Professor Nicholas Buckley

MD FRACP

Professor of Clinical Pharmacology, University of Sydney

Visiting Professor, University of Peradeniya, Sri Lanka & Research Director, South Asian Clinical Toxicology Research Collaboration (SACTRC)

Consultant Clinical Pharmacologist & Toxicologist, NSW Poisons Information Centre & Royal PrinceAlfred Hospital.

Deputy Editor,Clinical Toxicology.

Member of Editorial boards of Drug Safety & Australian Prescriber

Chair of the Editorial Advisory Board of the Australian Medicines Handbook

Chair of the Australian Therapeutic Guidelines - Toxicology and Toxinology writing group

Nick Buckley is Professor of Clinical Pharmacology and a practicing clinical toxicologist consulting at RPA and through all the Poisons Centres in Australia. He is best known internationally for being a co-founder of the SACTRC collaboration, a centre of clinical toxicology research excellence in Sri Lanka with a focus on agrochemical poisoning and snakebite. http://www.sactrc.org/ Nick has been involved with contributing to the Australian Medicines Handbook since it was founded in 1998, and is now Chair of the Editorial Advisory Board. He was a founding Member of the Australian Advisory Committee on the Safety of Medicines (ACSOM). He is a past President of the Asia Pacific Association of Medical Toxicology. Nick is highly experienced in clinical epidemiology and research design. His research has attracted continuous project and program funding since 2002 and has resulted in an extensive publication record including 440+ peer reviewed journal articles and 22 book chapters. He has supervised or co-supervised over 20 higher degree students.

  • Toxicovigilance - detection of emerging toxicological problems
  • Epidemiology of poisoning and drug abuse
  • Coronial data on lethal poisoning and adverse drug effects
  • Pharmaco-epidemiology studies on adverse drug effects and drug interactions
  • Mechanisms and outcomes from acute kidney injury after poisoning/snakebite
  • Effect of pesticide bans and safe storage of pesticides
  • Descriptive studies of the mechanism of toxicity of a range of pesticide poisonings
  • Comparisons of the relative toxicity of different pesticides
  • Measurement of long-term neurotoxicity after acute poisoning
  • Trials of regulatory restrictions and reformulation of pesticides
  • Evaluation of investigations used in poisoning
  • Clinical trials of existing antidotes for poisoning
  • Development of new antidotes for poisoning
  • Clinical trials comparing different strategies to manage snakebite
  • Systematic reviews of treatments of poisoning
  • Developmental toxicity from pesticides
  • Paracetamol poisoning
  • Pharmacometrics - modelling of drug concentrations and effects.
  • Cardiotoxicity of psychotropic drugs

My particular interests within undergraduate teaching are evidence-based clinical teaching with a focus on clinical pharmacology and toxicology and understanding the immediate relevance of mechanisms to clinical practice.

Reproductive, Maternal and Child Health, Neurosciences and Mental Health, Healthy Ageing
Project titleResearch student
Poisonings with over-the-counter medications: improving understanding to guide medication safety initiativesAnnabelle CHIDIAC
Epidemiological analysis of Benzodiazepine overdose and associated drugsSteven JOFFE
A pharmacoepidemiologic study of the cardiometabolic adverse effects associated with off-label low dose antipsychotic treatmentRamya RADHA KRISHNAN

Publications

Journals

  • Isbister, G., Jenkins, S., Downes, M., Fakes, K., Buckley, N. (2024). A randomized controlled trial and prospective cohort investigating antivenom for red-bellied black snake envenomation. Clinical Toxicology, 62(6), 343-351. [More Information]
  • Qiang, S., Abdul Cader, M., Raubenheimer, J., Buckley, N., Roberts, M., Mackenzie, L. (2024). Clinical toxicology of acute glyphosate self-poisoning: impact of plasma concentrations of glyphosate, its metabolite and polyethoxylated tallow amine surfactants on the toxicity. Clinical Toxicology. [More Information]
  • Isoardi, K., Harris, K., Currey, E., Buckley, N., Isbister, G. (2024). Effectiveness of intramuscular naloxone 1,600 μg in addition to titrated intravenous naloxone 100 μg for opioid poisoning: a randomised controlled trial. Clinical Toxicology. [More Information]

