A. Ant psychotics
B. Benzodiazepines
C. Ethylene glycol
D. Methanol
E. Opiates
F. Organophosphates
G. Salicylates
H. Sympathomimetic
I. Tricyclic antidepressants
J. Volatile solvents
Select the most appropriate agent from the above list that would elicit the following toxic effects:
1) Coma, pinpoint pupils, hyperventilation
2) Hyper salivation, broncho-rrhoea, broncho- spasms, perspiration, neuromuscular paralysis
3) Tachypnoea, metabolic acidosis, Haematemesis, Reyes Syndrome.
Answers :
E. Opiates
F. Organophosphates
G. Salicylates
Comments:
A pinpoint pupil suggests : opiates (Heroin – Morphine – codeine). The hyper salivation, tachypnoea and sweating suggest :Organophosphate poisoning. This drug inhibits ant-cholinesterase activity promoting Ach effects. Treatment consists of anticholinergics < (Atropine dose i.v 0.05 mg/kg repeated every 5-10 min as needed adverse effect tachycardia, dry mouth, blurred vision, and urinary retention). Finally, the use of salicylates in children is well-recognized cause of Reyes syndrome, a condition associated with fulminant hepatic failure. Suspected poisoning in children result in thousands of attendances at A&E department each year. Various drugs cause specific signs when taken in overdose. Careful examination of the child should follow A, B, C protocol.
