Title: Toxicological etiology of patient with flushed skin .<br/>Author: Hong Kim<br/><a href='http://umem.org/profiles/faculty/526/'>[Click to email author]</a><hr/><p> Monosodium glutamate</p> <ul> <li> Rapid onset 30 min and lasts about 1 hour</li> <li> May accompanied with headache & chest pain.</li> <li> No associated GI sx.</li> <li> History of eating Chinese food AKA "Chinese restaurant syndrome"</li> </ul> <p> </p> <p> Metabisulfites (Na sulfite, Na/K bisfulfite, Na/K metabisulfite, etc.)</p> <ul> <li> Food preservatives found in dried fruit, wine, molasses, sauerkraut, etc.</li> <li> Bronchospasm – asthma like, headache, mild hypotension can occur</li> <li> Most significant reaction in people with asthma/allergies</li> <li> History of trying to eat healthy</li> </ul> <p> </p> <p> Tyramine reaction</p> <ul> <li> Mostly among patients taking MAO inhibitors</li> <li> Source of tyramine (food): fermented, pickled product, avocado, chocolate, etc.</li> </ul> <p> </p> <p> Niacin</p> <ul> <li> Burning warm sensation to body</li> <li> Often used for sexual enhancement, elevated cholesterol and beating drug urine screens</li> </ul> <p> </p> <p> Trichloroethylene</p> <ul> <li> Occupational exposure – AKA “Degreaser’s flush”</li> <li> Facial flushing, head pressure, lacrimation & blurred vision may occur</li> <li> Require several weeks of exposure prior to symptoms</li> </ul> <p> </p> <p> Scrombroids</p> <ul> <li> Occurs after a “fish meal” (e.g. dark meat fish - tuna)</li> <li> Associated with GI symptoms (nausea, vomiting, diarrhea)</li> <li> Histamine related reaction due to poor refrigeration after catching fish.</li> </ul> <p> </p> <p> Hydroxocobalamin</p> <ul> <li> Antidote for CN poisoning</li> <li> Skin become red after administration due to its color (red)</li> </ul>