Chapter 21 Toxicology Flashcards
How do poisons typically act to harm the body?
By changing the normal metabolism of cells or by destroying them
If the victim of a toxicologic emergency vomits, an EMT should _____.
Use appropriate personal protective equipment and examine the vomitus for pill fragments or other clues for patient care
Of the four avenues of poisoning, generally _____ is the most worrisome in terms of treatment to the EMS provider.
Injection
Victims of inhaled poisoning will require what?
Immediate transport to an emergency department for evaluation
The recommended treatment for absorbed or contact poisons includes _____.
Safely removing or diluting the poisonous substance
Most poisoning occur via the _____ route.
Ingestion
Heroin is an example of a(n):
Opiod
Hypotension, hypoventilation, and pinpoint pupils would be expected following an overdose of:
Oxycodone (Percocet)
Activated charcoal is given to patients who have ingested certain substances because it:
Binds to the substance and prevents absorption
As you enter the residence of a patient who has possibly overdosed, you should:
Be alert for personal hazards
You receive a call to a residence where a man found his wife unresponsive on the couch. The patient’s respiratory rate is 8 breaths/min, her breathing is shallow, her heart rate is 40 beats/min, and her pulse is weak. The husband hands you an empty bottle of hydrocodone (Vicodin), which was refilled the day before. You should:
Ventilate her with a BVM
When caring for a known alcoholic patient with severe trauma to the chest and abdomen, you should be concerned that:
Internal bleeding may be profuse because prolonged alcohol consumption weakens the structure of the bones
Which of the following statements regarding the Salmonella bacterium is correct?
A) Refrigeration of food will prevent salmonellosis
B) Symptoms of salmonellosis appear within 12 hours
C) The Salmonella bacterium produces toxins that cause food poisoning
D) The Salmonella bacterium itself causes food poisoning
D) The Salmonella bacterium itself causes food poisoning
Which of the following sets of vital signs would the EMT most likely encounter in a patient with acute cocaine overdose?
A) BP, 60/40 mmHg; pulse, 140 beats/min
B) BP, 190/90 mmHg; pulse, 40 beats/min
C) BP, 200/100 mmHg; pulse, 150 beats/min
D) BP, 180/100 mmHg; pulse, 50 beats/min
C) BP, 200/100 mmHg; pulse, 150 beats/min
An overdose of acetaminophen, the active ingredient in Tylenol, will most likely cause:
Liver failure
In an apparent suicide attempt, a 19-year-old female ingested a full bottle of amitriptyline (Elavil). At present, she is conscious and alert and states that she swallowed the pills approximately 30 minutes earlier. Her blood pressure is 90/50 mmHg, her pulse is 140 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. When transporting this patient, you should be most alert for:
Seizures and cardiac arrhythmias
A 49-year-old male presents with confusion, sweating, and visual hallucinations. The patients wife tells you that he is a heavy drinker and she thinks he had a seizure shortly before your arrival. This patient is most likely experiencing:
Delirium tremens
A person who routinely misuses a substance and requires increasing amounts to achieve the same effect is experiencing:
Tolerance
The most important consideration in caring for a patient who has been exposed to an organophosphate insecticide or some other cholinergic agent is to:
Avoid exposure yourself
“Nerve gases” overstimulate normal body functions that are controlled by parasympathetic nerves, causing:
Increased salivation
You responded to the home of a 26-year-old woman who has reportedly taken a large number of pills in an attempt to commit suicide. As you enter the living room, you see her sleeping in her chair, and several empty alcohol containers are present. She is breathing heavily. You are able to arouse her consciousness for a short period of time. What course of action takes priority?
Have her take activated charcoal while she is conscious
The presence of burning or blistering of the mucous membranes suggests ingestion of _____.
Poison
If the patient has a chemical agent in the eyes, you should irrigate the eyes quickly and thoroughly for at least _____ to _____ minutes for acid substances
5; 10
If the patient has a chemical agent in the eyes, you should irrigate the eyes quickly and thoroughly for at least _____ to _____ minutes for alkali substances
15; 20
It is important to remember that some chemicals _____ when they come into contact with water.
