Miosis or Mydriasis
Mydriasis
What is the O2 sat gap?
Pulse oximeter O2 sat > ABG O2 sat
Toxidrome with uncoupling of oxidative phosphorylation presentation?
Anion gap metabolic acidosis
Lactic acidosis
Hyperventilation
High venous O2 sat (no oxygen extraction)
Fever
Cyanide
Metformin
Salicylate
Isoniazid
Propofol
Toxidrome with uncoupling of oxidative phosphorylation antidote?
Dialysis
Cyanide - Hydroxycobolamine
Cocaine overdose causes?
Mydriasis
Carboxyhemoglobinemia
Methemoglobinemia
Cyanohemoglobinemia
Sulfahemoglobinemia
Solvent toxidrome presentation?
Confusion
Lethargy
Headache
Incoordination
Derealization
Depersonalization
Sniffing - Type 1 RTA
Ingestion - increased OG
Solvent toxidrome etiology?
Toluene
Acetone
Hydrocarbons
Chlorinated Hydrocarbons
Naphthalene
Trichloroethane
Solvent Toxidrome antidote?
Supportive
NaHCO3 / K if Type 1 RTA
Dialysis if elevated OG
Nerve gas attack in a bus causes?
What is the nerve gas agent?
Miosis
Sarin, Soman, VX, Novichok
Causes of carboxyhemoglobinemia?
House Fires
Seratonin Toxidrome presentation?
Fever
Delirium
Hyperreflexia / Clonus
Ocular Clonus
Rigidity
Diarrhea
Seratonin Syndrome etiology?
2 hit mechanism (at least for seratonin over expression)
SSRI
SNRI
MAO-I
Dopamine agonists
Fentanyl
5 HT 3 antagonists
Stimulants
Seratonin Syndrome antidote?
Benzodiazepine
Cyproheptadine
Fentanyl overdose causes?
Miosis
Causes of methemoglobinemia?
Sulfa drugs, Benzocaine
Fever
Rigidity
Opisthotonus
Trismus
Hyperreflexia
Choreoathetosis
Dystonia
Extrapyramidal Toxidrome etiology?
Typical High Potency Antipsychotics
Haldol
Phenothiazines
Rispiridone
Olanzapine
Clozapine
Extrapyramidal Toxidrome antidote?
Benzodiazepine
Benztropine
Dantrolene
What is the mosquito fogging agent?
Miosis
Malathione
Causes of cyanohemoglobinemia?
Factory fires, cyanide ingestion
Cholinergic Toxidrome presentation?
Salivation
Lacrimation
Urination
Diarrhea
GI Cramping
Emesis
Bradycardia
Bronchorhea
Miosis
Cholinergic Toxidrome etiology?
Organophosphates
Carbamates
Nerve Gas
Novochok
Pilocarpine
Physostigmine
Cholinergic Toxidrome antidote?
Atropine (central/peripheral muscarinic antagonist)
Pralideoxime (reactivates acetylcholinesterase)