P O I S O N

Question 1

Post op, patient develops urinary retention, flushing, and dry mouth. Treatment?

Answer 1

Signs and symptoms consistent with anticholinergic syndrome which can be treated with physostigmine. This increases acetylcholine concentration at the sites of cholinergic neurotransmission. Preferred over neostigmine because it crosses BBB.

Question 2

Male on antihypertensives develops bradycardia, hypoglycemia, and signs of pulm edema. Treatment>?

Answer 2

High doses of beta blockers can elicit this sx. Both glucagon and atropine can be used to treat these effects. Atropine is an anticholinergic whose effect on the heart is a decrease in vagal tone, resulting in an increased heart rate.

Question 3

Signsand sx of ethylene glycol toxicity

Answer 3

Ataxia, hallucinations, seizures, and “sweet breath.” Chasmal respirations may be another sx as a result of severe metabolic acidosis.

Question 4

Tx for ethylene glycol tox

Answer 4

Ethanol. It saturates alcohol dehydrogenase, allowing free ethylene glycol to be eliminated moro e readily. Dialysis is sometimes required as well.

Question 5

Symptoms of mercury tox

Answer 5

Renal insufficiency, tremor, mental status changes, erythematous cheeks and lips, loss of hair/teeth/nails, transient rashes ,muscle weakness, and photophobia. Kidney dysfunction may also be present (leading to dx of Falcon syndrome)

Question 6

Tx for mercury poisonin

Answer 6

Dimercaprol, a chelating agent that works by competition with endogenous sylfhydryl groups.

Question 7

Tx of organophosphate poisoning

Answer 7

Atropine and pralidoxime. Atropine works by acting as a competitive antagonist at muscuarinic cholinergic receptors, in both the CNS and PNS.