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M4 Pharm B3 > 9 - Toxicology > Flashcards

9 - Toxicology Flashcards

1
Q

Approach to Poisoned Patient (ABCD)

A

Airways

Breathing

Circulation

Dextrose (especially if diabetic, 50% regains consciousness)

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2
Q

Approach to Poisoned Patient: Activated Charcoal prevents?

A

Toxin absorption

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3
Q

Approach to Poisoned Patient: Gastric Lavage

A

Removal of toxin from GIT

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4
Q

Approach to Poisoned Patient: Ionized diuresis

A

Facilitates excretion of toxin (Aspiring/Acidic drugs, give NaHCO3)

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5
Q

Opioids (Morphine) Poisoning

A

Give Naloxone

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6
Q

Benzos Poisoning

A

Give Flumazenil

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7
Q

Acetaminophen Poisoning

A

Give acetylcysteine

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8
Q

Fibrinolytics Poisoning

A

Give aminocaproic acid

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9
Q

Digoxin Poisoning (3)

A

K+

Atropine

Digoxin antibodies

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10
Q

Heparin Poisoning

A

Give Protamine sulfate

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11
Q

Warfarin Poisoning

A

Give Vitamin K

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12
Q

Methotrexate Poisoning

A

Give Leucovorin

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13
Q

Cyclophosphamide Poisoning

A

Give MESNA

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14
Q

Isoniazid Poisoning

A

Pyridoxine (B6)

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15
Q

Cholinergic (insecticides) Poisoning

A

Atropine and PAM

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16
Q

Anticholinergic Poisoning

A

Physostigmine

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17
Q

Beta Blockers Poisoning

A

Glucagon

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18
Q

Cyanide Poisoning (2)

A

Amyl nitrate + thiosulfate

Hydroxocobalamin

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19
Q

Methemoglobinemia Poisoning

A

Methylene blue

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20
Q

Methanol Poisoning

A

Ethanol

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21
Q

Ethylene Glycol Poisoning

A

Fomepizole

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22
Q

Arsenic, Gold, Mercury Poisoning

A

Dimercaprol (BAL)

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23
Q

Lead Poisoning (3)

A

CaEDTA

Dimercaprol

Succimer

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24
Q

Cooper Poisoning (2)

A

Penicillamine

Trientine

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25
Q

Iron Poisoning

A

Deferoxamine

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26
Q

Chelator Pharmacology Defined

A

To prevent or reverse the toxic effects of a heavy metal

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27
Q

Chelator Pharmacology: Dimercaprol (IM) Use (3)

A

AKA BAL

Aresenic, Lead, Mercury

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28
Q

Chelator Pharmacology: Succimer Use (DMSA Oral)

A

Water soluble of BAL

Arsenic, Lead, Mercury

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29
Q

Chelator Pharmacology: Unithiol (DMPS, oral) Use (3)

A

Mercury

Arsenic

Bismuth

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30
Q

Chelator Pharmacology: Edetate Calcium Disodium Use (5)

A

Lead

Zinc

Manganese

Plutonium

Curium

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31
Q

Chelator Pharmacology: Penicillamine (Oral) Use (3)

A

Copper

Wilson disease

Rheumatoid arthritis

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32
Q

Chelator Pharmacology: Deferoxamine (IM/IV) Use (2)

A

Iron

Aluminum

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33
Q

Chelator Pharmacology: Deferasirox (Oral) (1)

A

Iron

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34
Q

Chelator Pharmacology: Prussion Blue (Oral) Use (2)

A

Radiactive cesium

Thallium

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35
Q

Lead primarily affects the (3)

A

Nervous System

GIT

Hematopoietic system

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36
Q

Lead Poisoning X-Ray Clinical Presentation (2)

A

Lead lines on Gingivae (Buton’s Lines) and metaphyses

Lead lines metaphyses of long bones o x-ray

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37
Q

Acute Lead Poisoning Symptoms (3)

