Research Article
6 August 2026
Saudi Toxicology Journal (STJ) is the official journal of the Saudi Toxicology Society (STS) and hosted by digital commons of Elsevier. STJ is a peer-reviewed, multidisciplinary, open-access journal dedicated to advancing research across all areas of toxicological sciences. The journal operates a continuous publication model, ensuring rapid dissemination of high-quality research. STJ provides an international platform for scientific contributions addressing toxic agents, drugs/natural products safety and efficacy, underlying mechanisms, analytical approaches, and the prevention and management of toxic exposures and their impact on human health.
The readership of STJ includes researchers, clinicians, toxicologists, pharmacists, forensic scientists, and professionals working in academic, healthcare, industrial, environmental, and regulatory settings worldwide, as well as postgraduate trainees and advanced undergraduate students with an interest in toxicological sciences.
Current Issue
Volume 3, Issue 2 (2026)View issue
Featured Content
- Case Report3 August 2026
Accidental Transdermal Buprenorphine Patch Overdose in an Older Adult: A Case Report
Background: Buprenorphine is an opioid that is generally used for chronic pain and opioid dependence. Its pharmacological ceiling effect on respiratory depression gives it a comparatively favorable safety profile relative to other opioids. Despite its safety profile, inappropriate use can still result in clinically significant opioid poisoning. This case report highlights a case of accidental buprenorphine overdose in an aged patient. It illustrates the clinical presentation and preventive considerations associated with this uncommon but critical event. Case presentation: A 65-year-old woman with recent left total knee replacement was brought to the Emergency Department (ED) after being found drowsy and unresponsive at home. Initial clinical presentations showed a somnolence patient with hypoxia. A comprehensive physical examination and investigations showed no clear evidence of a respiratory etiology nor intracranial pathology. Detailed history revealed the use of buprenorphine transdermal patches that were mistaken for wound dressings. Three transdermal patches of (Butrans\textregistered ), 10 mcg/hour were used simultaneously. Intervention/Outcome: The patient was treated for suspected opioid toxicity with naloxone 0.4 mg intravenously followed by an additional 0.8 mg intravenously resulting in a rapid improvement in consciousness and resolution of hypoxia. Eventually the patient was admitted for observation for 24 hours and was discharged the next day with no complications. Conclusion: This case highlights that buprenorphine transdermal patches can cause life-threatening opioid toxicity when misused. Elderly patients are particularly vulnerable due to medication errors and age-related physiological changes. Careful counseling, clear labeling and appropriate prescribing practices are essential to prevent similar adverse events.
Current Articles
Most Popular Articles
- Review Article24 January 2026
SGLT2 Inhibitors in Diabetes Management: Mechanisms, Clinical Benefits, and Expanding Therapeutic Frontiers
The kidneys play a vital role in renal glucose reabsorption, with the sodium-glucose cotransporter-2 (SGLT2) in the proximal renal tubules performing a crucial function in reabsorbing glucose into the bloodstream. SGLT2-selective inhibitors are a new class of oral antidiabetic drugs that enhance glycemic control in diabetic patients by blocking glucose reabsorption. These drugs are primarily developed to treat type 2 diabetes mellitus (T2DM). This review summarizes the latest preclinical and clinical trials on SGLT2 inhibitors. These new oral antidiabetic agents effectively and selectively block SGLT2, leading to a reduction in blood glucose levels and HbA1c in both diabetic animal models and T2DM patients. SGLT2 inhibitors provide several advantages over other oral hypoglycemic agents, including consistent glucose control by avoiding major risks such as hypoglycemia, β-cell dysfunction, and insulin resistance, due to their insulin-independent mechanism. They have also shown promising results in lowering body weight and blood pressure. Preclinical and clinical trials have demonstrated their safety and tolerability, as well as the potential to be combined with other antidiabetic drugs for successful and long-term glycemic management. However, the long-term safety of these medications still requires thorough investigation. - Review Article13 February 2025
Pharmacogenomics Implications of Tamoxifen in Breast Cancer Treatment: Clinical Relevance and Future Directions
Tamoxifen is a cornerstone therapy for estrogen receptor-positive (ER+) breast cancer, improving survival and reducing recurrence. Its efficacy and toxicity, however, vary due to genetic polymorphisms influencing metabolism and transport. Key genes, such as CYP2D6, CYP3A4, and ATP-binding cassette transporters (ABCB1, ABCC2), are crucial in forming and distributing active metabolites like endoxifen. This review explores tamoxifen pharmacogenetics through an analysis of literature from PubMed, Scopus, Google Scholar, and PharmaGKB. Genetic variations like CYP2D6*10 in Asians and CYP2D6*17/29 in Africans impact therapeutic outcomes. Barriers to personalized tamoxifen therapy include inconsistent guidelines, limited access to genetic testing, and underrepresentation of ethnic groups in research.The findings highlight the need for multidisciplinary approaches integrating genetic, clinical, and environmental factors to optimize therapy. Large-scale, diverse, population-specific studies are essential to establish universal pharmacogenetic guidelines. - Research Article3 May 2026
Prevalence, Determinants, and Objective Risk of Unintentional Therapeutic Duplication Among Adults in Saudi Arabia
