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Alshiek Jonia, MD
jonia.alshiek@gmail.com
סיפור מקרה
1)Decontamination:
a.Avoid further exposure
1.Absorption:
By any routes:
(1) transdermal
(2) transconjunctival
(3) inhalation
(5) parenteral
PHARMACOLOGY
2.Metabolism: via liver
Parathion Paraoxon
(3) Sites:M1-5, N
a. Parasympathetic:
Ganglionic nicotinic sites
Postganglionic muscarinic sites
d. CNS sites
איזה סמפטומים וסימנים נוספים נצפה למצוא
אצל החולה הזה???
CLINICAL FEATURES
General considerations :
(1) within minutes to 12 hours
* SLUDGE
S =Salivation
L =Lacrimation
U =Urination
D =Diarrhea
G =GI cramps
E =Emesis
CLINICAL FEATURES
Muscarinic effects:
*Other effects:
b.Bradycardia
c.Bronchorrhea
d.Bronchonstriction
CLINICAL FEATURES
Nicotinic effects:
*appear after muscarinic effects
*MTWHF:
M =Mydriais , muscle cramps
T =Tachycardia
W =Weakness
F =Fasciculations
CLINICAL FEATURES
CNS effects: non specific
(1) confusion
(2) agitation
(3) lethargy
(4) seziure
(5) coma
CLINICAL FEATURES
Causes of death:
(1) Muscarinic effects:
a.Excessive pulmonary secretions
b.Bronchoconstriction
c.Pulmonary edema
b.bronchorrheahypoxiatachycardia
more atropin
2)Management – next step
Antidotes
1)Pralidoxime