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toxicology > Clinical Toxicology > Flashcards

Clinical Toxicology Flashcards

1
Q

what is the approach commonly used to treat poisoning

A

ABCDE

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2
Q

what does ABCDE stand for

A

airways, breathing, circulation, disability, exposure

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3
Q

what sort of drugs cause respiratory depression

A

opiates

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4
Q

why is it important to establish vasuclar access and check cardiac rhythm and bp

A

because many drugs cause cardiac dysrhythmias and shock

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5
Q

how do TCAs cause reduced contractility and dysrhythmias and how is it treated

A

block fast acting sodium channels in the myocardium

treated with sodium bicarbonate

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6
Q

what two factors contribute to hypotension in TCA poisoning and how is this treated

A

reduced contractility and increased vasodilation due to the blocking of alpha-adrenoreceptors
treated with fast acting vasorepressor eg norepinephrine or phenylephrine

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7
Q

how is hypertension treated

A

short acting vasodilator eg nitroprusside

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8
Q

what can shock lead to

A

cardiovasuclar collapse

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9
Q

what are the symptms of shock

A

low bp, tachycardia, cold pale skine, acidosis and lo oxygen tension in arterial blood

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10
Q

how is shock managed

A

increase circulating volume using dextran
increase cardiac output using glucagon, dopamine or dobutamine
correct acidosis with sodium bicarb

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11
Q

how do glucagon/dopamin/dobutamine increase cardiac output

A

activate cardiac D1 or b1 receptors preveting vasodilation

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12
Q

what are common disabilities cause by poison

A

seizures, agitation, delirium, coma

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13
Q

what is the general reason for disabilities from poisoning

A

impaired function of CNS

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14
Q

what two disabilities often lead to hypoglycaemia

A

delirium and coma

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15
Q

what is used to treat hypoglycaemia

A

dextrose

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16
Q

how is the impairement of cardiorespiratory function as a result of siezures controlled

A

benzodiazapines such as diazepam which has anticonvulsant activities

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17
Q

how is decreased blood volume in hyperthermia treated

A

fluid replacement

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18
Q

what is the function of dantrolene in the treatment of hyperthermia

A

prevent excitation contraction

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19
Q

how is hypothermia treated

A

rewarming and basic life support

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20
Q

how is exposure reduced after oral ingestion

A

gastric lavage, emesis, adsorption with activated charcoal, whole bowel irrigation

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21
Q

what syrup is used for emesis

A

ipecacuanha syrup

22
Q

in what circumstances is whole bowel irrigation particularly useful

A

removing ions and packages of illicit drugs

23
Q

what sort of poisons can be treated with diureses

A

weak acid/base poisoning

24
Q

what is weak acid treated with

A

NaHCO3

25
Q

what are weak bases treated with

A

NH4CL-

26
Q

give an example of a poison which is a weak bases

A

amphetamines

27
Q

give an example of a 2 posons whicch are weak acids

A

barbiturate or salicylic acid

28
Q

ODing with what requires treatment with short acting vasorepressors such as nitropruside due to hypotension

A

monoamine oxidase

29
Q

what is calcium used for in the treatment of hyperthermia

A

to prevent excitation contractions

30
Q

What is the cholinergic toxidrome

A 
Diarrhoea 
Urination
Miosis
Bronchorrhoea (pulmonary oedema)
Bronchospasm
Emesis
Lacrimation
Salivation
31
Q

what is the anti-cholinergic toxidrome

A 
Dry mucous membranes
Dilated pupils
Blurred near vision
Warm flushed skin
urinary retention
tachycardia
altered mental state
32
Q

what is the method to remember the anticholinergic toxidrom

A 
blind as a bat
mad as a hatter
hot as hades
red as beet
dry as a bone
33
Q

what is the sympathomimetic toxidrome

A 
hyperpyrexia
dilated pupils
excessive sweating
mental and physical agitation
tachycardia
hypertension
34
Q

what isthe opiate toxidrome

A 
CNS effects:
CNS depression
respiratory depression
pinpoint pupils
coma

PNS effects:
bradycardia
hypotension
decreased gastrointestinal motility

35
Q

what are the effects of OD with benzodiazapine

A

vital signs not effected
ataxia (clumsiness)
drowsiness
coma

36
Q

what is dimercatrol and DMSA used to treat

A

heavy metal poisoning

37
Q

what is calcium EDTA and DMSA used to treat

A

lead poisoning

38
Q

what is the treatment for iron poisoning

A

deferoxamine

39
Q

what is penecilllamine used in the treatment of

A

copper poisoning

40
Q

how is cyanide poisoning treated

A

thiosulphate therapy

41
Q

how is digoxin poisoning treated

A

digoxin specific antibodies

42
Q

how are snake bite treated

A

antivenoms

43
Q

how does pharmicalogical reversal treat poisoning

A

effects of the poison are blocked or reversed by administration of antagonists which compete for binding of the target

44
Q

how is CO poisoning treated

A

hyperbaric oxygen

45
Q

what is atropine used to treat

A

acetylcholinesterase poisoning

46
Q

what is used to treat opiate od

A

naloxone

47
Q

how is diazepam od treated

A

flumazenil

48
Q

what s warfarin used to treat

A

Vitamin K od

49
Q

what is folate and leucovorin used to treat

A

methotrexate-induced toxicity

50
Q

what is ethanol used to treat

A

methanol and ethylene glycol posioning

toxicology (11 decks)

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