Cholinergic Syndrome
Cholinergic Toxidrome
Category Toxicology
Paracetamol…too much, too often?
You are called by a doctor in a remote hospital asking for advice. The doctor is concerned about the risk of hepatotoxicity from repeated supratherapeutic ingestion (RSI) of paracetamol in the following patient:
Poisoning by a mercury thermometer
Your next patient is an 80 year old man suffering from Alzheimer's dementia. He was brought into the ED by his wife and daughter who are his care-givers. He had a recent catheter-associated urinary tract infection and his daughter was checking his temperature orally with a mercury thermometer 30 minutes previously.
Bitten by a Redback Spider
A 27 year-old woman felt a sting on the back of the right leg while pulling on her tracksuit pants. She investigated further and discovered a small black spider, with a red-stripe on its back, crawling around in her tracksuit pants.
Is this a RedBack I see before me?
Doctor X has just assessed a 44 year-old male who thinks he was bitten or stung by something under his house three days ago. The initial discomfort was mild and localized to his right forearm. However the pain traveled up his arm over the next few hours.
Snakebite versus Stickbite
aka Toxicology Conundrum 005 A 20 year-old male was walking in rural New South Wales (Australia!) when he noticed a brown-coloured snake. He was startled and stepped backwards onto a tree branch which snapped under his weight. He then saw…
Suboxone poisoning
The phone rings as you sit down for lunch. You are asked for advice concerning a drowsy 2 year-old boy who was brought in to a Children's Emergency Department by his worried parents.
Strychnine poisoning
Toxicological conundrum on the pharmacological effects of Strychnine toxicity
Stung Inside A Stinger Net
It's Christmas, and you're called by a doctor who has recently arrived in Australia from the UK. He is in North Queensland looking after a 23 year-old female swimmer who doesn't look at all well...
Gastric lavage
Gastric lavage is a GI decontamination technique that aims to empty the stomach of toxic substances by the sequential administration and aspiration of small volumes of fluid via an orogastric tube. Previously widely favoured method that has now been all but abandoned due to lack of evidence of efficacy and risk of complications.
Organophosphate Poisoning
Organophosphate Poisoning: common cause of poisoning in the developing world; covalent bonding with inactivation of acetylcholinesterase; results in cholinergic crisis
Toxicology Literature Summaries
CARBON MONOXIDE POISONING Scheinkestel, C.D. et al (1999) “Hyperbaric or normobaric oxygen for acute carbon monoxide poisoning: a randomized controlled clinical trial” Med J Aust, 170:203-210 Weaver, L.K. et al (2002) “Hyperbaric oxygen for acute carbon monoxide poisoning” NEJM 347:1057-1067…