Funnel-Web Spider Antivenom
Funnel-Web Spider Antivenom (lapine IgG Fab) can be used to treat envenomation from Funnel-Web spiders and maybe mouse spiders.
Funtabulously Frivolous Friday Five 192
Funtabulously Frivolous Friday Five 192 - Just when you thought your brain could unwind on a Friday, some medical trivia FFFF.
ICE 009: Foot trauma
A 29 year old man stumbled into a gutter, tripped awkwardly and fell injuring his left foot. He has diffuse swelling and tenderness of the mid foot and is unable to weight bear on that limb.
Roth spots
Roth spots: Retinal haemorrhages with white or pale centres, commonly associated with subacute bacterial endocarditis and immune complex mediated vasculitis.
Bupropion toxicity
Bupropion is an antidepressant mainly used now for nicotine suppression. It comes as an extended release preparation 150 mg in Australian and New Zealand. In overdose it can cause seizures and cardiotoxicity however, good supportive care usually prevents any adverse outcome.
MAOI toxicity
Monoamine Oxidase inhibitors (MAOIs) come in different varieties and there is a little more to remember than just the interaction with cheese. The irreversible non-selective (MAO-A+B) are notorious for causing lethal serotonin toxicity in overdose, these include Phenelzine and Tranylcypromine.
Valproic Acid
Valproic acid (sodium valproate) in overdose results in CNS depression and large overdoses can result in multi-system organ failure and death. Chronic toxicity can cause life threatening hyperammonia and hepatotoxicity.
Phenytoin toxicity
Phenytoin intoxication can occur either with repeated supra therapeutic dosing or an acute overdose. Dose-dependent CNS depression occurs. Most presentations are benign and have good outcomes with supportive care. The main risk to patients is falling which can last days.
Newer Anticonvulsants
Overdose with newer anticonvulsant agents include: Gabapentin, Lamotrigine, Levetiracetam, Oxcarbazepine, Pregabalin, Tiagabine, Topiramate and Vigabatrin.
Carbamazepine toxicity
Carbamazepine overdose has a predictable dose-dependent CNS depression and anticholinergic effects. Carbamazepine if unique in the anticonvulsants that is also has sodium channel blocking effects and can act similarly in overdose to a tricyclic antidepressant and the role of sodium bicarbonate should be remembered.
Benzodiazepine toxicity
We discuss the management of benzodiazepine overdose including zopiclone and zolpidem as which carefully selected cases to use flumazenil. Benzodiazepines are a frequent presentation either as a single ingesting or in combination. With good supportive care prognosis is excellent.
Warfarin toxicity
Over anticoagulation is a common problem with warfarin and acute intoxication maybe in those with or without an anticoagulation requirement. This can make the approach to treatment difficult when considering the need for therapeutic anticoagulation and expert advice maybe required.