Accepted
at 2:55 a.m. Feb, 23, 2025
by
andrewmathias8
Author:
andrewmathias8
Rationale for change
Card is directly related. Q describes a farmer with symptoms of organoposhpate poisoning. The Q stem then states that he is treated with "the appropriate initial medication, which improves his wheezing." And asks "Administration of which of the following medications is the most appropriate next step in management" Answer: Pralidoxime
No changes in fields
Text
What is the recommended treatment for organophosphate or acetylcholinesterase inhibitor poisoning?
{{c1::Atropine, then pralidoxime}}
{{c1::Atropine, then pralidoxime}}
Extra
- Equally important is the removal of any clothes, which may be contaminated with pesticides, and washing of skin to prevent further cutaneous absorption
- Atropine reverses muscarinic symptoms only as a competitive inhibitor at the muscarinic ACh receptors so the excessive ACh can't bind (stops secretions)
- Pralidoxime regenerates ACh-esterase = ↓ ACh = reverses muscarinic and nicotonic symptoms
- Pralidoxime has poor blood-brain barrier penetration and can lead to a transient worsening of acetylcholinesterase inhibition following administration, which is why atropine is typically administered first to treat CNS symptoms and prevent further acetylcholinesterase inhibition
- Pralidoxime induces a transient increase in acetylcholinesterase inactivation, so administering the drug without pretreatment with another drug could cause an exacerbation of the patient's symptoms
Lecture Notes
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Missed Questions
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Pathoma
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Boards and Beyond
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First Aid
Sketchy Extra




Picmonic
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Pixorize
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Physeo
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Bootcamp
Watch associated Bootcamp video - Autonomic System : Anticholinesterase Poisoning
Watch associated Bootcamp video - Side Effects and Toxins : Pharmacological Toxicity and Treatment
Watch associated Bootcamp video - Neuromuscular Junction (NMJ): Medications Targeting the NMJ
Watch associated Bootcamp video - Side Effects and Toxins : Pharmacological Toxicity and Treatment
Watch associated Bootcamp video - Neuromuscular Junction (NMJ): Medications Targeting the NMJ
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