Toxicologic Emergencies

Question 1

Radiopaque foreign bodies

Answer 1

BAT CHIPS: Barium; Antihistamines; TCAs; Ca2+, Cocaine, and Condoms; Heavy metals, Iodine and Iron; Phenothiazines and Potassium; Slow release (enteric-coated)

Question 2

Anticholinergic Toxidrome

Answer 2

• Hot as a hare (hyperthermia)
• Dry as a bone (dry)
• Red as a beet (flushed skin)
• Blind as a bat (mydriasis)
• Mad as a hatter (delirium)
• Full as a flask (urinary retention)
• Tacky as a pink flamingo (tachycardia)

Question 3

Meds that can cause anticholinergic toxidrome

Answer 3

• Amantadines
• Anticholinergics
• Antihistamines (incl. Benadryl)
• Antiparkinsonians
• Antipsychotics
• Antispasmodics (dicyclomine)
• Cyclic antidepressants
• Phenothiazine
• Plants (jimsonweed, nightshade, Amanita muscaria)
• Scopolamine

Question 4

Cholinergic toxidrome

Answer 4

• SLUDGE (Salivation, Lacrimation, Urination, Diarrhea, GI hyperactivity, Emesis) syndrome
• Killer B’s (Bronchorrhea, Bronchoconstriction, Bradycardia)

Question 5

Meds that can cause cholinergic toxidrome

Answer 5

• Acetylcholine
• Carbamates
• Some species mushrooms
• Organophosphates - Physostigmine
• Pilocarpine
• Tobacco
• Pesticides

Question 6

Extrapyridimal toxidrome

Answer 6

• Ataxia - Choreoathetosis (irregular writhing movements)
  dystonic reactions, hyperreflexia, opisthotonos (spasm and hyperextension of the back), rigidity, seizures, torticollis, tremor, and trismus