LITFL Medical Humor 340
Lost in Translation…again

Whether it is interpreting a physicians handwriting, transcribing the muffled rants of the dictating clinician or battling the auto-correct function of microsoft word...meaning can sometimes be lost in translation...

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Amisulpride toxicity

Amisulpride is an atypical antipsychotic in low doses will causes and anticholinergic effect but at higher doses prolongs the QT interval with cases of torsades de pointes noted.

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Benztropine toxicity

Normally used to ameliorate dyskinesia from antipsychotics but has been used for recreational purposes. Benztropine is a potent anticholingeric in overdose. You may also use it yourself as an antidote for an acute dystonic reaction.

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Clozapine toxicity

Clozapine is an atypical antipsychotic, due to its restricted use an acute overdose is a rare event but clinicians should be aware that coma can occur and management is with supportive care. In chronic toxicity agranulocytosis and myocarditis can occur, these are not features of an acute poisoning but monitored in patients with long term therapeutic use.

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Lithium toxicity

Lithium is commonly used to treat bipolar, for your toxicology encounter it will come in two varieties, either an acute overdose or chronic toxicity and it is important to distinguish the two (examiners love this question).

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Olanzapine toxicity

Olanzapine is a second generation atypical antipsychotic. Widely used in Australasia and therefore a fairly common presentation to the emergency department. Olanzapine like queitiapine has a predictable dose-dependent CNS depression.