2024

  • Isbister, G., Jenkins, S., Downes, M., Fakes, K., Buckley, N. (2024). A randomized controlled trial and prospective cohort investigating antivenom for red-bellied black snake envenomation. Clinical Toxicology, 62(6), 343-351. [More Information]
  • Qiang, S., Abdul Cader, M., Raubenheimer, J., Buckley, N., Roberts, M., Mackenzie, L. (2024). Clinical toxicology of acute glyphosate self-poisoning: impact of plasma concentrations of glyphosate, its metabolite and polyethoxylated tallow amine surfactants on the toxicity. Clinical Toxicology. [More Information]
  • Isoardi, K., Harris, K., Currey, E., Buckley, N., Isbister, G. (2024). Effectiveness of intramuscular naloxone 1,600 μg in addition to titrated intravenous naloxone 100 μg for opioid poisoning: a randomised controlled trial. Clinical Toxicology. [More Information]

2023

  • Chiew, A., Isbister, G., Stathakis, P., Isoardi, K., Page, C., Ress, K., Chan, B., Buckley, N. (2023). Acetaminophen Metabolites on Presentation Following an Acute Acetaminophen Overdose (ATOM-7). Clinical Pharmacology & Therapeutics. [More Information]
  • Pearson, M., Dawson, A., Raubenheimer, J., Senerathna, L., Conigrave, K., Lee, K., Rajapakse, T., Pushpakumara, P., Siribaddana, S., Soerensen, J., Buckley, N., Haber, P., Dzidowska, M., Glozier, N., et al (2023). Community-based alcohol education intervention (THEATRE) study to reduce harmful effects of alcohol in rural Sri Lanka: design and adaptation of a mixed-methods stepped wedge cluster randomised control trial. BMJ Open, 13(6). [More Information]
  • Deuster, E., Tomenson, J., Abdul Cader, M., Gawarammana, I., Buckley, N., Wilks, M., Eddleston, M. (2023). Dose ingested, vomiting, and outcome in patients ingesting a standard paraquat 20SL formulation. Clinical Toxicology, 61(1), 29-38. [More Information]

2022

  • Rambabu, L., Abdul Cader, M., Dhanarisi, J., Gawarammana, I., Raubenheimer, J., Mackenzie, L., Roberts, M., Buckley, N., Eddleston, M. (2022). Acute phenthoate self-poisoning: a prospective case series. Clinical Toxicology, 60(2), 214-220. [More Information]
  • Dassanayake, T., Weerasinghe, V., Gawarammana, I., Buckley, N. (2022). Changes of attention-related brain activity over 6 months after acute organophosphate pesticide poisoning: a prospective follow-up study. Clinical Toxicology, 60(5), 576-584. [More Information]
  • Perananthan, V., Wijerathna, T., Abdul Cader, M., Gawarammana, I., Dawson, A., Buckley, N. (2022). Circulating intestinal fatty acid binding protein and intestinal toxicity in Russell’s viper envenomation. Clinical Toxicology, 60(3), 311-318. [More Information]

2021

  • Brett, J., Pearson, S., Daniels, B., Wylie, C., Buckley, N. (2021). A cross sectional study of psychotropic medicine use in Australia in 2018: A focus on polypharmacy. British Journal of Clinical Pharmacology, 87(3), 1369-1377. [More Information]
  • Chiew, A., Buckley, N. (2021). Acetaminophen Poisoning. Critical Care Clinics, 37(3), 543-561. [More Information]
  • Hurzeler, T., Buckley, N., Noghrehchi, F., Malouf, P., Page, A., Schumann, J., Chitty, K. (2021). Alcohol-related suicide across Australia: a geospatial analysis. Australian and New Zealand Journal of Public Health, 45(4), 394-399. [More Information]

2020

  • Cairns, R., Raubenheimer, J., Brown, J., McArdle, K., Buckley, N. (2020). 2,4-Dinitrophenol exposures and deaths in Australia after the 2017 up-scheduling. Medical Journal of Australia, 212(9), 434-4340. [More Information]
  • Wylie, C., Daniels, B., Brett, J., Pearson, S., Buckley, N. (2020). A national study on prescribed medicine use in Australia on a typical day. Pharmacoepidemiology and Drug Safety, 29(9), 1046-1053. [More Information]
  • Chong, D., Buckley, N., Schumann, J., Chitty, K. (2020). Acute alcohol use in Australian coronial suicide cases, 2010-2015. Drug and Alcohol Dependence, 212, 108066. [More Information]

