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September 1988

Toxicologic Analysis in Patients With Drug Overdose

Arch Intern Med. 1988;148(9):2077. doi:10.1001/archinte.1988.00380090131034

To the Editor.  —In their editorial comment1 on my study of laboratory testing2 for drug overdose, Snyder and Vlasses consider several important issues regarding the role of toxicology analysis. However, they misinterpret two points.First, they suggest that the eight drugs listed in Table 3 represent my conception of a group of drugs for which specific therapies are available. Their implication is that I endorse selective screening only for these substances in overdose patients. However, as noted in the text and in the legend, Table 3 actually lists eight drugs with known drug-specific therapies that appeared unexpectedly on toxicology screening in this particular patient population. Certainly, as Snyder and Vlasses1 have noted, unique clinical circumstances might dictate testing for a variety of other substances.Second, they state that I "discount the need for prospective assessment" of more selective drug screening. On the contrary, I clearly stated that

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