Explode
What is a stimulant?
An agent that produces an excited state
What is an opioid?
A drug or agent with actions similar to morphine
What is the name for an agent that blocks the parasympathetic nerves?
Anticholinergic
What is the name for an agent that overstimulates the body functions controlled by the parasympathetic nerves?
Cholinergic
Define poison
Any substance that can damage body structure or impair body function
Define toxin
Substance produced by bacteria, animals, plants that changes normal metabolism
Define delerim tremens (DTs)
A severe withdrawal syndrome seen in alcoholics who are deprived of alcohol
What are some characteristics of DTs
Restlessness and agitation Fever Diaphoresis Disorientation and/or confusion Delusions and/or hallucinations Seizures
What is the usual dose of activated charcoal for a patient?
1g per kg of body weight
Define opioid
A type of narcotic medication used to relieve pain
Define opiate
A subset of opioids, referring to natural, non-synthetic opioids (no chemicals)
What is the most commonly accepted sign of opioid abuse?
Pinpoint pupils
What are some common opioids and opiates?
Codeine Fentanyl (Sublimaze) Heroin Hydrocodone (Vicodin) Morphine Oxycodone hydrochloride (OxyContin)
What are some abused inhalants?
Cleaning compounds Glues Paint thinners Lacquers Aerosol sprays
What do abused inhalants do to the brain?
Temporarily displace oxygen causing a rush of euphoria
What is hydrogen sulfide?
Highly toxic, colorless, and flammable gas with a distinctive rotten-egg odor
Where does hydrogen sulfide occur naturally?
Sewers
Volcanoes
Swamps
Crude petroleum
What do sympathomimetics mimic in the body?
The effects of the sympathetic (fight or flight) nervous system
What signs/symptoms do sympathomimetic frequently cause?
Hypertension
Tachycardia
Dilated pupils
What are some of the most addictive substances?
Cocaine Heroin Methamphetamine Alcohol Nicotine
What is an acute cocaine overdose patient at high risk for?
Seizures
Cardiac dysrhythmias
Stroke
How long can the effects of synthetic cathinones (bath salts) reportedly last?
As long as 48 hours
What does synthetic marijuana or “spice” refer to?
A variety of herbal incense or smoking blends that resemble THC and produce a similar high
(No medical benefit, high potential for abuse)
What do hallucinogens do to a person?
Alter their sensory perceptions
What signs/symptoms would a patient experiencing a “bad trip” on hallucinogens likely have?
Tachycardia
Hypertension
Anxiety
Paranoia
What do anticholinergics do to the body?
Block the parasympathetic nerves
What phrase can help paint a picture of an anticholinergic overdose?
“Hot as a hare” (hyperthermia)
“Blind as a bat” (dilated pupils)
“Dry as a bone” (dry skin and mucous membranes)
“Red as a beet” (reddened skin)
“Mad as a hatter” (agitation or delirium)
What do Cholinergic agents do to the body?
Overstimulate normal body functions caused by the parasympathetic nervous system
What might a patient exhibit if poisoned by a cholinergic agent?
Excess salivation
Mucous membrane oversecretion
Uncontrolled diarrhea
Excessive tearing of the eyes
What is the mnemonic SLUDGEM used for?
Remembering cholinergic poisoning signs and symptoms
What does SLUDGEM stand for?
Salvation, sweating Lacrimation (teary eyes) Urination Defecation, drooling, diarrhea Gastric upset and cramps Emesis Muscle twitching, miosis (pinpoint pupils)
What signs and symptoms would a patient with aspirin poisoning frequently exhibit?
Anxiety
Confusion
Tachypnea
Hyperthermia
What is staphylococcus?
A bacterium that is quick to grow and produce toxins in foods that have been prepared in advance and kept too long, even in the refrigerator
