Team what's going on

Zach here from med geeks so today we're going to discuss anti-colonergic

toxicity this is an important one as there are a ton of medications out

there that have antiicholinergic properties.

We'll go over a case, break it down by intro, etiology, clinical presentation,

workup diagnosis, differential, and lastly management.

Let us begin.

So you got a 75-year-old female with a past medical history of Parkinson's, COPD, hypertension, and hyperlipidemia.

She presents from a skilled nursing facility with altered mental status.

Per the nursing facility, the patient is alert and oriented times four baseline,

however does need assistance with ADLs and was noted at her baseline the night prior to arrival to the hospital.

The staff notes that the patient was acting weird this morning with intermittent agitation and disoriented to self, place, and time.

Her vitals were taken at the facility which revealed the fever of 102.3, heart rates in the 120s,

blood pressure 130 over 89. A respiratory rate of 16 and

oxygen saturation of 98% on Romare. She also has not urinated in over 12 hours. Perstaff, she has been her usual

self and the only change lately was that she was seen yesterday in the ER with a lower back musculoskeletal strain and was prescribed

flexoral and ibuprofen for pain, control, and muscle relaxation.

Denies any complaints of prior fevers, chills, headaches,

nausea, vomiting, diarrhea, shortness of breath, chest pain,

abdominal pain, or urinary complaints.

Initial vitals in the ER revealed a persistent fever of 101.8, heart rates in the

130s, blood pressure 128 over 75, and oxygen saturations of 98% on room air.

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