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Trial registered on ANZCTR
Registration number
ACTRN12612001240831
Ethics application status
Approved
Date submitted
1/11/2012
Date registered
23/11/2012
Date last updated
9/01/2023
Date data sharing statement initially provided
14/02/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Australian TOxicology Monitoring(ATOM) Study: The pharmacokinetics and pharmacodynamics of drugs in overdose
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Scientific title
Australian TOxicology Monitoring(ATOM) Study: The pharmacokinetics and pharmacodynamics of drugs in overdose
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Secondary ID [1]
281488
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Nil
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Universal Trial Number (UTN)
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Trial acronym
ATOM study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Drugs in overdose
287754
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Condition category
Condition code
Other
288094
288094
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0
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Conditions of unknown or disputed aetiology (such as chronic fatigue syndrome/myalgic encephalomyelitis)
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
This study is looking at the pharmacokinetics and pharmacodynamics of various drugs in overdose.
It is not an interventional study.
The aim of this research project is to study the clinical pharmacology of a number of new drugs, by modelling their concentrations and clinical effects from data collected from overdose patients.
Participants will be selected by the Prince of Wales Toxicology unit, either by the Clinical Toxicologist or Toxicology Fellow.
Drugs of interest that will be studied include any newly marketed drugs, rare but serious overdoses such as colchicine, analgesics such as paracetamol and antipsychotics.
Data collected on these partcipants include drug and dose ingested, any symptoms, ECG data, drug and metabolite levels.
The study will run for 5 years
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Intervention code [1]
285998
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Not applicable
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Comparator / control treatment
None
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Pharmacokinetics of various drugs in overdose - by measuring concentrations of the drug or its metabolite in serum and or urine.
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Assessment method [1]
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Timepoint [1]
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Standard treatment in patients, whom take an overdose of a medication, depends on the drug ingested. The majority of patient's whom take an overdose will have an ECG and bloods taken on arrival to the emergency department. Then depending on the drug ingested, severity of the overdose and response to treatment, the patient may require additional ECG's and blood tests. The number and timing of these investigations depends on the drug ingested and the patients clinical condition. The Toxicologist on duty will determine how many blood samples will need to be collected.
Hence timepoints for data collection depends on the drug ingested, its half life, if its a sustained release product and the clinical condition of the patient.
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Primary outcome [2]
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Pharmacodynamics:determine the relationship between drug concentration and clinical effects.
For the study, it is intended to employ a population analysis technique that is reliant on recording relatively sparse data obtained in drug overdose circumstances. The modelling will require the sequential collection of drug concentrations, ECG parameters (e.g. QT interval) and the tracking of associated clinical effects, including the occurrence of arrhythmias and seizures
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Assessment method [2]
288299
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Timepoint [2]
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The number and timing of these investigations depends on the drug ingested and the patients clinical condition. The Toxicologist on duty will determine how many blood samples will need to be collected.
Hence timepoints for data collection depends on the drug ingested, its half life, if its a sustained release product and the clinical condition of the patient.
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Secondary outcome [1]
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nil
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Assessment method [1]
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Timepoint [1]
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nil
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Eligibility
Key inclusion criteria
Overdose in the past 24 hours with a drug
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Minimum age
14
Years
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Maximum age
100
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
In custody
less than 14 years
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Convenience sample
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/12/2012
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Actual
1/12/2012
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
2000
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Accrual to date
1000
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD
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Recruitment hospital [1]
7472
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Prince of Wales Hospital - Randwick
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Recruitment hospital [2]
7473
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Royal Prince Alfred Hospital - Camperdown
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Recruitment hospital [3]
7474
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The Children's Hospital at Westmead - Westmead
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Recruitment hospital [4]
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Westmead Hospital - Westmead
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Recruitment hospital [5]
7476
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Blacktown Hospital - Blacktown
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Recruitment hospital [6]
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Sydney Children's Hospital - Randwick
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Recruitment hospital [7]
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Princess Alexandra Hospital - Woolloongabba
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Recruitment hospital [8]
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Calvary Mater Newcastle - Waratah
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Recruitment hospital [9]
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Royal North Shore Hospital - St Leonards
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Recruitment postcode(s) [1]
15301
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4102 - Woolloongabba
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Recruitment postcode(s) [2]