Background: Unintentional therapeutic duplication represents an underrecognized yet preventable contributor to medication-related harm, particularly in settings characterized by widespread over-the-counter (OTC) medicine use and self-medication practices. Objective: To estimate the prevalence of unintentional therapeutic duplication among adults in Saudi Arabia and identify sociodemographic and behavioral predictors associated with increased therapeutic duplication risk. Methods: A national crosssectional study was conducted between February 10 and April 28, 2025, using a structured, self-administered online questionnaire distributed via social media platforms. The survey assessed sociodemographic characteristics, medication-use behaviors, active-ingredient literacy, and duplication risk using both self-reported measures and scenario-based assessments. Multivariable logistic regression was performed to identify independent predictors of elevated therapeutic duplication risk. Results: A total of 700 participants were included (mean age 34.2 ± 10.5 years; 58% female). The prevalence of self-reported therapeutic duplication within the preceding 90 days was 43.0%. Paracetamol-containing products were the most commonly implicated (32.0%), followed by nonsteroidal antiinflammatory drugs (24.0%) and antihistamines (15.0%). The mean ingredient-literacy score was 5.1 ± 2.3 (out of 10), with only 48% correctly identifying duplication scenarios. In adjusted analysis, poor ingredient literacy (AOR 3.12, 95% CI 2.29–4.25), frequent OTC use (AOR 2.41, 95% CI 1.78–3.26), and lower educational attainment (AOR 1.89, 95% CI 1.32– 2.71) were independently associated with increased duplication risk ( p < 0.001). Conclusion: Unintentional therapeutic duplication is common among adults in Saudi Arabia and is strongly associated with limited activeingredient literacy. Targeted interventions focusing on patient education, improved labeling, and pharmacist-led counseling are warranted to mitigate preventable medication harm. - Research Article15 April 2026
Subchronic Oral Exposure to Propylparaben Induces Endocrine Disruption and Genotoxicity in Male Rats
ropylparaben (PP) is widely employed as a preservative in consumer products such as cosmetics, pharmaceuticals, and food items, prompting increasing safety apprehensions due to its possible endocrine-disrupting properties. A controlled experimental investigation was conducted to assess the toxicological effects of sub-chronic propylparaben exposure on the testes of adult male rats. Twenty adult male rats (n = 20) were randomly assigned to two groups (10 rats per group): a control group receiving distilled water and a treated group receiving PP orally at a dosage of 100 mg/kg body weight once daily for four consecutive weeks. This dosage was selected based on prior toxicological research indicating detrimental reproductive consequences after repeated exposure. Toxicological, hormonal, histopathological, and genotoxic assessments were performed. Data were analyzed using an unpaired Student’s t-test and are presented as mean ± SEM, with statistical significance established at p < 0.05. Exposure to propylparaben resulted in marked toxicological disruptions and hormonal dysregulation, as reflected by a reduction in testosterone (142 ± 5.9 ng/dL, p < 0.0001), an increase in luteinizing hormone (10.4 ± 0.4 IU/L, p < 0.0001), and an elevation in follicle-stimulating hormone (9.6 ± 0.43 mIU/mL, p < 0.0001) compared to controls. Genotoxicity was evident through increased DNA damage, indicated by a heightened comet assay tail length (261.33 ± 4.1 µm, p < 0.0001). Histopathological evaluation demonstrated atrophy and structural disarray of seminiferous tubules, characterized by luminal constriction, epithelial degeneration, and localized tubular necrosis with associated inflammatory infiltration. These results indicate that repeated oral exposure to propylparaben induces measurable hormonal disturbances, genotoxicity, and structural damage to the testes, supporting concerns regarding its potential reproductive toxicity. - Research Article23 December 2025
Machine Learning–Based Prediction of Potentially Inappropriate Prescribing in Geriatric Patients Presenting to the Emergency Department at Al-Qatif Central Hospital, Saudi Arabia
Potentially inappropriate prescribing (PIP) is an avoidable factor leading to adverse drug events in older adults, particularly in the emergency department (ED). This study aimed to train and validate a machine learning (ML) model to predict the probability of PIP in elderly patients in the ED. This retrospective analysis encompassed patients aged 65 years and above who presented to the Al-Qatif Central Hospital. PIPs were identified using a validated screening tool designed for older persons to ensure appropriate treatment. Variables have been detected by least absolute shrinkage and selection operator regression. An extreme gradient boosting model was trained and assessed across training, internal validation, and external validation cohorts. The evaluation of model performance was performed using receiver operating characteristic areas under the curve (ROC-AUC) and decision curve analysis. Among 4942 patients, 80% exhibited at least one PIP. The final model exhibited robust discrimination in the external validation cohort (ROC-AUC = 0.7, accuracy = 0.84, Brier score = 0.13). Important factors contributing to PIP risk were cardiovascular disease, the number of medications prescribed in the ED, arthritis-related diseases, and musculoskeletal pain. The model exhibited effective calibration and offered clinical value across a broad spectrum of thresholds (20 – 60%). This model demonstrated robust predictive efficacy in detecting PIP risk among older ED patients. Its implementation may augment prescribing safety and promote clinical outcomes in geriatric care. - Research Article20 March 2026
First Epidemiological Assessment: Syphilis Seroprevalence among Asymptomatic Blood Donors in Merowe, Northern Sudan, 2022
Syphilis remains a significant transfusion-transmissible infection, yet regional epidemiological data from Northern Sudan are lacking. This study aimed to establish preliminary baseline syphilis seroprevalence among asymptomatic blood donors in Merowe, Northern Sudan. A cross-sectional study was conducted in January 2022 at the Merowe blood donation center. Eighty-nine consecutive asymptomatic male blood donors were screened for anti-Treponema pallidum antibodies using a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit (Fortress Diagnostics, UK). Demographic data were collected via structured questionnaire. The overall seroprevalence was 2.25% (2/89; 95% CI: 0.6–7.9%). The donor population median age was 32 years (range: 18–64). Both reactive donors were referred for confirmatory testing and clinical management. This first syphilis seroprevalence report from Merowe provides preliminary regional data, highlights the importance of continued screening, and underscores the need for larger-scale surveillance in demographically dynamic regions. The findings should be interpreted with caution given the small sample size and single-center design.