Emergency Medicine - Toxicology Flashcards
Drugs that cause bradycardia
BB, CCB, digoxin, lithium
Drugs that cause HTN
Sympathomimetics: Cocaine, amphetamines, designer drugs
Causes of conjugate eye deviation - towards or away from lesion?
Stroke - towards. Seizure - away.
Causes of hemiparesis
Post-ictal, stroke, ICH
Drug therapy for the agitated patient
If drug induced, drug withdrawal, or unknown - give benzo (lorazepam, midazolam). If Dementia or psychiatric cause - give antipsychotic (haloperidol).
Effect of anticholinergic toxicity on HR
Increased HR
Effect of synpathomimetic toxicity on HR
Increased HR
Effect of sedative toxicity on HR
Bradycardia
Effect of cholinergic toxicity on HR
Variable
Oral findings for anti cholinergic, sympathomimetic, sedative and cholinergic overdoses
No oral findings except for with cholinergics you get salivation
Effect of anticholinergic toxicity on BP
Variable BP
Effect of sympathomimetic toxicity on BP
High BP
Effect of sedative toxicity on BP
Low bp
Effect of cholinergic toxicity on BP
Variable bp
How do pupils look with anti cholinergic toxicity
Dilated
How do pupils look with sympathomimetic toxicity
Dilated pupils
How do pupils look with sedative toxicity
Dilated or constricted
How do pupils look with cholinergic toxicity
Constricted pupils
Suspect overdose of what agent in patient with dry flushed skin?
Anticholinergic
Suspect overdose of what agent in diaphoretic patient with piloerection?
Sympathomimetic agent
Suspect overdose of what agent in patient with hypothermic skin?
Sedative
Suspect overdose of what agent in patient with diaphoretic skin and constricted pupils?
Cholinergics
Location of tension HA, migraines, cluster HA
Bilateral, unilateral, unilateral in orbital/supraorbital/temporal region
Pinpoint pupils, resp depression, lethargy, bradycardia, hypothermia, borderline hypotension
Opioid overdose
Way to remember anticholinergic toxicity
Blind as a bat, mad as a hatter, red at a beet, hot as a hare, full as a tick, dry as a bone, bowel loses tone and heart runs alone
Way to remember cholinergic toxicity
Dumb bells : diarrhea/diaphoresis, urination, miosis (constricted pupil), bradycardia, bronchorrhea, emesis, lacrimation, salivation/seizures
Also AMS, fasciculation, weakness
Examples of anticholinergic drugs
Diphenhydramine (OTC cold/sleep meds), antiparkinson meds benztropine, toxic jimsonweed
Sympathomimetic drugs
Cocaine, amphetamines, anorectics, otc stimulants, herbal stimulants
Cholinergic drugs
Organophosphates, carbamates (pesticides), donepezil (ACEi for Alzheimer’s), physostigmine (MG, Alzheimer’s, delayed gastric emptying), nerve gas agents
Sedatives
Anticonvulsants, barbs, benzos, GHB, methaqualone, etoh
