Drug OD/ Poisoning Flashcards
Ethanol- Sx
- Ataxia, dysarthria, depressed sensorium, nystagmus
- Coma, resp depression
Ethanol- Dx
- Blood ethanol concentration
- Dx hypovolemia, hypothermia, infection, trauma or GI bleeding
Ethanol- Tx
- Supportive
- GI decontamination
- Thiamine and glucose
Salicylates- Sx
- Nausea, vomiting
- Hyperventilation
- Tinnitus
- Listlessness
- Seizures
- Resp alkalosis followed by metabolic acidosis
Salicylates- Dx
- Blood salicylate levels
- Acid-base status
Salicylates- Tx
- Charcoal
- Irrigation
- Correct dehydration, hypoglycemia, acidosis
PCP- Sx
- Alternation of severe agitation to quiet stupor
- Bizzare, paranoid and extreme violence
- Nystagmus
- Muscle rigidity, dystonia, seziures
PCP- Dx
- Urine PCP
- Gastric aspirate
PCP- Tx
- Supportive care
- GI decontamination
- Diazepam
Acetaminophen- Sx
- Anorexia, nausea, RUQ pain
- Jaundice 24-73 hrs after ingestion
- Hepatic failure
Acetaminophen- Dx
- Serum concentration to guide tx
Acetaminophen- Tx
N-Acetylcystine
- Within 12-16 hrs of ingestion
Sedative hypnotics- Sx
- Nystagmus
- Atonia, lethargy, somnolence
- Resp depression
- Hypotension
- Hypothermia
Sedative hypnotics-Dx
- Serum levels misleading due to variety
- Flat EEG, extreme sedation
Sedative hypnotics-Tx
- Tx shock and hypotension
- Restore temp
- Fluid replacement
Alkali ingestion- Sx
- Lye, ammonia and detergents
- Liquifactive necrosis
- Corrosive burns of airways
- Mouth and throat pain
- Dysphagia
- Drooling
- Substernal pain
Alkali ingestion- Dx
Endoscopy
Alkali ingestion- Tx
- Dilute with saline, milk or water
- Do not induce vomiting
Acid ingestion- Sx
- Toilet bowl cleaners, bleach, battery acid
- Mouth and throat pain
- Dysphagia
- Gastric or esophageal burns
Acid ingestion- Dx
Endoscopy
Acid ingestion- Tx
Dilute, do not neutralize
- Do not induce vomiting
Opiates- Sx
- Sedation
- Hypotension
- Bradycardia
- Hypothermia
- Resp depression
- Pinpoint pupils
- Pulm edema
Opiates-Dx
Regain consxiousness with naloxone admin
Opiates- Tx
- Naloxone injection
- Nalmefene
- Support
Organophosphates- Eti
- Cholenesterase inhibitors
- Insectisides, nerve gas
Organophosphates- Sx
Dumbels
- Diarrhea
- Urination
- Miosis
- Brochorrhea
- Emesis
- Excitation with muscle fasciculation
- Lacrimation
- Salvation
- Death from resp depression
Organophosphates- Dx
- Low plasma or RBC cholinesterase level
Organophosphates- Tx
- Intensive supportive care
- Atropine or pralidoxime
- Avoid aspiration
Cocaine- Sx
- Euphoria, excitement, restless ness
- Toxic psychosis, seizure, hypertension
- Chest pain, MI, aoritc dissection
Cocaine- Tx
- Supportive measures
- Clears body in 1 hr
- Manage sympathetic hyperactivity
Petrolium distillates - Eti
- Oils, lighter fluid, vaseline, turpentine
Petrolium distillates -Sx
- Chocking, gagging or gasping
- Hypoxia
- Delayed findings, aspiration penumonia
- CXR infiltraties
Petrolium distillates -Tx
- Gastric lavage
- Symptomatic tx
Amphetamines- Sx
- Euphoria
- Mydriasis
- Restlessness, psychosis and seizures
- Hypertension
- Palpitations and arrhythmias
Amphetamines- Dx
- Short 1/2 life, drug levels of little value
Amphetamines- Tx
- Diazepam or lorazepam
- Supportive care
Tricyclics- Sx
- Amtryptaline, imipramine doxepin
- Rapid onset of life threatening effects
- Anticholinergic activity
- Mydriasis, dry mouth, tachycardia, agitation, hallucinations
- Rapid coma onset
- Twitching, myoclonus
- Wide QRS
Tricyclics- Dx
- 3 Cs- Cardiac abn, convulsions, coma
- Wide QRS, prolonged QT
Tricyclics- Tx
- Do not induce emesis
- ECG monitoring
- Activated charcoal
- Tx seizures, arrhythmias, hypotension
Ferrous sulfate- Sx
- Severe N/V abd pain 1-4 hrs- hemorrhagic gastroenteritis, shock, acidosis
- Improvement 6-12 hrs
- Shock, acidosis, coagulopathy and hypoglycemia 12-24 hrs
- Hepatic poisoning
Ferrous sulfate-Dx
- Serum concentration
- Elevated WBCs
- CXR
Ferrous sulfate- Tx
- IV chelation- deferozamine
- Supportive care
Sympathomimetic syndrome
- Elevated BP and pulse
- Severe HTN, reflex bradycardia
- High temp
- Dilated pupil
- Sweaty skin, dry mucous membranes
- Agitation, anxious, psychotic
Sympathomimetic syndrome- Eti
- Amphetamine
- Cocaine
- Ephedrine
- Psuedoephedrine
Sympatholytic syndrome-
- Low BP, pulse and temp
- Small, pinpoint pupils
- Obtunsation or comatose
Sympatholytic syndrome- Eti
- Barbituates
- Benzos
- Sedative hypnotics- GHB , clonidine, opioids
Cholinergic syndrome
- Bradycardia
- Miosis
- Sweating
- Hyperperistalsis
- Bronchorrhea, wheezing, salivation
- Urinary incontinence
- Agitation and anxiety
- Muscle fasciculation
Cholinergic syndrome- Eti
- Carbamates
- Nicotine
- Organophosphates
Anticholinergic syndrome
- Tachycardia
- Mild HTN
- High temp
- Dilated pupil
- Hot, flushed, dry skin
- Myoclonus
- Agitated delrium
Anticholinergic syndrome- Eti
- Atropine
- Anticholinergics
- Antihistamines
- Tricyclics
Serotonin syndrome
- Tachycardia
- Diarrhea
- Hyperthermia
- Tremor, clonus
- Agitation and delirium
Serotonin syndrome- Eti
- SSRI/ SNRIs
- TCAs
- MAOIs
- Fentanyl
- Tramadol
Synthetic amphetamines- Sx
- Anxiety and agitation
- HTN, tachy, hypertherm.
- Hyperactive, AMS- hallucinations
Synthetic amphetamines- Eti
MDMA, molly, ecstacy
- Effects last 3-5 hrs
Synthetic amphetamines- Tx
- Cooling
- Benzo for seizures
- Supportive care
Synthetic cathinones- Eti
- Bath salts
- 1-5 hrs
- Taken repeatedly- awake hrs to days
Synthetic cathiones- sx
- Tremors, seizures
- Irritability, hallucinations
- CV dysfxn, HTN, N/V
Synthetic cathiones- Tx
- Benzos for seizures, sedation
- Antipsych for hallucinations
Synthetic cannabinoids- Eti
Spyce
- Smoked or tea infusion
- Last 3-4 hrs
Synthetic cannabinoids- Sx
- AMS- confusion, hallucination, seizures, anxiety
- Tachy
- Agitation
Synthetic cannabinoids- Tx
- Supportive care
- Benzos
- Tx HTN
