Meghan Spyres

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Scholarly Contributions

Journals/Publications

• Crow, E. M., Spyres, M. B., Boley, S. P., Levine, M., & Stellpflug, S. J. (2021). Delayed peaks of acetaminophen in overdose patients with concomitant abdominal trauma. Clinical toxicology (Philadelphia, Pa.), 59(1), 65-68.
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  To present two cases of delayed acetaminophen absorption in abdominal trauma patients with concomitant acetaminophen overdose.
• Levine, M., Pizon, A., Beuhler, M., Cantrell, F. L., LoVecchio, F., Spyres, M., Skolnik, A. B., & Brooks, D. E. (2020). Exploratory Ingestions of Novel Anticoagulants and Antiplatelets: What Is the Risk?. Pediatric emergency care, 36(6), 283-285.
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  Historically, anticoagulants and antiplatelet agents included warfarin and aspirin, respectively. In recent years, numerous novel anticoagulants (eg, direct thrombin inhibitors and factor Xa inhibitors) as well as the adenosine diphosphate receptor antagonists have increased significantly. Little information on the bleeding risk after exploratory ingestion of these agents is available. The primary purpose of this study is to evaluate the bleeding risk of these agents after an exploratory ingestion in children 6 years or younger.
• Spyres, M. B., & Lapoint, J. (2020). Identification and management of marine envenomationsin pediatric patients. Pediatric emergency medicine practice, 17(4), 1-24.
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  Marine envenomations can cause a diverse array of clinical syndromes. Systemic and life-threatening reactions, as well as delayed presentations, can occur. The pediatric population is at higher risk for serious reactions to envenomations because their greater body surface area and smaller body mass can lead to a higher relative venom load. Although the majority of the literature on marine envenomations is of low quality, the available literature does suggest that management varies depending on the geographic location. This issue reviews both common and life-threatening presentations of marine envenomations, highlights key aspects of the history and physical examination that will help narrow the differential, and offers recommendations for management based on the envenomating creature and geographic location.
• Spyres, M. B., & O'Connor, A. D. (2020). Periorbital Edema Mimicking an Allergic Reaction After Black Widow Envenomation. Wilderness & environmental medicine, 31(1), 116-118.
• Spyres, M. B., Farrugia, L. A., Kang, A. M., Aldy, K., Calello, D. P., Campleman, S. L., Li, S., Beauchamp, G. A., Wiegand, T., Wax, P. M., Brent, J., & , T. I. (2020). The Toxicology Investigators Consortium Case Registry-the 2019 Annual Report. Journal of medical toxicology : official journal of the American College of Medical Toxicology, 16(4), 361-387.
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  The Toxicology Investigators Consortium (ToxIC) Registry was established by the American College of Medical Toxicology (ACMT) in 2010. The Registry collects data from participating sites with the agreement that all bedside medical toxicology consultation will be entered. This tenth annual report summarizes the Registry's 2019 data and activity with its additional 7177 cases. Cases were identified for inclusion in this report by a query of the ToxIC database for any case entered from 1 January to 31 December 2019. Detailed data was collected from these cases and aggregated to provide information which included demographics, reason for medical toxicology evaluation, agent and agent class, clinical signs and symptoms, treatments and antidotes administered, mortality, and whether life support was withdrawn. 50.7% of cases were female, 48.5% were male, and 0.8% were transgender. Non-opioid analgesics was the most commonly reported agent class, followed by opioid and antidepressant classes. Acetaminophen was once again the most common agent reported. There were 91 fatalities, comprising 1.3% of all Registry cases. Major trends in demographics and exposure characteristics remained similar to past years' reports. Sub-analyses were conducted to describe exposures in cases of self-harm, gender differences in substance use disorder, and trends in addiction medicine and pain management consultations.
• Spyres, M. B., Farrugia, L. A., Kang, A. M., Calello, D. P., Campleman, S. L., Pizon, A., Wiegand, T., Kao, L., Riley, B. D., Li, S., Wax, P. M., Brent, J., & , T. I. (2019). The Toxicology Investigators Consortium Case Registry-the 2018 Annual Report. Journal of medical toxicology : official journal of the American College of Medical Toxicology, 15(4), 228-254.
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  The Toxicology Investigators Consortium (ToxIC) Registry was established by the American College of Medical Toxicology (ACMT) in 2010. The Registry collects data from participating sites with the agreement that all bedside medical toxicology consultation will be entered. The objective of this ninth annual report is to summarize the Registry's 2018 data and activity with its additional 7043 cases. Cases were identified for inclusion in this report by a query of the ToxIC database for any case entered from 1 January to 31 December 2018. Detailed data was collected from these cases and aggregated to provide information which included demographics, reason for medical toxicology evaluation, agent and agent class, clinical signs and symptoms, treatments and antidotes administered, mortality, and whether life support was withdrawn. A total of 51.5% of cases were female, 48% were male, and 0.6% transgender. Non-opioid analgesics were the most commonly reported agent class, followed by antidepressants and opioids. Acetaminophen was once again the most common agent reported. There were 106 fatalities, comprising 1.5% of all registry cases. Major trends in demographics and exposure characteristics remained similar to past years' reports. Sub-analyses were conducted to describe exposures in elderly patients, addiction consultation practices, and risk factors for bupropion-induced seizures. The launch of the ToxIC Qualified Clinical Data Registry (TQCDR) is also described.
• Spyres, M. B., Moore, E. C., Ruha, A. M., & O'Connor, A. D. (2019). Moving Towards Gender Equality in Medical Toxicology. Journal of medical toxicology : official journal of the American College of Medical Toxicology, 15(4), 217-219.