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a 34- year old is brought to the ER because of diffuse muscle weakness and palpitations. His temperature is 37.2C, pulse is 82/min, respirations are 12/min, and blood pressure is 137/62 mm Hg. Physical exam shows mydriasis. Which of the following agents is the most likely cause of the findings seen in this patient?
A. Atropine
B Botulinum toxin
C. Ephedrine
D.Phenelzine
E. Succinylcholine.
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d or e!!! ill go with eee
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So im thinking muscle weakness and palpitations.
Faster heart from inhibition of Muscarinics (M2 receptor)
Along with muscle weakness from inhibition of NMJ
So im with B.
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I said faster heart from the feeling of palpitations but ur right pulse is normal.
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Atropine shouldnt effect muscles
Phelzine and Ephedrine should both cause Adrenergic effects
and Succinylcholine I think would be a much more pronounced response (ie paralysis) also its halflife is SOOOO small like 1 minute if i remember correctly.
So im still leaning toward Botulinum.
Answer?
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the answer is BB. Botulinum toxin binds to motor neurons and prevents the release of Ach; tachycardia, mydriasis, and increased body temperature because of decreased Ach activity of the Muscarinic receptors, these effects are seen with anticholinergic agents and botulinum toxin
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but isn't both HR and temperature are normal here?