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Challenger Toxicology
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Issue: February 15, 2008
Case:Poisonous Plants
Taken from
Challenger Toxicology
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Question:
A child is found eating the last of several oleander leaves
that she was using for a make-believe tea party. On exam, she is noted to be bradycardic. Electrolytes
reveal a potassium of 6.2 mmol/L. Which methods confirm the diagnosis and what are the treatment options? Check all that apply
- Calcium should be given to protect myocardium prior to using insulin, dextrose,
or bicarbonate to lower the potassium.
- Severe hyperkalemia may require hemodialysis.
- Digoxin-specific Fab may be used for lanoxin, digoxin, or digitalis, but not for oleander.
- A positive serum digoxin level will qualitatively confirm the diagnosis.
- Kayexalate in weight-appropriate dosage should be given PO or rectally.
- Of the more common cardiac glycoside-containing plants (lily of the valley, foxglove, and
oleander), oleander is the most toxic.
Answer:
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