118 Mod 3 (Toxicology and Behavioral Emer) Flashcards
1
Q
Overt Behavior
A
open and generally understood
2
Q
Covert Behavior
A
have hidden meanings or intentions that only that person understands
3
Q
Behavioral Emergency vs
Psychiatric Emergency
A
Behavioral - behavior that interferes with daily living activity
Psych - when it threatens a person health and safety (or another persons)
4
Q
Delusions vs Hallucinations
A
Delusions - false beliefs
Hallucinations - sense perceptions not found on objective reality
5
Q
If a patient refuses to engage with you…
A
continue to talk with them about the situation, explain your responsiblities
6
Q
What are 4 causes of abnormal behavior
A
1 - biologic or organic
2 - environment
3 - acute injury, illness
4 - substance- related
7
Q
Psychiatric Signs vs Symptoms
A
Symptoms - the effects of the abnormalities and corrective measures
Signs - Observing the effects
8
Q
Define Affect
A
The outward expression of a person’s inner feelings
9
Q
Define Stereotyped movements
A
Repetition of movement that dont seem to have purpose
10
Q
Define Compulsions
A
Repetitive actions to relieve anxiety of obsessive thoughts
11
Q
Define Pressure of Speech
A
pouring out of words like water escaping under pressure
12
Q
Define Neologisms
A
words the patient invents
13
Q
Define Echolalia
A
patient echoes words he or she hears
14
Q
Define Mutism
A
Patient doesnt speak at all
15
Q
Define Flight of Ideas
A
Fast thinking but skipping from one thought to the next
16
Q
Define Confabulation
A
Inventing things to fill gaps in memory
17
Q
Define Circumstantial thinking
A
Inclusion of many irrelevant details
18
Q
Define Perseveration
A
repetition of the same idea over and over again
19
Q
Define Inappropriate affect
A
emotion out of sync with situation
20
Q
Define Flat affect
A
absence of emotion
21
Q
Define Catatonic
A
Lacking expression or movement, appearing rigid
22
Q
Constricted Pupils vs
Unequal pupils
A
Constricted - opiate ingestion
Unequal - cerebral trauma
23
Q
Define MSE COASTMAP
A
C - consciousness (attentive)
O - orientation (year, location)
A - Activity (sitting still)
S - Speak (speaking clear)
T - Thought (making sense)
M - Memory - (remembers)
A - Affect/Mood (is appropriate)
P - Perception (awareness)
24
Q
Signs Organic causes
A
part of the secondary assessment
Fever, intracranial pressure, skin temp, tattoos, scars, trauma, pupils, breath odors, needle tracks, tremors, loss of sensation
25
Define Confrontations
Directing the patients attention to something they might not have noticed without sounding condescending or judging
26
Things you should do when talking to patient
Ask open non leading questions
Sit 45 degree across
Don't give patient choices, state best action
Observe the patient at all times (never alone)
Stay between patient and exit
Let patient do things for themself
Bring all meds to hospital
Assume patient can hear everything, explain everything
27
How many people does it take to restrain a patient
5 trained - one at head, one at each limb
28
When restraining patient
avoid injury, give option of non violence
Remove any equipment or jewelry from your own body that could be used as a weapon (eg, name badge, scissors worn on the belt, key chain, earrings).
Secure Supine, with head turned to side
Never tie ankle and wrist together
Do not make deals
Monitor ABC, CMS
29
What is a two point restraint
one arm is placed upward toward the head and the other is placed downward toward the waist.
