Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NAPLEX 2023 > Chapter 81: Emergency Preparedness, Toxicology & Antidotes > Flashcards

Chapter 81: Emergency Preparedness, Toxicology & Antidotes Flashcards

1
Q

Which resources have information on toxicology

A

Micromedex POISONDEX & Lexicomp Lexi-Tox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

To reduce accidental poisoning in children, what can be helpful

A

child-resistant containers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which drug is excluded from child-resistant containers

A

Nitroglycerin SL tabs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Common child-resistant packaging includes

A
  • Screw caps
  • Unit dose packaging
  • Card adherence
  • Safety packaging
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Topical overdose management

A

Remove contaminated clothing and wash skin with soap and water for 10 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ocular overdose management

A

remove contact lenses and rinse eye/s with a gentle stream of water for at least 15 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which drug is no longer available but used to induce emesis for certain exposures

A

Ipecac syrup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The first step to the CAB’s (circulation, airway, breathing) is

A

to evaluate if the pt has a pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When is activated charcoal most effective

A

when used within 1 hour of ingestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does activated charcoal work

A

it absorbs the drug, which prevents GI absorption and systemic toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the dose of activated charcoal

A

1 g/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What must be done prior to using activated charcoal

A

airway should be protected (with intubation, if needed) to prevent aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Activated charcoal CI

A
  • when the airway is unprotected (unconscious, cannot clear throat, cannot hold head upright)
  • intestinal obstruction
  • when GI tract is not intact or when there is decreased paristalsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hepatotoxicity is a dose-dependent adverse effect caused by the increased metabolism of APAP by CYP450 ___ to ____

A

2E1 to NAPQI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Phase 1 of APAP overdose

A

1-24 hrs: commonly asymptomatic or non-specific symptoms such as nausea and vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Phase 2 of APAP overdose

A

24-48 hrs: elevated INR, AST/ALT; symptoms from phase 1 usually subside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Phase 3 of APAP overdose

A

48-96 hrs: fulminant hepatic failure (e.g., jaundice, coagulopathy, renal failure, &/or death)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Phase 4 of APAP overdose

A

> 96 hrs: the patient recovers or receives a liver transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Antidote for APAP overdose

A

N-acetylcysteine (NAC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How does NAC work for APAP overdose

A

Increases glutathione, which increases GSH.
GSH converts NAPQI to mercapturic acid, which can safely be excreted from the body.
If NAPQI has already bonded to hepatocytes, the damage is irreversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

APAP levels are plotted on

A

Rumack-Matthew nomogram to determine risk of hepatotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What formulations does NAC come in

A

oral and IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Acetadote generic name

A

NAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When is the APAP level drawn

A

4-24 hrs after ingestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How is oral NAC dosed

A

high-dose bolus x1, then lower dose for 17 dose. Repeat the dose if emesis occurs within 1 hr of administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How is IV NAC dosed

A

3 infusions over a total of 21 hrs

27
Q

Anticholinergic overdose symptoms

A

Flushing, dry skin, mydriasis with double or blurry vision

28
Q

Anticholinergic overdose treatment

A

Primarily supportive care, rarely physostigmine

29
Q

Treatments for warfarin OD

A

Phytonadione (Vitamin K)
Prothrombin complex concentrate (Kcentra)

30
Q

Treatments for factor Xa inhibitor OD

A

Prothrombin complex concentrate (Kcentra)

31
Q

Treatment for heparin & LMWH OD

32
Q

Treatments for dabigatran OD

A

Idarucizumab (Praxbind)

33
Q

Treatments for apixaban & rivaroxaban OD

A

Abdexanet alfa (Andexxa)

34
Q

Treatment for BZD OD

A

Flumazenil - can cause seizures when used in pts on BZDs chronially

not routinely recommended

35
Q

Treatment for BB OD

A

Glucagon (if unresponsive to symptomatic tx)

high dose insulin

36
Q

Treatment for CCB OD

A

Glucagon
Calcium chloride or gluconate (administer Ca IV only)

37
Q

Cyanide: smoke inhalation, nitroprusside in high doses/long durations/renal impairment treatment for OD

A

Hydroxocobalamin (Cyanokit)

38
Q

Treatment for digoxin OD

A

Digoxin Immune Fab (DigiFab)

39
Q

What should be administered for ethanol OD if suspected to be a chronic alcohol user

A

thiamine (B1) to prevent Wernicke’s encephalopathy
Can cause increased anion gap

40
Q

Treatment for arsenic, gold, mercury OD

A

Dimercaprol

41
Q

Treatment for copper OD

A

Penicillamine

42
Q

Treatment for lead OD

A

Succimer (Chemet)

43
Q

In patient’s with Hydrocarbon OD (petroleum products, gaosline, kerosene, mineral oil, paint thinners), what should be avoided

A

Do not induce vomiting; keep pt NPO d/t aspiration risk

44
Q

Treatment for insulin or other hypoglycemic OD

A
  • Dextrose injection or infusion (drip), oral glucose (do not administer if pt is unconscious)
  • Glucagon (when IV or oral dextrose cannot be administered)
45
Q

Treatment for isoniazid OD

A

Pyridoxine (B6)

46
Q

Iron & aluminum OD treatment

A

Deferoxamine (Desferal)

47
Q

Symptoms of organophosphate OD

A

OPs block acetylcholinesterase, which increases ACh levels and causes cholinergic “SLUDD” sx: salivation, lacrimation, urination, diarrhea/defecation

48
Q

Treatment for organophosphate, including industrial insecticide, OD

A
  1. Atropine (anticholinergic effects)
  2. pralidoxime (treats muscle weakness and relieves paralysis of respiratory muscles by reactivating cholinesterase)
  3. combo of both
49
Q

Treatment for MTX OD

A

Leucovorin (folinic acid), levoleucovorin (Fusilev)

50
Q

Methylene blue is CI in pts with

A

G6PD deficiency

51
Q

Treatment for neostigmine, pyridostigmine OD

A

Pralidoxime (counteracts muscle weakness)

52
Q

Early sx of nicotine OD

A

abdominal pain, nausea

53
Q

Treatment for nicotine OD

A

Supportive care (e.g., atropine for symptomatic bradycardia, BZDs for seizures)

54
Q

Treatment for salicylate OD

A

Sodium bicarbonate (alkylating agent to alkalinize the urine to decrease drug absorption and increase excretion of salicylates)

55
Q

Stimulant OD treatment (including ADHD and weight loss drugs)

A

supportive care for agitation or seizures (BZDs)

56
Q

Toxic alcohols, ethylene glycol (antifreeze), methanol treatment for OD

A

Can cause increased anion gap
Fomepizole is preferred, ethanol 2nd line

57
Q

OD of TCAs can quickly cause

A

fatal arrhythmias

58
Q

TCA OD treatment

A

Sodium bicarbonate to decrease a widened QRS complex

59
Q

Valproic acid or topiramate-induced hyperammonemia treatment

A

Levocarnitine

60
Q

What are the SLUDD symptoms for organophosphate OD

A 
Salivation
Lacrimation
Urination
Diarrhea
Defecation
61
Q

What is the combination of atropine and pralidoxime called for organophosphate OD

62
Q

Antidote for animal bites

A

Rabies vaccine + Human rabies immune globulin

63
Q

Black Widow spider bites and scorpion sting antidote

A

Antivenim (specific to bite)

64
Q

Snake bite antidote

A

Crotalidae polyvalent immune FAB (Crofab) for copperhead and rattlesnake bites

NAPLEX 2023 (88 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions