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Pharm SJSM > Block 3 materials (poisoning) > Flashcards

Block 3 materials (poisoning) Flashcards

1
Q

Severe GI distress leading to necrotizing gastroenteritis with hematemesis and bloody diarrhea, dyspnea, shock and coma –– typically seen in children who have ingested iron tablets

A

Iron Poisoning

Treatment
deferoxamine, deferasirox, deferiprone (iron chelators)

gastric aspiration
carbonate lavage

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2
Q

Acetaminophen poisoning

A

N-acetylcysteine (replenish glutathione)

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3
Q

Organophosphates or AChE inhibitor poisoning

A

Atropine & Pralidoxime

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4
Q

Antimuscarinic/anticholinergic agent poisoning

A

Physostigmine

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5
Q

Benzodiazepine poisoning

A

Flumazenil

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6
Q

Arsenic poisoning

A

Dimercaprol (British anti-Lewisite(BAL) & Succimer

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7
Q

B-blocker poisoning

A

Atropine
Glucagon
Saline

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8
Q

Carbon monoxide poisoning

A

100%O2 & or hyperbaric O2

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9
Q

Copper poisoning

A

copper chelators: penicillamine, trientine

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10
Q

Cyanide poisoning

A

Hydroxocobalamin
Nitrites & sodium thiosulfate

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11
Q

Dabigatran poisoning

A

Idarucizumab

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12
Q

Digoxin poisoning

A

Digoxin Fabs

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13
Q

Direct factor XA inhibitors (i.e apixaban) poisoning

A

Andexanet alfa

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14
Q

Heparin poisoning

A

Protamine sulfate

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15
Q

Mercury poisoning

A

Dimercaprol & Succimer

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16
Q

Lead poisoning

A

Penicillamine
Calcium disodium EDTA
Dimercaprol (British anti-Lewisite(BAL))
Succimer
(PEDS)

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17
Q

Methanol & Ethylene glycol poisoning

A

Fomepizole > ethanol, dialysis

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18
Q

Methemoglobin poisoning

A

Methylene blue
Vitamin C

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19
Q

Methotrexate poisoning

A

Leucovorin

20
Q

Opioid poisoning

A

Naloxone

21
Q

Salicylate & TCA poisoning

A

Sodium bicarbonate (NaHCO3

22
Q

Warfarin poisoning

A

Vitamin K & Fresh frozen plasma

23
Q

Lethargy, bradycardia, hypotension, cool skin, flaccid muscles, decreased gag reflex, miosis, respiratory and CNS depression, seizures

A

Morphine poisoning

Rx: Naloxone

24
Q

impaired judgment, mydriasis, tactile hallucinations (bugs crawling), paranoia, angina, coronary vasospasm, sudden cardiac death

A

Cocaine poisoning

Rx: Benzodiazepines, mixed a/B blockers (HTN/Tachycardia)

25
Q

: restlessness, irritability, anxiety

A

Nicotine intoxication

Rx: NRT, bupropion, varenicline, clonidine

26
Q

Respiratory failure, severe anion gap metabolic acidosis, & ocular damage

A

Methanol poisoning

Rx: Fomepizole (long acting alcohol dehydrogenase inhibitor)

27
Q

: acute: gastroenteritis, hypotension, metabolic acidosis, garlic breath, rice water stools, torsade’s, seizures; chronic: pallor, skin pigmentation, alopecia, stocking glove neuropathy, myelosuppression

A

Arsenic poisoning

Rx:
Dimercaprol (British anti-Lewisite(BAL)), Succimer, Penicillamine, or activated charcoal

28
Q

: mild anorexia, N/V, delayed jaundice, hepatic and renal failure

A

Acetaminophen poisoning

Rx: N-acetylcysteine (replenish glutathione)

29
Q

tachycardia, hypertension, hyperthermia (hot, dry skin), delirium, hallucinations, mydriasis

A

Atropine poisoning

Rx: Physostigmine & control cardio/hyperthermia

30
Q

major psychosis, serotonin syndrome, hyperpyrexia, acute renal and hepatic failure, cardiac arrhythmia, coronary vasospasm, seizures, cardiac arrest, death

A

Amphetamine poisoning

Rx: Benzodiazepine

31
Q

pink/cherry red skin, bitter almond breath, cardiovascular collapse, seizures, coma

A

Cyanide poisoning

Rx:
Activated charcoal
Hydroxocobalamin
Nitrites and Sodium thiosulfate

32
Q

renal failure, urine crystals, increases anion and osmolar gap, CNS excitation

A

Ethylene glycol poisoning

Rx:
alkalinization via fomepizole (ADH inhibitor) > ethanol, hemodialysis

33
Q

respiratory depression, hyperpyrexia, prolonged QT (Na+ channel inhibition), convulsions, coma

