Isoniazid
Seizure Glutamic acid decarboxylase Coenzyme pyridoxamine No GABA formed AG metabolic acidosis Blocks conversion of lactate to pyruvate Hyperglycemia
22 y/o male asthmatic took some pills to kill himself and is comatose. BP 120/80 HR 110 RR 20 T 101 Wheezing 7.36/22/250
Primary Metabolic Acidosis Primary Metabolic Alkalosis
ASA Post-ictal Ibuprofen Xanthines Asthma Liver disease
24 y/o male intern on July 2 cannot handle the work and is found in the call room comatose.
HR 75 BP 120/80 RR 16 T 98
Sedatives/Hypnotics
Benzodiazepines Not Barbituates or opiates Meprobamate Cyclic esters ETOH Methaqualone
RR Fluctuating MSE PE Smell Anti-ACH,EPS Hyperaccussis
50 y/o male with nebulous complaints, asking for something to help him sleep. You noticed that he has blisters on legs and trunk.
Bullae
Barbituates Meprobamate Ethyl chlorovinyl Diclofenac Not Skin poppers Consider Pemphigus Drug rxn
I have blurry vision and cannot focus my eyes.
Mydriatics
Anticholinergics Nicotinic Antidepressants Antihistamines Sympathomimetics Crack eye or nebulizer Red top drops Eye disease
Miotics
Opiates Clonidine Cholinergics Anticholinergics Muscarinic-rare Buspirone/olanzipine Neuroleptics Post-eye surgery Green/blue/yellow top drops Pontine hemorrhage
3 y/o BIBA unresponsive after eating 3 of granny’s BP pills. HR 70 BP na RR 11 Child responsive to deep stimulus and has pinpoint pupils
50 y/o hypertensive BIBA for syncope in church.
HR 40 BP 90/60 RR 16
Bradycardia
Clonidine* Calcium channel blockers Beta-blockers Cardiac glycosides Opiates Cholinergics Cushing reflex Inferior wall MI Health
On the first cold day of fall, a child BIBA comatose. Later, parents arrive with c/o HA and not feeling well, but are more concerned of child’s status and what they are going to tell him when he wakes up as his dog has mysteriously died on the same day.
Hypothermia
CO Sulfonylureas Phenothiazines Sedative/hypnotics Opiates ETOH
17 y/o female was just dumped by her boyfriend. Mother called EMS because she is breathing “too fast”.
OE: upset, anxious female
AG Metabolic Acidosis
Methanol Uremia DKA Paraldehyde Iron, INH, Ibuprofen Lactic acidosis Ethylene glycol Salicylates Also CN,CO,theophylline,hydrocarbons
Hyperventilation
Cholinergics Theophylline Cocaine AG metabolic acidosis Midbrain hemorrhage Anxiety Fever Sepsis Hypoxia Asthma PE
Police bring in a “crack head” wandering on the Grand Concourse on July 4, confused and agitated.
BP 150/105 HR110 RR 22 T 104
Hyperthermia
Sympathomimetics Anticholinergics NMS Serotonin syndrome Arsenic LSD Ecstasy Heat stroke/exhuastion Thyriod Storm
22 y/o female found in a club’s bathroom comatose. Intubated on field without drugs.
Hypoventilation
Opiates ETOH Isopropyl Clonidine Cholinergics (late) Botulism NMJ disorders Sedatives/hypnotics GHB
38 y/o male BIBA at the gym c/o weakness and had a syncopal event. He takes an antiepileptic agent and a new medicine for his back pain. Unremarkable exam. EKG shows widened QRS with QT 530 ms
Class IA Antiarrhythmics
Quinidine, procainamide TCA Propoxyphene Methacarbamol, cyclobenzoprene Cocaine Phenothiazines Carbamazepine 2nd generation antihistamines
50 y/o female who just arrived from Mexico, c/o of being bitten by a scorpion which was in her coat pocket while she was reaching for her medication. She was also bitten 10 days ago by a skunk while running away from a snake after using IV drugs in her backyard. OE: agitated and salivating copiously.
Sialorrhea
Rabies Clozaril Metal fume fever Mercury Scorpion stings Crotalids Cholinergics Ketamine
20 y/o male returned from Dominican Republic c/o diarrhea. He has spent a month eating his grandmother’s cooking, whose hygiene is dubious. HR 50 BP 120/80 RR 20 T 104
Faget’s sign/Pel-Ebstien Fever
Salmonella Legionella Psittacosis Antineoplastic drugs Tumors Hepatomas/liver mets Nephroma Sarcoma Yellow Fever
Myxoma Lymphoma