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Isoniazid

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.

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Isoniazid

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  1. Isoniazid • Seizure • Glutamic acid decarboxylase • Coenzyme pyridoxamine • No GABA formed • AG metabolic acidosis • Blocks conversion of lactate to pyruvate • Hyperglycemia

  2. 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

  3. Primary Metabolic AcidosisPrimary Metabolic Alkalosis • ASA • Post-ictal • Ibuprofen • Xanthines • Asthma • Liver disease

  4. 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

  5. Sedatives/Hypnotics • Benzodiazepines • Not • Barbituates or opiates RR • Meprobamate Fluctuating MSE • Cyclic esters PE • ETOH Smell • Methaqualone Anti-ACH,EPS Hyperaccussis

  6. 50 y/o male with nebulous complaints, asking for something to help him sleep. • You noticed that he has blisters on legs and trunk.

  7. Bullae • Barbituates Consider • Meprobamate Pemphigus • Ethyl chlorovinyl Drug rxn • Diclofenac • Not • Skin poppers

  8. I have blurry vision and cannot focus my eyes.

  9. Mydriatics • Anticholinergics Nicotinic • Antidepressants • Antihistamines • Sympathomimetics • Crack eye or nebulizer • Red top drops • Eye disease

  10. Miotics • Opiates • Clonidine • Cholinergics • Anticholinergics Muscarinic-rare • Buspirone/olanzipine • Neuroleptics • Post-eye surgery • Green/blue/yellow top drops • Pontine hemorrhage

  11. 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

  12. 50 y/o hypertensive BIBA for syncope in church. • HR 40 BP 90/60 RR 16

  13. Bradycardia • Clonidine* • Calcium channel blockers • Beta-blockers • Cardiac glycosides • Opiates • Cholinergics • Cushing reflex • Inferior wall MI • Health

  14. 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.

  15. Hypothermia • CO • Sulfonylureas • Phenothiazines • Sedative/hypnotics • Opiates • ETOH

  16. 17 y/o female was just dumped by her boyfriend. Mother called EMS because she is breathing “too fast”. • OE: upset, anxious female

  17. AG Metabolic Acidosis • Methanol • Uremia • DKA • Paraldehyde • Iron, INH, Ibuprofen • Lactic acidosis • Ethylene glycol • Salicylates • Also CN,CO,theophylline,hydrocarbons

  18. Hyperventilation • Cholinergics Fever • Theophylline Sepsis • Cocaine Hypoxia • AG metabolic acidosis Asthma • PE • Midbrain hemorrhage • Anxiety

  19. 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

  20. Hyperthermia • Sympathomimetics • Anticholinergics • NMS • Serotonin syndrome • Arsenic • LSD • Ecstasy • Heat stroke/exhuastion • Thyriod Storm

  21. 22 y/o female found in a club’s bathroom comatose. Intubated on field without drugs.

  22. Hypoventilation • Opiates • ETOH • Isopropyl • Clonidine • Cholinergics (late) • Botulism • NMJ disorders • Sedatives/hypnotics • GHB

  23. 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

  24. Class IA Antiarrhythmics • Quinidine, procainamide • TCA • Propoxyphene • Methacarbamol, cyclobenzoprene • Cocaine • Phenothiazines • Carbamazepine • 2nd generation antihistamines

  25. 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.

  26. Sialorrhea • Rabies • Clozaril • Metal fume fever • Mercury • Scorpion stings • Crotalids • Cholinergics • Ketamine

  27. 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

  28. Faget’s sign/Pel-Ebstien Fever • Salmonella Yellow Fever • Legionella • Psittacosis • Antineoplastic drugs • Tumors • Hepatomas/liver mets Myxoma • Nephroma Lymphoma • Sarcoma

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