Funtabulously Frivolous Friday Five 156
Funtabulously Frivolous Friday Five 156 - Just when you thought your brain could unwind on a Friday, some medical trivia FFFF.
Month February 2019
Löffler syndrome
Löffler (Loeffler) syndrome is a transient, self-limiting, and benign pulmonary eosinophilia, characterised by pulmonary opacities on X-ray, elevated blood eosinophils and an acute onset of potential symptoms of mainly cough and dyspnoea.
Wilhelm Löffler
Wilhelm Löffler (1887 – 1972) was a Swiss physician. Löffler is eponymously associated with two clinical manifestations of eosinophilia which he described: transient pulmonary infiltrates with eosinophilia (Löffler syndrome, 1932) and endocarditis parietalis fibroplastica (Löffler endocarditis, 1936).
Idarucizumab
Idarucizumab is the antidote to dabigatran. Perhaps the hardest thing about it is saying its name. Eye-da-roo-ciz-oo-mab or praxbind until to comes off label. It is a humanised monoclonal antibody fragment (Fab) that binds to dabigatran with very high affinity (340x fold more than dabigatran binds to thrombin).
Hydroxocobalamin
Hydroxocobalamin is a vitamin B12 (cyanocobalamin) precursor. In high doses, it is an effective chelator of cyanide. It is also the preferred antidote to cyanide poisoning due to its low side effect profile, thus if given to a patient without cyanide poisoning there is low risk of an adverse outcome
Glucose
Symptomatic hypoglycaemia resulting from toxic exposures must be immediately corrected by administration of glucose. In all but the mildest of cases this is achieved with an intravenous bolus of hypertonic glucose solution
Glucagon
Polypeptide hormone secreted by the alpha-cells of the pancreas. Supra-physiological doses have previously been advocated in the management of beta-blocker and calcium channel blocker poisoning but this practice is now largely abandoned.
Fomepizole
Fomepizole is an alcohol dehydrogenase inhibitor used in management of methanol and ethylene glycol poisoning. It is not currently available in either Australia or New Zealand.
Folinic Acid
Folinic acid is the active form of folic acid. It is routinely used for “folinic acid rescue therapy” following administration of high-doses of parenteral methotrexate in oncologic practice.
Flumazenil
Flumazenil is a competitive benzodiazepine antagonist with a limited role in the management of benzodiazepine poisoning. Usually to reverse procedural sedation, accidental paediatric ingestion with compromise, and rarely to help make a diagnosis of benzodiazepine overdose or if a patient's airway is compromised without quick access to intubation equipment
Ethanol
Competitively blocks the formation of toxic metabolites in toxic alcohol ingestion by having a higher affinity for the enzyme Alcohol Dehydrogenase (ADH). Its chief application is in methanol and ethylene glycol ingestion, although it has been used with other toxic alcohols. Ethanol is now regarded as the second choice antidote in those countries with access to the specific ADH blocker, fomepizole.
Benztropine
Benztropine is the first line agent for the treatment of acute dystonic reactions. See how to administer and dose this drug.