australia [3] (multiple letters)', EMA - Emergency Medicine Australasia, 17 181-183 (2005)
2005 Isbister GK, Buckley NA, 'Clomipramine and neuroleptic malignant syndrome - Literature on adverse reactions to psychotropic drugs continues to confuse', BMJ-BRITISH MEDICAL JOURNAL, 330 790-791 (2005)
DOI 10.1136/bmj.330.7494.790-c
Citations Scopus - 4Web of Science - 4
2005 Isbister GK, Hooper J, 'Clinical effects of stings by sponges of the genus Tedania and a review of sponge stings worldwide', Toxicon, 46 782-785 (2005) [C1]
DOI 10.1016/j.toxicon.2005.08.009
Citations Scopus - 10Web of Science - 9
2005 Ramasamy S, Isbister GK, Seymour JS, Hodgson WC, 'The In Vivo Cardiovascular Effects of an Australasian Box Jellyfish (Chiropsalmus sp.) Venom in Rats', Toxicon, 45 321-327 (2005) [C1]
DOI 10.1016/j.toxicon.2004.11.002
Citations Scopus - 19Web of Science - 18
2004 Isbister GK, 'Sublingual glyceryl trinitrate as prehospital treatment for hypertension in Irukandji syndrome', MEDICAL JOURNAL OF AUSTRALIA, 180 483-483 (2004)
Citations Scopus - 2Web of Science - 1
2004 Isbister GK, 'Mouse spider bites (Missulena spp.) and their medical importance', MJA, 180 225-227 (2004) [C1]
Citations Scopus - 14Web of Science - 10
2004 Isbister GK, 'Antivenom, anecdotes and evidence', MJA, 181 685-686 (2004) [C1]
Citations Scopus - 4Web of Science - 4
2004 Isbister GK, Ramasamy S, Seymour JE, Hodgson WC, 'Verapamil treatment in severe Chironex fleckeri stings - Reply', TOXICON, 44 819-820 (2004)
DOI 10.1016/j.toxicon.2004.08.014
2004 Burnett JW, Calton GJ, Isbister GK, Ramasamy S, Seymour JE, Hodgson WC, 'The case for verapamil use in alarming jellyfish stings remains (multiple letters)', Toxicon, 44 817-820 (2004)
DOI 10.1016/j.toxicon.2004.08.003
Citations Scopus - 4
2004 O'Leary MA, Schneider JJ, Isbister GK, 'Use of high performance liquid chromatography to measure tetrodotoxin in serum and urine of poisoned patients', Toxicon, 44 549-553 (2004) [C1]
DOI 10.1016/j.toxicon.2004.07.008
Citations Scopus - 46Web of Science - 43
Co-authors Jennifer Schneider
2004 Ramasamy S, Isbister GK, Seymour JE, Hodgson WC, 'The in vivo cardiovascular effects of box jellyfish Chironex fleckeri venom in rats: efficiacy of pre-treatment with antivenom, verapamil and magnesium sulphate', Toxicon, 34 685-690 (2004) [C1]
DOI 10.1016/j.toxicon.2004.02.024
Citations Scopus - 48Web of Science - 46
2004 Isbister GK, Whaite J, 'Clinical consequences of spider bites: recent advances in our understanding', Toxicon, 43 477-492 (2004) [C1]
DOI 10.1016/j.toxicon.2004.02.002
Citations Scopus - 49Web of Science - 39
2004 Isbister GK, Gray MR, 'Bites by Australian mygalomorph spiders (Araneae, Mygalomorphae), including funnel-web spiders (Atracinae) and mouse spiders (Actinopodidae: Missulena spp)', Toxicon, 43 133-140 (2004) [C1]
DOI 10.1016/j.toxicon.2003.11.009
Citations Scopus - 13Web of Science - 9
2004 Ramasamy S, Isbister GK, Hodgson WC, 'The Efficacy of Two Antivenoms against the in Vitro Myotoxic effects of Black Snake (Pseudechis) Venoms in the Chick Biventer Cervicis Nerve-Muscle Preparation', Toxicon, 44 837-845 (2004) [C1]
DOI 10.1016/j.toxicon.2004.08.005
Citations Scopus - 17Web of Science - 17
2004 Isbister GK, Downes F, Sibbritt DW, Dawson AH, Whyte IM, 'Aspiration pneumonitis in an overdose population: Frequency, predictors and outcomes', Critical Care Medicine, 32 88-93 (2004) [C1]
DOI 10.1097/01.CCM.0000104207.42729.E4
Citations Scopus - 50Web of Science - 37
2004 Isbister GK, 'Necrotic arachnidism: the mythology of a modern plague', The Lancet, 364 549-553 (2004) [C3]
Citations Scopus - 35Web of Science - 20
2004 Vetter RS, Isbister GK, 'Do hobo spider bites cause dermonecrotic injuries?', ANNALS OF EMERGENCY MEDICINE, 44 605-607 (2004)
DOI 10.1016/j.annemergmed.2004.03.016
Citations Scopus - 21Web of Science - 16
2004 Isbister GK, O'Regan L, Sibbritt DW, Whyte IM, 'Alprazolam is relatively more toxic than other benzodiazepines in overdose', British Journal of Clinical Pharmacology, 58 88-95 (2004) [C1]
DOI 10.1111/j.1365-2125.2004.02089.x
Citations Scopus - 44Web of Science - 29
2004 Balit CR, Harvey MS, Waldock JM, Isbister GK, 'Prospective Study of Centipede Bites in Australia', Clinical Toxicology, 42 41-48 (2004) [C1]
DOI 10.1081/CLT-120028743
Citations Scopus - 30Web of Science - 19
2004 Isbister GK, Framenau VW, 'Australian Wolf Spider Bites (Lycosidae): Clinical Effects and Influence of Species on Bite Circumstances', Clinical Toxicology, 42 153-161 (2004) [C1]
DOI 10.1081/CLT-120030941
Citations Scopus - 13Web of Science - 11
2004 Isbister GK, Dawson AH, Whyte IM, 'Arsenic trioxide poisoning: a description of two acute overdoses', Human & Experimental Toxicology, 23 359-364 (2004) [C3]
Citations Scopus - 9Web of Science - 10
2004 Isbister GK, 'Prospective cohort study of definite spider bites in Australian children', Journal of Pediatrics and Child Health, 40 360-364 (2004) [C1]
DOI 10.1111/j.1440-1754.2004.00402.x
Citations Scopus - 4Web of Science - 2
2004 Isbister GK, Whyte IM, 'Suspected white-tail spider bite and necrotic ulcers', Internal Medicine Journal, 34 38-44 (2004) [C1]
DOI 10.1111/j.1444-0903.2004.00506.x
Citations Scopus - 25Web of Science - 21
2004 Isbister GK, Volschenk ES, Seymour JE, 'Scorpion stings in Australia: five definite stings and a review', Internal Medicine Journal, 34 427-430 (2004) [C1]
DOI 10.1111/j.1445-5994.2004.00625.x
Citations Scopus - 9Web of Science - 8
2004 Isbister GK, Gray MR, 'Black house spiders are unlikely culprits in necrotic arachnidism: a prospective study', Internal Medicine Journal, 34 287-289 (2004) [C1]
DOI 10.1111/j.1444-0903.2004.00562.x
Citations Scopus - 13Web of Science - 12
2004 Isbister GK, Bowe SJ, Dawson AH, Whyte IM, 'Relative Toxicity of Selective Serotonin Reuptake Inhibitors (SSRIs) in Overdose', Clinical Toxicology, 42 277-285 (2004) [C1]
DOI 10.1081/CLT-120037428
Citations Scopus - 228Web of Science - 160
2004 Isbister GK, Sibbritt DW, 'Developing a decision tree algorithm for the diagnosis of suspected spider bites', Emergency Medicine Australasia, 16 161-166 (2004) [C1]
Citations Scopus - 3
2004 Balit CR, Geary MJ, Russell RC, Isbister GK, 'Clinical effects of exposure to the White-stemmed gum moth (Chelepteryx collesi)', Emergency Medicine Australasia, 16 74-81 (2004) [C1]
Citations Scopus - 11
2004 Isbister GK, Adams J, 'Investigating the relationships between emergency departments and complementary and alternative medicine use in Australia', Emergency Medicine Australasia, 16 378-381 (2004) [C3]
