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PHM 702- Toxicology > Approach to the Poisoned Patient: Toxidromes > Flashcards

Approach to the Poisoned Patient: Toxidromes Flashcards

1
Q

Toxidrome defintion

A

constellation of signs and symptoms that point to a class of toxin based upon understanding of pharmacology

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2
Q

What do toxidromes help with?

A

Information in an unknown OD, consistency in known ODs

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3
Q

Adrenergic drugs

A

cocaine, amphetamines

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4
Q

Anticholinergic drugs

A

TCAs, antihistamines

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5
Q

Opioid drugs

A

Morphine, heroin

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6
Q

Sedative-hypnotic drugs

A

BZDs, ethanol

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7
Q

Cholinergic drugs

A

Organophosphates

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8
Q

Adrenergic toxidrome: mental status

A

Alert, seizures

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9
Q

Adrenergic toxidrome: pupils

A

Dilated

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10
Q

Adrenergic toxidrome: BP

A

increased

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11
Q

Adrenergic toxidrome: HR

A

increased

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12
Q

Adrenergic toxidrome: RR

A

increased

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13
Q

Adrenergic toxidrome: temperature

A

increased

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14
Q

Adrenergic toxidrome: bowel sounds

A

increased

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15
Q

Adrenergic toxidrome: other symptoms

A

tremor

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16
Q

Anticholinergic toxidrome: mental status

A

Decreased, agitated, seizures

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17
Q

Anticholinergic toxidrome: pupils

A

increased

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18
Q

Anticholinergic toxidrome: BP

A

increased

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19
Q

Anticholinergic toxidrome: HR

A

increased

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20
Q

Anticholinergic toxidrome: RR

A

increased

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21
Q

Anticholinergic toxidrome: temperature

A

increased

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22
Q

Anticholinergic toxidrome: bowel sounds

A

decreased

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23
Q

Anticholinergic toxidrome: other symptoms

A

dry, urinary retention

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24
Q

Opioid toxidrome: mental status

A

decreased

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25
Opioid toxidrome: pupils
decreased PINPOINT PUPILS
26
Opioid toxidrome: BP
decreased
27
Opioid toxidrome: HR
decreased
28
Opioid toxidrome: RR
decreased
29
Opioid toxidrome: temperature
decreased
30
Opioid toxidrome: bowel sounds
decreased
31
Opioid toxidrome: other symptoms
hyporeflexia
32
Sedative-hypnotic toxidrome: mental status
Decreased
33
Sedative-hypnotic toxidrome: pupils
Can increase or decrease
34
Sedative-hypnotic toxidrome: BP
decreased
35
Sedative-hypnotic toxidrome: HR
decreased
36
Sedative-hypnotic toxidrome: RR
decreased
37
Sedative-hypnotic toxidrome: temperature
can increase or decrease
38
Sedative-hypnotic toxidrome: bowel sounds
can increase or decrease
39
Sedative-hypnotic toxidrome: other symptoms
hyporeflexia
40
Cholinergic toxidrome: mental status
decreased, seizures
41
Cholinergic toxidrome: pupils
decreased
42
Cholinergic toxidrome: BP
decreased
43
Cholinergic toxidrome: HR
decreased
44
Cholinergic toxidrome: RR
can increase or decrease
45
Cholinergic toxidrome: temperature
can increase or decrease
46
Cholinergic toxidrome: bowel sounds
increase
47
Cholinergic toxidrome: other symptoms
SLUDGE, BBB
48
SLUDGE symptoms
salivation lacrimation urination defecation GI cramps emesis
49
Killer Bs symptoms
Bradycardia Bronchorrhea Bronchospasm
50
Anticholinergic antidote
Physostigmine 0.5-2mg IV
51
Onset of action of physostigmine
2-5 minutes
52
Cholinergic antidotes
Atropine, pralidoxime
53
Atropine dose for cholinergic antidote
1mg IV- titrate to effect
54
2-PAM dose for cholinergic antidote
30mg/kg IV load 8-10mg/kg/hr continuous IV infusion
55
Exclusions to toxidromes
APAP, salicylates
56
Does APAP have a toxidrome?
No
57
What to do in regards to an APAP and salicylate level
Obtain a level with every intentional or unknown ingestion
58
MoA of physostigmine
Acetylcholinesterase inhibitor; allows amount of ACh to be present within the synapse to be more available for use
59
MoA of atropine
Inhibits muscarinic actions of ACh
60
MoA of pralidoxime (2-PAM)
Reactivates cholinesterase so it can break down the amount of ACh causing the cholinergic toxicity

PHM 702- Toxicology (12 decks)

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