A

TCA poisoning

Rx: NaHCO3 (stabilizes cardiac cell membrane), activated charcoal

34
Q

Chronic: pallor, skin pigmentation (rain drop pattern), alopecia, Stocking glove neuropathy, & myelosuppression

A

Arsenic poisoning

Rx:
Penicillamine
Activated charcoal
Dimercaprol (British anti-Lewisite(BAL))

Succimer

35
Q

Drugs contraindicated in hemodialysis

A

A : Amphetamines
V : Verapamil
O : OP Poisoning , Opioids
I : Imipramine
D : Digitalis
Dialysis : Diazepam

36
Q

Carbamazepine
Ethylene glycol
Lithium
Methanol
Metformin
Phenobarbital
Salicylate
Theophylline
Valproic acid

Poisoning requires which type of treatment?

A

Hemodialysis

37
Q

Amphetamine poisoning

A

Rx:
1) Benzodiazepines: sedation and control ofseizures
2) Ammonium chloride

38
Q

Cheese Reaction: TCA & MAO Inhibitors

A

Tyramine (cheese, wine, smoked meats) –– is metabolized by MAOA in the intestines and is not absorbed

Phentolamine is the drug of choice for ‘cheese reaction’

39
Q

Lubiprostone
Classification: Cl- channel activator
Mechanism of Action: activates the type 2 Cl- channels in the small intestine –– increasing Cl- rich fluid content into the intestine stimulating intestinal motility and shortens intestinal transit time
Clinical Indications: women with IBS (predominantly constipation)
Adverse Effects: category C (pregnancy)

A
40
Q

Any drug that increases 5-HT

1) Activity (neuromuscular;clonus
hyperreflexia, hypertonia, tremor, seizure)

2) autonomic instability (eg,
hyperthermia, diaphoresis,
diarrhea)

3) altered mental status

A

Serotonin syndrome

Rx:
Cyproheptadine (5-HT2
receptor antagonist)

41
Q

Hypertensive crisis:

Eating tyramine-rich foods (eg,
aged cheeses, cured meats,
wine, chocolate) while taking
MAOIs

A

Rx: Phentolamine

42
Q

Neuroleptic malignant
syndrome:

Malignant FEVER:
Myoglobinuria, Fever,
Encephalopathy, Vitals
unstable,  Enzymes (eg,
CK), muscle Rigidity (“lead
pipe”)

A

Rx:
Dantrolene, dopaminergics (eg,
bromocriptine, amantadine),
benzodiazepines; discontinue
causative agent

43
Q

Tricyclic antidepressant toxicity:

Respiratory depression,
hyperpyrexia, prolonged QT
Tricyclic’s: convulsions, coma,
cardiotoxicity (arrhythmia due
to Na+ channel inhibition

A

Supportive treatment, monitor
ECG, NaHCO3
(prevents arrhythmia), activated
charcoal

44
Q

Disulfiram Reaction (Enzyme: Aldehyde Dehydrogenase):

A

MOA:
Disulfiram inhibits aldehyde dehydrogenase, leading to the accumulation of acetaldehyde when ethanol is consumed.

Adverse effects:
1) Flushing
2) headache/nausea
3) palpitations,

deterring alcohol consumption.

45
Q

Smoking Cessation Medication

Target: Nicotinic acetylcholine receptors

● Moa:
Acts as a (alpha 4 beta 2) partial agonist at these receptors, reducing craving and
withdrawal symptoms.

● Clinical uses: Smoking cessation

Adverse effects:
1) mood changes
2) vivid dreams.

A

Varenicline:

46
Q

Bupropion

MOA:

Clinical uses:

Adverse effects:

Toxicity

A

atypical antidepressant (NE-DA reuptake inhibitor)

MOA:
inhibits NE and DA reuptake

Clinical Indications:
1) depression
2) smoking cessation

Adverse Effects:
1) seizures
2) HTN

Toxicity:
1) stimulant effects (tachycardia, insomnia), 2) headache/seizures in patients with eating disorders

47
Q

atypical antidepressant (NE-DA reuptake inhibitor)

MOA:
inhibits NE and DA reuptake

Clinical Indications:
1) depression
2) smoking cessation

Adverse Effects:
1) seizures
2) HTN

Toxicity:
1) stimulant effects (tachycardia, insomnia), 2) headache/seizures in patients with eating disorders

A

Bupropion

Pharm SJSM (23 decks)

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