In this Clinical Lesson, using two illustrating cases, we explain how to do the initial assessment and treatment of an intoxicated patient. An approach aimed at toxidromes can serve as a stepping stone. A toxidrome is a combination of symptoms and clinical features that can occur with the use of certain drugs and substances. The most commonly encountered toxidromes are sympathomimetic, serotonergic, anticholinergic, cholinergic, sedative-hypnotic and opioid. All patients need to be approach according to the ABCDE method. The treatment is based on pharmacokinetics by means of the ADME principle (absorption, distribution, metabolism and excretion) and based on pharmacodynamics, aimed at the toxidrome.
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Chest
November 2024
Mather Hospital at Northwell, Port Jefferson, NY.
Diffuse alveolar hemorrhage (DAH) is a form of hemoptysis caused by disruption of the alveolar-capillary basement membrane causing alveolar bleeding. Inhalation of cocaine and other sympathomimetic agents are described as one of many pathologic causes. We describe what is to the author's knowledge the first reported case of DAH caused by inhalation of bupropion, a norepinephrine-dopamine reuptake inhibitor, which was successfully treated with systemic steroids.
View Article and Find Full Text PDFJ Educ Teach Emerg Med
October 2024
Medical University of South Carolina, Division of Pediatric Emergency Medicine, Charleston, SC.
Audience: The target audience for this small group workshop are interns and residents of any specialty.
Introduction: All residents are expected to become proficient teachers in a variety of settings as they progress in training, and many residency programs offer advanced training or credentialing in medical education.1,2 Recently, some emergency medicine programs have also begun to offer a formal medical education fellowship.
Int J Emerg Med
October 2024
Department of Paediatrics and Child Health, College of Health science, Arba Minch University, Arba Minch, Ethiopia.
Introduction: Datura stramonium poisoning, resulting from the ingestion of seeds, leaves, or flowers of Datura stramonium, is a severe condition with significant risks, particularly for young children. Most documented cases of Datura stramonium poisoning in the literature involve teenagers who intentionally ingest the plant to induce hallucinogenic and euphoric experiences. This report presents a rare instance of unintentional Datura stramonium poisoning in a 3year-old Ethiopian toddler.
View Article and Find Full Text PDFToxicol Rep
December 2024
Pediatrics, Pediatric Emergency Medicine, Monroe Carell Jr. Children's Hospital at Vanderbilt, 2200 Children's Way, Nashville, TN 37212, USA.
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