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1. Toxicology > Emergency Managment If Poisoning > Flashcards

Emergency Managment If Poisoning Flashcards

1
Q

Stabilizing the patient

A

Airways —>intubate
Breathing —> ventilate
Circulation —> PRN
Disability —> reflexes

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2
Q

Respiratory failure or depression

A

A patent airway
Cuffed endotracheal tube
Mechanical ventilation or oxygen (apnea, anoxia, severe anemia)

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3
Q

How do you treat respiratory failure?

A

Doxapram- respiratory stimulant
Naloxone- If opiate induced

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4
Q

Seizures

A

Comes with hypoxia, hyperthermia and acidosis
Use diazepam, phenobarbital and pentobarbital

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5
Q

Diazapam

A

Drug of choice for acute seizures (prototype drug)
Usually re-administered every 10-20 minutes

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6
Q

Phenobarbital

A

Use if diazapm is ineffective
Can cause respiratory depression with excessive prolonged use

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7
Q

Pentobarbital

A

Use to induce light anesthesia for refractory seizures
Excessive or prolonged use may cause CNS depression

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8
Q

CNS depression

A

Opiate pain meds: tramadol

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9
Q

Nalaxon (Narcan)

A

Useful for opiate induced respiratory depression
Reduces opioid overdoses (antagonist)

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10
Q

Shock

A

Toxicants: cause fluid loss, vomiting, diarrhea, blood loss and cardiomyopathy
Monitor using Hb, PCV, and oxygen saturation

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11
Q

Treating shock

A

Lactated rings solution, plasma expanders and whole blood

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12
Q

Hyperthermia

A

Cold baths, ice packs and cooled IV fluids
Rehydrated with fluid therapy

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13
Q

Hypothermia

A

Blankets, warm water bottles and heating pads
Warming the animals surroundings

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14
Q

Prolonged vomiting or diarrhea possible etiologies

A

Toxicants: Organophosphate toxicosis
CNS causes or local irritation

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15
Q

Treatment for prolonged vomiting or diarrhea possible etiologies

A

Atropine
GI hyperactivity
Helps to eliminate ingested toixcants →dehydration, acid base disturbances and electrolyte loss

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16
Q

Histamine-type 2 receptor blockers

A

Cimetidine in dogs orally –> clinical improvement of simple gastritis

17
Q

Emesis

A

Removing poisons from the stomach (vomit)
Most effective first 2 hours post ingestion
Least effective if > 4 hrs

18
Q

How do you achieve emesis?

A

Physically (avoid)
Ipecac (humans), hydrogen peroxide
Pharmaceuticals (apomophine, xylazine and ropinirole/ clevor)

19
Q

Ipecac

A

Used orally in dogs and cats
Bitter taste and potential toxicity
Excessive vomiting, CNS depression

20
Q

Hydrogen peroxide

A

3% concentration
@ 1 tsp/10 lb bwt and wait 15-20 minutes
May repeat dose if needed, use after meal

21
Q

Ropinirole (clevor) in dogs

A

Eye drops (FDA approve fro dogs)
Stimulates D2 receptores in CRTZ

22
Q

Contraindications for emesis

A

Unconscious, depressed animals
Seizures or spontaneous seizures
Exposed to corrosive or caustic chemicals
Volatile materials (gas, petroleum, hydrocarbons)

23
Q

Which animals shouldn’t emesis be practiced on?

A

Rats, horse, rabbits and ruminants

24
Q

Catharsis

A

Enhancing elimination (defecation)
Sorbitol (most rapid/ potent)
Lactulose, Magnesium SO4, epsom salts, castor oil

25
Q

Gastric Lavage

A

Alternative of decontamination GIT
Used when emesis ineffective/ contraindicated and unconscious/ anesthetized patient
Used along with endotracheal tube to prevent aspiration of stomach contents

26
Q

Activated charcoal (AC)

A

Adsorbent
Given following gastric lavage and when emesis is contraindicated
Dosage: 2-5 g/kg in water slurry

27
Q

Gastrotomy/ rumenotomy

A

Used refractory to emesis, lavage or activated charcoal
Indications: foreigns bodies, abnormal rads

28
Q

Persistent materials in the GIT

A

Toxic oils, tars, agents that reduce rumen motility

29
Q

Forced diuretics

A

Rapid renal filtration
Furosemide and mannitol (cerebral edema)

30
Q

Caution with use of diuretics

A

Excessive fluid administration comes with cerebral edema, pulmonary edema and disturbance of acid-base or electrolyte status

31
Q

Ion trapping

A

To enhance elimination:
Acidic drugs (aspirin), basic drugs (amphetamines), agents use to change pH

32
Q

Acid urine is promoted by ____________

A

Ammonium chloride

33
Q

Alkaline urine is promoted by _________

A

Sodium bicarbonate

34
Q

When is peritoneal dialysis used?

A

Useful failure and anuria cases

35
Q

Ocular exposure to toxins (decontamination)

A

Immediate flushing with water
Repeated many times (20-30 minutes)

36
Q

Dermal exposure of toxins

A

Bathe –> warm water and soap, mild detergent, repeat prn
Clipping to remove toxic residues from long haired animals

1. Toxicology (14 decks)

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