Podcast 534: Nerve Agents

Podcast 534: Nerve Agents

Author: Michael Hunt, MD

Educational Pearls:

  • Organophosphate "nerve agents" were developed in the 1930's
  • These agents have cholinergic effects, which can be remembered by the mnemonic "SLUDGE"
    • Salivation
    • Lacrimation
    • Urination
    • Defecation
    • GI cramping
    • Emesis
  • The "SLUDGE" toxidrome is mediated through the muscarinic acetylcholine receptors. Nerve agents also affect the nicotinic acetylcholine receptors, which leads to muscle paralysis
  • Death in these cases is from respiratory collapse due to secretions (bronchorrhea) and diaphragmatic paralysis
  • Treatment includes atropine to reduce secretions (often in incredibly high doses) and pralidoxime (2-PAM) to treat muscle paralysis
  • Benzodiazepines may be necessary for seizures

References

https://www.osha.gov/SLTC/emergencypreparedness/guides/nerve.html

Michael Eddleston Novel Clinical Toxicology and Pharmacology of Organophosphorus Insecticide Self-Poisoning. Annual Review of Pharmacology and Toxicology 2019 59:1, 341-360

Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD



Jaksot(1146)

Podcast #286: Coronary Vascular Conditions that aren't STEMI

Podcast #286: Coronary Vascular Conditions that aren't STEMI

Author: Don Stader, M.D. Educational Pearls While we usually associate the coronary vasculature with STEMIs, there are other pathologies that can affect the heart's blood supply. Kounis syndrome: an ...

3 Tammi 20184min

Podcast #285: C Diff

Podcast #285: C Diff

Author: Aaron Lessen, M.D. Educational Pearls While C. difficile infections are generally thought of as nosocomial, there is a subset of patients who acquire the infection in the community. One rece...

1 Tammi 20182min

Podcast #284: Plane Emergencies

Podcast #284: Plane Emergencies

Author: Erik Verzemneicks, M.D. Educational Pearls 1/600 flights has an on-board request for medical assistance. Most common complaints on board include: syncope, respiratory complaints, and GI compl...

29 Joulu 20173min

Podcast #283: Snow Blindness

Podcast #283: Snow Blindness

Author: John Winkler, M.D. Educational Pearls Photokeratitis is a UV burn of the sclera and cornea, which can cause blindness. UV light causes eyelid swelling with diffuse scarring of the eye (wides...

27 Joulu 20173min

Podcast #282: EKG Changes in DKA

Podcast #282: EKG Changes in DKA

Author: Dave Rosenberg, M.D. Educational Pearls EKG changes that can be seen in DKA include ST elevation and peaked T-waves secondary to derangements in K levels. In DKA, serum K is high, but total ...

25 Joulu 20173min

Deep Dive #8: Wintertime Wilderness Medicine

Deep Dive #8: Wintertime Wilderness Medicine

Author: John Winkler, M.D. Dr. Winkler shares his knowledge of wilderness medicine and provides insight on how to prevent and treat conditions such as hypothermia, frostbite and sun blindness. More im...

18 Joulu 201729min

Podcast #281: Intracranial Hemorrhage Treatment

Podcast #281: Intracranial Hemorrhage Treatment

Podcast #281: Intracranial Hemorrhage Treatment Author: Don Stader, M.D. Educational Pearls Types of traumatic bleeds include subdural, epidural, and subarachnoid. Treatment for a traumatic bleed inc...

15 Joulu 20172min

Podcast #280: Isolated Aphasia in Stroke

Podcast #280: Isolated Aphasia in Stroke

Author: Aaron Lessen, M.D. Educational Pearls Patients with an ischemic stroke from occlusion of the left middle cerebral artery often present with aphasia in addition to other neurological deficits....

11 Joulu 20171min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-poliisin-mieli
rss-mita-tulisi-tietaa
docemilia
rss-duodecim-lehti
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
utelias-mieli
radio-antro
rss-astetta-parempi-elama-podcast
rss-lapsuuden-rakentajat-podcast
rss-lihavuudesta-podcast
rss-sosiopodi