Meet our experts

Maryann Amirshahi, PharmD, MD, MPH, PhD, FACMT, FACEP, FASAM, FCP

Maryann Amirshahi, PharmD, MD, MPH, PhD, FACMT, FACEP, FASAM, FCP is a medical toxicologist at the National Capital Poison Center. Dr. Amirshahi completed her Bachelors in Pharmacy and PharmD degrees at the University of the Sciences in Philadelphia, followed by medical school at Temple University. She completed her emergency medicine residency at the Hospital of the University of Pennsylvania, medical toxicology fellowship at the George Washington University/National Capital Poison Center, and clinical pharmacology fellowship at Children’s National Medical Center. She also received an MPH from the George Washington University focusing on environmental and occupational health. She completed her PhD at Erasmus University, with a focus on pharmacology and public health. She is board certified in emergency medicine, medical toxicology, addiction medicine, and clinical pharmacology. She is also a registered pharmacist with over a decade of practice experience and is a Board Certified Pharmacotherapy Specialist, and a Professor of Emergency Medicine at the Georgetown University School of Medicine in Washington, DC.

Maryann practices clinically at MedStar Washington Hospital Center, where she not only treats poisoned patients on a daily basis, but also plays a major role in bringing addiction care to the emergency department setting. She also is active at the health system level with roles in medication safety, opioid stewardship, and resident education. Nationally, she serves on the Board of Directors for the American College of Medical Toxicology.

Maryann is a prolific researcher with nearly 200 peer-reviewed publications and book chapters. Her research interests include medication safety, medical toxicology, drug shortages, addiction treatment in the emergency department, and prescription drug abuse. She lives in the Washington, DC Metro area with her husband and two children. She is an avid animal lover, amateur home decorator, and considers herself a bit of a history buff.

Selected Publications

Joint Clinical Practice Guideline on Benzodiazepine Tapering: Considerations When Risks Outweigh Benefits

The American Society of Addiction Medicine (ASAM) has partnered with nine other medical societies and professional associations representing a wide range of clinical settings and patient populations to provide guidance on evidence-based strategies for tapering benzodiazepine (BZD) medication across a variety of settings.

_{Brunner E, Chen CA, Klein T, Maust D, Mazer-Amirshahi M, Mecca M, Najera D, Ogbonna C, Rajneesh KF, Roll E, Sanders AE, Snodgrass B, VandenBerg A, Wright T, Boyle M, Devoto A, Framnes-DeBoer S, Kleykamp B, Norrington J, Lindsay D; Clinical Guideline Committee (CGC) Members; ASAM Staff and Contractors. Joint Clinical Practice Guideline on Benzodiazepine Tapering: Considerations When Risks Outweigh Benefits. J Gen Intern Med. 2025 Sep;40(12):2814-2859. doi: 10.1007/s11606-025-09499-2. Epub 2025 Jun 17. PMID: 40526204; PMCID: PMC12463801.}

Journal of General Internal Medicine

Out-of-hospital assessment and triage of paracetamol (acetaminophen) exposure in the United States and Canada: a consensus guideline

Consensus guidelines for out-of-hospital assessment and triage of paracetamol (acetaminophen) exposure were published in 2006. Changes in the healthcare system, paracetamol ingestion trends, and availability of paracetamol-containing products necessitate an update to these guidelines. Updated guidelines were created for out-of-hospital management of paracetamol exposure in the United States and Canada.

_{Fox EJ, Dalton AM, Mullins ME, Matoushek T, Ruha AM, Burns MM, Simone K, Beuhler MC, Heard KJ, Mazer-Amirshahi M, Stork CM, Varney SM, Funk AR, Cantrell FL, Cole JB, Banner W, Stolbach AI, Hendrickson RG, Lucyk SN, Sivilotti MLA, Su MK, Nelson LS, Rumack BH, Dart RC. Out-of-hospital assessment and triage of paracetamol (acetaminophen) exposure in the United States and Canada: a consensus guideline. Clin Toxicol (Phila). 2025 May;63(5):348-352. doi: 10.1080/15563650.2025.2471915. Epub 2025 Mar 6. PMID: 40047505.}

Clinical Toxicology

2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

In this focused update, the American Heart Association provides updated guidance for resuscitation of patients with cardiac arrest, respiratory arrest, and refractory shock due to poisoning. Based on structured evidence reviews, guidelines are provided for the treatment of critical poisoning from benzodiazepines, β-adrenergic receptor antagonists (also known as β-blockers), L-type calcium channel antagonists (commonly called calcium channel blockers), cocaine, cyanide, digoxin and related cardiac glycosides, local anesthetics, methemoglobinemia, opioids, organophosphates and carbamates, sodium channel antagonists (also called sodium channel blockers), and sympathomimetics.

_{Lavonas EJ, Akpunonu PD, Arens AM, Babu KM, Cao D, Hoffman RS, Hoyte CO, Mazer-Amirshahi ME, Stolbach A, St-Onge M, Thompson TM, Wang GS, Hoover AV, Drennan IR; American Heart Association. 2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2023 Oct 17;148(16):e149-e184. doi: 10.1161/CIR.0000000000001161. Epub 2023 Sep 18. PMID: 37721023.}

Circulation

Management of Acetaminophen Poisoning in the US and Canada: A Consensus Statement

The search retrieved 84 guidelines and 278 publications. The panel developed guidelines for emergency department management of single or repeated ingestion of acetaminophen. In addition, the panel addressed extended-release formulation, high-risk ingestion, coingestion of anticholinergics or opioids, age younger than 6 years, pregnancy, weight greater than 100 kg, and intravenous acetaminophen use.