2003 Little M, Murray L, Armstrong J, Dawson AH, Whyte IM, Isbister GK, et al., 'Clinical toxicology; 'bones' of contention', Critical Care and Resuscitation, 5 71-73 (2003) [C3]
2003 Sibbritt DW, Dawson AH, Whyte IM, Dunkley EJC, Isbister GK, 'The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity', Q J Medicine: an international journal of medicine, 96 635-642 (2003) [C1]
DOI 10.1093/qjmed/hcg109
Citations Scopus - 362Web of Science - 244
2003 Isbister GK, Dawson AH, Whyte IM, 'Feasibility of prehospital treatment with activated charcoal: Who could we treat, who should we treat?', Emergency Medicine Journal, 375-378 (2003) [C1]
DOI 10.1136/emj.20.4.375
Citations Scopus - 14Web of Science - 9
2003 Isbister GK, Oakley P, Dawson AH, Whyte IM, 'Presumed Angel's trumpet (Brugmansia) poisoning: Clinical effects and epidemiology', Emergency Medicine Journal, 376-382 (2003) [C1]
DOI 10.1046/j.1442-2026.2003.00477.x
Citations Scopus - 10
2003 Isbister GK, Currie BJ, 'Suspected snakebite: One year prospective study of emergency department presentations', Emergency Medicine (Carleton South), 15 160-169 (2003) [C1]
DOI 10.1046/j.1442-2026.2003.00434.x
Citations Scopus - 21
2003 Caldicott D, Isbister J, Das R, Isbister GK, 'Medical activism, refugees, and Australia (The land of the 'fair go')', Emergency Medicine (Carleton South), 15 176-182 (2003) [C1]
DOI 10.1046/j.1442-2026.2003.00353.x
Citations Scopus - 1
2003 Isbister GK, McGettigan P, Harris I, 'Hyperbaric oxygen for acute carbon monoxide poisoning', NEW ENGLAND JOURNAL OF MEDICINE, 348 558-558 (2003)
2003 Isbister GK, 'Acute conjunctival inflammation following contact with squashed spider contents', American Journal of Opthalmology, 136 563-564 (2003) [C3]
Citations Scopus - 6Web of Science - 6
2003 Isbister GK, 'Latrodectism: a prospective cohort study of bites by formally identified redback spiders - Reply', MEDICAL JOURNAL OF AUSTRALIA, 179 455-456 (2003)
Citations Scopus - 4
2003 Balit CR, Isbister GK, Dawson AH, Daly FF, Whyte IM, 'The effect of recalling paracetamol on hospital admissions for poisoning', Medical Journal of Australia, 179 221 (2003) [C3]
2003 Balit CR, Lynch CN, Isbister GK, 'Bupropion poisoning: A case series', Medical Journal of Australia, 178 61-63 (2003) [C1]
Citations Scopus - 45Web of Science - 34
2003 Isbister GK, Gray MR, 'Latrodectism: a prospective cohort study of bites by formally identified redback spiders', Medical Journal of Australia, 179 88-91 (2003) [C1]
Citations Scopus - 41Web of Science - 32
2003 Isbister GK, Gray MR, 'White-tail spider bite: a prospective study of 130 definite bites by Lampona species', Medical Journal of Australia, 179 199-202 (2003) [C1]
Citations Scopus - 45Web of Science - 31
2003 Isbister GK, McGettigan P, Harris I, 'Hyperbaric oxygen for acute carbon monoxide poisoning', NEW ENGLAND JOURNAL OF MEDICINE, 348 558-558 (2003)
Citations Scopus - 33Web of Science - 2
2003 Isbister GK, McGettigan PG, Harris I, 'Hyperbaric Oxygen for Acute Carbon Monoxide Poisoning', New England Journal of Medicine, 348 557-560 (2003) [C3]
Citations Scopus - 9
2003 McGettigan PG, Isbister GK, Whyte IM, 'Adolescent Depression', New England Journal of Medicine, 348 473 (2003) [C3]
2003 Isbister GK, Hirst D, 'A prospective study of definite bites by spiders of the family Sparassidae (huntsmen spiders) with identification to species level', Toxicon, 163-171 (2003) [C1]
DOI 10.1016/S0041-0101(03)00129-6
Citations Scopus - 10Web of Science - 7
2003 Isbister GK, Volschenk ES, Balit CR, Harvey MS, 'Australian scorpion stings: a prospective study of definite stings', Toxicon, 877-883 (2003) [C1]
DOI 10.1016/S0041-0101(03)00065-5
Citations Scopus - 19Web of Science - 15
2003 Isbister GK, Seymour JE, Gray MR, Raven RJ, 'Bites by spiders of the family Theraphosidae in humans and canines', Toxicon, 519-524 (2003) [C1]
DOI 10.1016/S0041-0101(02)00395-1
Citations Scopus - 33Web of Science - 28
2003 Ramasamy S, Isbister GK, Seymour JE, Hodgson WC, 'The in vitro effects of two chirodropid (Chironex fleckeri and Chiropsalmus sp.) venoms: efficacy of box jellyfish antivenom', Toxicon, 703-711 (2003) [C1]
DOI 10.1016/S0041-0101(03)00046-1
Citations Scopus - 24Web of Science - 20
2003 Balit CR, Geary MJ, Russell RC, Isbister GK, 'Prospective study of definite caterpillar exposures', Toxicon: an interdisciplinary journal on the toxins derived from animals, plants and microorganisms, 42 657-662 (2003) [C1]
DOI 10.1016/j.toxicon.2003.09.003
Citations Scopus - 12Web of Science - 10
2003 Isbister GK, Hackett LP, Whyte IM, 'Intentional Warfarin Overdose', Therapeutic Drug Monitoring, 25 715-722 (2003) [C1]
DOI 10.1097/00007691-200312000-00010
Citations Scopus - 9Web of Science - 6
2003 Balit CR, Isbister GK, Hackett L, Whyte IM, 'Quetiapine Poinsoning : A case series', Annals o f emergency Medicine, 42 751-758 (2003) [C1]
DOI 10.1016/S0196-0644(03)00600-0
Citations Scopus - 73Web of Science - 58
2003 Isbister GK, Downes F, Whyte IM, 'Regular medication and paracetamol overdose', Alimentary Pharmacology and Therapeutics, 17 609-610 (2003) [C3]
Citations Scopus - 1Web of Science - 1
2003 Isbister GK, Balit CR, Whyte IM, Dawson AH, 'Valproate overdose: a comparative cohort study of self poisonings', British Journal of Clinical Pharmacology, 398-404 (2003) [C1]
DOI 10.1046/j.1365-2125.2003.01772.x
Citations Scopus - 32Web of Science - 21
2003 Isbister GK, Hackett LP, Dawson AH, Whyte IM, Smith AJ, 'Moclobemide poisoning: toxicokinetics and occurrence of serotonin toxicity', British Journal of Clinical Pharmacology, 441-450 (2003) [C1]
DOI 10.1046/j.1365-2125.2003.01895.x
Citations Scopus - 45Web of Science - 30
Co-authors Anthony Smith
2003 Isbister GK, Whyte IM, Downes F, Dawson AH, McGettigan PG, 'Concomitant overdosing of other drugs in patients with paracetamol poisoning', British Journal of Clinical Pharmacology, 55 326 (2003) [C3]
Citations Scopus - 1
2003 Isbister GK, Warner G, 'Acute myocardial injury caused by Sydney funnel-web spider (atrax robustus) envenoming', Anaesthesia and Intensive Care, 31 672-674 (2003) [C1]
Citations Scopus - 4Web of Science - 2
2003 Jaiswal S, Coombs RC, Isbister GK, 'Paroxetine withdrawal in a neonate with historical and aboratory confirmation', European Journal of Pediatrics, 162 723-724 (2003) [C3]
Citations Scopus - 20Web of Science - 17
2003 Isbister GK, Whyte IM, 'Adverse reactions to Mirtazapine are unlikely to be serotonin toxicity', Clinical Neuropharmacology, 26 287-288 (2003) [C3]
