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 #279: Sedation After Intubation

Podcast #279: Sedation After Intubation

Author: Aaron Lessen, M.D. Educational Pearls Post-intubation care should always include pain control and adequate sedation. Commonly used sedation agents include propofol, ketamine and versed. Howev...

8 Joulu 20171min

Podcast #278: Subdural Hematomas

Podcast #278: Subdural Hematomas

Educational Pearls Subdural hematomas can happen in the elderly because of brain atrophy, and can manifest with neurological deficit. Subdural hematomas are caused by rupture of the bridging veins of...

6 Joulu 20172min

Podcast #277: Mucor

Podcast #277: Mucor

Author: Don Stader, M.D. Educational Pearls Mucor/Rhizopus fungal infections usually present in diabetic or immunocompromised patients as a black, necrotic lesion on the face. The fungus invades the ...

4 Joulu 20172min

Podcast #276: Angioedema

Podcast #276: Angioedema

Author: John Winkler, M.D. Educational Pearls Angioedema is immediately life-threatening due to airway obstruction. Mechanisms include allergic reaction (histamine-related) or bradykinin-related (ACE...

1 Joulu 20173min

Podcast #275: Battery Ingestions

Podcast #275: Battery Ingestions

Author: Nick Hatch, M.D. Educational Pearls Unlike coin ingestions, button batteries can cause necrosis of the GI tract. If lodged in the esophagus, removal within 2 hours is important, because they ...

29 Marras 20174min

Podcast #274: Pediatric Sedation

Podcast #274: Pediatric Sedation

Author: Aaron Lessen, M.D. Educational Pearls A recent prospective observational study was performed to examine the safety of different sedation medications in the pediatric ED. This study included 6...

27 Marras 20172min

Podcast #273:  Bag Valve Masks

Podcast #273: Bag Valve Masks

Author: Sam Killian, M.D. Educational Pearls Difficulty with bag valve mask (BVM) ventilation can be addressed using the MOANS mnemonic. Mask seal, Obesity/obstruction, Age, No teeth, Sleep apnea. O...

17 Marras 20173min

Podcast #272: More on Temperature in Sepsis

Podcast #272: More on Temperature in Sepsis

Author: David Rosenberg, M.D. Educational Pearls A study of 20,000 subjects found that reducing fever in sepsis did not improve outcomes such as morbidity, mortality, or length of stay. However, corr...

16 Marras 20172min

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