_{Dart RC, Mullins ME, Matoushek T, Ruha AM, Burns MM, Simone K, Beuhler MC, Heard KJ, Mazer-Amirshahi M, Stork CM, Varney SM, Funk AR, Cantrell LF, Cole JB, Banner W, Stolbach AI, Hendrickson RG, Lucyk SN, Sivilotti MLA, Su MK, Nelson LS, Rumack BH. Management of Acetaminophen Poisoning in the US and Canada: A Consensus Statement. JAMA Netw Open. 2023 Aug 1;6(8):e2327739. doi: 10.1001/jamanetworkopen.2023.27739. Erratum in: JAMA Netw Open. 2023 Sep 5;6(9):e2337926. doi: 10.1001/jamanetworkopen.2023.37926. PMID: 37552484.}

JAMA Network Open

Saline Shortages - Many Causes, No Simple Solution

_{Mazer-Amirshahi M, Fox ER. Saline Shortages - Many Causes, No Simple Solution. N Engl J Med. 2018 Apr 19;378(16):1472-1474. doi: 10.1056/NEJMp1800347. Epub 2018 Mar 21. PMID: 29561694.}

The New England Journal of Medicine

Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003–2011

In recent years, there has been an increase in poisoning-related emergency department (ED) visits. This study examines trends in ED resource utilization for poisoning-related visits over time. A retrospective review of data from the National Hospital Ambulatory Medical Care Survey, 2003–2011, was conducted. All ED visits with a reason for visit or ICD-9 code related to poisoning were included. We examined the number of ED visits and resources used including diagnostic studies and procedures performed, medications provided, admission rates, and length of stay.

_{Mazer-Amirshahi M, Sun C, Mullins P, Perrone J, Nelson L, Pines JM. Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003-2011. J Med Toxicol. 2016 Sep;12(3):248-54. doi: 10.1007/s13181-016-0564-6. Epub 2016 Jun 24. PMID: 27342464; PMCID: PMC4996794.}

Journal of Medical Toxicology

Effect of cough and cold medication restriction and label changes on pediatric ingestions reported to United States poison centers

Unintentional ingestions of OTC cough and cold medications decreased 33.4% and therapeutic errors by 46.0%. Health care facility referral declined for unintentional ingestions (28.9% <2 years of age, 19.9% 2-5 years of age, P < .0001) and therapeutic errors in children younger than 2 years of age (59.2%, P < .0001). Moderate and severe adverse outcomes decreased for unintentional ingestions in children younger than 2 years of age by 32.4% and by 21.3% in 2- to 5-year olds, P < .0001.

_{Mazer-Amirshahi M, Reid N, van den Anker J, Litovitz T. Effect of cough and cold medication restriction and label changes on pediatric ingestions reported to United States poison centers. J Pediatr. 2013 Nov;163(5):1372-6. doi: 10.1016/j.jpeds.2013.04.054. Epub 2013 Jun 12. PMID: 23769500.}

The Journal of Pediatrics

Antibacterial drug shortages from 2001 to 2013: implications for clinical practice

One hundred forty-eight antibacterial drugs were on shortage over the 13-year study period, with 26 drugs still active on shortage as of December 2013. The median number of new shortages per year was 10 (interquartile range [IQR], 7). The number of drugs on shortage increased at a rate of 0.35 additional drugs every month (95% confidence interval, .22-.49) from July 2007 to December 2013 (P < .001). The median shortage duration was 188 days (IQR, 366.5). Twenty-two percent of drugs experienced multiple shortage periods.

_{Quadri F, Mazer-Amirshahi M, Fox ER, Hawley KL, Pines JM, Zocchi MS, May L. Antibacterial drug shortages from 2001 to 2013: implications for clinical practice. Clin Infect Dis. 2015 Jun 15;60(12):1737-42. doi: 10.1093/cid/civ201. Epub 2015 Apr 22. Erratum in: Clin Infect Dis. 2015 Dec 1;61(11):1769. doi: 10.1093/cid/civ857. PMID: 25908680.}

Clinical Infectious Diseases

Suspected synthetic cannabinoid receptor agonist intoxication: Does analysis of samples reflect the presence of suspected agents?

There has been a surge in synthetic cannabinoid receptor agonist (SCRA) exposures reported in recent years. The constituents of SCRA preparations are constantly evolving and rarely confirmed. We sought to characterize the constituents of reported SCRA exposures presenting to the emergency department (ED).

_{Tebo C, Mazer-Amirshahi M, DeGeorge L, Gelfand B, Leak C, Tolliver S, Sauter D. Suspected synthetic cannabinoid receptor agonist intoxication: Does analysis of samples reflect the presence of suspected agents? Am J Emerg Med. 2019 Oct;37(10):1846-1849. doi: 10.1016/j.ajem.2018.12.044. Epub 2018 Dec 24. PMID: 30595429.}

American Journal of Emergency Medicine

Toxicity of abortifacients: A review for physicians in the post roe era

On June 24, 2022, the Supreme Court overturned Roe v. Wade, which will limit legal abortion in many areas of the U.S. Over half of abortions in the U.S. are performed using medication as opposed to surgical techniques. With widespread access to agents that are used for medication abortion, there may be an increase in emergency department presentations related to improper or unsupervised use of these medications.

_{Mazer-Amirshahi M, Ye P. Toxicity of abortifacients: A review for physicians in the post roe era. Am J Emerg Med. 2022 Nov;61:7-11. doi: 10.1016/j.ajem.2022.08.027. Epub 2022 Aug 18. PMID: 36007432.}

American Journal of Emergency Medicine