Citations Scopus - 9Web of Science - 7
2003 Isbister GK, Gray MR, 'Effects of envenoming by comb-footed spiders of the genera steatoda and achaearanea (family theridiidae: araneae) in Australia', Journal of Toxicology. Clinical Toxicology, 41 809-819 (2003) [C1]
DOI 10.1081/CLT-120025346
Citations Scopus - 23Web of Science - 19
2003 Smith AJ, Isbister GK, 'Antivenoms: Editorial Commentary', Journal of Toxicology, 41 261-262 (2003) [C3]
Citations Scopus - 3Web of Science - 3
Co-authors Anthony Smith
2003 Isbister GK, Graudins A, White J, Warrell D, 'Antivenom Treatment in Arachnidism', Journal of Toxicology, Clinical Toxicology, 41 291-300 (2003) [C1]
DOI 10.1081/CLT-120021114
Citations Scopus - 82Web of Science - 62
2003 Isbister GK, Hackett LP, 'Nefazodone Poisoning: Toxicokinetics and Toxicodynamics Using Continuous Data Collection', Journal of Toxicology, Clinical Toxicology, 41 167-173 (2003) [C3]
Citations Scopus - 10Web of Science - 7
2003 White J, Warrell D, Eddleston M, Currie BJ, Whyte IM, Isbister GK, 'Clinical Toxinology - Where Are We Now?', Journal of Toxicology, Clinical Toxicology, 41 263-267 (2003) [C1]
DOI 10.1081/CLT-120021112
Citations Scopus - 43Web of Science - 38
2003 Balit CR, Isbister GK, Buckley NA, 'Randomized controlled trial of topical aspirin in the treatment of bee and wasp stings', Journal of Toxicology. Clinical Toxicology, 41 801-808 (2003) [C1]
DOI 10.1081/CLT-120025345
Citations Scopus - 8Web of Science - 3
2003 Isbister GK, 'Comment: combination risperidone and SSRI-induced serotonin syndrome', ANNALS OF PHARMACOTHERAPY, 37 1531-1532 (2003)
DOI 10.1345/aph.1C228a
Citations Scopus - 5Web of Science - 2
2003 Isbister GK, Balit CR, 'Bupropion Overdose: QTc Prolongation and Its Clinical Significance', The Annals of Pharmacotherapy, 999-1002 (2003) [C1]
DOI 10.1345/aph.1C481
Citations Scopus - 38Web of Science - 30
2003 Isbister GK, Downes F, Whyte IM, 'Olanzapine and serotonin toxicity', Psychiatry and Clinical Neurosciences, 57 241-242 (2003) [C3]
Citations Scopus - 11Web of Science - 9
2002 Balit CR, Isbister GK, Dawson AH, Whyte IM, 'Paracetamol recall: a natural experiment influencing analgesic poisoning - Reply', MEDICAL JOURNAL OF AUSTRALIA, 176 562-563 (2002)
2002 Isbister GK, Son J, Wang F, Maclean C, Lin C, Ujma J, et al., 'Puffer fish poisoning: a potentially life-threatening condition', Medical Journal of Australia, 177 650-653 (2002) [C1]
Citations Scopus - 35Web of Science - 27
2002 Prior F, Isbister GK, Dawson AH, Whyte IM, 'Serotonin toxicity with therapeutic doses of dexamphetamine and venlafaxine', Medical Journal of Australia, 176 240-241 (2002) [C3]
Citations Scopus - 13Web of Science - 10
2002 Balit CR, Isbister GK, Peat J, Dawson AH, Whyte IM, 'Paracetamol recall: A natural experiment influencing analgesic poisoning', Medical Journal of Australia, 176 162-165 (2002) [C1]
Citations Scopus - 12Web of Science - 13
2002 Isbister GK, Currie B, Little M, Daly F, 'Coagulopathy from tiger snake envenoming and its treatment', Pathology, 34 588-589 (2002) [C3]
Citations Scopus - 7Web of Science - 7
2002 Isbister GK, Dawson AH, Whyte IM, 'Two cases of bites by the black-bellied swamp snake (Hemiaspis signata)', TOXICON, 40 317-319 (2002)
DOI 10.1016/S0041-0101(01)00221-5
Citations Scopus - 4Web of Science - 3
2002 Isbister GK, 'Acute allergic reaction following contact with a spider', Toxicon, 40 1495-1497 (2002) [C1]
Citations Scopus - 13Web of Science - 9
2002 Eddleston M, Karalliedde L, Buckley N, Fernando R, Hutchinson G, Isbister GK, et al., 'Pesticide poisoning in the developing world - a minimum pesticides list', The Lancet, 360 1163-1167 (2002) [C1]
Citations Scopus - 219Web of Science - 182
2002 Isbister G, Whyte IM, 'Atypical Presentation of Risperidone Toxicity', Veterinary and Human Toxicology, 44(2) 118-119 (2002) [C3]
Citations Scopus - 8Web of Science - 6
2002 Isbister GK, Hirst D, 'Injuries from spider spines, not spider bites', Veterinary and Human Toxicology, 44(6) 339-342 (2002) [C1]
Citations Scopus - 9Web of Science - 8
2002 Isbister G, 'Toxicology', Current Therapeutics, 43 (2002)
2002 Isbister G, 'Toxicology', Current Therapeutics, 43 (2002)
2002 Isbister G, 'Toxicology', Current Therapeutics, 43 (2002)
2002 Isbister G, 'Toxicology', Current Therapeutics, 43 (2002)
2002 Isbister G, 'Toxicology', Current Therapeutics, 43 (2002)
2002 Isbister G, 'Rat poison', Current Therapeutics, 43 (2002)
2002 Isbister G, 'Hydroxychloroquine poisoning', Current Therapeutics, 43 (2002)
2002 Isbister GK, 'Data Collection in Clinical Toxinology: Debunking Myths and Developing Diagnostic Algorithms', Journal of Toxicology-Clinical Toxicology, 40(3) 231-237 (2002) [C1]
Citations Scopus - 45Web of Science - 42
2002 Isbister G, Dawson AH, Whyte IM, 'Hydroxychloroquine Overdose: a Prospective case series', American Journal of Emergency Medicine, 20(4) 377-378 (2002) [C3]
Citations Scopus - 10Web of Science - 7
2002 Caldicott D, Isbister GK, Edwards N, 'Publication and patriotism', ANZ JOURNAL OF SURGERY, 72 768-768 (2002)
DOI 10.1046/j.1445-2197.2002.t01-1-02534.x
2002 Isbister GK, Gray M, 'A prospective study of 750 definite spider bites, with expert spider identification', QJMedicine, 95 723-731 (2002) [C1]
Citations Scopus - 66Web of Science - 52
2002 Isbister GK, 'Delayed asystolic cardiac arrest after diltiazem overdose; resuscitation with high dose intravenous calcium', Emergency Medicine Journal, 19 355-356 (2002) [C2]
Citations Scopus - 24Web of Science - 12
2002 Isbister GK, Dawson A, Whyte IM, 'Comment: serotonin syndrome and 5-HT2a antagonism (vol 35, pg 1143, 2001)', ANNALS OF PHARMACOTHERAPY, 36 1484-1484 (2002)
2002 Isbister GK, Dawson AH, Whyte IM, 'Comment: neuroleptic malignant syndrome associated with risperidone and fluvoxamine', The Annals of Pharmacotherapy, 36 1293 (2002) [C3]
Citations Scopus - 3Web of Science - 1
2002 Isbister GK, 'Failure of intramuscular antivenom in Red-back spider envenoming', Emergency Medicine, 14(4) 436-439 (2002) [C1]
Citations Scopus - 12
2002 Isbister G, Whyte IM, 'Serotonin toxicity and malignant hyperthermia: role of 5-HT2 receptors', British Journal of Anaesthesia, 88(4) 603 (2002) [C3]
Citations Scopus - 14Web of Science - 12
2001 Isbister G, Whyte IM, Smith AN, 'Olanzapine overdose', Anaesthesia, 56 400-401 (2001) [C3]
Citations Scopus - 6Web of Science - 5