30
Define Psychosis
A state of delusion in which a person is out of touch with reality
31
When should you give Chemical Restraint
After verbal attempts
and with approval from medical control (following protocols)
32
What are most common chemical restraints
benzodiazepines, antipsychotics, dissociative agents, and antihistamines
(black box warning - serious adverse effects)
33
Name some Benzos
Diazepam (valium) - IV
Lorazepam (Ativan) - IM/IV
Midazolam (Versed) - IM/IV,IN (short acting)
can be for ped or adult
34
Define Ataxia
Impaired balance or coordination
35
Name some Antipsychotics
Droperidol (inapsine)
Haloperidol (Haldol)
Ziprasidone (Geodon)
- black box warning for Droperidol cause prolonged QT, caution with electrolye imbalance
- High doses of Haldol and IV -cause prolonged QT and torsades de pointes. Do not give haldol under 14, or head trauma, or pregnant, not approved for dementia, caution with electrolye imbalance
Monitor with ECG
May cause seizures (extra pyramidal symptoms)
36
Name the newer Antipsychotics
Olanzapine (Zyprexa)
Ziprasidone
(may have fewer extra pyramidal symptoms)
monitor for hypotension, bradycardia, BGL
37
What is recommended for ped patients
Droperidol
38
What combination should you avoid in older dementia patients
parenteral olanzapine and a
benzodiazepine to the same patient
39
Is Ketamine used to chemically restrain patients?
Ketamine - N-methyl-D-aspartate
receptor antagonist
is used for sedation but has complications
not approved by the FDA
40
Name antihistamine used
Diphenhydramine (Benadryl)
used for sedation
produces anticholinergic effect in brain
used for both adult and peds
41
Define Acute Psychosis
person is out of touch with reality (voices feelings within)
hyper, stereotyped movement,
many causes both organic and biologic, common cause mind altering drugs.
other causes - stress, disorders, schizophrenia
42
When dealing with a violent patient
Do not turn your back on the patient
Maintain a safety zone of two arms lengths
Stand slightly to the side at 45 degrees with escape route unobstructed
Note any possible weapons
43
Define Unipolar Mood Disorder
Patients who experience either depression or mania
mood remains at only one side
unipolar mania is rare
44
Define BiPolar Mood Disorder
Alternating between mania and depression (both sides)
45
Define Mania (Manic Behavior)
Having exaggerated perception of joy with hyperactivity and insomnia. My have hallucinations.
unable to concentrate
rapid speech, rapid thoughts
tangential thinking - skipping topics
may become hostile.
Be calm, firm, talk away from others. consult medical control if needed.
46
Tangential thinking vs Circumstantial thinking
Tangential - rapid skipping topics
Circumstantial - including many irrelevant details
47
Define Depression
can be sudden or subtle in onset and chronic in nature.
dysthymic disorder - chronic form of depression, most days over atleast 2 years.
48
Mnemonic for depression
GAS PIPES
G - Guilt
A - Appetite
S - Sleep
P - Paying attention
I - Interest
P - Psychomotor abnormal
E - Energy
S - Suicidal thoughts
49
Define Schizophrenia
A mental disorder usually onset during early adulthood.
delusions, hallucinations, apathy, mutism, flat affect, lack of interest in pleasure, erratic speech, dysfunctional emotional responses, and dysfunctional motor behavior.
50
Define Neurotic disorder
several disorders without psychotic symptoms.
51
Define anxiety disorder
patients experience persistent, incapacitating anxiety in the absence of external threat.
52
Define Generalized Anxiety Disorder
A diagnosis of GAD requires that symptoms (anxiety and worry) must be present more days than not for a period of at least 6 months, and the worry must be difficult to turn off or control.
53
Define Phobic Disorder
Fear of a specific situation or thing.
54
Define Simple phobia`
patient focuses all anxieties onto one class of objects or situation.
55
Define Panic Disorder
sudden, usually unexpected, and overwhelming. feelings of fear. Attacks usually begin in 20s.
Massive activation of the autonomic nervous system.
palpitation and sweating, hyperventilation
peak 10 mins last up to an hour
seperate from public, calm, safe
56
Define Agoraphobia
Fear of public places
57
4 Levels of substance related disorders
Moderate
Substance intoxication - use causes impaired thinking/motor
Substance Abuse - disrupts ADLs
Substance Dependence - needs more and more
58
Bulimia vs Anorexia
bulimia - binging then puriging food
anorexia - lose so much weight, jeopardize health. fear of obesity while being underweight. May have amenorrhea (absence of menstruation)
both could have severe electrolyte imbalance leading to cardiac, seizures, renal failure, etc.
59
Define Somatoform Disorder
overly concerned with physical health and appearance.
hypochondriasis is a classic example, patients have extreme anxiety or fear that they may have a serious disease. Imagined symptoms
60
Define Conversion disorder
physical condition (eg, paralysis, blindness, or seizures) has no identifiable pathophysiology but results from malingering or faking a physical disorder.
