Multiprofessional Critical Care Review: Pediatric 2024 (MCCRCP24ON)-Poisons and Toxidromes

Pdf Summary

The presentation titled "Poisons & Toxidromes" by Dr. Edward E. Conway Jr. from Jacobi Medical Center covers various aspects of poisoning, toxic agents, and management of toxidromes. <br /><br />It begins with a mnemonic for altered mental status (A Alcohol, E Encephalitis/ Electrolytes/Endocrine, I Ingestions/Infection, etc.) to aid in differential diagnosis. Toxidromes, symptom profiles associated with specific types of toxins, are highlighted, encompassing several categories:<br /><br />1. <strong>Sympathomimetic</strong>: Drugs like cocaine and amphetamines result in hyperactivity and sympathetic stimulation.<br />2. <strong>Anticholinergic</strong>: Substances like antihistamines, tricyclic antidepressants (TCA), and atropine which can cause symptoms such as dry mouth, dilated pupils, and hallucinations.<br />3. <strong>Cholinergic</strong>: Commonly caused by organophosphates and nerve agents, leading to sludgy symptoms (Salivation, Lacrimation, Urinary retention, Defecation, GI cramps, Emesis).<br /><br />A significant section is dedicated to organophosphates, detailing their mechanism of action and treatment. They inhibit acetylcholinesterase, causing a cholinergic crisis and are treated with atropine and pralidoxime (2-PAM).<br /><br />Several drug classes with potential for overdose and toxicity are reviewed:<br /><br />- <strong>Opiates</strong>: Including morphine, fentanyl, heroin, and methadone.<br />- <strong>Sedatives/Hypnotics</strong>: Such as benzodiazepines and ethanol.<br />- <strong>Serotonin Syndrome</strong>: Caused by MAOIs, SSRIs, meperidine, and dextromethorphan.<br />- <strong>Hallucinogens</strong>: Including LSD, PCP, and MDMA.<br />- <strong>Neuroleptics</strong>: Drugs like chlorpromazine and haloperidol.<br /><br />Key points include the importance of initiating resuscitation (A, B, C, D, E approach) without knowing the exact intoxicant, recognizing that toxidromes may overlap, and understanding that infants and children respond differently to medications compared to adults.<br /><br />Lastly, it emphasizes the need for clinicians to comprehend these toxidromes and be prepared with immediate interventions. Normal head CT scans are mentioned, possibly implying the use of imaging in diagnostic processes for altered mental status.

Meta Tag

Concept Pediatric Toxidrome

Concept Cholinergic Toxidrome

Concept Serotonin Syndrome

Concept Altered Mental Status

Concept Cholinergic Crisis

Concept Organophosphate Poisoning

Concept Atropine

Concept Pralidoxime

Concept Resuscitation

Keywords

Poisons

Toxidromes

Dr. Edward E. Conway Jr.

Jacobi Medical Center

Sympathomimetic

Anticholinergic

Cholinergic

Organophosphates

Serotonin Syndrome

Resuscitation

Pediatric Toxidrome

Cholinergic Toxidrome

Serotonin Syndrome

Altered Mental Status

Cholinergic Crisis

Organophosphate Poisoning

Atropine

Pralidoxime

Resuscitation

	Society of Critical Care Medicine 500 Midway Drive Mount Prospect, IL 60056 USA Phone: +1 847 827-6888 Fax: +1 847 439-7226 Email: support@sccm.org	Contact Us About SCCM Newsroom Advertising & Sponsorship DONATE	MySCCM LearnICU Patients & Families Surviving Sepsis Campaign Critical Care Societies Collaborative	GET OUR NEWSLETTER
© Society of Critical Care Medicine. All rights reserved. \| Privacy Statement \| Terms & Conditions The Society of Critical Care Medicine, SCCM, and Critical Care Congress are registered trademarks of the Society of Critical Care Medicine.