Emergency Medicine/Toxicology Flashcards
Acute mental status change of unclear etiology, first treatment should be
Naloxone, Dextrose, and Thiamine
Gastric emptying is ONLY useful when?
First hour after overdose (NEVER in case of acids or alkalines)
Ipecac is always wrong in
children
In a toxicology case where you don’t know what to do, give
charcoal
Antidote for acetaminophen OD
N-acetylcysteine
Antidote for aspirin OD
bicarbonate to alkalinize the urine, charcoal to block absorption, and dialysis in severe cases
Antidote for carbon monoxide poisoning
100% oxygen, hyperbaric in some cases
Antidote for digoxin poisoning
digoxin binding antibodies
Antidote for ethylene glycol and methanol poisoning
fomepizole or ethanol
Antidote for methemoglobinemia
Methylene blue
Antidote for Neuroleptic malignant syndrome
bromocriptine, dantrolene
Antidote for organophosphates
atropine, pralidoxime
Antidote for TCA OD
bicarbonate to protect the heart!
Hepatic failure in setting of acetaminophen OD will take place ___ hours later
48-72
NAC is only useful to prevent liver toxicity ___ hours after ingestion of acetaminophen
24
Aspirin acts as a direct stimulant to the ___ causing ___
brainstem; hyperventilation
Aspirin can cause what disease of the lungs?
Acute respiratory distress syndrome
In aspirin OD, respiratory alkalosis always precedes
metabolic acidosis
In addition to CBC and CMP, order which three tests in aspirin/salicylate overdose
ABG, PT/INR/PTT, and salicylate level
Benzo overdose is not fatal!
Let the patient sleep
On all OD patients, order which three levels?
aspirin, acetaminophen, and alcohol levels due to high frequency of co-ingestion!
The most common cause of death in fires is
CO poisoning!
CO poisoning presents with what symptoms?
shortness of breath
lightheadedness/headaches
disorientation
metabolic acidosis in severe disease
Cyanosis + Normal pO2 =
methemoglobinemia
The most urgent step in TCA overdose is
EKG to check for widening of the QRS
The most urgent step in hypothermia patients is to perform an
EKG: look for J waves of Osborn, which look like ST segment elevation
Red eye + fixed midpoint dilated pupil =
Acute angle closure glaucoma
Initial therapy for acute angle closure glaucoma is
pilocarpine drops to constrict the pupil
Mannitol can also be used to open the angle
Acetazolamide decreases production of aqueous humor
Sudden loss of vision like “a curtain coming down” =
retinal detachment, consult optho!
Diagnose uveitis with
slit-lamp examination
