Common Toxicants in the PH Setting Flashcards
has a role as a neurotoxin, a psychotropic drug, a central
nervous system stimulant, a xenobiotic, and an
environmental contaminant
METHAMPHETAMINE
can induce effects such as euphoria,
increased alertness and energy, and enhanced self-esteem
Methamphetamine
T/F: The FDA withdrew its approval for the use of all
parenteral drug products containing methamphetamine
hydrochloride, a methamphetamine salt
True
How does Metamphenamine Affect the Body?
HAHRBAC
Highly Addictive
Agitation
Increased heart rate and bp
Increased respiration
Increased body temp
Anxiety Paranoia
Convulsions, Cardiovascular collapse, stroke death
Overdose effect of Methamphenamine
stroke, heart attack, or multiple
organ problems
Methamphenamine acute toxicity
adverse reaction
T/F: Acute Toxicity of Meth can still be fatal
True
Reason: When methamphetamine
users experience an adverse
reaction due to using a
large amounts of
methamphetamine one time,
it can be fatal
SIGNS AND SYMPTOMS OF TOXICITY of Meth
MISHAA BCIKG
Mydriasis (dilated pupils) Bradycardia or Tachycardia
Irregular heart rhythm
(arrhythmia)
Chest pains
Shortness of breath
Increased body temperature
Hypertension Kidney damage
Altered mental status Gastrointestinal distress
Agitation, violent, psychotic behaviors
Patients who experience methamphetamine toxicity
usually present with
an altered mental status
Chronic long-term methamphetamine use can also
cause
dental complications, significant weight loss, and
skin problems such as sores and abscesses.
chlorine compound often used as a disinfectant or a
bleaching agent.
Sodium hypochlorite
Sodium hypochlorite in 0.5% w/v solution is called
Dakin’s
solution
Dakin’s solution is used as an _________________ to clean infected topical wounds
antiseptic
sodium salt of hypochlorous acid
Sodium Hypochlorite
commonly known as bleach or
liquid bleach
Sodium Hypochlorite
Household bleach is, typically, a solution containing
__________ sodium hypochlorite and ____________ sodium
hydroxide
3-8%; 0.01-0.05%
Antiformin other name
Sodium hypochlorite
T/F: Sodium hypochrloite are oxidants
True
Chlorine is a strong ________ (Corrosive/Caustic) matermail
corrosive
T/F: Symptoms may be delayed in Chlorine
True
If eye is not irrigated immediately after contact with Chlorine it may result to ______
permanent eye damage
T/F: Chlorine has carcinogenic activity
False
Adverse Effects of Chlorine
Methemoglobinemia
Dermatoxin
Toxic Pneumonitis
Methemoglobinemia in Chlorine Toxicity is a ________ (primary/secondary) toxic effect
secondary
Chlorine Antidote/Emergency Treatment:
Administer oxygen by non rebreather mask at
10-15 L/min
Chlorine Antidote/Emergency Treatment:
Irrigate each eye with ______ during transport
NSS
T/F: Chlorine Antidote/Emergency Treatment:
Emetics can be used
False
T/F: Chlorine Antidote/Emergency Treatment:
rinse mouth and administer ______ mL/kg up
to ________ mL of water for dilution if the patient can
swallow, has a strong gag reflex, and does not drool
5; 200
Chlorine Antidote/Emergency Treatment:
_________-pressure
ventilation techniques with a bag-valve-mask device
may be beneficial.
Positive
Chlorine Antidote/Emergency Treatment:
Consider ____________ if hypotensive
with a normal fluid volume
vasopressors
Chlorine Antidote/Emergency Treatment:
Use __________ Ringer’s if signs of hypovolemia are
present
lactated
Chlorine Antidote/Emergency Treatment:
Treat seizures with ________ (Valium).
diazepam
Chlorine Antidote/Emergency Treatment:
Use ___________ hydrochloride to assist eye irrigation.
proparacaine
Metabolite found in or produced by Saccharomyces
cerevisiae
ETHANOL
ETHANOL has a ________ (bactericidal/bacteriostatic) property
bactericidal
Ethanol’s ___________ is considered as drug
psychoactive effects
Ethanol acts as agonist against
GABA Receptors
Blood alcohol level reaches:
0.1% =
causes intoxication
Blood alcohol level reaches:
0.3-0.4% =
unconsciousness
Blood alcohol level reaches:
0.4% =
Death from ethanol consumption
Blood alcohol level reaches:
0.5% =
commonly fatal
Ethanol within the human body is converted into
___________ by alcohol dehydrogenase
acetaldehyde
T/F: acetaldehyde, is more toxic than ethanol
True
Consumption of this form of ethanol can be fatal over
a short period of time
Absolute
Fatal dose of liquor
500-1000mL of 100-proof liquor ingested in an hour or two
300-400mL of pure ethanol
Lethal Dose of liquor
Pure ethanol
5-8kg (3g/kg for children)
At >__________% blood alcohol levels= decreased blood flow to the brain
0.14
At greater than _________% blood alcohol= marked degree of
stupefaction and possible unconsciousness.
