Miscellaneous

Question 1

What is Cholinesterase inhibitor poisoning often due to?

Answer 1

Organophosphates (insecticides), such as parathion, that irreversibly inhibit AChE; commonly seen in farmers

Question 2

What does Cholinesterase inhibitor poisoning cost?

Answer 2

DUMBBELSS - Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating, and Salivation

Question 3

What is the antidote for Cholinesterase inhibitor poisoning?

Answer 3

Antidote: atropine (competitive inhibitor) + pralidoxime (regenerates AChE if given early)

Question 4

What is Atropine?

Answer 4

Muscarinic antagonist used to treat bradycardia and for ophthalmic applications

Question 5

What are Atropine’s actions?

Answer 5

Blocks DUMBBeLSS (skeletal muscle and CNS excitation is mediated by nicotinic receptors).
↑ pupil dilatation, cycloplegia
↓ airway secretions, ↓ gastric acid secretions, ↓ motility, and ↓ urgency in cystitis

Question 6

What are the effects of Atropine toxicity?

Answer 6

↑ body temperature (due to ↓ sweating); rapid pulse; dry mouth; dry, flushed skin; cycloplegia; constipation; disorientation
Can cause acute angle-closure glaucoma in elderly (due to mydriasis), urinary retention in men with prostatic hyperplasia, and hyperthermia in infants.

Question 7

What does Jimson weed (Datura), which has Atropine, cause?

Answer 7

Gardener’s pupil (mydriasis due to plant alkaloids)

Question 8

Sympatholytics (α2-agonists) - What are the applications of Clonidine?

Answer 8

Hypertensive urgency (limited situations); does not decrease reneal blood flow
ADHD, severe pain, and a variety of off-label indications (e.g., ethanol and opioid withdrawal)

Question 9

Sympatholytics (α2-agonists) - What toxicity does Clonidine have?

Answer 9

CNS depression, bradycardia, hypotension, respiratory depression, and small pupil size

Question 10

Sympatholytics (α2-agonists) - What are the applications of α-methyldopa?

Answer 10

Hypertension in pregnancy

Safe in pregnancy

Question 11

Sympatholytics (α2-agonists) - What toxicity does α-methyldopa have?

Answer 11

Direct Coombs + hemolytic anemia, SLE-like syndrome

Question 12

What are the Sulfa Drugs?

Answer 12

Probenecid, Furosemide, Acetazolamide, Celecoxib, Thiazides, Sulfonamide antibiotics, Sulfasalazine, Sulfonylureas
(Acronym - Popular FACTSSS)

Question 13

What do patients with sulfa allergies develop?

Answer 13

Fever, UTI, Stevens-Johnson syndrome, hemolytic anemia, thrombocytopenia, agranulocytosis, and urticaria (hives)