22.8.2013(washington Manual) Flashcards
Five general toxidromes
Sympathomimetic Cholinergic Anticholinergic Opiate Sedative hypnotic
Physical examination in poisoning
Vitals Pupils Skin Bowel Bladder
Features of sympathomimetic toxidrome
Hypertension Tachycardia Mydriasis Hyperpyrexia Diaphoresis
Causes of sympathomimetic toxidrome
Amphetamines
Cocaine
Vasopressors
Beta agonists
Features of cholinergic toxidrome
Bradycardia Low oxygen saturation Respiratory depression Pinpoint pupils SLUDGE salivation Lacrimation Urination Defecation GI distress Emesis Seizures Coma Fasciculation Paralysis
Anticholinergic toxidrome
Tachycardia Dry skin Hyperpyrexia Agitation,delirium Mydriasis Urinary retention Decreased intestinal motility
Features of opiate toxidrome
Miosis
Respiratory depression
Decreased GI motility
Coma
Features of sedative hypnotic toxidrome
Coma with normal vitals(ingested benzodiazepines donot cause respiratory depression)
Poisonings in which adequate oxygenation is of concern
Cyanide
Methhemoglobinemia
CO poisoning
Effect of cardiac toxins in ECG and their explanations
PR prolongation- nodal blockade
QRS- sodium channel blockade
QT- potassium channel blockade
Toxins which are radio dense in X ray
CHIPS Chloral hydrate Heavy metals Iron Phenothiazines Enteric coated preparations Sustained release preparations
The clinical utility of activated charcoal is limited if ingestion occurred _______ hrs prior to presentation
1
Dose of activated charcoal
1g/kg
Indications for multi-dose charcoal
Bind to concretions Aspirin Prevent enterohepatic or enteroenteric circulation Phenobarbital Phenytoin Theophylline
Indications for whole bowel irrigation
Sustained release preparations
Metals
Body packing