2019

  • Borruso, L., Buckley, N., Kirby, K., Carter, G., Pilgrim, J., Chitty, K. (2019). Acute Alcohol Co-Ingestion and Hospital-Treated Deliberate Self-Poisoning: Is There an Effect on Subsequent Self-Harm? Suicide and Life-Threatening Behavior, 49(1), 293-301. [More Information]
  • Albuquerque, P., da Silva Junior, G., Meneses, G., Marins, A., Lima, D., Raubenheimer, J., Fatima, S., Buckley, N., Daher, E. (2019). Acute Kidney Injury Induced by Bothrops Venom: Insights into the Pathogenic Mechanisms. Toxins, 11(3), 1-14. [More Information]
  • Cairns, R., Brown, J., Buckley, N. (2019). Adolescent self-harm: over-the-counter medicines fly under the radar. Australian Prescriber, 42(5), 151. [More Information]

2018

  • Bell, J., Bentley, J., Downie, C., Cairns, R., Buckley, N., Katelaris, A., Pearson, S., Nassar, N. (2018). Accidental pharmacological poisonings in young children: population-based study in three settings. Clinical Toxicology, 56(8), 782-789. [More Information]
  • Wijerathna, T., Abdul Cader, M., Dissanayaka, D., Gawarammana, I., Palangasinghe, C., Shihana, F., Endre, Z., Shahmy, S., Buckley, N. (2018). Albuminuria and other renal damage biomarkers detect acute kidney injury soon after acute ingestion of oxalic acid and potassium permanganate. Toxicology Letters, 299, 182-190. [More Information]
  • Chan, B., Chiew, A., Grainger, S., Page, C., Gault, A., Mostafa, A., Roberts, M., Buckley, N. (2018). Bromoxynil and 2-methyl-4-chlorophenoxyacetic acid (MCPA) poisoning could be a bad combination. Clinical Toxicology, 56(9), 861-863. [More Information]

2017

  • Isbister, G., Jayamanne, S., Mohamed, F., Dawson, A., Maduwage, K., Gawarammana, I., Lalloo, D., de Silva, H., Scorgie, F., Lincz, L., Buckley, N. (2017). A randomized controlled trial of fresh frozen plasma for coagulopathy in Russell's viper (Daboia russelii) envenoming. Journal of Thrombosis and Haemostasis, 15(4), 645-654. [More Information]
  • Silva, A., Maduwage, K., Buckley, N., Lalloo, D., de Silva, H., Isbister, G. (2017). Antivenom for snake venom-induced neuromuscular paralysis [intervention protocol]. Cochrane Database of Systematic Reviews, 2017 (3), 1-10. [More Information]
  • Chitty, K., Isbister, G., Dawson, A., Buckley, N. (2017). Authors' reply. British Journal of Psychiatry, 211(1), 53-54. [More Information]

2016

  • Shihana, F., Dawson, A., Dobbins, T., Dissanayake, D., Buckley, N. (2016). A bedside test for methaemoglobinemia improved antidote use in propanil poisoning. Clinical Toxicology, 54(7), 576-580. [More Information]
  • Shihana, F., Dawson, A., Buckley, N. (2016). A bedside test for methemoglobinemia, Sri Lanka. Bulletin of the World Health Organization, 94(8), 622-625. [More Information]
  • Cairns, R., Brown, J., Lynch, A., Robinson, J., Wylie, C., Buckley, N. (2016). A decade of Australian methotrexate dosing errors. Medical Journal of Australia, 204(10), 384.e1-384.e6. [More Information]

2015

  • Berling, I., Buckley, N., Mostafa, A., Downes, M., Grice, J., Medley, G., Roberts, M., Isbister, G. (2015). 2-Methyl-4-chlorophenoxyacetic acid and bromoxynil herbicide death. Clinical Toxicology, 53(5), 486-488. [More Information]
  • Buckley, N., Whyte, I., Dawson, A., Isbister, G. (2015). A prospective cohort study of trends in self-poisoning, Newcastle, Australia, 1987-2012: plus ca change, plus c'est la meme chose. Medical Journal of Australia, 202(8), 438-442. [More Information]
  • Pearson, S., Abrahamowicz, M., Srasuebkul, P., Buckley, N. (2015). Antidepressant therapy in cancer patients: initiation and factors associated with treatment. Pharmacoepidemiology and Drug Safety, 24(6), 600-609. [More Information]

