Basic Approaches to Treatment III (20) - End E2 Flashcards

1
Q

What is activated charcoal?

A

organic matter - first burned then oxidized to increase number of pores

  • huge number of pores!
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2
Q

What does activated charcoal’s efficacy depend on?

A
  • time after ingestion of toxin
  • how long it stays in the GI tract
  • toxin to ACT ratio
  • stomach contents
  • quality of AC product
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3
Q

What is ToxiBan?

A

kaolin - cathartic, protects against mucosa/GI tract

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4
Q

What is sorbitol?

A

a cathartic - a substance that accelerates bowel movements (osmotic in this case)

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5
Q

When do you give activated charcoal?

A

the sooner the better!

best results if given within 30 minutes of toxin ingestion

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6
Q

What is the MOA for AC?

A

enhances elimination by decreasing enterohepatic recycling

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7
Q

If you give AC before emesis or lavage, what are the characteristics?

A
  • starts binding the toxin right away
  • increases contents in the stomach, improves emesis
  • CAN’T USE VOMIT
  • must repeat after emesis or lavage is complete
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8
Q

If you give AC after emesis or lavage, what are the characteristics?

A
  • less toxin to bind up all available sites on AC
  • vomit or lavage fluid can be used for analysis
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9
Q

What may be way more common than we think with activated charcoal?

A

hypernatremia

previously thought was due to cathartic in AC mixture
- now know can be associated with AC alone

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10
Q

What are adsorbing agents other than AC?

A
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11
Q

What is the goal of using activated charcoal and other things like it?

A

to remove as rapidly as possible any toxin that has already been absorbed into the systemic circulation and tissues

to diminish degree and duration of toxic effects

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12
Q

What are the major methods for elimination?

A
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13
Q

In some cases, the goal is to decrease conversion of a ______

A

less-toxic substance to a more toxic metabolite

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14
Q

What is the intravenous lipid emulsion treatment?

A

uses products designed for partnered nutrition

lipid-soluble compounds in blood extracted by lipid emulsion

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15
Q

What are less common methods of enhancing elimination?

A
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16
Q

What are systemic chelators?

A
  • enhances elimination of absorbed toxin by altering diffusion gradient
  • metal chelators
17
Q

What does an alteration of metabolism due regarding elimination?

A

prevention of toxic metabolite formation
- ethylene glycol

18
Q

What is an antidote?

A

An antidote is an agent that reacts with the poison or its receptor or interferes with its metabolite pathway to decrease the ability of the poison to cause toxicity.

19
Q

T/F: There is no such thing as a “universal antidote”

A

TRUE - NOT superior to AC

20
Q

What are antidote mechanisms?

A
  • block receptor used by toxin
  • inhibit metabolism of original substance to a toxic metabolite
21
Q

T/F: Some antidotes do not have risks

A

FALSE - all do, be sure the risks from the toxin outweigh the risks from the antidote

22
Q

What is the antidote to anticoagulant rodenticides, i.e. warfarin?

A

if bleeding: whole blood or plasma + vitamin K1

if not bleeding: vitamin K1

give in reduced state

23
Q

What is the antidote to benzodiazepines?

A

flumazenil - block action

24
Q

What is the antidote to carbamates?

A

atropine

25
Q

What is the antidote to cholecalciferol?

A

bisphosphonates or calcitonin

26
Q

What is the antidote to cyanide?

A

sodium thiosulfate or hydroxocobalamin (cyanokit)

27
Q

What is the antidote to ethylene glycol?

A

4-methylpyrazone (fomepizol) or ethanol

28
Q

What is the antidote to medetomidine (dex)?

A

atipamezole

29
Q

What is the antidote to nitrate?

A

methylene blue

30
Q

What is the antidote to opioids?

A

naloxone