A

Tinnitus

Encephalopathy

Abdominal Colic

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38
Q

Chronic Lead Poisoning Symptoms (5)

A

Anemia (decrease heme)

Wrist drop

Proteinuria

Decrease fertility

Pica (leads to mental retardation)

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39
Q

Lead Poisoning in Children Rx

A

Succimer PO

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40
Q

Lead Poisoning in Adults Rx (3)

A

Dimercaprol

EDTA

Penicillamine

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41
Q

Arsenic is found in (3)

A

Pesticides

Wood preservatives

Ant Poisons

42
Q

Acute Arsenic Poisoning Symptoms (3)

A

Rice watery stools

Garlic breath

Seizures

43
Q

Chronic Arsenic Poisoning Symptoms (2)

A

Stocking glove neuropathy

Alopecia

44
Q

Arsenic Poisoning Buzzword (3)

A

Dimercaprol

Unithiol

Succimer

45
Q

Acute Iron Poisoning in Children Presentation (3)

A

Necrotizing Gastroenteritis

Hematemesis

Bloody diarrhea

46
Q

Iron Poisoning Rx (2)

A

IV Deferoxamine

PO Deferasirox

47
Q

Acute Mercury Poisoning Symptoms of Vapor (1) and Salt Ingestion (1)

A

Vapor - pneumonitis

Salt ingestion - bleeding renal failure

48
Q

Chronic Mercury Poisoning (3)

A

Auditory and Visual Loss

Ataxia

Paresthesia

49
Q

Mercury Poisoning Rx (3)

A

Succimer PO

Dimercaprol (IM)

Unithiol

50
Q

Copper Poisoning Disease and Rx

A

Wilson’s Disease

Rx: Penicillamine and Treintene

51
Q

Substance Abuse: Opiates (Morphine, Heroin, Methadone) - Overdose (3)

A

Pinpoint pupils

Respiratory depression

Coma

52
Q

Substance Abuse: Opiates (Morphine, Heroin, Methadone) Rx (1)

A

Naloxone

53
Q

Substance Abuse: Opiates (Morphine, Heroin, Methadone) Withdrawal Symptoms (1)

A

Flu-like symptoms

54
Q

Substance Abuse: Opiates (Morphine, Heroin, Methadone) Withdrawal Rx (2)

A

Cloniidine

Methadone

55
Q

Substance Abuse: Amphetamine and Cocaine - Dopamine Receptors are located in

A

Nucleus accumbens

56
Q

Substance Abuse: Amphetamine and Cocaine - Overdose Symptoms (3)

A

Euphoria

Hypervigilance

Paranoia

57
Q

Substance Abuse: Amphetamine and Cocaine - Rx (2)

A

Haloperidol

Lorazepam

58
Q

Substance Abuse: Amphetamine and Cocaine - Withdrawal Symptoms (3)

A

Dysphoric mood

Unpleasant dreams

Cocaine (crash)

59
Q

Substance Abuse: Amphetamine and Cocaine - Withdrawal Rx (2)

A

Bromocriptine

Amantadine

60
Q

Substance Abuse - Cocaine is a powerful inhibitor of?

A

Dopamine transporters (Causes dopamine to accumualte)

61
Q

Substance Abuse: Cocaine produces what and reduces what?

A

Produces euphoria

Reduces fatigue

62
Q

Substance Abuse: Barbs and Benzos Overdose (5)

A

Impaired judgment

Slurred speech

Uncoordination

Unsteady gait

Coma

63
Q

Substance Abuse: Barbs and Benzos Overdose Rx

A

Flumazenil for Benzo

64
Q

Substance Abuse: Barbs and Benzos Withdrawal (2)

A

Benzo - anxiety and rebound insomnia

Barb - life threatening seizures

65
Q

Substance Abuse: Barbs and Benzos Overdose Rx

A

Sodium bicarbonate

66
Q

Substance Abuse: Hallucinogens (LSD) Affect what receptors?

