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T2 - Phase 3 - Brain, Mind, and Behavior > BMB 3 - Toxidromes & Antidotes > Flashcards

BMB 3 - Toxidromes & Antidotes Flashcards

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1
Q

What do ED50, TD50, and LD50 stand for in terms of a particular pharmacologic agent?

A

Effective dose 50

Toxic dose 50

Lethal dose 50

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2
Q

What is the ED50 for a pharmacologic agent?

A

The dose at which 50% of individuals experience the therapeutic effect

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3
Q

What is the TD50 for a pharmacologic agent?

A

The dose at which 50% of individuals experience toxicity

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4
Q

What is the LD50 for a pharmacologic agent?

A

The dose at which 50% of individuals are killed

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5
Q

How is the therapeutic index calculated for a particular pharmacologic agent?

A

TD50 / ED50

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6
Q

Which is safer, a high therapeutic index or a low therapeutic index?

A

High

(TI = TD50 / ED50)

(Higher TIs indicate a larger gap between toxic dosing and the lower doses at which efficacy is achieved.)

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7
Q

Management of drug toxicities, overdoses, etc. should always start with what three things?

A

The ABCs

Airway

Breathing

Circulation

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8
Q

A patient presents in an apparent coma. What should you administer?

A

Glucose

Insulin

Naloxone

(thiamin?)

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9
Q

A patient presents while seizing.

What should you administer to stop the seizure?

A

Diazepam

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10
Q

A patient presents with severe agitation.

What should you administer?

A

An anxiolytic

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11
Q

In order of importance, name the three main laboratory methods for determining the cause of a poisoning.

A
  1. Urine (first choice)
  2. Blood/serum (second choice)
  3. Gastric contents (third choice)
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12
Q

A patient presents with lead poisoning.

What do you administer?

A

Dimercaprol

or

penicillamine

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13
Q

A patient presents with arsenic poisoning.

What do you administer?

A

Dimercaprol

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14
Q

A patient presents with mercury poisoning.

What do you administer?

A

Dimercaprol

or

penicillamine

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15
Q

A patient presents with iron poisoning.

What do you administer?

A

Deferoxamine

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16
Q

A patient presents with copper poisoning.

What do you administer?

A

Penicillamine

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17
Q

A patient presents with heparin toxicity.

What do you do?

A

Administer protamine sulfate

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18
Q

A patient presents with botulinum toxicity.

What do you do?

A

Administer antitoxin

+

provide respiratory support

19
Q

A patient presents with organophosphate poisoning.

What do you do?

A

Administer atropine + pralidoxime

20
Q

A patient presents with cyanide poisoning.

What do you do?

A

Administer amyl nitrate

(subsequent thiosulfate can increase excretion)

21
Q

A patient presents with ethylene glycol poisoning.

What substances can be used to prevent its conversion to toxic metabolites?

A

Ethanol

Fomepizole

22
Q

A patient presents with methanol poisoning.

What substances can be used to prevent its conversion to toxic metabolites?

A

Ethanol

Fomepizole

23
Q

A patient presents with carbon monoxide poisoning.

What do you do?

A

Administer hyperbaric O2

24
Q

A patient presents with warfarin toxicity.

What do you do?

A

Administer fresh frozen plasma + vitamin K

25
Q

A patient presents with opiate overdose.

What do you do?

A

Administer naloxone

(and subsequent naltrexone)

26
Q

A patient presents with curarine poisoning.

What do you do?

A

Administer cholinesterase inhibitors

(to reverse the NMJ blockade)

27
Q

A patient presents with methemogobulinemia due to nitrate poisoning.

What do you do?

A

Administer methylene blue

(to reduce Fe3+ to Fe2+)

28
Q

A patient presents with methemogobulinemia due to sulfa drugs.

What do you do?

A

Administer methylene blue

(to reduce Fe3+ to Fe2+)

29
Q

A patient presents with digitalis toxicity.

What digoxin-antibody can you administer?

A

Digibind

30
Q

A patient presents with a 5-fluorouracil overdose.

What do you do?

A

Administer thymidine

31
Q

A patient presents with anticholinesterase toxicity.

What do you do?

A

Administer atropine

32
Q

A patient presents with agitation, mydriasis, seizures, and hypertension.

What toxidrome is on your differential?

A

Sympathomimetic use

(e.g. cocaine, amphetamines, PCP, etc.)

33
Q

A patient presents with CNS depression, decreased reflexes, and hypotension.

What toxidrome is on your differential?

A

Sedative use

(e.g. alcohol, benzodiazepines, barbituates, etc.)

34
Q

A patient presents with respiratory depression, hypothermia, pinpoint pupils, and hypotension.

What toxidrome is on your differential?

A

Opiate use

(e.g. morphine, codeine, heroin, etc.)

35
Q

A patient presents with agitation, mydriasis, fever, dry skin, flushing, and urinary retention.

What toxidrome is on your differential?

A

Anticholinergic use

(e.g. atropine, scopolamine, TCAs, etc.)

36
Q

A patient presents with coma, fasciculation, salivation, lacrimation, and wheezing.

What toxidrome is on your differential?

A

Cholinergic use

(e.g. organophosphates, carbamates, nicotine, etc.)

37
Q

A patient presents with diaphoresis, tinnitus, early alkalosis, and late acidosis.

What toxidrome is on your differential?

A

Salicylate use

38
Q

Describe the S/Sy of the toxidrome caused by overdose with the following:

Sympathomimetics

(e.g. cocaine, amphetamines, PCP, etc.)

A

Agitation,

mydriasis,

seizures,

hypertension

39
Q

Describe the S/Sy of the toxidrome caused by overdose with the following:

Sedatives

(e.g. alcohol, benzodiazepines, barbituates, etc.)

A

CNS depression,

decreased reflexes,

hypotension

40
Q

Describe the S/Sy of the toxidrome caused by overdose with the following:

Opiates

(e.g. morphine, codeine, heroin, etc.)

A

Respiratory depression,

hypothermia,

pinpoint pupils,

hypotension

41
Q

Describe the S/Sy of the toxidrome caused by overdose with the following:

Anticholinergics

(e.g. atropine, scopolamine, TCAs, etc.)

A

Agitation,

mydriasis,

fever,

dry skin,

flushing,

urinary retention

42
Q

Describe the S/Sy of the toxidrome caused by overdose with the following:

Cholinergics

(e.g. organophosphates, carbamates, nicotine, etc.)

A

Coma,

fasciculation,

salivation,

lacrimation,

wheezing

43
Q

Describe the S/Sy of the toxidrome caused by overdose with the following:

Salicylates

A

Diaphoresis,

tinnitus,

early alkalosis,

late acidosis.

T2 - Phase 3 - Brain, Mind, and Behavior (43 decks)

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