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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
Q

Opioid toxidrome: pupils

A

decreased

PINPOINT PUPILS

26
Q

Opioid toxidrome: BP

A

decreased

27
Q

Opioid toxidrome: HR

A

decreased

28
Q

Opioid toxidrome: RR

A

decreased

29
Q

Opioid toxidrome: temperature

A

decreased

30
Q

Opioid toxidrome: bowel sounds

A

decreased

31
Q

Opioid toxidrome: other symptoms

A

hyporeflexia

32
Q

Sedative-hypnotic toxidrome: mental status

A

Decreased

33
Q

Sedative-hypnotic toxidrome: pupils

A

Can increase or decrease

34
Q

Sedative-hypnotic toxidrome: BP

A

decreased

35
Q

Sedative-hypnotic toxidrome: HR

A

decreased

36
Q

Sedative-hypnotic toxidrome: RR

A

decreased

37
Q

Sedative-hypnotic toxidrome: temperature

A

can increase or decrease

38
Q

Sedative-hypnotic toxidrome: bowel sounds

A

can increase or decrease

39
Q

Sedative-hypnotic toxidrome: other symptoms

A

hyporeflexia

40
Q

Cholinergic toxidrome: mental status

A

decreased, seizures

41
Q

Cholinergic toxidrome: pupils

A

decreased

42
Q

Cholinergic toxidrome: BP

A

decreased

43
Q

Cholinergic toxidrome: HR

A

decreased

44
Q

Cholinergic toxidrome: RR

A

can increase or decrease

45
Q

Cholinergic toxidrome: temperature

A

can increase or decrease

46
Q

Cholinergic toxidrome: bowel sounds

A

increase

47
Q

Cholinergic toxidrome: other symptoms

A

SLUDGE, BBB

48
Q

SLUDGE symptoms

A

salivation
lacrimation
urination
defecation
GI cramps
emesis

49
Q

Killer Bs symptoms

A

Bradycardia
Bronchorrhea
Bronchospasm

50
Q

Anticholinergic antidote

A

Physostigmine 0.5-2mg IV

51
Q

Onset of action of physostigmine

A

2-5 minutes

52
Q

Cholinergic antidotes

A

Atropine, pralidoxime

53
Q

Atropine dose for cholinergic antidote

A

1mg IV- titrate to effect

54
Q

2-PAM dose for cholinergic antidote

A

30mg/kg IV load

8-10mg/kg/hr continuous IV infusion

55
Q

Exclusions to toxidromes

A

APAP, salicylates

56
Q

Does APAP have a toxidrome?

A

No

57
Q

What to do in regards to an APAP and salicylate level

A

Obtain a level with every intentional or unknown ingestion

58
Q

MoA of physostigmine

A

Acetylcholinesterase inhibitor; allows amount of ACh to be present within the synapse to be more available for use

59
Q

MoA of atropine

A

Inhibits muscarinic actions of ACh

60
Q

MoA of pralidoxime (2-PAM)

A

Reactivates cholinesterase so it can break down the amount of ACh causing the cholinergic toxicity

PHM 702- Toxicology (12 decks)

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