drugs used for bioterrorism and management of poisoning Flashcards
treatment for anthrax?
oral-ciprofloxacin
inhalation- combined cipro and doxycycline
if a pregnant person has anthrax, what med would you give them?
streptomycin or genomycin
is there a vaccine for anthrax? if so, give some info.
yes.
can get it if exposed.
3 subq injections 2 weeks apart then at 6,12 and 18 months with annual boosters.
what teaching would you do with doxycycline ?
could cause teeth deformation and cleft lip.
what is botulism?
it paralyzes!! (botox)
mainly food bourne pathogen
not transmissible
-if a person is not treated, they will fairly rapidly develop paralysis and respiratory failure
what is the treatment for botulism?
no preventable measures
- supportive care with fluid and nutrional support
- *** infusion of botulinum antitoxin (this should be given immediately to minimize damage to nerves)… dont wait on lab confirmation of botulism
is there a vaccine for botulism?
yes
through state health departments or CDC also a vaccine is avaliable through department of defense.
-is an investigational drug, only used in select cases
what bacteria is found in rodents and fleas?
yersinia pestis (pneumonic plague)
___ is transmitted person to person… acquired by ____ aerosolied yersinia pestis
pneumonic plague
inhaling
what is the treatment for pneumonic plague?
has to be treated within 24 hrs or rapidly progressed to respiratory failure and death.
- doxycycline or ciprofloxacin for 7 days
- NO vaccine
is pneumonic plague contagious?
yes highly!
what is known as rabbit fever or deer fly fever?
tularemia is an infectious process exposure to francisella tularensis
how to avoid tularemia?
treatment?
use insect repelant;wear correct clothing
im streptomycin or gentamicin (whichever you can get ahold of)
mass outbreak= oral doxycycline (14-21 days) or oral ciprofloxacin (10 days)
what is the most infectious disease known?
tularemia
inoculation with only 10 microbes can cause diease
is their a vaccine with tularemia?
yes. but it an investigational drug so not given on regular basic.
smallpox is caused by ___.
variola virus
is their a treatment for smallpox?
NO, just the vaccine
- treatment is supportive with fluid and electrolytes.
- vaccine gives immunity for 3-5 years; it is most effective if given prior to exposure or up to 3 days post exposure
when given smallpox vaccine, how should the site be covered?
with sterile gauze, taped on all sides and perphaps covered with a semipermeable membrane.
-dressing should be disposed in a ziploc baggy.
what is significant about the smallbox vaccine?
live vaccination with bifurcated needle
- do not prepare with alcohol!
- scar =successfully vaccinated
___ causes cholinergic crisis by causing excessive muscarinic stimultaion and depolarizing neuromuscular bloackade– servere muscle weakness
sarin
what is the treatment for sarin?
atropine
-if having convulsions, gie diazapam!
remove clothing (double bagged), flush with soap and water; objects can be flushed with 5% bleach and water.
-mechical ventilation (if resp. failure)
the magic antedote for sarin is?
atropine!! if they start to seize give diazepam
what is the same as organophosphate poisoning?
sarin
if the patient is concious you give iv of ___, if the patient is unconcious you give iv of __/
Latated ringer
dextrose
what are the 3 broad catergories of the sign and symptoms of organophosphate poisoning?
- SLUDGE ( salivation, lacrimation, urination, diarrhea, GI upset, emesis)
- nicotinic signs and symptoms (muscle fasculations, cramping, weakness, and diaphragmatic failure.)
- cns effects
what is the instructions for giving atropine
give 3xs per 30 mins!
by injection!
when you get radiation exposure what is the most important thng?
to get potassium iodine ASAP! 48 hrs is your outside window
what are the treatments for radiation exposure?
potassium iodine
and perssian blue
what is important about perssian blue?
increases the excretion tme of radioactive substances.. works by preventing reabsorbtion of the substances in the small intestines.
assess bowel sounds
give laxative along with this because is can cause constipation
-can turn stool and teeth blue
-
___ happens when body is not able to completely metabolize, detoxify, and eliminate agents.
toxicity
if convulsion are present, you give ___.
diazapam; valium
what is the antedote for acetaminophen?
acetylcysteince (mucomyst)
what is the antedote for beta blockers?
glucagen
what is the antedote for digoxin?
digoxin iumme fab (digibind)
what is the antedote for opioids?
nalaxone (narcan)
what is the antedote for cholinesterase inhibitors?
atropine
what is used when a substance is swallowed and needs to be eliminated through GI system?
activated charcoal
if they person is unconcious, should you give activated charcoal?
NO
how can activated charcoal be given?
given po or though NG tube. best bet is through an NG tube. it is not metabolized or absorbed.
before giving activated charcoal, you should assess? and teach what?
assess bowel sounds and gag reflex
and warned patient stool will be black.
-milk or dairy products decrease the effectveness of charcoal
when giving oral med, what should you know about charcoal?
will decrease absorbtion of oral meds, so wait at least 2 hours before giving oral meds
charcoal absorbs up to __ of toxic substance.
60%
if you overdose on alkaline drugs (ampgetamines or strichyn) , you should give
acid product like ascorbic acid to flush out with furosemide (laxis)
if you overdose on acidic drugs (aspirin or phenobarbital) , you give
alkaline bases product to neutralize it (sodium bicarbonate) then flush out with furosemide (laxis)
acidic drugs are?
aspirin and phenobarbital
alkaline drugs are?
amphetamines or strichyn
overdoes on acidic drug, you get
sodium biacarbonate
overdose on alkaline drug, you get
ascorbic acid
what is the antidote for heavy medal poisoning?
chelating agents
what does chelating agents do?
engulf and remove heavy metal
___ is used to treat poisoning with lead, manganese, nickel and zinc.
edetate calcium disodium (calcium EDTA)
- used iv or im
__ used to treat poisoning with arsenic, gold, mercury, ad in conjuction with EDTA calcium in lead encephalopathy
dimercapol (BAL in oil)
given im
what is important about the 2 drugs for heavy metal poisoning?
they can be given at the same timebut can not be mixed. has to be 2 seperate sites and 2 seperate injections!!