61
Define Factitious Disorder
Aka Münchausen syndrome, is a condition in which a person intentionally produces or feigns physical or psychological signs or symptoms. In such cases, the patient wishes to be sick.
by proxy - parent faking child sickness
62
Define Impulse control disorder
Examples include intermittent explosive disorder, kleptomania, pyromania, and pathologic gambling.
Typically associated with other disorders depression, alzheimers
63
Define Personality disorders
When these ways of relating to others become dysfunctional or cause distress to other people, that person is considered to have a personality disorder.
64
Name types of Psychiatric Meds
Antidepressants
Benzodiazepines
Antipsychotics
Amphetamines
65
Name 4 types of Antidepressants
SSRI - selective reuptake inhibitors - also used for panic/anxiety disorders
SNRI - serotonin-norepinephrine reuptake
tricyclic antidepressants (TCAs),
monoamine oxidase inhibitors (MAOIs).
66
What is a common antidepressants
Citalopram (Celexa) - SSRI
SSRI lack the anticholinergic, and cardiac effects of other antidepressants
67
Benzos contraindication
Allergic
Narrow angle gaucoma
Pregnancy
Have long half lives and can cause sedation, confusion in older patients
68
Name two common Benzos
Diazepam (Valium)
Lorazepam (Ativan)
may be prescribed for emotional distress, panic, anxiety, seizures, muscle relaxation
69
Define AntiPsychotic Drugs
Neuroleptics - neurologic function meds
Newer - AAP - atypical anti -psychotic drugs (seroquel, zyprexa)
order - typical antipsychotic drugs (prolixin, thorazine)
relieve delusions, hallucinations
side effects - glucose dereg, hypertension, ecg changes
Phenothiazines - HALOPERIDOL - ecg changes
May have Anticholinergic effects - drymouth, urinary retention, etc
70
Define Acute Dystonic Reaction
patient develops muscle spasms of the neck, face, and back within a few days of starting treatment with antipsychotic meds.
You can rapidly correct an acute dystonic reaction by giving diphenhydramine (Benadryl), 25 to 50 mg IV.
However, the muscle spasms are likely to recur after the diphenhydramine wears off.
71
Define Amphetamines
Are Central Nervous and parasympathetic stimulants
stimulants similar to other sympathomimetic medications (eg, epi)
Amphetamines (eg, Adderall) are prescribed to help with attention deficit disorder with hyperactivity.
may raise both systolic and diastolic blood pressure while often slowing the pulse rate. Cardiac dysrhythmias may occur with large doses.
72
What meds are good for aggression
Benzodiazepines and antipsychotics
73
What are the 2 most frequent diagnoses of Vets
PTSD,
depressive disorders
were number one and two on the list,
acute stress disorder - within days of event, diagnosis is made within the first month of symptoms.
74
Licit vs Illicit
Licit - legal
Illicit - illegal
75
What do we give for Excited Delirium
Benzos
Versed IM -
76
What do you give for Benzo overdose
Flumazanil - 0.2mg IV over 15 secs
signs: respiratory depression
77
Signs and Treatment for Atropine or Benadryl (and TCA) overdose
Anticholinergic overdose
(and Antihistamine, TCA)
Dilated pupils, blurred, tachy,, dry as a bone.
78
Define poison
a substance whose chemical action could damage the body
79
Define Toxin
a poison produced by bacteria, animals, or plants
80
Define Bioavailability
the percentage of unchanged substance that is present in the systemic circulation.
81
Define Half-Life
the amount of time needed for the average person to metabolize or eliminate 50% of a substance in the plasma. The half-life of a drug is commonly expressed in minutes, but it is possible for the half-life to last for hours or even days.
82
Intentional vs Unintentional Toxicology
Intentional: suicide, sexual assault, chemical terrorism
Unintentional: neglect, oversight, exposure, several doses for pain, child ingestion
83
What are the 4 primary routes of entry
Ingestion, inhalation, injection, and absorption
84
Where does most absorption take place?
the small intestine
(little absorption occurs in the stomach)
85
When is activated charcoal most effective
close to time of ingestion
(of extended release capsules)
will not bind to alcohols
86
Define Chemical suicide
also called detergent suicide, is a method that involves mixing certain household chemicals in an enclosed space to create toxic gases (such as hydrogen sulfide and hydrogen cyanide), which are then inhaled.
