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



Avsnitt(1146)

Podcast 747: Food Impaction

Podcast 747: Food Impaction

Contributor: Ricky Dhaliwal, MD Educational Pearls: Esophageal food impaction can be managed in the ED prior to calling GI for endoscopy Coca-cola, glucagon, benzodiazepines, calcium channel blockers...

17 Jan 20223min

Podcast 746: Elderly Head Trauma on Anticoagulation

Podcast 746: Elderly Head Trauma on Anticoagulation

Contributor: Aaron Lessen, MD Educational Pearls: Biggest study to date examined new protocol for repeat head CT in anticoagulated elderly patients with head trauma and an initial negative head CT ...

11 Jan 20223min

Podcast 745: Nitrous-Induced B12 Deficiency

Podcast 745: Nitrous-Induced B12 Deficiency

Contributor: Alicia Oberle, MD Educational Pearls: Nitrous oxide (N2O) can cause a vitamin B12 deficiency in patients after regular use N2O is used in procedural sedation but also as a popular recrea...

10 Jan 20222min

Podcast 744: Glucagon for Beta Blocker Toxicity

Podcast 744: Glucagon for Beta Blocker Toxicity

Educational Pearls: Glucagon can be used to treat hypoglycemia and esophageal foreign body, but it can also be used in beta-blocker toxicity to bypass cardiac beta-blockade The superior option for tr...

4 Jan 20222min

Podcast 743: Rust Rings

Podcast 743: Rust Rings

Contributor: Jared Scott, MD Educational Pearls: A rust ring can occur after a metallic foreign body is left in the eye for a prolonged period of time Issues occur when the rust ring is left as it ca...

3 Jan 20225min

Podcast 742: Pulse Check During CPR

Podcast 742: Pulse Check During CPR

Contributor: Aaron Lessen, MD Educational Pearls: Pulse checks are necessary during CPR to check for return of spontaneous circulation (ROSC) Previous studies have shown that assessing ROSC with palp...

29 Dec 20213min

Podcast 741: Calcium for Cardiac Arrest

Podcast 741: Calcium for Cardiac Arrest

Contributor: Aaron Lessen, MD Educational Pearls: Study of nearly 400 patients evaluating giving calcium during cardiac arrest with the endpoint as return of spontaneous circulation (ROSC) Compared g...

28 Dec 20212min

Podcast 740: Placenta Previa

Podcast 740: Placenta Previa

Contributor: Peter Bakes, MD Educational Pearls: High concern causes of third trimester vaginal bleeding include placenta previa, placental abruption, or vasa previa In placenta previa, the placenta ...

21 Dec 20213min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
rss-ufo-bortom-rimligt-tvivel
sexet
rss-vetenskapsradion
pojkmottagningen
rss-vetenskapsradion-2
dumforklarat
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
halsorevolutionen
rss-spraket
bildningspodden
hacka-livet
rss-experimentet
medicinvetarna
rss-lara-fran-larda-en-fackbok-och-en-forfattare