2014

  • Chan, B., Buckley, N. (2014). Authors' responses to Letter to the Editor regarding 'Early digoxin-specific antibody fragments to treat patients at risk of life-threatening toxicity'. Clinical Toxicology, 52(9), 987-987. [More Information]
  • Chiew, A., Buckley, N. (2014). Carbon monoxide poisoning in the 21st century. Critical Care, 18(2), 1-8. [More Information]
  • Chan, B., Buckley, N. (2014). Digoxin-specific antibody fragments in the treatment of digoxin toxicity. Clinical Toxicology, 52(8), 824-836. [More Information]

2013

  • Isbister, G., Buckley, N., Page, C., Scorgie, F., Lincz, L., Seldon, M., Brown, S. (2013). A randomized controlled trial of fresh frozen plasma for treating venom-induced consumption coagulopathy in cases of Australian snakebite (ASP-18). Journal of Thrombosis and Haemostasis, 11(7), 1310-1318. [More Information]
  • Roberts, D., Hall, M., Falkland, M., Strasser, S., Buckley, N. (2013). Amanita phalloides poisoning and treatment with silibinin in the Australian Capital Territory and New South Wales. Medical Journal of Australia, 198(1), 43-47. [More Information]
  • Buckley, N., Juurlink, D. (2013). Carbon monoxide treatment guidelines must acknowledge the limitations of the existing evidence. American Journal of Respiratory and Critical Care Medicine, 187(12), 1390-1390. [More Information]

2012

  • Senarathna, L., Jayamanna, S., Kelly, P., Buckley, N., Dibley, M., Dawson, A. (2012). Changing epidemiologic patterns of deliberate self poisoning in a rural district of Sri Lanka. BMC Public Health, 12, 1-8. [More Information]
  • Allen, G., Brown, S., Buckley, N., O'Leary, M., Page, C., Currie, B., White, J., Isbister, G., et al (2012). Clinical effects and antivenom dosing in brown snake (Pseudonaja spp.) envenoming--Australian snakebite project (ASP-14). PloS One, 7(12), e53188. [More Information]
  • Stavrou, E., Buckley, N., Olivier, J., Pearson, S. (2012). Discontinuation of statin therapy in older people: does a cancer diagnosis make a difference? An observational cohort study using data linkage. BMJ Open, 2(3), 1-6. [More Information]

2011

  • Pearson, M., Konradsen, F., Gunnell, D., Dawson, A., Pieris, R., Weerasinghe, M., Knipe, D., Jayamanne, S., Metcalfe, C., Hawton, K., et al (2011). A community-based cluster randomised trial of safe storage to reduce pesticide self-poisoning in rural Sri Lanka: study protocol. BMC Public Health, 11, 1-8. [More Information]
  • Buckley, N., Rossi, S. (2011). Bringing greater transparency to "black box" warnings. Clinical Toxicology, 49(6), 448-451. [More Information]
  • Roberts, D., Wilks, M., Roberts, M., Swaminathan, R., Mohamed, F., Dawson, A., Buckley, N. (2011). Changes in the concentrations of creatinine, cystatin C and NGAL in patients with acute paraquat self-poisoning. Toxicology Letters, 202(1), 69-74. [More Information]

2010

  • Roberts, D., Buckley, N., Mohamed, F., Eddleston, M., Goldstein, D., Mehrsheikh, A., Bleeke, M., Dawson, A. (2010). A prospective observational study of the clinical toxicology of glyphosate-containing herbicides in adults with acute self-poisoning. Clinical Toxicology, 48(2), 129-136. [More Information]
  • Shihana, F., Dissanayake, D., Buckley, N., Dawson, A. (2010). A simple quantitative bedside test to determine methemoglobin. Annals of Emergency Medicine, 55(2), 184-185. [More Information]
  • Dawson, A., Eddleston, M., Senarathna, L., Mohamed, F., Gawarammana, I., Bowe, S., Manuweera, G., Buckley, N. (2010). Acute human lethal toxicity of agricultural pesticides: a prospective cohort study. PLoS Medicine, 7(10), 1-10. [More Information]