2001 Isbister G, Bucens I, Whyte IM, 'Paracetamol overdose in a preterm neonate', Archives of Disease in Childhood: Fetal & Neonatal Edition, 85 F70-F72 (2001) [C2]
Citations Scopus - 27Web of Science - 14
2001 Isbister GK, Balit C, 'Eye exposure to squashed spiders', MEDICAL JOURNAL OF AUSTRALIA, 175 391-392 (2001)
Citations Scopus - 4Web of Science - 4
2001 Balit CR, Ptolemy HC, Geary MJ, Russell RC, Isbister GK, 'Outbreak of caterpillar dermatitis caused by airborne hairs of the mistletoe browntail moth (Euproctis edwardsi)', MEDICAL JOURNAL OF AUSTRALIA, 175 641-643 (2001)
Citations Scopus - 20Web of Science - 15
2001 Balit C, Ptolemy H, Geary MJ, Russell RC, Isbister GK, 'A caterpillar dermatitis outbreak following contact with the hairs of the Mistletoe Browntail moth (Euproctis edwardsi)', Med J Aust 2001; 175:641-3, 641-643 (2001) [C3]
2001 Isbister GK, Hirst DB, Gray MR, Currie BJ, 'Clinical effects in bites from formally identified spiders in tropical Northern Territory', Medical Journal Australia, 174 79-82 (2001) [C1]
Citations Scopus - 15Web of Science - 15
2001 O''Reilly GM, Isbister GK, Lawrie PM, Treston G, Currie BJ, 'Prospective study of jellyfish stings from tropical Australia, including the major box jellyfish Chironex fleckeri', Medical Journal Australia, 175 652-655 (2001) [C1]
Citations Scopus - 43Web of Science - 36
2001 Isbister GK, 'Necrotic arachnidism in Australia', Toxicon. 2001 Dec;39(12):1941-2, 1941-1942 (2001) [C3]
Citations Web of Science - 7
2001 Isbister G, 'Serotonin syndrome and 5-HT2a antagonism', Ann Pharm, 0 1143-1144 (2001) [C3]
2001 Isbister GK, 'Serotonin syndrome, mydriasis, and cyproheptadine', Ann Pharmacother 2001 Dec ;35(12):1672, (2001) [C3]
2001 Isbister GK, Dawson AH, Whyte IM, 'Serotonin syndrome induced by fluvoxamine and mirtazapine', Ann Pharmacother 2001 Dec ;35(12):1674, (2001) [C3]
2001 Isbister GK, Little M, Seymour J, 'Jellyfish stings', Vet Hum Toxicol 2001, 43(6): 373, (2001) [C3]
Citations Web of Science - 1
2001 Isbister GK, Whyte IM, 'Management of anticoagulant poisoning', Vet Hum Toxicol, 43(2):117, 2001 April, (2001) [C3]
Citations Web of Science - 1
2001 Whyte IM, Isbister G, 'Misdiagnosis of Myoclonus in Antidepressant Induced Serotonin Excess', Veterinary and Human Toxicology, 43(6) 376 (2001) [C3]
Citations Scopus - 2Web of Science - 2
2001 Isbister G, McGettigan PG, Dawson AH, 'A Fatal Case of Moclobemide-Citalopram Intoxication', Journal of Analytical Toxicology, 25 716-717 (2001) [C3]
Citations Scopus - 7Web of Science - 5
2001 Isbister G, Oakley P, Whyte IM, Dawson AH, 'Treatment of Anticholinergic-Induced Ileus With Neostigmine', Annals of Emergency Medicine, 38(6) 689-693 (2001) [C2]
Citations Scopus - 7Web of Science - 3
2001 Isbister GK, Dawson A, Whyte IM, 'Citalopram overdose, serotonin toxicity, or neuroleptic malignant syndrome?', Can J Psych 2001 Sep;46(7):657-9., 657-659 (2001) [C3]
Citations Scopus - 5Web of Science - 4
2001 Isbister G, Whyte IM, Dawson AH, 'Pediatric Acetaminophen Overdose', Clinical Toxicology, 39(2) 169-170 (2001) [C3]
Citations Scopus - 5Web of Science - 1
2001 Isbister GK, 'Venomous fish stings in tropical northern Australia', AMERICAN JOURNAL OF EMERGENCY MEDICINE, 19 561-565 (2001)
DOI 10.1053/ajem.2001.28325
Citations Scopus - 36Web of Science - 27
2001 Isbister GK, 'Venomous fish stings', Am J Emerg Med, 19 561-565 (2001) [C1]
2001 Isbister GK, Balit C, 'Effects of legislation restricting pack sizes of paracetamol on self poisoning. Authors did not look at effects on all deliberate and accidental self poisoning', BMJ. 2001 Sep 15;323(7313):633-4, 633-634 (2001) [C3]
Citations Scopus - 2Web of Science - 2
2001 Dargan P, Jones A, Isbister G, Balit C, Andrus JP, Herzenberg LA, et al., 'Effects of legislation restricting pack sizes of paracetamol on self poisoning [8] (multiple letters)', British Medical Journal, 323 633-634 (2001)
Citations Scopus - 2
2001 Isbister G, Dawson AH, Isbister J, 'Recommendations for the management of over-anticoagulation with warfarin', Emergency Medicine, 13 469-472 (2001) [C2]
Citations Scopus - 5
2001 Isbister GK, 'Comment: serotonin syndrome, mydriasis, and cyproheptadine', ANNALS OF PHARMACOTHERAPY, 35 1672-1673 (2001)
Citations Scopus - 8Web of Science - 7
2001 Isbister GK, Prior F, Foy A, 'Citalopram-Induced Bradycardia and Presyncope', Ann Pharm 2001 Dec 35(12): 1552-5, 1552-1555 (2001) [C3]
Citations Scopus - 22Web of Science - 14
2001 Isbister G, Dawson AH, Whyte IM, 'Comment: serotonin syndrome and 5-HT2a antagonism', The Annals of Pharmacotherapy, 35(9) 1143-1144 (2001) [C3]
Citations Scopus - 6Web of Science - 7
2001 Isbister G, Dawson AH, Whyte IM, 'Comment: serotonin syndrome induced by fluvoxamine and mirtazapine', The Annals of Pharmacotherapy, 35 1674-1675 (2001) [C3]
Citations Scopus - 12Web of Science - 8
2001 Isbister G, Whyte I, Dawson A, 'Pediatric acetaminophen poisoning', ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 155 417-418 (2001)
Citations Scopus - 9Web of Science - 3
2001 Isbister G, Dawson AH, Whyte IM, Prior F, Clancy C, Smith AN, 'Neonatal paroxetine withdrawal syndrome or actually serotinin syndrome?', Archives of Disease in Childhood: Fetal & Neonatal Edition, 85(2) 147-148 (2001) [C3]
Citations Scopus - 44Web of Science - 32
Co-authors Anthony Smith
2001 Isbister GK, Whyte IM, Dawson A, 'The Pediatric Forum: Pediatric Acetaminophen Poisoning', Arch Pediatr Adolesc Med. 2001 Mar;155(3):417-9, 417-419 (2001) [C3]
2001 Isbister GK, 'Spider mythology across the world', West J Med. 2001 Aug;175(2):86-7, 86-87 (2001) [C3]
Citations Scopus - 16Web of Science - 16
2000 Isbister G, Gray M, 'Acute and recurrent skin ulceration after spider bite', MEDICAL JOURNAL OF AUSTRALIA, 172 303-304 (2000)
Citations Web of Science - 7
2000 Isbister GK, Whelan PI, 'Envenomation by the billygoat plum stinging caterpillar (Thosea penthima)', MEDICAL JOURNAL OF AUSTRALIA, 173 654-655 (2000)
Citations Scopus - 8Web of Science - 5
2000 Isbister G, Gray M, Winkel KD, 'Acute and recurrent skin ulceration after spider bite [7] (multiple letters)', Medical Journal of Australia, 172 303-304 (2000)
Citations Scopus - 6
2000 Isbister GK, 'Failure of intravenous calcium gluconate for hydrofluoric acid burns', ANNALS OF EMERGENCY MEDICINE, 36 398-399 (2000)
DOI 10.1067/mem.2000.110019
Citations Scopus - 1Web of Science - 1
2000 Isbister GK, Smart DR, 'Spider bites in Australia (multiple letters)', Emergency Medicine, 12 72-73 (2000)
DOI 10.1046/j.1442-2026.2000.00099.x
Show 408 more journal articles

