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401 - Toxicology, Drug Abuse, Pharmacology > 14: PADIS > Flashcards

14: PADIS Flashcards

1
Q

PADIS offers
1. medical advice for poisonings
2. information on poison pervention
3. information on med use in pregnancy or lactation
4. education on how to dose medication
5. 1, 2, 3
6. all of the above

A

6

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2
Q

which of the following is not a top 10 category of concern for PADIS (select all that apply)
1. analgesics
2. vitamins and NHPs
3. foreign bodies or toys
4. cosmetics and personal care products
5. cardiovascular drugs
6. none of the above

A

6

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3
Q

which of the following is a top 10 substances of concern? (select all that apply)
1. citalopram
2. alcohol
3. quetiapine
4. antibiotics
5. buspirone

A

1, 2, 4

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4
Q

which of the following is true
1. the national poison data system is updated in real time
2. NPDS can generate system alerts on ADEs and other drugs or commercial products of public health interest
3. NPDS can issue alerts on contaminated food or product recalls
4. NPDS is a data warehouse that sees info uploaded in real time ~20 minutes
5. 1, 2, 3

A

5
(4 - is actually ~9.5min)

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5
Q

what do the ABCDEFGs stand for in general approach to toxicology pt

A

Airway, Breathing, Circulation, Decontamination, Elimination, Find an antidote, General management

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6
Q

list the 6 portions of the toxicological exam

A

CNS
pupils
vital signs
skin and mucous membranes
muscle tone/ reflexes/ clonus
odors

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7
Q

list the ABCDEFs for opioids

A

ABCs: severe toxicity risk
D: potentially useful
E: none
F: naloxone
0.4-2.0mg IV
Sys opioid dependence = start as low as 0.04mg then titrate up
Repeat q2-3min until 10mg
Doses of 10-20mg rarely needed unless high potency opioids
IV infusion: ⅔ doses that worked/ hr
G: supportive care

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8
Q

what is a typical IV naloxone dose

A

0.4-2mg IV

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9
Q

in systemic opioid dependence, what naloxone dose should we start at

A

0.04mg then titrate up, repeat q2-3min until 10mg

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10
Q

T or F: AC is possibly effective for anticholinergic toxicity

A

T

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11
Q

which of the following may be used for anticholinergic toxicity (select all that apply
1. AC
2. urinary alkalinization
3. MDAC
4. hemodyalsis
5. phytostigmine

A

1, 5

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12
Q

what is the mainstay of anticholinergic toxicity tx

A

supportive care

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13
Q

list 3 sx of anticholinergic toxidrome

A

CNS: Delirium, hallucinations, picking, sedation
CVS: Tachycardia, HPTN, wide QRS (Na channel blocker in some meds)
GI/GU: ↓ bowel sounds, urinary retention
Skin: dry and flushed mucous membranes (including axilla)
Mild temp elevation
Mydriasis

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14
Q

what are the nicotinic days of the week

A

Mydriasis
Tachycardia
Weakness
tHypertension
Fasciculations
Seizures

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15
Q

cholinergic MOA

A

directly stimulate postganglionic cholinergic receptors. Vary in selectivity for muscarinic receptors and nicotinic sites

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16
Q

cholinergic toxicology

A

AChE does not adequately metabolize ACh in synapse = excess ACh to interact with receptors

17
Q

cholinergic toxidrome antidote

A

atropine and pralidoxime
protect HCP (secondary contamination possible)

18
Q

MOA of sympathomimetic toxicology

A

MOA: direct binding at beta and alpha adrenergic receptors OR by indirectly causing ↑ NE or DA (catecholamines) at the neural junction
Toxicology: direct receptor binding or catecholamine increase = hyperadrenergic physiologic state

19
Q

describe the ABCDEFGs for sympathomimetics

A

ABCs: severe toxicity risk
D: possibly AC/ WBI
E: none
F: none
G: BZDs for agitation, tremors, tachycardia, HPTN- key to preventing severe toxicity (seizures, hyperthermia, AKI)
Be prepared to provide airway support

20
Q

which of the following sx in serotonin sx is the most life threatening
1. akathisia
2. termor
3. sustained clonus
4. hyperthermia

A

4

21
Q

describe the toxicoogy of serotonin sx

A

MOA: excessive stimulation of central and peripheral nervous system serotonin receptors (5HT1A and 2A)
drug intx, therapeutic dosing, or deliberate self harm
Toxicology: ↓ 5HT breakdown, reuptake (ex- SSRIs, cocaine, dM, meperidine, SNRI), ↑5HT precursors or agonists (L-tryptophan, LSD) or release (amphetamines, ecstasy, buspirone, lithium)

22
Q

what is the antidote for serotonin sx

A

cyproheptadine- 1st gen histamine -1 blocker with nonspecific 5HT antagonism

23
Q

supportive care in serotonin sx is focused on

A

stopping muscle hyperactivity and hyperthermia
High dose benzos + external cooling

24
Q

what are the sedative ABCDEFGs

A

A: may need to be captured
B: can be shallow
C: not usually cardiotoxic but can be decreased
D: AC binds
E: no role
F: not usually employed, may be risky

25
Q

which withdrawal is life threatening
1. ethanol
2. opiates
3. antidepressants

A

1

401 - Toxicology, Drug Abuse, Pharmacology (32 decks)

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