Difference between revisions of "Tetrodotoxin"

(Mechanism of Injury)
 
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==Management==
 
==Management==
*Supportive care, intubate if concern for progressive paralysis
+
*Supportive care is mainstay of treatment
*[[Acetylcholinesterase inhibitors]] (e.g. [[neostigmine]])<ref>Tintanelli's</ref>
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*May require intubation if concern for progressive paralysis
 +
*[[Acetylcholinesterase inhibitors]] (e.g. [[neostigmine]])
  
 
==Disposition==
 
==Disposition==
*Admit, may need ICU
+
*Admit (may need ICU)
 +
 
 +
==External Links==
 +
 
  
 
==See Also==
 
==See Also==

Latest revision as of 06:42, 6 March 2019

Background

  • Neurotoxin found in several marine animals (pufferfish, certain angelfish, blue-ringed octopus)
    • Heat-stable toxin not destroyed by washing, freezing or cooking
  • Blocks neuronal action potential by blocking voltage-gated sodium channels
  • Consumption of improperly prepared pufferfish responsible for vast majority of human toxicity (e.g. fugu restaurants)
Blue-ringed-octopus.jpeg

Mechanism of Injury

  • Tetrodotoxin binds to and blocks fast-gated sodium channels, blocking conduction of nerve signals.

Clinical Features

Onset of symptoms usually within 30 min to 4 hours after eating pufferfish

Differential Diagnosis

Marine toxins, envenomations, and bites

Evaluation

  • Pufferfish can be tested for the toxin, but decision to treat should be based on clinical picture
  • Evaluate for other treatable causes of symptoms

Management

Disposition

  • Admit (may need ICU)

External Links

See Also

References


Video