Review (2 outputs)

Year Citation Altmetrics Link
2014 Marcus EN, Isbister GK, 'Jellyfish stings (2014) [D1]
2014 Isbister GK, 'Marine envenomations from corals, sea urchins, fish, or stingrays (2014) [D1]

Conference (81 outputs)

Year Citation Altmetrics Link
2016 Ryan NM, Page CP, Isbister GK, 'The incidence of pregabalin overdose has increased but clinical effects are primarily associated with the coingestants' (2016)
Co-authors Nicole Ryan
2016 Isbister GK, Heppell SP, Page CB, Ryan NM, 'Adult clonidine overdose: prolonged bradycardia and central nervous system depression, but not severe toxicity', CLINICAL TOXICOLOGY (2016)
Co-authors Nicole Ryan
2016 Johnston C, Silva A, Siribaddana S, Ryan NM, Maduwage K, Isbister GK, 'Sri Lankan Russell's viper envenoming causes mild myotoxicity', CLINICAL TOXICOLOGY (2016)
Co-authors Nicole Ryan
2016 Page CB, Ryan NM, Isbister GK, 'The use and safety of high-dose insulin euglycaemia therapy in toxin-induced cardiac toxicity', CLINICAL TOXICOLOGY (2016)
Co-authors Nicole Ryan
2015 Berling I, Brown SGA, Miteff F, Levi C, Isbister GK, 'Australian elapid envenoming and intracranial haemorrhage', CLINICAL TOXICOLOGY (2015) [E3]
Co-authors Chris Levi
2015 Isbister GK, Maduwage K, Saiao A, Buckley NA, Jayamanne SF, Seyed S, et al., 'Population pharmacokinetics of an Indian F(ab')2 snake antivenom in patients with Russell's viper bite', CLINICAL TOXICOLOGY (2015) [E3]
Co-authors Alexandre Mendes
2015 Chan BS, O'Leary M, Isbister G, Buckley NA, 'The use of digoxin-specific antibodies in chronic digoxin poisoning', CLINICAL TOXICOLOGY (2015) [E3]
Citations Web of Science - 2
2015 Berling I, Buckley NA, Isbister GK, 'The antipsychotic story ... an epidemic of prescription and overdose', CLINICAL TOXICOLOGY (2015) [E3]
2015 Isbister GK, Downes MA, Mcnamara K, Berling I, Whyte IM, Page CB, 'A novel infusion protocol for the administration of acetylcysteine', CLINICAL TOXICOLOGY (2015) [E3]
Citations Web of Science - 2
2015 Isbister GK, Buckley NA, Page CB, Brown SGA, 'A multicentre cohort study of snake envenoming defines clinical syndromes and influences clinical practice', CLINICAL TOXICOLOGY (2015) [E3]
2015 Downes MA, Berling IL, Stanley TH, Isbister GK, 'Spurious serum chloride measurement in severe metabolic disturbance associated with 2-butoxyethanol ingestion', CLINICAL TOXICOLOGY (2015) [E3]
2015 Michael A, Mustafa A, Medley G, Grice J, Roberts MS, Isbister GK, 'Severe but reversible toxicity with aldicarb ingestion', CLINICAL TOXICOLOGY (2015) [E3]
2015 Silva A, Siribaddana S, Sedgwick EM, Maduwage K, Buckley N, Isbister GK, 'Indian Krait (Bungarus caeruleus) envenoming: A clinical and neurophysiological investigation of neuromuscular dysfunction', CLINICAL TOXICOLOGY (2015) [E3]
Citations Web of Science - 1
2015 Berling I, Isbister GK, 'The myth of the half RR rule and QT prolongation', CLINICAL TOXICOLOGY (2015) [E3]
2015 Downes MA, Berling IL, Isbister GK, 'Acute behavioural disturbance associated with phenibut purchased via an Internet supplier', CLINICAL TOXICOLOGY (2015) [E3]
2015 Page CB, Mostafa A, Saiao A, Medley G, Grice J, Roberts M, Isbister G, 'Cardiovascular toxicity with levetiracetam overdose', CLINICAL TOXICOLOGY (2015) [E3]
2015 Chiew AL, Isbister GK, Buckley NA, '"Massive" paracetamol overdose', CLINICAL TOXICOLOGY (2015) [E3]
2015 Ryan N, Isbister GK, 'Tramadol overdose is associated with an increased risk of seizure but not serotonin toxicity', CLINICAL TOXICOLOGY (2015) [E3]
Co-authors Nicole Ryan
2015 Skinner K, Saiao A, Mustafa A, Soderstrom J, Medley G, Roberts MS, Isbister GK, 'Isoniazid poisoning: Pharmacokinetics and effect of dialysis after massive ingestion', CLINICAL TOXICOLOGY (2015) [E3]
Citations Scopus - 3
2015 Silva A, Siribaddana S, Sedgwick M, Maduwage K, Kuruppu S, Buckley NA, et al., 'Neurotoxicity due to Sri Lankan Russell's viper envenomation is caused by a weak presynaptic neurotoxin', CLINICAL TOXICOLOGY (2015) [E3]
2015 Miller M, O'Leary MA, Isbister GK, 'Rationalisation of antivenom use in funnel-web spider envenomation: enzyme immunoassays for venom and antivenom concentrations', CLINICAL TOXICOLOGY (2015) [E3]
2015 Isbister GK, Poklis A, Poklis JL, Grice J, 'Beware of blue pills and blotting paper hallucinogens severe toxicity with NBOMe', CLINICAL TOXICOLOGY (2015) [E3]
2015 Coooper JM, Isbister GK, 'Desvenlafaxine overdose and the incidence of serotonin toxicity, seizures and cardiovascular effects', CLINICAL TOXICOLOGY (2015) [E3]
Co-authors Joyce Cooper
2015 Ryan NM, Brown SGA, Isbister GK, 'Serum sickness after the administration of Australian snake antivenoms' (2015)
Co-authors Nicole Ryan
2014 Ryan NM, Isbister GK, 'Tramadol overdose is associated with an increased risk of seizure and unassociated with serotonin toxicity', TAPNA Conference Program (2014) [E3]
Co-authors Nicole Ryan
2014 Cooper J, Duffull SB, Saiao AS, Isbister GK, 'The effect of single-dose activated charcoal following sertraline overdose', The 40th SHPA National Conference: Book of Abstracts (2014) [E3]
Co-authors Joyce Cooper
2014 Drinkwater V, Calver L, Bjorksten C, Isbister G, Gupta R, 'HOW AN INTERFACE BETWEEN ACUTE PSYCHIATRIC SERVICES AND AN EMERGENCY DEPARTMENT HAS IMPROVED THE MANAGEMENT OF ACUTE BEHAVIOURAL DISTURBANCE', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY (2014) [E3]
2014 Scott A, Brown A, Dunlop A, Gill T, Holland R, Fisk C, et al., 'QT PROLONGATION IN OPIOID SUBSTITUTION THERAPY: ANALYSIS OF CONTINUOUS 12-LEAD ELECTROCARDIOGRAM RECORDINGS', DRUG AND ALCOHOL REVIEW (2014) [E3]
Co-authors Adrian Dunlop
2014 Maduwage K, Scorgie F, Fahim M, Karunathilake H, Abeyasinghe C, O'Leary MA, et al., 'Measurement of venom and clotting function in patients with Russell's viper coagulopathy and response to antivenom', CLINICAL TOXICOLOGY (2014) [E3]
2014 Isbister GK, Buckley NA, Brown SGA, 'The knowledge of receiving antivenom is more effective than antivenom or analgesia for treating latrodectism', CLINICAL TOXICOLOGY (2014) [E3]
2014 Downes MA, Muscat TM, Ritchie N, Isbister GK, 'Impact of an emergency short stay unit on emergency department performance with toxicology patients', CLINICAL TOXICOLOGY (2014) [E3]
2014 Berling I, Isbister GK, 'Antipsychotic overdose QT nomogram risk assessment', CLINICAL TOXICOLOGY (2014) [E3]
2014 Isbister GK, Buckley NA, Brown SGA, 'The knowledge of receiving antivenom is more effective than antivenom or analgesia for treating latrodectism', CLINICAL TOXICOLOGY (2014) [E3]
2014 Ryan NM, Brown SSGA, Isbister GK, 'Serum sickness after the administration of Australian snake antivenoms', CLINICAL TOXICOLOGY (2014) [E3]
Co-authors Nicole Ryan
2014 Page CB, Berling I, Isbister GK, 'Rate dependent bundle branch block in drug overdose: A case report', CLINICAL TOXICOLOGY (2014) [E3]
2014 Maduwage KP, O'Leary MA, Isbister GK, 'Diagnosis of snake envenomation using a simple phospholipase A2 assay', CLINICAL TOXICOLOGY (2014) [E3]
2014 Ryan NM, Brown SSGA, Isbister GK, 'Serum sickness after the administration of Australian snake antivenoms', CLINICAL TOXICOLOGY (2014) [E3]
Co-authors Nicole Ryan
2013 Brown SGA, Stone SF, Fatovich DM, Burrows SA, Holdgate A, Celenza A, et al., 'Anaphylaxis: clinical features and evidence for a mast cell-leukocyte cytokine cascade in humans', ALLERGY (2013) [E3]
2012 Lincz L, Johnston CI, Scorgie FE, O'Leary MA, Prasad R, Seldon MR, et al., 'Comparative sensitivity of different commercially available aPTT reagents to a clinically relevant 'coagulation inhibitor'', HAA 2012: 2012 Co-Joint Scientific Meeting. ASTH Posters (2012) [E3]
Co-authors Lisa Lincz
2012 Noutsos T, Currie B, Brown SGA, Isbister GK, 'Thrombotic microangiopathy due to snake envenomation: A large case series', HAA 2012: 2012 Co-Joint Scientific Meeting. ASTH Posters (2012) [E3]
2012 Scorgie FE, Maduwage KP, Lincz L, Shahmy S, Mohamed F, Seldon MR, Isbister GK, 'Comparison of the haemostatic effects of three different procoagulant snake venoms in human envenoming', HAA 2012: 2012 Co-Joint Scientific Meeting. ASTH Posters (2012) [E3]
