What this is
ResusDoc Toxicology Monographs is a free, referenced library explaining how poisons actually work — what the toxic species is, how it is made, where it goes, which organ it destroys and why that organ, and how the whole thing unfolds against the clock. It is written for UK-registered healthcare professionals.
A poison is a drug whose kinetics have escaped its pharmacology.
It exists because the free references answer a different question. TOXBASE is a management database behind an NHS login; UpToDate is paywalled; the textbooks are not indexed. What almost nothing free answers is why — why paracetamol kills zone 3 hepatocytes and not the whole liver, why the ethylene glycol patient looks well for eight hours and then loses their kidneys.
If you are in crisis
Every page on this site carries a crisis-support block that cannot be dismissed. That is a deliberate design decision, and it is worth explaining rather than leaving people to wonder why the banner will not close.
Pages about poisons are indexed publicly, and somebody typing paracetamol overdose into a search engine is not reliably a clinician. An audience statement in the footer does not change who arrives. So the signposting is part of the page rather than a notification: no close button, and no memory of having been closed, because the reader who most needs it may not be the reader who dismissed it on a previous visit.
What this site deliberately does not contain
- No comparative lethality. Nothing here ranks poisons by danger, and there are no "most toxic" lists.
- No lethal-dose framing. Where a number appears it is a treatment threshold — the point at which a clinician should act — sourced to NPIS-aligned guidance.
- Nothing about obtaining or preparing any substance.
- Nothing written as instruction. These pages explain what a poison does to a body. That is a different thing from telling anybody what to do.
Evidence tiers — and why they are on the page
A mechanism library is made almost entirely of received mechanisms — explanations that are taught, repeated and rarely re-checked. The sibling Drug Monographs site learned this the hard way: its audits found that well-known mechanisms survive unchallenged far longer than numbers do, because nobody thinks to verify something everybody already knows.
So every mechanistic claim here carries a visible tier rather than a private one:
- Established — demonstrated in humans, or in an animal or cellular model that reproduces the human syndrome.
- Inferred — consistent with the biochemistry and widely accepted, but the causal step itself has not been shown in humans. Most of what is taught as mechanism sits here honestly.
- Traditional teaching — taught and repeated but not demonstrated. A claim is only downgraded to this tier when there is a published source questioning it, and that source is cited on the page.
Who writes it
Written and edited by Dr Nirmalya Hore, Associate Specialist in Emergency Medicine, practising in the UK NHS.
This is a personal, independent project. It is not produced by, affiliated with, or endorsed by any NHS body, royal college, university, poisons service or manufacturer. No content is sponsored, commissioned or reviewed by any commercial interest.
How it is written — including the use of AI
The verification process
- Toxicokinetic figures and treatment thresholds are checked against a primary source — normally the published systematic review or the current Summary of Product Characteristics on the electronic Medicines Compendium, fetched directly rather than taken from a search summary.
- Dialysability is cited to the EXTRIP workgroup recommendation for that specific poison, with the strength of the recommendation stated, not to a general statement that a poison is "dialysable".
- Trial and cohort figures are checked against the publication itself, not against reviews of it. A genuine citation attached to a number is not evidence that the number came from it.
- Mechanisms carry an explicit evidence tier, and a downgrade requires a citation for the doubt.
- Each content band gets an independent audit pass before it is deployed, split across separate reviewers, each given one specific thing to check.
A verification date is recorded against each reference. Where a figure could be sourced only once, or where a source could not be re-retrieved, the reference says so.
Known limitations
Stating these is more useful than implying they do not exist.
- Mechanism is the least verifiable content type on this site, which is the reverse of the drug library where dosing dominates. There is no equivalent of a product licence to check a mechanism against. The evidence tiers exist because of this, not despite it.
- Threshold doses and concentrations are frequently soft. For several poisons the literature simply does not contain a defensible human threshold, and where that is the case the page says so rather than quoting a number that looks authoritative.
- This site does not cover management, so it will not tell you a decontamination window, an antidote dose or a disposition. That is TOXBASE's job and it does it better.
- Guidance changes, sometimes faster than this site does. The last reviewed date on each page tells you how current that specific check is.
Corrections and review
Monographs are reviewed at least annually, and sooner where relevant guidance changes. Each page carries a last reviewed date at the foot and a version stamp in the footer.
This site holds no personal data. There are no accounts, no logins and nothing is stored about you or your patients.