ACMT Toxicology Visual Pearls: Toxic Mouth Pain

betel nut mouthA middle-aged Asian female presents to the emergency department complaining of 2-3 days of mouth pain. She has chewed betel nut for a number of years. Which of the following is true regarding her presentation and management?

  1. Debridement should be avoided.
  2. Metronidazole is contraindicated due to the potential of a disulfiram-like reaction.
  3. Oral secretagogues should be used due to the anticholinergic effects.
  4. The patient is at increased risk of oral cancer.

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