87
For inhalation in an industrial environment as for clues such as
Safety Data Sheet (SDS)
Shipping manifest
Bill of Lading
Transportation Placards
88
What is WISER
Its an information database that gives info about hazardous chemicals and treatment info.
89
What must be done in inhalation poisoning
Correction of hypoxia is a must; deliver a high concentration of oxygen and make sure to support adequate ventilation, if needed. Establish vascular access, apply an electrocardiogram (ECG) monitor, and perform pulse oximetry and capnography.
90
What is an example of absorption, and speed
Slow absorption
pesticides, such as organophosphates
91
Define Toxidrome
The syndrome-like symptoms of a class or group of similar poisonous agents are termed a toxic syndrome or Toxidrome
92
What are the 5 major toxidromes
narcotic,
sympathomimetic,
sedative-hypnotic,
cholinergic,
anticholinergic
93
Give examples and signs of Narcotic Toxidrome
Narcotic (Opioid)
Ex. Morphine, Heroin, Fentanyl, Aspirin Combo, Methadone
Signs: pinpoint, hypotension, stupor, hypoventilation, resp arrest, track marks
94
Give examples and signs of Sympathomimetic Toxidrome
Ex. cocaine, caffeine, bath salts, nasal decongest, amphetamine
Signs: hypertension, diaphoresis, Tachy, Dilated pupils (mydriasis), seizures, hyperthermia, paranoia
95
Give examples and signs of Sedative-Hypnotic Toxidrome
Ex. Diazepam, Midazolam, Propofol, Ethanol
Signs: Hypoventilation, resp arrest, (ataxia = loss of muscle coord) hypotension, CNS depression, slurred speech, mental confusion, resp depression
96
Give examples and signs of Cholinergic Toxidrome
Ex. Organophosphates
Signs: DUMBELS: diarrhea, Urination, Miosis (constrict), Muscle weak, Brady, Emesis, Lacrimation (tearing of eyes) Seizures, respiratory depression, apnea (not breathing)
97
Give examples and signs of Anticholinergic Toxidrome
Ex. Atropine, antihistomines, diphenhydramine, TCAs
Signs: hyperthermia, Tachy, Dialted pupils (mydrysis), mild hallucin, delirium, flushed skin, agitation
98
Patient has symptoms:
Hypoventilation, Resp arrest, Bradycardia, Hypotension
but which is for pinpoint pupils and which is for dilated pupils
pinpoint - narcotic
dilated - barbiturate
99
Define Idiosyncratic Reaction
An allergic reaction that was unexpected
100
Define Wernicke Korsakoff Syndrome
is a memory disorder that results from vitamin B1 deficiency and is associated with alcoholism. Damages nerve cells, part of the brain involved with memory.
101
Define Nystagmus
Double vision, eyelid drooping
102
Symptoms of Wernicke
vs
Symptoms of Korsakoff
W: confusion, coma, death, double vision (nystagmus), leg tremor (ataxia)
K: can't form new memories, memory loss, confabulation, hallucinations
103
Define Antidote
Something to counteract poison
104
Define Caustics
Chemicals that are acids or alkalis, causing damage to tissues
105
Define Amphetamines
Class of drugs, stimulants, ex. methamphe, MDA, Ecstasy, MDMA,
106
Define DT's
Delirium Tremens, withdrawal from alcoholism, fever sweating, agitation, seizures, can be fatal.
