USMLE

Tetrodotoxin

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Toxicology
  1. Cyanide Poisoning
  2. Tetrodotoxin
  3. Methanol Poisoning
  4. Ethylene Glycol Poisoning
  5. Ciguatoxin (Ciguatera Fish Poisoning)
  6. Spoiled Fish (Scombroid) Poisoning
  7. Carbon Monoxide Poisoning
  8. Amanita Phalloides

Tetrodotoxin is a neurotoxin that is found in pufferfish, like those served at fugu restaurants. Patients develop signs and symptoms within 30 minutes of ingestion, such as vomiting and diarrhea.

Tetrodotoxin exerts its neurologic effects by binding to and blocking fast voltage-gated sodium channels. These channels are needed for nerve impulses, and patients can develop paresthesias, paralysis, and decreased reflexes. Severe paralysis can cause respiratory arrest, which can be lethal.

Treatment is generally supportive, with intubation if respiratory function is impaired.

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