Co-authors Lisa Lincz
2012 Johnston CI, O'Leary MA, Brown SGA, Currie BJ, Isbister GK, 'Death Adder envenoming causes neurotoxicity not reversed by antivenom - Australian Snakebite Project (ASP-16)', Toxicon (2012) [E3]
2012 Brinkman DL, Mulvenna J, Konstantakopoulos N, Hodgson WC, Isbister GK, Seymour JE, Burnell JN, 'Molecular diversity of Box Jellyfish toxins', Toxicon (2012) [E3]
Citations Web of Science - 1
2012 Calver L, Page BC, Downes M, Chan B, Isbister GK, 'Safety of droperidol for sedation and acute behavioural disturbance', Academic Emergency Medicine (2012) [E3]
2012 Calver L, Page BC, Downes M, Chan B, Isbister GK, 'Droperidol for sedation of acute behavioural disturbance', Academic Emergency Medicine (2012) [E3]
2012 Allen G, O'Leary MA, Brown SGA, Buckley NA, Isbister GK, 'Clinical effects and antivenom dosing in Brown Snake (Pseudonaja spp.) Envenoming - Australian Snakebite Project (ASP-14)', Clinical Toxicology (2012) [E3]
Citations Scopus - 25
2012 Saiao A, Chan B, Isbister GK, 'Pharmacokinetics and outcomes in massive paracetamol overdose', Clinical Toxicology (2012) [E3]
Citations Web of Science - 1
2012 Isbister GK, Brown SGA, 'Bites in Australian snake handlers - Australian Snakebite Project (ASP-15)', Clinical Toxicology (2012) [E3]
2012 Berling I, Whyte IM, Isbister GK, 'Oxycodone overdose: A case series', Clinical Toxicology (2012) [E3]
2012 Johnston CI, O'Leary MA, Brown SGA, Currie BJ, Greenberg R, Taylor M, et al., 'Mulga snake (Pseudechis australis) envenoming: A spectrum of myotoxicity, anticoagulant coagulopathy, haemolysis and the role of early antivenom therapy - Australian Snakebite Project (ASP-18)', ASCEPT-APSA Oral Abstracts (2012) [E3]
2011 Calver L, Downes MA, Isbister GK, 'Assessment of QT prolongation in high-dose droperidol administration using continuous 12-lead holter recording', Clinical Toxicology (2011) [E3]
2011 Downes MA, Calver L, Isbister GK, 'Intralipid treatment of sedative hypnotic drug overdose: A case series', Clinical Toxicology (2011) [E3]
Citations Web of Science - 1
2011 Isbister GK, Shahmy S, Makarim MFM, Fahim M, Abeysinghe C, Karunatilake H, Ariaratnam CA, 'A randomised controlled trial of two infusion rates to decrease reactions to antivenom', Clinical Toxicology (2011) [E3]
2011 Isbister GK, White J, Currie BJ, Brown SGA, 'Clinical effects and treatment of envenoming by hoplocephalus spp. snakes in Australia', Clinical Toxicology (2011) [E3]
DOI 10.1016/j.toxicon.2011.09.013
2011 Van Gorp F, Duffull SB, Hackett LP, Isbister GK, 'Population pharmacokinetics and pharmacodynamics of escitalopram in overdose and the effect of activated charcoal', Clinical Toxicology (2011) [E3]
2010 Isbister GK, Calver LA, Page CB, Stoke B, Bryant JL, Downes MA, 'Randomised Comparison Study of Intramuscular Droperidol Versus Midazolam for Violence and Acute Behavioural Disturbance in the Emergency Department - the DORM Study', CLINICAL TOXICOLOGY (2010) [E3]
2010 Isbister GK, Churchman A, O'Leary MA, Brown SGA, Brown CB, 'Clinical effects of red-bellied black snake (Pseudechis porphyriacus) envenoming and correlation with venom concentrations', Clinical Toxicology (2010) [E3]
2010 Isbister GK, Coulter C, Kleintjes F, Kwan WF, Lu B, McInnes S, Duffull SB, 'Developing a new administration regimen for N-acetylcysteine in paracetamol overdose using pharmacokinetic simulations', Clinical Toxicology (2010) [E2]
2010 Isbister GK, Calver L, Page CB, Stokes BJ, Bryant J, Downes MA, 'Randomised comparison study of intramuscular droperidol versus midazolam for violence and acute behavioural disturbance in the emergency department - the DORM Study', Clinical Toxicology (2010) [E3]
2010 Isbister GK, 'Snake bites in Sri Lanka', 2010 North American Congress on Clinical Toxicology (NACCT) Meeting (2010) [E3]
2010 Isbister GK, 'The Australian Snakebite Project', AACB AIMS Combined Scientific Meeting 2010 (2010) [E3]
2010 Isbister GK, 'Snake bites and coagulopathy', Australian and New Zealand Children's Haematology and Oncology Group Annual Scientific Meeting 2010. Program (2010) [E3]
2010 Isbister GK, 'Developing a rational approach to antivenom therapy', Australasian Society of Clinical and Experimental Pharmacology and Toxicology (ASCEPT) Annual Scientific Meeting (2010) [E3]
2010 Calver L, Downes MA, Page CB, Bryant J, Isbister GK, 'Randomised controlled trial of intramuscular droperidol versus midazolam for acute behavioural disturbance - The DORM study', International Journal of Mental Health Nursing (2010) [E3]
DOI 10.1016/j.annemergmed.2010.05.037
Citations Scopus - 31
2010 Isbister GK, 'Pathophysiology of serotonin toxicity: A tale of rodents, receptors and remedies', International Journal of Neuropsychopharmacology (2010) [E3]
2009 Lincz L, Woods D, Alley S, O'Leary MA, Seldon MR, Isbister GK, 'Endogenous thrombin potential as a novel method for characterisation of procoagulant snake venoms', Journal of Thrombosis and Haemostasis (2009) [E3]
DOI 10.1111/j.1538-7836.2009.03473_2.x
Co-authors Lisa Lincz
2009 Downes MA, Healy P, Page CB, Bryant JL, Isbister GK, 'Code black: A structured approach to the agitated patient in the emergency department', Clinical Toxicology (2009) [E3]
2009 Isbister GK, 'Marine toxinology: Antivenom in hot water and other treatment controversies', Clinical Toxicology (2009) [E3]
2009 Isbister GK, Balit CR, Macleod D, Joy JP, Duffull SB, 'Amisulpride overdose causes QT prolongation and torsade de pointes: A national study', Clinical Toxicology (2009) [E3]
Citations Web of Science - 2
2009 Isbister GK, Scorgie F, Brown SGA, O'Leary MA, Seldon MR, Lincz L, 'Coagulation factor deficiencies associated with venom induced consumption coagulopathy in Australian snake envenoming', Clinical Toxicology (2009) [E3]
Citations Web of Science - 4
Co-authors Lisa Lincz
2009 Page CB, Calver LA, Isbister GK, 'Risperidone overdose: Much to do about nothing', Clinical Toxicology (2009) [E3]
2009 Kumar VVP, Oscarsson S, Friberg LE, Isbister GK, Hackett LP, Duffull SB, 'The Effect of Decontamination Procedures on the Pharmacokinetics of Venlafaxine in Overdose', THERAPEUTIC DRUG MONITORING (2009) [E3]
2009 Van Gorp F, Duffull SB, Hackett LP, Isbister GK, 'Population pharmacokinetics of escitalopram in overdose and the effect of charcoal', Therapeutic Drug Monitoring (2009) [E3]
DOI 10.1111/j.1365-2125.2011.04091.x
2009 Kumar VVP, Oscarsson S, Friberg LE, Isbister GK, Hackett LP, Duffull SB, 'The effect of decontamination procedures on the pharmacokinetics of venlafaxine in overdose', Therapeutic Drug Monitoring (2009) [E3]
DOI 10.1038/clpt.2009.114
Citations Scopus - 14Web of Science - 12
2008 Isbister GK, 'Is venlafaxine cardiotoxic in overdose? Evaluation of a case series using a QT nomogram', CLINICAL TOXICOLOGY (2008) [E3]
2008 Isbister GK, Brown SGA, Duffull S, 'Failure of antivenom for venom induced consumption coagulopathy in Australian snakebite', CLINICAL TOXICOLOGY (2008) [E3]
2008 Isbister GK, Duffull SB, 'Predicting intubation, duration of ventilation and cardiac monitoring in quetiapine overdose and the effect of activated charcoal', CLINICAL TOXICOLOGY (2008) [E3]
2008 Page CB, Isbister GK, Whyte IM, 'Delirium from Promethazine poisoning: A case series', Clinical Toxicology (2008) [E3]
DOI 10.1080/15563650802071703
2008 Isbister G, 'The role of coagulation testing in snake envenoming', INTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY (2008) [E3]
2008 Enjeti A, Scorgie FE, Lincz L, Brown S, Isbister GK, Seldon MR, 'Circulating microparticles in snake bite patients with microangiopathy', 50th ASH Annual Meeting and Exposition. Online Program and Abstracts (2008) [E3]
Co-authors Lisa Lincz
2008 Lincz L, Woods D, Alley S, O'Leary MA, Seldon MR, Isbister GK, 'Endogenous thrombin potential (ETP) as a novel method for characterization of procoagulant snake venoms', HAA 2008 HSANZ ANZSBT ASTH: 2008 Annual Scientific Meeting: Abstracts (2008) [E3]
Co-authors Lisa Lincz
Show 78 more conferences
Edit