tremors, diaphoresis, confusion, fever, reslessness, and tachy
107
Define Habituation
A physical tolerance and psych dependence on drugs
108
Define Lithium
A common mood stabilizer used for bipolar
109
Define Hydrocarbons
Compdrogen and carbon atoms, from the distillation of petroleum
110
Define Hallucinogen
An agent that produces false perceptions in any one of the 5 senses
111
Define Potentiation
Enhancement of the effect of one drug by another drug
112
Define MAOI's
Monoamine Oxidase Inhibitors
psych med used for depression
increases norepi and serotonin levels in CNS
113
Define SSRI
Selective Serotonin Reuptake Inhibitors
A class of anti-depressants that inhibit the reuptake of serotonin
114
Define Rhabdomyolysis
The destruction of muscle tissue leading to the release of potassium and myoglobin
115
Define Salicylates
A primary ingredient in aspirin
116
Define Serotonin syndrome
an idiosyncratic complication that occurs with anti-depressant therapy, lower muscle rigidity, confusion, agitation
117
Define withdraw syndrome
predictable signs and symptoms, after abruptly quitting a drug or quickly decreasing the usual dosage of a drug
118
Define TCA
Tricyclic Anti-Depressants
A group of meds for depression and pain, minimal dosing errors can cause toxic results
119
Alcoholism is diagnosed when
patient has physical and psychological addication to ethanol
120
Alcohol abuse causes
subdural hematoma
gi bleeding
a higher risk of burns
121
Best source for accidental ingestion
Poison center
122
The treatment for Cocaine, Amphetamine, Meth
Airway
IV
Contact med control for sedation if violent
123
Signs and symptoms of overdose with cardiac drugs
Hypotension
Weakness or confusion
nausea and vomiting
124
Signs and symptoms of Cyanide poisoning
Altered mental
Rapid labored resp, that become slow
A BITTER ALMOND SCENT
125
TCA overdose signs
Tachy hr
Tachypnea (rapid breathing)
Hypotension
126
Salicylate overdose signs
a history of drug abuse or psychiatric condition
127
Signs of Foxglove ingestion
cardiac dysthythmias
128
CO poisoning treatment
highest concentration of oxygen to displace CO molecules from the hemoglobin
129
Acid vs Alkalis with water
Acid is more water soluble
(diluted quick)
Alkalis needs water continually flowing (takes longer)
130
Signs of huffing
and treatment
Euphoria
anesthesia
weakness
vomitting
ab cramps
loss of coordination
blindness
dysthyhmias
grand mal seizure
decon
ABC
high O2
IV
ECG
Normal Salin for hypotension
Transport
131
Hydrocarbon products cause
GI irritation
abdominal pain
diarrhea
belching
can be life-thratening
132
What are some TCA overdose ecg concerns
prolonged PR interval
tachy
widening QRS
terminal E wave greater than 3mm
Prolong QT interval
133
Organic Mercury is
lipid soluble and accumulates in the liver
134
Two sedative drug Toxidrome example
and signs of sedative overdose
Diazepam (valium) and Midazolam
confused
hypo perfusion
slurred speech
SLEEPY
135
Two Stimulant drug Toxidrome examples
and signs of Stimulant overdose
Cocaine, diet aids, Methanphetamines and Nasal decongestion
agitated
paranoid
136
Signs- cold dry skin
could be...
sedative overdose
or alchol
137
signs - resp slower 12 shallow
could be...
Sedative overdose
138
signs - Pupils dilated and not reactive to light, shallow breathing, sluggishness, drowsy, lack of consciousness
could be...
