A 22-year-old man is brought to the emergency department because of agitation after ingesting an unknown amount of jimson weed at a party. His temperature is 39.8°C, heart rate is 128/min, and blood pressure is 145/90 mmHg. He is flushed, febrile, and delirious. His skin is dry, pupils are dilated to 8 mm bilaterally, mucous membranes are dry, and bowel sounds are decreased. Urinary retention is noted on abdominal examination. Which of the following best explains the mechanism of the agent responsible for his findings?
- A)Competitive antagonism of muscarinic acetylcholine receptorsGABARITO
- B)Increased release of norepinephrine from presynaptic vesicles
- C)Irreversible inhibition of acetylcholinesterase
- D)Activation of nicotinic ganglionic receptors
- E)Alpha 2 agonism in the central nervous system
Explicação
Jimson weed contains antimuscarinic alkaloids with atropine like effects. The classic anticholinergic toxidrome of dry skin, mydriasis, ileus, urinary retention, hyperthermia, and delirium is due to competitive blockade of muscarinic receptors. Ver explicação completa e trilha adaptativa →