A

Serotonin receptors

67
Q

Substance Abuse: Hallucinogens (LSD) Overdose Symptoms (4)

A

Idea of reference

Depersonalization

Illusions

Flashbacks

68
Q

Substance Abuse: Hallucinogens (LSD) Rx (2)

A

Haloperidol

Diazepam

69
Q

Substance Abuse: Hallucinogens (LSD) Withdrawal

A

None

70
Q

Malignant Hyperthermia from what drugs (2)

A

Succinylchoine and volatile anesthetics

71
Q

Malignant Hyperthermia Sxs (3) and Onset

A

Hyperthermia, hypertension, muscle rigidity

Onset within minutes

72
Q

Malignant Hyperthermia Rx

A

Dantrolene

73
Q

Serotonin Syndrome from what drugs? (6)

A

SSRI, MAOI, Linezolid

Sumatriptan, St.John wort, Ginseng, LSD

74
Q

Serotonin Syndrome Sxs (5) and Onset

A

Hyperthermia, hypertension, tremors, clonus, mydriasis, coma

Onset: Within hours

75
Q

Serotonin Syndrome: Rx

A

Benzos

76
Q

Neuroleptic Malignant Syndrome from what drugs? (1)

A

D2-blocking antipsychotics

77
Q

Neuroleptic Malignant Syndrome Sxs (3) and Onset

A

Hyperthermia, parkinsonism, hypertension

Onset and 1-3 days

78
Q

Neuroleptic Malignant Syndrome Rx (3)

A

Diphenydramine

Botulenum

Dantrolene

79
Q

PCP MOA

A

Binds to glutamate receptors –> prolonged depolarization

80
Q

PCP Overdose Sx (3)

A

Vertical nystagmus

Impulsiveness

Violent behaviora

81
Q

PCP Rx (3)

A

Dark room

Talk down

Haloperidol

82
Q

PCP Withdrawal

A

None

83
Q

Cannabis MOA

A

Inhibits Gaba

84
Q

Cannabis Overdose Sxs (3)

A

Slowed time

Impaired judgment

Amotivational syndrome

85
Q

Cannabis Rx (2)

A

Abstinence

Support

86
Q

Cannabis Withdrawal

A

None

87
Q

Nicotine MOA

A

Activates dopamine receptors

88
Q

Nicotine Overdose Sx (3)

A

Headache

Increased depression

Impotency

89
Q

Nicotine Overdose Rx (4)

A

Nicotine patch

Fluoxetine

Wellbutrin

Varenicline

90
Q

Nicotine Withdrawal (5)

A

Irritability

Increased appetite

Anxiety

Depressed mood

Decreased heart rate

91
Q

Nicotine Withdrawal Rx (2)

A

Education

Wellbutrin

92
Q

Caffeine MOA

A

Antagonist of adenosine receptors

93
Q

Caffeine Overdose Sxs (3)

A

Restlessness

Agitation

Insomnia

94
Q

Caffeine Withdrawal Sxs (3)

A

Headache

Drowsiness

Nausea

95
Q

Caffeine Rx (2)

A

Analgesics

Lower caffeine intake

96
Q

Inhalants Types (2) and MOA (1)

A

Glue and paint thinner

MOA: GABA receptors

97
Q

Inhalants overdose Sxs (3)

A

Uncoordination

Lethargy

Unsteady gait

98
Q

Inhalants Rx (2)

A

Education

Counselling

99
Q

Inhalants withdrawal (1)

A

None

100
Q

Ethylene Glycol (antifreeze) and Methanol: Rx

A

Fomepizole (alcohol DH inhibitory)

101
Q

Cyanide Poisoning Does What? (2)

A

Inactivating cytochrome oxidase

Interferes ETC

102
Q

Cyanide Poisoning Antidoes (3)

A

Hydroxocobalamin

Sodium thiosulfate and amyl nitrate

M4 Pharm B3 (9 decks)

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