2009

  • Perera, P., Jayamanna, S., Hettiarachchi, R., Abeysinghe, C., Karunatilake, H., Dawson, A., Buckley, N. (2009). A phase II clinical trial to assess the safety of clonidine in acute organophosphorus pesticide poisoning. Trials, 10, 73-73. [More Information]
  • Eddleston, M., Buckley, N. (2009). A strategy for changing plasma pralidoxime kinetics and, perhaps, effect in organophosphorus insecticide poisoning. Critical Care Medicine, 39(4), 908-909. [More Information]
  • Fahim, M., Gawarammana, I., Robertson, T., Roberts, M., Palangasinghe, C., Zawahir, S., Jayamanne, S., Kandasamy, J., Eddleston, M., Buckley, N., Dawson, A., et al (2009). Acute human self-poisoning with imidacloprid compound: a neonicotinoid insecticide. PloS One, 4(4), e5127. [More Information]

2008

  • Eyer, P., Eddleston, M., Thiermann, H., Worek, F., Buckley, N. (2008). Are we using the right dose? - A tale of mole and gram. British Journal of Clinical Pharmacology, 66(4), 451-452. [More Information]
  • Ding, G., Buckley, N. (2008). Evidence and consequences of spectrum bias in studies of criteria for liver transplant in paracetamol hepatotoxicity. QJM: Quarterly Journal of Medicine, 10(9), 723-729. [More Information]
  • Wilks, M., Fernando, R., Ariyananda, P., Eddleston, M., Berry, D., Tomenson, J., Buckley, N., Jayamanne, S., Gunnell, D., Dawson, A. (2008). Improvement in survival after paraquat ingestion following introduction of a new formulation in Sri Lanka. PLoS Medicine, 5(2), 0250-0259. [More Information]

2007

  • Isbister, G., Friberg, L., Stokes, B., Buckley, N., Lee, C., Gunja, N., Brown, S., MacDonald, E., Graudins, A., Holdgate, A., et al (2007). Activated charcoal decreases the risk of QT prolongation after citalopram overdose. Annals of Emergency Medicine, 50(5), 593-600 +600.e1-600.e46. [More Information]

2006

  • Eddleston, M., Buckley, N., Gunnell, D., Dawson, A., Konradsen, F. (2006). Identification of strategies to prevent death after pesticide self-poisoning using a Haddon matrix. Injury Prevention, 12, 333-337. [More Information]

2005

  • Cooper, G., Le Couteur, D., Richardson, D., Buckley, N. (2005). A randomized clinical trial of activated charcoal for the routine management of oral drug overdose. QJM, 98(9), 655-660. [More Information]
  • Roberts, D., Buckley, N. (2005). Alkalinisation for organophosphorus pesticide poisoning. Cochrane Database of Systematic Reviews. [More Information]
  • Isbister, G., Buckley, N. (2005). Clomipramine and neuroleptic malignant syndrome: literature on adverse reactions to psychotropic drugs continues to confuse. BMJ. [More Information]

2003

  • Buckley, N., Chevalier, S., Leditschke, A., O'Connell, D., Leitch, J., Pond, S. (2003). The limited utility of electrocardiography variables used to predict arrhythmia in psychotropic drug overdose. Critical Care, 7(5), R101-R107.

2002

  • Whyte, I., Buckley, N., Dawson, A. (2002). Data Collection in Clinical Toxicology: Are There Too Many Variables? Journal of Toxicology. Clinical Toxicology, 40(3), 223-230. [More Information]
  • Buckley, N., Whyte, I., Dawson, A. (2002). Diagnostic Data in Clinical Toxicology-Should We Use a Bayesian Approach? Journal of Toxicology. Clinical Toxicology, 40(3), 213-222. [More Information]
  • Buckley, N., McManus, P. (2002). Fatal toxicity of serotoninergic and other antidepressant drugs: analysis of United Kingdom mortalilty data. BMJ: British Medical Journal, 325(7376), 1332-1333. [More Information]

Selected Grants

2023

  • Rewarding Research 2024, Buckley N, Faculty of Medicine and Health/FMH Rewarding Research Success

2022

  • A realist evaluation of an Inter-Professional medication safety micro-curriculum bridging case-based and simulation worlds, Charles (nee Slaviero) K, Schneider C, Frotjold A, Carter S, Maw M, Buckley N, Australian and New Zealand Association for Health Professional Educators (ANZAHPE)/ANZAHPE Research Grants