Abstract
The discipline of clinical toxicology has evolved from the art of identifying and managing common poisoning emergencies to an evidence-based specialty. In the main, the important early challenges which involved gastrointestinal decontamination and the specific treatment of medication-related poisonings (e.g., N-acetylcysteine for acetaminophen poisoning) have been met and have led to improvement in patient care. Clinical toxicologists must now begin to address the new challenges:namely, exposure to industrial, agricultural, and environmental chemicals. Thousands of new chemical compounds are developed each year. For many, we do not know the mechanism of toxicity, the long-term sequelae from exposure, or the appropriate management of toxicity.