Grants and Funding

Summary

Number of grants 27
Total funding $9,629,487

Click on a grant title below to expand the full details for that specific grant.


20161 grants / $19,966

Combination Analgesia for Redback spider Envenoming (CARE) Study- A randomised controlled trial$19,966

Funding body: University of Sydney

Funding body University of Sydney
Project Team Doctor Nicole Ryan, Professor Geoff Isbister, Professor Nicholas Buckley, Professor Andis Graudins, Professor Daniel Fatovich
Scheme Translational Australian Clinical Toxicology (TACT) Pilot Grant
Role Investigator
Funding Start 2016
Funding Finish 2016
GNo G1501400
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

20151 grants / $2,506,118

Translational Venom and Antivenom Research$2,506,118

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Geoff Isbister, Professor Nicholas Buckley, Professor Janaka de Silva, Associate Professor Simon Brown, Professor Wayne Hodgson, Professor David Lalloo, Professor Asita de Silva, Professor Andrew Dawson, Professor Indika Gawarammana, Professor Andis Graudins
Scheme Centres of Research Excellence (CRE) - Centres of Clinical Research Excellence
Role Lead
Funding Start 2015
Funding Finish 2020
GNo G1500435
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

20143 grants / $1,975,336

An integrated research program in human toxicology to ensure rapid translation of results into practice and regulation$1,202,251

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Nicholas Buckley, Professor Geoff Isbister, Professor Andrew Dawson, Professor Michael Roberts
Scheme Program Grant
Role Lead
Funding Start 2014
Funding Finish 2018
GNo G1300141
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Improving Health Outcomes in Drug Overdose and Envenoming$753,085

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Geoff Isbister
Scheme Research Fellowships
Role Lead
Funding Start 2014
Funding Finish 2018
GNo G1300082
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Neuromuscular junction toxicity after anticholinesterase pesticide poisoning and envenomation$20,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Nicholas Buckley, Professor Geoff Isbister, Professor Michael Roberts
Scheme Project Grant
Role Lead
Funding Start 2014
Funding Finish 2015
GNo G1500439
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

20123 grants / $230,721

A novel approach to snakebite first aid$195,721

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Dirk Van Helden, Professor Geoff Isbister
Scheme Project Grant
Role Investigator
Funding Start 2012
Funding Finish 2014
GNo G1100333
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

First Aid for Cytotoxic Snakebite$25,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Professor Dirk Van Helden, Professor Geoff Isbister
Scheme Project Grant
Role Investigator
Funding Start 2012
Funding Finish 2012
GNo G1200154
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

Biomarkers of acute renal toxicity in humans$10,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Nicholas Buckley, Professor Zoltan Endre, Professor Andrew Dawson, Professor Rezvi Sheriff, Professor Geoff Isbister, Professor Michael Roberts
Scheme Project Grant
Role Lead
Funding Start 2012
Funding Finish 2013
GNo G1100879
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

20112 grants / $1,490,286

Biomarkers of acute renal toxicity in humans$1,044,710

Multicentre observational study of poisoned and snake bite patients in Sri Lanka investigating renal toxicity and renal biomarkers.

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team

Buckley NA

Scheme Project Grant
Role Investigator
Funding Start 2011
Funding Finish 2013
GNo
Type Of Funding Not Known
Category UNKN
UON N

A randomised controlled trial of antivenom for red-bellied black snake envenoming$445,576

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Geoff Isbister, Professor Nicholas Buckley
Scheme Project Grant
Role Lead
Funding Start 2011
Funding Finish 2014
GNo G1000301
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

20104 grants / $1,178,272

Does fresh frozen plasma in Russells viper bite coagulopathy reduce the dose and duration of antivenom therapy?$600,500

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Geoff Isbister, Professor Nicholas Buckley, Professor Janaka de Silva, Conjoint Professor Andrew Dawson, Professor David Lalloo
Scheme Project Grant
Role Lead
Funding Start 2010
Funding Finish 2012
GNo G0190172
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Multicentre studies of interventions in clinical toxicology and envenoming, including antivenoms and decontamination $417,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Geoff Isbister
Scheme Career Development Fellowships
Role Lead
Funding Start 2010
Funding Finish 2013
GNo G0900229
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Randomised controlled trial of intravenous antivenom versus placebo in the treatment of red back spider bite$148,772

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Geoff Isbister, Associate Professor Simon Brown
Scheme Project Grant
Role Lead
Funding Start 2010
Funding Finish 2010
GNo G0900241
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Evaluation of the kinetics of blood clotting for assessing enoxaparin activity$12,000

Developing an assay to monitor low molecular weight heparins in patients.