Barbituate overdose
139
Define Comatose
prolonged unconsciousness, from trauma, intoxication or diabetes, or infection
140
Define Stuporous
unresponsiveness, but aroused by vigorous physical stimulation
141
Define Obtunded
Dulled or reduced level or alertness
142
Treatment for Comatose patient
airway
breathing -vent
circulation
high o2
IV - poss dextrose
antidote
Transport
12 lead, poss intubate
143
contraindication for activated charcoal
alchol, acid, or alkali
144
Treatment for ingested drano
abc
high o2
IV
consider antidote
manage shock,coma,seizures
transport LEFT lateral
145
Signs of Ethylene Glycol Toxicity
and treatment
High bp
High respiration, noisy crackles
High hr
24 hours after drinking
ABC
IV
BGL
Consult for Sodium Bicarb
Transport
146
Signs of Methyl Alcohol Poisoning
and treatment
Pupils react sluggishly to light
abdomen rigid
speech slurred, barely walk
elevated vitals
ABC
IV
BGL
Consult for Sodium Bicarb
Transport
147
Signs of CO poisoning
and treatment
Vomiting
pale and dehydrated
bounding pulse
seizures
nausea
HEADACHE
remove, open windows
ABC
High O2
IV
Rest
ECG
Transport to hyperbaric
148
Signs of Organo phosphate posioning
and treatment
nausea
ab pain
weakness
chest tight
pale and diaphoretic
hr low
respiration up, labored
pupils constricted
salivation, breath smells like garlic
decon
ABC
suction
high o2
IV/IO
ATROPINE
Admin Pralidoxime auto injector
ECG
Transport
149
Who is at risk for Toxic Lithium levels
patients who take lithium and NSAIDS (slows renal clearance of lithium)
150
Signs of caustic substances
severe resp distress
pain in mouth, throat, or chest
151
Ex of poison with strong acid
toilet cleaners, batteries
152
Ex of poison with strong alkali
drano, dish detergent
153
Ex of poison with hydro carbons
paint thinner, gasoline, spray paint
154
Ex of toxic plants
diffenbachia, fox glove, caladium
155
What are the stages of Acetaminophen toxicity
1 - 24hrs - nausea vomit
2 - RUQ pain
3 - GI symptoms
4 - Liver failure, death
156
Define Labile
Rapidly shifting among different emotional states
157
Define Organic Brain Syndrome
temp or perm dysfunction of the brain
158
Typical signs of (only) organic brain syndrome
Delirium
Visual hallucinations
Confabulation
Coma
159
Typical signs of (only) psychiatic illness
Obessional thinking
Flat affect
Compulsions
Circumstantial thinking
160
Typical signs of both Psychiatric and Organic illness
Distractibility
Anxiety
161
Lisinopril
class - ace inhibitor
for - HTN, post MI
trade name - zestril
162
Levothyroxine
class - hormone
for - hypothyroidism
trade name - synthroid
163
Metformin
class - anti-diabetic
for - type 2 diabetes
trade name - glucophage
164
Simvastatin
class - statin
for - high cholesterol
trade name - zocor
165
Atorvastatin
class - statin
for - high cholesterol
trade name - lipitor
166
Metoprolol
class - beta blocker
for - HTN, angina
trade name - lopressor
167
Omeprazole
class - proton-pump inhibitor
for - gerd, ulcers, heartburn
trade name - prilosec
168
Amlodipine
class - calcium channel blocker
for - HTN, angina
trade name - norvasc
169
Cyanide poisoning kit
Hydroxycobalamin
5g IV/IO
170
Explain how methyl alcohol poisonings and ethylene glycol cause such toxicity in the human body.
In methyl alcohol, metabolism breaks down into formaldehyde and formic acid.
For ethylene glycol, metabolism breaks down into toxic metabolites such as aldehydes, lactate, oxylate, and glycolate. These substances inhibit cellular respiration, glucose metabolism, and also cause metabolic acidosis.
171
Dose of Activated charcoal
both adult and ped dose is
1-2g/kg PO/NG
172
Name four heavy-metal poisonings.
Lead, Iron, Mercury, Arsenic
173
What are the four routes of poisonings? Describe a type of toxin for each route.
1) Ingestion. An example of a toxin via this route is prescription medication overdose.
2) Inhalation. An example of a toxin via this route is cyanide poisoning via smoke inhalation.
3) Injection. An example of a toxin via this route is a jellyfish sting.
4) Absorption. An example of a toxin via this route is organophosphate poisoning.
174
List three common substances, signs or symptoms of overdose, and general treatment guidelines for the drug class hallucinogens.
Three common substances in the hallucinogen class include LSD, Ketamine, and Phencyclidine (PCP). Signs and symptoms of an overdose include:1) violent outbursts
2) rapid change in mood
3) hypotension
4) bradycardia
5) bradyapnea
6) seizures, coma, death
General treatment guidelines for patients who have used hallucinogens include:
1) prioritizing scene and provider safety
2) ABCs
3) benzos
4) fluids
5) anti nausea medications
175
List three common substances, four signs or symptoms of overdose, and general treatment guidelines for the drug class narcotics, opiates, and opioids.
