[toxnews] Toxicology Case Conference for 6/16/22

[Christine Stork]

Toxicology Case Conference
June 16, 2022
Leaders: Keenan/Stork

Agenda:

1300-1400: ACMT National Case Conference
1400 – Case and Journal Club (journals attached)

Case for discussion:

A 45-year-old male presents to the emergency department with complaints of vomiting after making a soup from some greens he foraged. He ate the soup around 1730, and began to vomit around 2230 (it is now 2300). He said he thought what he found were wild leaks.

Vital signs on arrival:
BP: 65/44 mmHg
HR: 45 beats per minute


  1.  What is the toxicologic differential of hypotension and bradycardia?
  2.  What plants produce bradycardia and hypotension?
     *   Are any in common with pharmaceuticals?
  3.  How would you approach this patient from a diagnostic perspective?
  4.  What plants are commonly mistaken for wild leaks?
     *   What is(are) the mechanism of toxicity?
     *   What is(are) their identification and treatment?

                                                              i.      Are there any potential antidotes?

  1.  How would you go about managing this patient?


Journal Club Articles

1. Saitz R, Mayo-Smith MF, Roberts MS, Redmond HA, Bernard DR, Calkins DR. Individualized treatment for alcohol withdrawal. A randomized double-blind controlled trial. JAMA. 1994;272(7):519-523.

2. Staidle A, Geier C. Phenobarbital and/or benzodiazepines for recurrent alcohol withdrawal: A self-controlled, retrospective cohort study. Am J Emerg Med. 2022;54:263-266.

Christine M. Stork, BSPharm, PharmD, MPH, DABAT, FAACT
Professor, Department of Emergency Medicine
Clinical Director, Upstate NY Poison Center
Upstate Medical University
Syracuse, NY

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