Funding body: University of Otago

Funding body University of Otago
Project Team

Duffull SB

Scheme Research Grant
Role Investigator
Funding Start 2010
Funding Finish 2011
GNo
Type Of Funding International - Competitive
Category 3IFA
UON N

20091 grants / $300,000

Randomised controlled trial of intravenous antivenom versus placebo in the treatment of redback spider bite$300,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team

Isbister GK

Scheme Project Grant
Role Lead
Funding Start 2009
Funding Finish 2010
GNo
Type Of Funding Not Known
Category UNKN
UON N

20081 grants / $689,500

A randomised controlled trial of factor replacement therapy in snake bite coagulopathy$689,500

Randomised controlled trial of fresh frozen plasma after antivenom administration in Australian snake bite coagulopathy - multicentre study across over 50 sites in 5 States.

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team

Isbister GK

Scheme Project Grant
Role Lead
Funding Start 2008
Funding Finish 2010
GNo
Type Of Funding Not Known
Category UNKN
UON N

20073 grants / $705,765

Mediators in Anaphylaxis$350,000

Developing mediator assays for patient with anaphylaxis presenting to emergency departments in NSW and WA.

Funding body: Food and Allergy Network

Funding body Food and Allergy Network
Project Team

Brown SGA

Scheme Unknown
Role Investigator
Funding Start 2007
Funding Finish 2008
GNo
Type Of Funding International - Competitive
Category 3IFA
UON N

Molecular toxinology of Australian Box jellyfish venoms$271,750

Isolation and characterisation of toxins in box jellyfish, including Chironex fleckeri.

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team

Hodgson WC

Scheme Project Grant
Role Investigator
Funding Start 2007
Funding Finish 2010
GNo
Type Of Funding Not Known
Category UNKN
UON N

A randomised controlled trial of intramuscular droperidol for rapid sedation of aggressive and agitated psychostimulant-associated delirium$84,015

Funding body: NSW Health

Funding body NSW Health
Project Team

Isbister GK

Scheme Drug and Alcohol Council Research Grants Program
Role Lead
Funding Start 2007
Funding Finish 2008
GNo
Type Of Funding Aust Competitive - Non Commonwealth
Category 1NS
UON N

20052 grants / $495,972

Prospective evaluation of terrestrial and marine envenoming in humans: clinical effects, predictors of severity, toxicokinetics and potential treatments$486,250

Fellowship to cover salary for multiple studies in clinical toxicology.

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team

Isbister GK

Scheme Career Development Fellowships
Role Lead
Funding Start 2005
Funding Finish 2009
GNo
Type Of Funding Not Known
Category UNKN
UON N

A Randomised Controlled Trial of Hot Water (45°C) Immersion versus Ice Packs for Chironex fleckeri Stings$9,722

Funding body: Emergency Medicine Research Foundation Pty Ltd

Funding body Emergency Medicine Research Foundation Pty Ltd
Project Team

Isbister GK

Scheme Morson Taylor Research Award
Role Lead
Funding Start 2005
Funding Finish 2005
GNo
Type Of Funding Aust Competitive - Non Commonwealth
Category 1NS
UON N

20041 grants / $9,651

A randomised controlled trial of warm water versus ice packs for acute treatment of blue bottle (Physalia spp.) stings$9,651

RCT of hot water for blue bottle stings.

Funding body: Calvary Mater Newcastle

Funding body Calvary Mater Newcastle
Project Team

Isbister GK

Scheme Margaret Mitchell Grant
Role Lead
Funding Start 2004
Funding Finish 2005
GNo
Type Of Funding Aust Competitive - Non Commonwealth
Category 1NS
UON N

20032 grants / $7,500

PULSE Young Medical Researcher of the Year$5,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Professor Geoff Isbister
Scheme Research Grant
Role Lead
Funding Start 2003
Funding Finish 2003
GNo G0182734
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

North american Congress of Clinical Toxicology - 2003, Chicago, Illinois 4-9 September, 2003$2,500

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Geoff Isbister
Scheme Travel Grant
Role Lead
Funding Start 2003
Funding Finish 2003
GNo G0183162
Type Of Funding Internal
Category INTE
UON Y

20023 grants / $20,400

Development of High Performance liquid chromatography for assaying tetrodotoxin in urine and correlation with clinical features in tetrodotoxin poisoning$12,500

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Geoff Isbister
Scheme New Staff Grant
Role Lead
Funding Start 2002
Funding Finish 2002
GNo G0182662
Type Of Funding Internal
Category INTE
UON Y

Paediatric Poisoning$5,400

Funding body: Childrens Hospital Fund

Funding body Childrens Hospital Fund
Project Team

Corrine Balit

Scheme Small Grants Scheme
Role Investigator
Funding Start 2002
Funding Finish 2002
GNo
Type Of Funding External
Category EXTE
UON N

European Association of Poisons Centres and Clinical Toxicologists XXII International Congress, Lisbon Portugal, 22 - 25 May 2002$2,500

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Geoff Isbister
Scheme Travel Grant
Role Lead
Funding Start 2002
Funding Finish 2002
GNo G0181723
Type Of Funding Internal
Category INTE
UON Y
Edit

Research Supervision

Number of supervisions

Completed2
Current4

Total current UON EFTSL

PhD1.45

Current Supervision

Commenced Level of Study Research Title / Program / Supervisor Type
2016 PhD Co-evolution of Australian Snake Venoms and Prey
PhD (Clinical Pharm), Faculty of Health and Medicine, The University of Newcastle
Principal Supervisor
2015 PhD Snake Envenoming in Australia and Beyond: Investigating Myotoxicity and the Early use of Antivenom
PhD (Clinical Pharm), Faculty of Health and Medicine, The University of Newcastle
Principal Supervisor
2015 PhD Antidotes and Treatments in Overdose
PhD (Clinical Pharm), Faculty of Health and Medicine, The University of Newcastle
Principal Supervisor
2008 PhD Factors Contributing to Serotonin Toxicity
PhD (Clinical Pharm), Faculty of Health and Medicine, The University of Newcastle
Principal Supervisor

Past Supervision

Year Level of Study Research Title / Program / Supervisor Type
2016 PhD Investigation of the Coagulant Effects of Sri Lankan Snake Venoms and the Efficacy of Antivenoms
PhD (Clinical Pharm), Faculty of Health and Medicine, The University of Newcastle
Principal Supervisor
2015 PhD Sedation of Acute Behavioural Disturbance
PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle
Principal Supervisor
Edit

Research Collaborations

The map is a representation of a researchers co-authorship with collaborators across the globe. The map displays the number of publications against a country, where there is at least one co-author based in that country. Data is sourced from the University of Newcastle research publication management system (NURO) and may not fully represent the authors complete body of work.

Country Count of Publications
Australia 452
New Zealand 40
United Kingdom 30
Sri Lanka 30
United States 24
More...
Edit

News

Venom centre supported as part of $18.5 million health research boost

November 9, 2015

Researchers from the University of Newcastle (UON) will establish Australia's first Centre of Research Excellence (CRE) for venom and antivenom with $2.5 million funding from the National Health and Medical Research Council (NHMRC), just announced.

Professor Geoff Isbister

Position

Professor
Clinical Toxicology Research Group
School of Medicine and Public Health
Faculty of Health and Medicine

Contact Details

Email geoff.isbister@newcastle.edu.au
Phone (02) 4921 1211
Mobile 438466471
Fax (02) 4960 2088

Office

Room NM2 547
Building Mater Hospital Level 5 - New Med 2
Location Callaghan
University Drive
Callaghan, NSW 2308
Australia
Edit