Acute poisoning Flashcards
3 timeframes of poison exposure
- acute
- chronic
- acute on chronic
top 3 products
- pain meds
- sleeping pills
- household products
treatment steps for poisoned PT
- remove from harm
- ABCs
- treat PT, not poisoning
- minimize absorption
- enhance elim
- use antagonism or antidote if possible
action of charcoal
help adsorb the product
where is charcoal not used (3)
- low molecular weights (alcohols)
- metals, highly ionized salts
- Pt has unprotected airways
ratio of charcoal
10:1
when to induce vomiting
not usually done anymore - maybe if right after
when to lavage
only if very toxic substance has recently been taken (<1hour)
when to use whole bowel irrigation
metals or enteric coated drugs
how can metabolism be targeted
for agent that need to be bioactivated (glycol) to toxic species, slow the metabolism
2 ways to enhance elimination
- bicarb to elim acidic species
2. hemodyalisis
N-acetycysteine fixes
- thiol donor
naloxone fixes
opiods
calcium fixes
CCBs
glucagon fixes
B-blockers, CCBs
fomepizole fixes
ADH
digoxin fabs
digoxin toxicity
deferoxamine fixes
iron OD
atropine fixes
anti-muscarinic
what is anion gap formula and when to tell
Na - Cl- bicarb (>12)
what is osmolar gap formula and when to tell
OSM - 2xNa - BUN - gluc
5 causes of elevated OSM gap
ME DIE Methanol Ethylene glycol Diuretics (mannitol) Isopropyl alc Ethanol
what is para symp toxidrome
DUMBBELS Diarrhea Urination Miosis, muscle weakness Bronchospasm Bradycardia Emesis Lacrimation Salivation
Muscarinic toxidrome
SLUDGE Salivation Lacrimation Urination Diarrhea GI upset Emesis
Nicotinic toxidrome
Muscle fasciculations Cramping Hypertension Tachycard Pupil dilation Pallor
Anticholinergic mneumonic
mad as a hatter dry as a bone red as a beet hot as a hare blind as a bat
