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(1146)

Podcast 768: Takotsubo Cardiomyopathy

Podcast 768: Takotsubo Cardiomyopathy

Contributor: Peter Bakes, MD Educational Pearls: 3% of cases of acute coronary syndrome are due to Takotsubo Takotsubo cardiomyopathy or "broken heart syndrome" can occur with severe physiologic or ...

29 Mar 20224min

Podcast 767: Transaminitis and Rhabdomyolysis

Podcast 767: Transaminitis and Rhabdomyolysis

Contributor: Sam Killian, MD Educational Pearls: Transaminitis refers to the elevation of transaminases, enzymes of the liver (AST and ALT) Elevation of ALT is relatively specific to the liver, but A...

28 Mar 20223min

Podcast 766: Truth about Tramadol

Podcast 766: Truth about Tramadol

Contributor: Aaron Lessen, MD Educational Pearls: Tramadol is often thought of as a mild-opiate to use for analgesia, but it is a more complicated drug Tramadol needs to be metabolized into an effect...

22 Mar 20223min

Podcast 765: Phenobarbital for Alcohol Withdrawal

Podcast 765: Phenobarbital for Alcohol Withdrawal

Contributor: Aaron Lessen, MD Educational Pearls: Retrospective cohort study looked at return rate of discharged patients after receiving either phenobarbital or benzodiazepines or both in the ED for...

21 Mar 20222min

Podcast 764: Myth or Merit: Beta-Blockers for Cocaine Chest Pain

Podcast 764: Myth or Merit: Beta-Blockers for Cocaine Chest Pain

Contributor: Chris Holmes, MD Educational Pearls: Many are taught that patients with cocaine chest pain should not receive beta-blockers due to unopposed alpha agonism, but is this true? 363 consecut...

15 Mar 20223min

Podcast 763: Sternoclavicular Infection

Podcast 763: Sternoclavicular Infection

Contributor: Aaron Lessen, MD Educational Pearls: Septic arthritis can occur at any joint, including the sternoclavicular joint Sternoclavicular joint infections comprise 1% of all bone and joint inf...

14 Mar 20223min

UnfilterED #14: Patricia Hernandez, MSIV and Leyanet Gonzalez, MSIV

UnfilterED #14: Patricia Hernandez, MSIV and Leyanet Gonzalez, MSIV

Tune in for a double feature with our Equity, Diversity and Inclusion Award winners from this fall as Nick asks them about their backgrounds, what brought them into medicine and Emergency Medicine spe...

9 Mar 202250min

Podcast 762: Endocarditis

Podcast 762: Endocarditis

Contributor: Jared Scott, MD Educational Pearls: Variability of organisms in infecting the myocardial valves Duke Criteria for Infective Endocarditis includes three categories that can be used to def...

8 Mar 20225min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
jss
rss-rekommandert
liberal-halvtime
villmarksliv
forskningno
rss-paradigmepodden
sinnsyn
fjellsportpodden
rss-nysgjerrige-norge
vett-og-vitenskap-med-gaute-einevoll
nevropodden
diagnose
smart-forklart
dekodet-2
abid-nadia-skyld-og-skam
tidlose-historier
nordnorsk-historie