6 - Toxicology Flashcards
Antimuscarinic poisoning
HOT as hare (hyperthermia) DRY as bone (decreased secretion) RED as beet (cutaneous vasodilation) BLIND as a bat (cyclopegia) MAD as hatter (CNS toxicity)
Physostigmine
- may be helpful
- NOT for tricyclic overdose
Cholinomimetics
Organophosphate poisoning
DUMBBELSS
- diarrhea
- urination
- miosis
- bronchospasm
- bradycardia
- excitation (skeletal muscle and CNS)
- lacrimation
- sweating
- salivation
Pralidoxime + atropine
Opioids
PCR
- pupillary constriction
- comatose state
- respiratory depression
Naloxone
Aspirin poisoning
Salicylates
CHAFS
- coma
- hyperventilation
- acidosis (HAGMA)
- fever
- seizures
Correct acidose and fluid and electrolyte imbalance
Alkaline diuresis or hemodialysis to aid elimination
Sedative-hypnotic poisoning
Hot Hot Hot DeCisioN
- hypothermia
- hypotension
- hypoactive BS
- disinhibition
- coma
- nystagmus
- consider flumanezil for benzodiazepine overdose
- airway and respiratory support
- avoid fluid overload
TCA overdose
3Cs
- coma
- convulsion
- cardiotoxicity
- control seizures
- correct acidosis and cardiotoxicity with sodium bicarbonate
- give NE for hypotension
- control hyperthermia
Dimercaprol
- chronic lead (+ EDTA in calcium disodium salt for severe cases)
- acute mercury (DO NOT give in chronic - may redistribute to CNS)
- arsenic
Deferoxamine
Iron
- thalassemia
- myelodysplastic syndrome sucks
Succimer
Oral
- OPD patients chronic lead
- acute mercury
Unithiol
Chronic mercury
- with succimer
- do not give dimercaprol - may redistribute to CNS
Mee’s line
Arsenic
Sweet garlicky odor in breath and stools
Arsenic
Erethism
Mercury
Minamata disease
- cerebral palsy
- deafness
- blindness
- mental retardation
Organic Mercury
- fish and grains containing methylmercury
Blood level of LEAD to be able to give succimer
Greater than 45 mcg/dL
Penicillamine
- chelates copper
- copper toxicity
- Wilson’s disease
- adjunctive therapy in gold
- arsenic and lead
To prevent dangerous hypocalcemia, EDTA is given as
Calcium disodium salts
Odorless, colorless gas
Carbon monoxide
- give 100% O2
Accelerates clearance of CO
Hyperbaric oxygen
Colorless, irritating gas from combustion of fossils
Sulfur dioxide
Bluish irritant gas produced in air and water purification devices and in electrical fields
Ozone
Brownish irritant gas formed in fires and silage on farms
Nitrogen oxide
Aliphatic hydrocarbons
CCTT
- chloroform
- carbon tetrachloride
- trichloroethylene
- trichloroethane
Aliphatic carbons that cause peripheral neuropathy
- trichloroethylene
- trichloroethane
Aromatic hydrocarbons
- benzene
- toluene
- xylene
Long-term exposure to benzene can cause
- hematotoxicity
- hematologic cancers
Botanical insecticides
PRN
- pyrethrum
- rotenone
- nicotine
Most widely used herbicide in the world
Glyphosate
Bipyridil herbicide used to kill weeds and for highway maintenance
Paraquat
Chlorphenoxy acids
- 2,4 - diphenoxyacetic acid
- 2,4,5 - triphenoxyacetic acid
Long-term exposure to chlorophenoxy acids can cause
Non-Hodgkin Lymphoma
Environmental pollutant
Source: electrical equipment
Polychlorinated biphenyls
Environmental pollutant
Source: chemical
Dioxins
- cystic acneiform
Environmental pollutant
Source: manufacturing and building
Asbestos
- mesothelioma
Causes of increased stool osmolar gap
MEDIE
- methanol
- ethanol
- diuretics
- Isopropyl alcohol
- Ethylene glycol
