Pyrexia of unknown origin

Also known as PUO.

[Toxicology] MDMA poisoning

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MDMA (3,4-Methyl​enedioxy​methamphetamine) is also known as ectasy or molly.

In overdose, this can cause fatal arrhythmias, AKI, hyperpyrexia, and neurological disturbances. 

[Toxicology] Pharmaceutical poisoning

 Poison database

• Medication overdose 
• Acetylcholinesterase inhibitor overdose 
• Barbiturate overdose 
• Benzodiazepine overdose 
• Digoxin poisoning
• Dipyridamole overdose 
• Opioid overdose 
• Paracetamol overdose 
• Salicylate poisoning
• Tricyclic antidepressant overdose

• Hypervitaminosis 
• Vitamin A
• Vitamin D
• Vitamin E

• Recreational drug overdose
• MDMA poisoning 

Ecstasy poisoning

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Ethanol poisoning

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Benzodiazepine overdose

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Benzodiazepines depress the CNS.
In overdose, the GCS and respiratory rate fall.

 

Management

• Medical therapy
• The reversal agent is flumazenil, a GABA_A antagonist (blocker) which counteracts benzodiazepines by competitive inhibition.
• Airway management
• Tracheal intubation
• Mechanical ventilation 

Psychosis

Definition

One of a group of mental disorders in which the affected person loses contact with reality. Thought processes can be so disturbed that the person does not realise that he or she is ill. 

Symptoms include delusions, hallucinations, loss of emotion, mania, depression, poverty of thought and seriously abnormal behaviour.

Source: Black's Medical Dictionary (42nd ed, 2010, ISBN 978-1-4081-0419-4) 

Opioid overdose

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Opioid receptor agonists depress the respiratory drive.
In overdose, the respiratory rate falls to 0 breaths per minute.

 

Signs

• Pupillary constriction (miosis)

 

Management

• Medical therapy
• The reversal agent is naloxone, an opioid receptor antagonist (blocker).
• This will quickly reverse any respiratory depression, but also reverses any euphoria, or analgesia. In palliative care, this is an important consideration.
• Airway management
• Tracheal intubation
• Mechanical ventilation