15302
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2298 - Waratah
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Recruitment postcode(s) [3]
29343
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2065 - St Leonards
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Funding & Sponsors
Funding source category [1]
286260
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Hospital
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Name [1]
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Prince of Wales Hospital
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Address [1]
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Clinical Toxicology Unit
POWH
Barker Street Randwick 2031
NSW
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Country [1]
286260
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Australia
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Primary sponsor type
Hospital
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Name
Prince of Wales Hospital
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Address
Clinical Toxicology Unit
POWH
Barker Street Randwick 2031
NSW
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
285060
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Address [1]
285060
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Country [1]
285060
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288336
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South Eastern Sydney Local Health District HREC - southern sector
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Ethics committee address [1]
288336
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Room G71 East wing Edmund Blacket Building POWH Barker Street Randwick NSW 2031
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Ethics committee country [1]
288336
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Australia
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Date submitted for ethics approval [1]
288336
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Approval date [1]
288336
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05/10/2012
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Ethics approval number [1]
288336
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1/12/0067
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Summary
Brief summary
To study the clinical pharmacology of a number of drugs in overdose. Many medications behave differently in overdose than in clinical situations. There is limited data on the pharmacokinetics and dynamics of many new drugs in overdose. This study aims to model drug concentration and clinical effects from data collected from overdose patients
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Trial website
https://www.newcastle.edu.au/research/centre/clinical-toxicology/research/australian-toxicology-monitoring-study-atom
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Trial related presentations / publications
1. 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). Clin Toxicol (Phila). 2016;54(6):488-94. 2. Chiew AL, Isbister GK, Kirby KA, Page CB, Chan BSH, Buckley NA. Massive paracetamol overdose: an observational study of the effect of activated charcoal and increased acetylcysteine dose (ATOM-2). Clin Toxicol (Phila). 2017; 55(10): 1055-65. 3. Chiew AL, Isbister GK, Page CB, Kirby KA, Chan BSH, Buckley NA. Modified release paracetamol overdose: a prospective observational study (ATOM-3). Clin Toxicol (Phila). 2018: 1-10. 4. Chan BS, Isbister GK, Page CB, Isoardi KZ, Chiew AL, Kirby KA, et al. Clinical outcomes from early use of digoxin-specific antibodies versus observation in chronic digoxin poisoning (ATOM-4). Clin Toxicol (Phila). 2019;57(7):638-43. 5. Chiew AL, James LP, Isbister GK, Pickering JW, McArdle K, Chan SH, Buckley NA. Early acetaminophen-protein adducts predict hepatotoxicity following overdose (ATOM 5). Journal of Hepatology. 2020, 72(3): 450–462. 6. Chan BS, Isbister GK, Chiew A, Isoardi K, Buckley NA. Clinical experience with titrating doses of digoxin antibodies in acute digoxin poisoning. (ATOM-6). Clin Toxicol (Phila). 2022 Apr;60(4):433-439.
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Public notes
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Contacts
Principal investigator
Name
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Dr Angela Chiew
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Address
34911
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Department of Clinical Toxicology
Prince of Wales Hospital
Barker Street
Randwick NSW 2031
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Country
34911
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Australia
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Phone
34911
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+61 9382 8400
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Fax
34911
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+61 2 60160860
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Email
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[email protected]
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Contact person for public queries
Name
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Angela Chiew
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Address
18158
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Prince of Wales Hospital
Emergency Department
Barker Street
Randwick, NSW 2031
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Country
18158
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Australia
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Phone
18158
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+61 2 9382 4269
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Fax
18158
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Email
18158
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[email protected]
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Contact person for scientific queries
Name
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Angela Chiew
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Address
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Prince of Wales Hospital
Emergency Department
Barker Street
Randwick, NSW 2031
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Country
9086
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Australia
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Phone
9086
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+61 2 9382 4269
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Fax
9086
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Email
9086
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
6918
Study protocol
363233-(Uploaded-07-02-2020-09-33-06)-Study-related document.pdf
6919
Ethical approval
363233-(Uploaded-03-02-2020-10-37-13)-Study-related document.pdf
6920
Informed consent form
363233-(Uploaded-03-02-2020-10-36-55)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Modified release paracetamol overdose: a prospective observational study (ATOM-3).
2018
https://dx.doi.org/10.1080/15563650.2018.1439950
Embase
Early acetaminophen-protein adducts predict hepatotoxicity following overdose (ATOM-5).
2020
https://dx.doi.org/10.1016/j.jhep.2019.10.030
N.B. These documents automatically identified may not have been verified by the study sponsor.
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