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Toxicology Case Conference</p>
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June 16, 2022</p>
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Leaders: Keenan/Stork</p>
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<b style="">Agenda:</b></p>
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1300-1400: ACMT National Case Conference</p>
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1400 – Case and Journal Club (journals attached)</p>
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<b style="">Case for discussion:</b></p>
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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.
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Vital signs on arrival: <br>
BP: 65/44 mmHg</p>
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HR: 45 beats per minute</p>
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What is the toxicologic differential of hypotension and bradycardia?</li><li class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0.0001pt 0.5in; font-size: 12pt; font-family: Calibri, sans-serif;margin-left:0in">
What plants produce bradycardia and hypotension?</li><ol start="1" type="a" style="margin-bottom: 0in;margin-top:0in">
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Are any in common with pharmaceuticals?</li></ol>
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How would you approach this patient from a diagnostic perspective? </li><li class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0.0001pt 0.5in; font-size: 12pt; font-family: Calibri, sans-serif;margin-left:0in">
What plants are commonly mistaken for wild leaks? </li><ol start="1" type="a" style="margin-bottom: 0in;margin-top:0in">
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What is(are) the mechanism of toxicity? </li><li class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0.0001pt 0.5in; font-size: 12pt; font-family: Calibri, sans-serif;margin-left:0in">
What is(are) their identification and treatment? </li></ol>
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<span style=""><span style="mso-list:Ignore"><span style="font:7.0pt "Times New Roman"">
</span>i.<span style="font:7.0pt "Times New Roman""> </span></span></span>Are there any potential antidotes?</p>
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How would you go about managing this patient?</li></ol>
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<b style="">Journal Club Articles</b></p>
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1. <span class="SpellE">Saitz</span> 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.</p>
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2. <span class="SpellE">Staidle</span> A, Geier C. Phenobarbital and/or benzodiazepines for recurrent alcohol withdrawal: A self-controlled, retrospective cohort study. Am J
<span class="SpellE">Emerg</span> Med. 2022;54:263-266.</p>
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<a name="_MailAutoSig"><span style="font-family:"Script MT Bold"">Christine M. Stork, BSPharm, PharmD, MPH, DABAT, FAACT</span></a></p>
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<span style=""><span style="font-family:"Script MT Bold"">Professor, Department of Emergency Medicine</span></span></p>
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<span style=""><span style="font-family:"Script MT Bold"">Clinical Director, Upstate NY Poison Center</span></span></p>
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<span style=""><span style="font-family:"Script MT Bold"">Upstate Medical University</span></span></p>
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<span style=""><span style="font-family:"Script MT Bold"">Syracuse, NY</span></span></p>
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