Block 3 More, why?? Flashcards
What is the poison control number?
1-800-222-1222
or text POISON to 797979
Sympathomimetic toxidromes are caused by what? Tx?
Caused by caffeine, cocaine, amphetamines, alcohol/drug withdrawal
Tx = BZD
Cholinergic toxidromes are caused by what? Sx?
Cholinesterase inhibitors, nerve gas, pesticides
SLUDGE
Salivation, lacrimation, urination, diarrhea, GI distress, emesis
Muscarinic + Nicotinic effects
Anticholinergic toxidromes are caused by what? Sx? Tx?
Diphenhydramine, OAB rx, Atropine, glypyrollate
Blind as a bat, mad as a hatter, red as a beet, hot as a hare, dry as a bone, and heart runs alone
Tx = BZD or physostigmine (dont use if you dont know what rx went in)
What does RADAR stand for?
Recognition Assessment Definitive Diagnosis Advice Reporting
PR prolongation
QRS prolongation
QTC prolongation
Antidepressants
Non DHB CCB
TCAs
Which Rx cause the AE?
TCA - QRS prolongation
Antidepressants - QTC prolongation
Non DHB CCB - PR prolongation
Anion Gap elevations is due to what?
Methanol, propylene glycol, ethylene glycol, salicylate
SDT vs UDS, which one provides quantitative values?
SDT
What are some poor candidates to use with activated charcoal?
Inorganic
Polar
Charged
Can only adsorb to something in dissolved liquid phase
PHAILS
Pesticides, hydrocarbons, acids/alkali, iron, lithium, solvents
Single and multiple dosing strategy for activated charcoal?
Single = 1mg/kg
Multiple = 0.25-0.5mg/kg every 1 to 6 hrs
Activated charcoal CI?
Pt in stupor phase, coma, convulsing unless they have endotracheal tube
Who should get whole bowel irrigation?
Any delayed/sustained release products
Large amounts of metal
Xenobiotics w/ slow absorption phase
Hemodialysis is beneficial for xenobiotics that have..
Low or High Vd Single or multiple PK parameters Low or high protein binding capacity Small or High weight Water soluble or insoluble
Low Vd (<1L/kg) Single PK Low protein Small weight (<5000 Daltons) Water soluble
What class do organophosphates and carbamates belong to?
Cholinesterase inhibitors
What groups are found in the organophosphates and carbamates?
Organo - oxygen + leaving group that attaches to O2 or phosphorous + 2 side chains
Carbamates - N methyl group + NCOO
How do you manage organophosphate toxicity?
BZD for seizures
Atropine (only works on ACh receptors); so no effect on paralysis, fasciculations
Alternatives to atropine: glycopyrrolate (only works for periphery), ipratropium, scopolamine
Pralidoxime (2-PAM), give atropine prior