Three common opioids include: fentanyl, Percocet, and Oxycodone. Four signs or symptoms of overdose include:
1) Coma
2) seizures
3) cardiac arrest
4) respiratory arrest
General treatment guidelines include:
1) protect the airway
2) oxygenate the patient
3) ECG
4) IV access
5) Naloxone and naltrexone
176
What is the difference between drug abuse and drug addiction?
Drug abuse is any use of a drug that causes physical, psychological, economic, legal, or social harm to the user or others affected by the user's behavior.
Drug addiction, on the other hand, is a chronic disorder characterized by the compulsive use of a substance that results in the physical, psychological, economic, legal, or social harm to the user...and the user continues to use the substance despite the harm.
177
Older patient with Altered mental and smell
UTI
178
MD protocol for CO poison
Remove environment - PPE
IV
179
For beta blocker overdose
Give glucacon 1mg IVP every 5mins
180
For Sodium channel blocker
and TCA overdose
Give Sodium BiCarbbonate
1 mEq/kg IVP bolus initially
181
Opiate vs Opioid
Opiate - used to describe various alkaloids from opium or poppy (ex. morphine, codeine)
Opioid - synthetic narcotic with sedative properties not from opium (ex. oxy, fentanyl, tramadol)
182
Name 3 opioids
Oxycodone, Fentanyl, Tramadol
183
Name 3 Opiates
Opium, Morphine, Codeine
184
Fentanyl vs Morphine
both analgesic narcotics,
fentanyl is more potent (doesnt mean stronger, need less) shorter half life
Morphine has vasodilatory due to histamine release
185
Patho of Opioids
Effects CNS
binds with Delta, Kappa, and MU
gives euphoric sensation
186
Define Agnosia
Failure to recognize objects
187
Define Cataonia
Immobility and stupor
188
Define Dementia
Gradual memory loss
189
Define Paranoid
Distrust and suspicion
190
Define Antisocial
Disregard for rights of others
191
Define Narcissistic
Need for admiration
192
Define Avoidant
Social inhibition
193
Define Dependent
submissive and clinging behavior
194
Define Aphasia
Impaired ability to speak
195
Define Apraxia
Impaired ability to carry out motor function
196
What are the signs of Sympathomimetic Toxins
HR/BP - way up
Resp - up
Temp - up
Pupils - Dialated
Skin - diaphoretic (main sign)
Mental - agitated
possible - cocaine, amphetamines, diet drugs
give - act charcol (consult and alert)
Hypertension - benzos (valium)
197
What are the signs of Anticholinergic Toxins
HR/BP way up
Resp - up
Temp - way up
Pupils - Dialated
Skin - DRY (main sign)
Mental - agitated
possible - atropen, TCA, antihistamine
give -
198
What are the signs of Cholinergic Toxins
HR/BP - way down (main sign)
Resp - Down
Temp - Down
Pupils - Constricted
Skin - Copiously wet (main sign)
possible - SLUDGEM
give -
199
What are signs of Opioids
Resp way down
Pupils - constricted
Skin - normal
Mental - somnolent-coma
200
Define Doudote
Pralidoxime Chloride and Atropine
201
Treatment for OPIOID
Naloxone (Narcan) 0.4-2mg IV/IO/IN
4mg in 1 nare
BVM, ECG, o2
Vitals down pinpoint pupils, skin normal
202
Treatment for SEDATIVE
Flumazenil (consider, but may seize)
Consider Charcoal (consult)
Vitals all down resp, bp, hr, pupils normal
203
Treatment for Cholinergic
Atropine for Organo (1mg IV, every 3-5mins max dose 3mg)
Midazolam/Versed (10mg/IM for seizures)
ECG, IV, Capno, O2
Vitals Resp up, HR/BP down, Pinpoint pupils
204
Anticholinergic Treatment
Midazolam/Versed 01.mg/kg, 2mg increaments slow IV push (max 5mg)
Cooling
vitals pupils not reactive, dry as hell, hr/bp up
205
Treatment for SYMPATHOMIMETIC
Midazolam/Versed 01.mg/kg, 2mg increaments slow IV push (max 5mg)
vitals pupils reactive, bp/hr resp up
cooling iv fluids
