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 # 490: Canadian Syncope Rule

Podcast # 490: Canadian Syncope Rule

Contributor: Don Stader, MD Educational Pearls: Syncope is usually benign but can be caused by serious etiologies which include: PE, certain cardiac arrhythmias, AAA, intracranial bleed/stroke The Ca...

22 Jul 20194min

Podcast # 489: Bats & Rabies

Podcast # 489: Bats & Rabies

Contributor: Jared Scott, MD Educational Pearls: The CDC recommends rabies prophylaxis if there was a direct encounter with a possibly rabid animal except... Bats are treated differently since their ...

18 Jul 20193min

Podcast # 488: Dalbavancin

Podcast # 488: Dalbavancin

Contributor: Nick Hatch, MD Educational Pearls: Dalbavancin (Dalvance®) is an antibiotic that can be used for skin and soft tissue infections, providing MRSA coverage It cannot be used in other infec...

15 Jul 20193min

Podcast # 487: Hunting for Epiglottitis

Podcast # 487: Hunting for Epiglottitis

Contributor: Michael Hunt, MD Educational Pearls: Due to the efficacy of vaccination, epiglottitis is now more common in adults than children Risk factors include smoking and other immunocompromising...

10 Jul 20193min

Podcast # 486: Morel Mushrooms

Podcast # 486: Morel Mushrooms

Contributor: Nick Hatch, MD Educational Pearls: True morel mushrooms are commonly foraged The false morel mushroom (Gyromitra esculenta) looks similar to the true morel, but is toxic False morel mush...

8 Jul 20194min

Podcast # 485: Cerebellar Stroke

Podcast # 485: Cerebellar Stroke

Contributor: Jared Scott, MD Educational Pearls: Cerebellar strokes make up a disproportionate number of missed or delayed diagnosis for stroke likely due to the subtle nature of the presentation Cer...

6 Jul 20195min

Podcast # 484: Elevated ICP

Podcast # 484: Elevated ICP

Contributor: Charleen Gnisci, PharmD Educational Pearls: Causes of increased intracranial pressure may include intracranial hemorrhage, malignancy, and trauma. While definite treatment is to remove ...

4 Jul 20196min

Podcast # 483: Dual Antiplatelet Therapy in TIA

Podcast # 483: Dual Antiplatelet Therapy in TIA

Contributor: Don Stader, MD Educational Pearls: Antiplatelets include aspirin and clopidogrel, and are generally used for arterial clotting (MI, stroke) Anticoagulants such as coumadin, Xarelto, Eliq...

28 Jun 20192min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
rss-rekommandert
jss
liberal-halvtime
villmarksliv
rss-paradigmepodden
forskningno
sinnsyn
fjellsportpodden
pod-britannia
nevropodden
rss-nysgjerrige-norge
tidlose-historier
hva-er-greia-med
diagnose
rss-overskuddsliv
smart-forklart
rss-lundqvist-podden