Teasing out minutia, splitting hairs, and beating dead horses have a place in refining a point. We're teaching here. I know you know the big picture and I also know people casually throw out terms that they think mean one thing, but mean another. Discussions like these are valuable even though on their face, they may appear trivial. Thanks for playing along, E.sure, i agree we are 'pharmocolic experts'. we have to be. as for the argument of toxicity vs adverse effect, i can only attest to what i've read in the past and what grand rounds has shown me. let me get some info and i'll pass along what i find out.
as to defining what adverse effect is, or what overdose is, i think there are some similarities and overlapping. i see it as a grey area, but.. let me posit this.. if an overdose of fentanyl, let's say, causes severe bradycardia, severe hypotension and ultimately asystole, who's to say that an accumulated dose (or even one time dose) can't cause similar reactions? i think we think of overdose as a volume/amount issue, and adverse effect regardless of volume/amount, but i think it goes 'deeper' than that. none the less, i almost took your questions as a tad rhetorical, as they easily can be.