Fortunately mercury poisoning is very rare. The risk of toxicity depends on the type of mercury you have been exposed to. Elemental mercury is found in thermometers, barometers, paints, and pigments, these are benign presentations unless aerosolised
Theophylline has a narrow therapeutic index, both acute and chronic overdose is potentially life-threatening requiring aggressive supportive care and dialysis to ensure a good outcome
Isoniazid overdose is rare but life threatening. Isoniazid can cause refractory seizures which require the specific antidote pyridoxine. It should be thought about in cases of status epileptics where this is a relative or a potential history of TB in the family.
Baclofen in overdose produces a rapid onset of delirium, respiratory depression, coma and seizures. In large overdose the patient can appear brain dead and it has resulted in the pursuit of organ donation only for the patient to wake on the operating table. The mainstay of treatment is good supportive care.
Redback spider bite is the most common envenoming in Australia with 5000–10,000 human bites occurring annually.
Opioids are obviously our bread and butter in emergency medicine, what more is there to know? This post is designed to give you a few extra tips and some idiosyncrasies with some of the other opiates to assist you in your clinical management.
Gamma-Hydroxybutyrate - GHB has many names including: Cherry meth, liquid Fanta, Easy Lay, Fantasy, Georgia Homeboy, Liquid Ecstasy, Liquid G and most annoyingly...water. GHB is the opposite of Amphetamine, instead of making you angry and hypervigilant it depresses your CNS. It is a precursor and metabolite of gamma-aminobutyric acid (GABA - the inhibitory neurotransmitter).
Cocaine is a classic sympathomimetic, used by the Incas as an appetite suppressant and noted for its analgesic properties we now use it medically as a local anaesthetic (Sodium channel blockade of the nerves).
Marijuana is the most widely used illicit drug in Australia, most people have a pleasant experience with the psychoactive drug. Cannabinoids can have adverse effects particularly in children if high doses are consumed which result in CNS depression and a coma lasting up to 36 hours.
An uncommon presentation but you need to know that barbiturates can cause a profound coma mimicking brain death. Without good supportive care this overdose or mis-adventure can be lethal.
Amphetamine toxicity and how to manage the severe complications in the emergency department.
Colchicine toxicity is rare but any intention overdose with colchicine is potentially lethal. Although resuscitation is a priority as with all toxicities, colchicine requires urgent decontamination due to the limited therapies we have once toxic serum levels develop.