0.3
At levels greater than ______= risk of death
0.4%
Acute consumption leading to blood alcohol levels greater
than __________ is almost universally fatal.
0.5%
ADE of Liquor
Acute solvent Sydrome
Occupational hepatotoxins
Reproductive Toxins
ACGIH Carcinogen
Treatment for Acute ethanol poisoning:
Give ___________ and ________
and treat coma and seizures if
they occur
glucose; thiamine
Alcohol withdrawal can be treated with
benzodiazepines
Treatment for Acute ethanol poisoning:
Aspirating gastric contents can be done if alcohol ingestion was massive and within
30-45 minutes
T/F: HCl is used as Virucide. Fungicide, and Fungistat
True
rapidly dissociate, and its effects
are thought to result from pH
change (local deposition of H+)
rather than the effects of
hydrogen chloride/hydrochloric
acid.
HCl
HCl effects to the skin
ulceration -> keloid and contractile scarring
HCl effects to the eyes
reduced vision/blindness
HCl effects to teeth
dental decay
Acclimatized workers can work
undisturbed with a hydrogen
chloride level of ______ mg/cu
15
● The hazard of hydrochloric acid for the environment
is caused by the ________ (pH effect)
proton
ESCITALOPRAM belongs to the class of
SSRIs
It is typically used as an antidepressant to treat
depression associated with mood disorders
ESCITALOPRAM
ESCITALOPRAM causes Dry mouth, nausea, dizziness, drowsiness, _______________, headache
sexual
dysfunction
This vasodilator may be administered to px with Escitalopram toxicity
Albuterol
A synthetic dihydropyridine and a calcium channel
blocker with antihypertensive and antianginal properties
Amlodipine
In geriatric patients, Amlodipine clearance is _________, and AUC is
___________ by about 40-60%
decreased; increased
NSAID that is believed to work through the inhibition of
cyclooxygenase (COX), thus inhibiting prostaglandin
synthesis
Ibuprofen
Anthranilic acid and non-steroidal anti-inflammatory
drug (NSAID) with anti-inflammatory, antipyretic, and
analgesic activities
Mefenamic Acid
Activated charcoal may not be warranted in
patients presenting before_________ post ingestion of Mefenamic Acid
1-4 hours
Patients with significant toxicity who develop severe
acidosis due to NSAID poisoning may require supportive treatment with
intravenous _____
sodium bicarbonate
T/F: For NSAID toxicity, Hemodialysis may be considered for the correction of
severe acidosis however hemodialysis may not help clear the drug from
the blood,
True
An anticonvulsant is used for several types of seizures,
including myotonic or atonic seizures, photosensitive
epilepsy, and absence seizures, although tolerance may
develop
CLONAZEPAM
mechanism of action appears to involve the
enhancement of gamma-aminobutyric acid receptor
responses
CLONAZEPAM
CLONAZEPAM is a schedule ________ controlled substance
4
clonazepam is assumed to be capable
of causing an increased risk of
congenital abnormalities when
administered to a pregnant woman
during the __________ trimester
first
Hypotension in Clonazepam toxicity may be combated using
evarterenol or
metaraminol
a specific benzodiazepine-receptor
antagonist, is indicated for the complete or partial
reversal of the sedative effects of benzodiazepines and
may be used in situations when an overdose with a
benzodiazepine is known or suspected.
Flumazenil
Is indicated for the treatment of schizophrenia, depressive
episodes associated with bipolar disorder, acute manic
episodes associated with bipolar I disorder, and
maintenance treatment of bipolar I disorder
QUETIAPINE
Improves the positive and negative symptoms of
schizophrenia and major depression by acting on
various neurotransmitter receptors, such as the
serotonin and dopamine receptors
QUETIAPINE
In bipolar disorder, it improves both depressive and
manic symptoms
QUETIAPINE
The most common adverse effects
reported in 5% or more of patients
receiving quetiapine therapy for
schizophrenia or bipolar disorder and
at a frequency twice that reported
among patients receiving placebo in
clinical trials include
somnolence,
sedation, asthenia, lethargy, dizziness,
dry mouth, constipation, increased ALT,
weight gain, dyspepsia, abdominal
pain, postural hypotension, and
pharyngitis
