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(1147)

Podcast 533:  Hypoglycemia

Podcast 533: Hypoglycemia

Contributor: Dylan Luyten, MD Educational Pearls: Insulin related hypoglycemia can vary from a brief transient effect from short-acting forms (i.e. insulin lispro) to prolonged from long acting (i.e....

20 Jan 20204min

Podcast 532:  SVC Syndrome

Podcast 532: SVC Syndrome

Contributor: Jared Scott, MD Educational Pearls: Superior vena cava (SVC) syndrome is caused by physical compression of the SVC and can present with facial swelling, upper extremity swelling, flushin...

14 Jan 20204min

Podcast 531:  Migraine Cocktail

Podcast 531: Migraine Cocktail

Contributor: Don Stader, MD Educational Pearls: The classic migraine cocktail includes: Reglan (or other dopamine antagonist), Benadryl, Toradol, Decadron, and IV fluids.  The most effective agent in...

13 Jan 20203min

Podcast 530: Anion Gap Acidosis + Metformin Toxicity

Podcast 530: Anion Gap Acidosis + Metformin Toxicity

Contributor: Don Stader, MD Educational Pearls: The common causes of anion gap metabolic acidosis include (MUDPILES) Metformin, Methanol Uremia DKA Paraldehyde INH/Iron Lactate Ethylene Glycol ...

8 Jan 20204min

Podcast 529: Hemophilia

Podcast 529: Hemophilia

Contributor: Aaron Lessen, MD Educational Pearls: Hemophilia is characterized by bleeding (A /B) A is is 8, B (chrstmas, 9) Hemophilia refers to a group of bleeding disorders caused by a deficiency ...

8 Jan 20203min

Podcast 528:  Decompensated Liver Failure

Podcast 528: Decompensated Liver Failure

Contributor: Michael Hunt, MD Educational Pearls: Cirrhosis is the end stage of chronic structural damage to the liver. This is most commonly due to  alcohol but other causes viral hepatitis and hepa...

6 Jan 20204min

Podcast 527: Knee Dislocations

Podcast 527: Knee Dislocations

Contributor:  Erik Verzemnieks, MD Educational Pearls: Knee dislocations are most common in high energy trauma, such as a motor vehicle accident The knee may appear grossly normal on initial inspecti...

3 Jan 20202min

Podcast 526:  Desmopressin for Intracranial Hemorrhage

Podcast 526: Desmopressin for Intracranial Hemorrhage

Contributor: Charleen Melton, PharmD Educational Pearls: Desmopressin (DDAVP) is an analogue of anti-diuretic hormone (ADH) that has been used for the treatment of intracranial hemorrhage. It works b...

30 Des 20193min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
jss
rss-rekommandert
liberal-halvtime
villmarksliv
rss-paradigmepodden
forskningno
sinnsyn
fjellsportpodden
pod-britannia
rss-nysgjerrige-norge
tidlose-historier
hva-er-greia-med
rss-lundqvist-podden
dekodet-2
tomprat-med-gunnar-tjomlid
vett-og-vitenskap-med-gaute-einevoll
nordnorsk-historie