Pharmacology and Poisoning
7 lessonsAbout this course
Pharmacology and toxicology form a vital component of Emergency Medicine practice and a high-yield area in the MRCEM SBA exam. Emergency clinicians encounter patients affected by therapeutic drug use, adverse reactions, overdoses, and toxic exposures every day — from paracetamol ingestion to organophosphate poisoning or opioid toxicity.
Understanding how drugs act (pharmacodynamics), how the body handles them (pharmacokinetics), and how to recognise and treat poisoning is critical for safe and effective emergency care.
Questions in this domain commonly test:
- Recognition of specific toxidromes (e.g. anticholinergic, opioid, cholinergic).
- Use of time-critical antidotes (e.g. NAC, naloxone, flumazenil, sodium bicarbonate, glucagon).
- Management of common overdoses using the ABCDE + TOX approach.
- Drug interactions, side-effects, and contraindications relevant to emergency prescribing.
- Safe use of procedural drugs (sedation, analgesia, antiemetics, etc.) in the ED setting.
This chapter provides a structured, RCEM-aligned summary of essential pharmacology principles, toxicology management, and antidote use — designed to help you quickly identify life-threatening poisonings, deliver evidence-based treatment, and succeed in MRCEM SBA questions that test both knowledge and prioritisation skills.
In the exam, always think: “What’s the mechanism, what’s the antidote, and what’s the next safest step in management?”