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Section 15: Toxicology > Chapter 176: General Management of Poisoned Patients > Flashcards

Chapter 176: General Management of Poisoned Patients Flashcards

1
Q

The key element in reducing unintentional poisoning death

A

Prevention

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2
Q

Criteria used to determine whether the exposure is nontoxic are

A
  1. Unintentional exposure to a clearly identified single substance
  2. Estimate of dose is known
  3. Recognized information source confirms the subtance as nontoxic in the reported dose
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3
Q

The first priority in any poisoned patients

A

Resucitation

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4
Q

First line to treatment for hypotension with poisoning?

A

IV crystalloid bolus of 10 - 20ml/kg

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5
Q

If the patient is still hypotensive even after fluids were given. what is the next step?

A

Antidote

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6
Q

Empirical management for patients with poisoning and altered mental status

A
  • Oxygen
  • Thiamine
  • Glucose
  • Naloxone
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7
Q

Cardiac arrhythmias induced by sodium channel-blocker should be given with

A

Sodium bicarbonate

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8
Q

Cardiovascular complication of sodium bicarbonate

A

wide QRS complex tachydysrhythmias

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9
Q

All drug induced seizure are treated with IV benzodiazepine except?

A

Isoniazid-induced seizure that requires pyridoxine

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10
Q

This class of drug shown no role in treatment in toxin-induced seizures

A

Phenytoin

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11
Q

Second line of treatment for agigation

A

Antipsychotics

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12
Q

Treatment for calcium channel blocker and beta blocker toxicity

A

High dose insulin infusion

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13
Q

Treatment for patient with calcium channel blocker toxicity and hypermanesemia

A

Calcium gluconate
0.5 - 45ml/kg IV for pedia
10 - 30ml/kg IV for adult

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14
Q

Component of cyanide antidote kit

A
  • Amyl nitrate
  • Sodium nitrite
  • Sodium thiosulfate
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15
Q

Dose of dextrose (glucose) in insulin or oral hypoglycemic drug toxicity

A

0.5 - 1.09g/kg IV - pedia

1g/kg IV- adult

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16
Q

Treatment for Benzodiazepine toxicity

A

Flumazenil

  1. 01mg/kg IV for pedia
  2. 2mg/kg IV for adult
17
Q

Patients with core temperatures of ____ require aggressive active cooling measures to prevent complications

A

Patients with core temperatures of >39°C (>102.2°F) require aggressive active cooling measures to prevent complications

18
Q

A core temperature ____ is an indication for active rewarming

A

A core temperature <32°C (<90°F) is an indication for active rewarming

19
Q

Nontoxic, diagnostic, and therapeutic antidote. It is a competitive opioid antagonist administered IV, IM, or intranasally

A

Naloxone

  1. 01mg IV for pedia
  2. 1-0.4mgIV for adult
20
Q

Predictor of response to naloxone

A

Respiratory rate of <12 breaths/min

21
Q

How many hours should the patient be observe after administration of IV Naloxone?

A

2-3 hours

22
Q

IV lipid emulsion should be used as part of management of cardiac arrest in?

A

IV lipid emulsion should be used as part of management of cardiac arrest in bupivacaine toxicity

23
Q

IV lipid emulsion can be considered as a potential rescue therapy in life- threatening cardiotoxicity caused by ____ that is resistant to conventional therapies

A

IV lipid emulsion can be considered as a potential rescue therapy in life- threatening cardiotoxicity caused by lipophilic cardiotoxins that is resistant to conventional therapies

24
Q

A routine screening test in poisoned patients

A

A serum Acetaminophen concentration

25
Q

Goal of pH in ocular decontamination

A

pH between 7.2 and 7.4

26
Q

Whole bowel irrifation is used in

A
  • Iron ingestion >60mg/kg
  • life threatening Diltiazem or Verapamil and Lithium
  • Lead ingestion
27
Q

Dose of activated charcoal and whole-bowel irrigation

A
  • Activated Charcoal
    Adults 50 grams orally, children 1 gram/kg orally
  • Whole-Bowel Irrigation
    Polyethylene glycol 2 L/h in adults, children 25 mL/kg per hour (maximum 2 L/h)
28
Q

Multidose activated charcoal should not be given when ____?

A

Multidose activated charcoal should not be given when bowel sounds are absent

29
Q

Complication of urinary alkalinization

A
  • Hypokalemia
  • Volume overload
  • Alkalemia
  • Hypocalcemia (usually mild)
30
Q

A toxin must possess a number of properties to be effectively removed by an extracorporeal technique, which are?

A
  • Low volume of distribution (<1.0 L/kg)
  • Low molecular weight (<500 Da)
  • Low protein binding
  • Low endogenous clearance

Section 15: Toxicology (5 decks)

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