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



Episoder(1148)

Podcast #296: Synthetic Cannabinoids

Podcast #296: Synthetic Cannabinoids

Author: Rachael Duncan, PharmD Educational Pearls A NEJM study report in July 2016 discussed a situation in New York during which 30 people became "zombie-like" after ingesting synthetic cannabinoids...

29 Jan 20185min

Podcast #295: UTI

Podcast #295: UTI

Author: Sam Killian, M.D. Educational Pearls Traditionally, UTI diagnosis has been dependent on urine culture, urinalysis and clinical symptoms. But a recent study casts some doubt on the utility of ...

26 Jan 20184min

Podcast #294: Rhabdomyolysis

Podcast #294: Rhabdomyolysis

Author: Michael Hunt, M.D. Educational Pearls Rhabdomyolysis is caused by the destruction of skeletal muscle that leads to the release of myoglobin, which causes renal failure. It presents with pain ...

22 Jan 20183min

Podcast #293: Transient Global Amnesia

Podcast #293: Transient Global Amnesia

Author: Sam Killian, M.D. Educational Pearls Transient global amnesia is a paroxysmal, transient memory issue. Remote and immediate memory is preserved, but new memories cannot be made. Patients will...

19 Jan 20184min

Podcast #292: Hypercalcemia

Podcast #292: Hypercalcemia

Author: John Winkler, M.D. Educational Pearls Normally, the parathyroid is the master regulator of serum Ca levels. It secretes PTH, which stimulates calcium uptake from the bone and gut. Causes of ...

17 Jan 20182min

Podcast #291: Cincinnati Stroke Scale

Podcast #291: Cincinnati Stroke Scale

Author: Nick Hatch, M.D. Educational Pearls The Cincinnati Stroke Scale uses 3 measures to screen for ischemic stroke. The measures are: facial asymmetry, speech quality and arm drift. This scale is ...

15 Jan 20182min

Podcast #290: The Biochemistry of DKA

Podcast #290: The Biochemistry of DKA

Author: Dave Rosenberg, M.D. Educational Pearls DKA commonly causes hyperkalemia, leading to peaked T-waves on ECG. However, DKA causes hypokalemia at the same time. In DKA, glucose cannot be taken i...

12 Jan 20186min

Podcast #289: Cannabinoid Hyperemesis

Podcast #289: Cannabinoid Hyperemesis

Author: Dylan Luyten, M.D. Educational Pearls Cannabinoid Hyperemesis syndrome is a relatively new diagnosis that presents with vomiting and abdominal pain without a clear etiology in the setting of ...

10 Jan 20183min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
sinnsyn
rss-rekommandert
forskningno
jss
liberal-halvtime
tomprat-med-gunnar-tjomlid
smart-forklart
villmarksliv
fjellsportpodden
rss-paradigmepodden
tidlose-historier
dekodet-2
psykopoden
rss-overskuddsliv
diagnose
abid-nadia-skyld-og-skam
rss-nysgjerrige-norge