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Emerg > 41 toxicology > Flashcards

41 toxicology Flashcards

1
Q

3 steps in initial approach to poisoning

A
  1. treat patient, not poison
  2. remember it is the dose, not the substance
  3. clinical manifestations may be delayed a long time
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2
Q

5 general steps

A
  1. ABC
  2. give universal antidotes if indicated
  3. Hx, Phx, ID toxidromes
  4. consider decontamination
  5. reassess
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3
Q

parts of Phx after stable

A
  1. appearance
  2. vitals
  3. menatla status
  4. trauma signs
  5. seizure
  6. infection
  7. chronic substance abuse
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4
Q

4 classic toxidromes

A
  1. anticholinergic
  2. cholinergic
  3. sympathomimetic
  4. narcotics and sedatives
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5
Q

Sx of anticholinergic

A
  • hyperthermia
  • dilated pupils
  • dry
  • agitated
  • hallucinations
  • seizures
  • tachycardia
  • urinary retention
    ileus
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6
Q

causes of antichol

A
  • antihistamines
  • atropine
  • diphenhydramine
  • TCAs
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7
Q

Sx of cholinergic

A
  • salivation, seizures
  • lacrimation
  • incontinence
  • diaphoresis
  • bronchospasm
  • bronchorrhea
  • bradycard
  • emesis, exitation
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8
Q

causes of cholinergic

A
  • carbamate
  • nerve gases
  • organophosphates
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9
Q

Sx of sympathomimetic

A
  • hyperthermia
  • dilated pupils
  • diaphoresis
  • seizures
  • tachycardia
  • exitations
  • HT
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10
Q

causes of sympathomimetics

A
  • tylenol
  • ASA
  • cocaine
  • LSD
  • PCP
  • theophyllines
  • alc and sedative withdrawal
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11
Q

Sx of narcos and sedaties

A
  • CNS depression
  • resp depression
  • hypotension
  • miosis
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12
Q

causes of narcos

A
  • barbituates
  • benzos
  • booze
  • GHB
  • opiods
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13
Q

anion gap formula

A

Na- (HCO3 + Cl)

normal

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14
Q

causes of anion gap

A 
MUDPILES
Methanol
Uremia
DKA, also alc KA and starvation KA
Paraldyhyde
INH
Lactic acidosis
Ethylene glycol
Salicylate
CO
CYanide
Toluene
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15
Q

formula for osmolar gap

A

(measured - calculated)
2(Na) + BUN + Glucose + 1.25xethanol
normal should be -14-10

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16
Q

causes of increased osmolar gap

A 
ethylene glycol
isopropyl alcohol
glycerol
mannitol
methanol
sorbitol
17
Q

see table 4, p200 for antidotes

A

do it

18
Q

what are 3 methods of enhanced elim

A
  1. multiple dose activated charcoal
  2. dialysis
  3. urine alkalization

Emerg (53 decks)

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