MedTox Fellows: 44YOM in ED c/o OD of new med. HR 129 noted, then seizures, hypotension, no pulses. Post ROSC, on epi: ABG- 7.26/40/65/18; Na 141, K 4.5, Cl 109, CO2 18, AG 14, lactate 4.7 mM. Glu 168 mg/dL. ECG post-ROSC & stat drug screen. What single agent best fits?
MedTox Fellows: Don't be discouraged when you don't recognize a toxidrome in a comatose patient. This is a typical urine drug screen at our center. It is the exception to ever find a single substance. Meth, ketamine, fentanyl and PCP.
MedTox Fellows: Don't be discouraged when you don't recognize a toxidrome in a comatose patient. This is a typical urine drug screen at our center. It is the exception to ever find a single substance. Meth, ketamine, fentanyl and PCP.
MedTox Fellows: Board review. Here is a photo from social media. The molecular action of the toxin contained in this animal is most similar to which one of the following? And how is the toxin delivered?
A. saxitoxin
B. ciguatoxin
C. bungarotoxin
D. batrachotoxin
E. brevetoxin
Currency Contamination II. It has been long recognized paper currency is contaminated with methamphetamine & cocaine. We recently just took 1 bill (gloves & forceps) from 8 physicians’ or students’ billfolds/ purses, washed bills with methanol, and screened for drugs by LC/qTOFF.
Adding suzetrigine to MS library. MedTox Fellows, this analgesic Na channel blocker is highly specific for Nav 1.8, mainly found in peripheral neurons. How else is blockade different from other Na channel blockers?
1/
I once heard that a fever in the ICU was a "fever of too many origins."
Same can be said altered mental status/encephalopathy!
We put together a comprehensive approach to these challenging patients for #SeminarsinNeurology
A thread with our approach!
https://t.co/VK9Dm1v8iQ
MedTox Fellows: 13 YOM ingested "sleeping pills" after fight with parents. Suprapubic tenderness, dry axillae. Pupils normal. What might he have taken? @ToxAndHound@ToxicSnowEM
MedTox Fellows: 28YOM, coma, friend says only drug used is gabapentin. Tachy and mydriasis. Urine stat mTOF/LC/MS screen below. Many agents used, some of which only metabolites are found.
Which taken drug activates M4 muscarinic receptors but antagonizes all other M receptors?
MedTox Fellows, rattlesnake bite season is well underway in Arizona. A reminder to be aware of rapid onset shock and anaphylactoid reactions following snakebite, and following Gila Monster envenomations.
https://t.co/DY5XuWLtWZ
@ToxAndHound@ToxicSnowEM