Epidemiology of Poisoning

Question 1

What is the difference between a toxin and a poison?

Answer 1

Poisons are substances that can cause harm when enough is absorbed, inhaled, ingested.
A toxin is a special type of poison that is produced within living cells or organisms

Question 2

What are toxidromes

Answer 2

collection of signs and symptoms that consistently occur after ingestion of a particular toxin or drug class

Question 3

what are the two most common age groups for poisoning?

Answer 3

0-5 y/o and 20-64 y/o

Question 4

What are some common substances for poisoning?

Answer 4

Personal care products/cosmetics
cleaning substances
analgesics
sedatives

Question 5

Sympathomimetic: vitals, pupils, mental status, bowl sounds, skin, complications

Answer 5

RR+ ,BP+ ,HR+ ,T+
pupils dilated
mental status agitated
bowel sounds +
warm, clammy skin
hyperthermia, tachyarrhythmias

Question 6

Anticholinergic: vitals, pupils, mental status, bowl sounds, skin, complications

Answer 6

RR +/0, BP +/0, HR +, T+
Pupils dilated
mental status confused
decreased bowel sounds
dry skin
Hyperthermia

Question 7

Cholinergic: vitals, pupils, mental status, bowl sounds, skin, complications

Answer 7

RR +/0, BP 0, HR -, T 0
pupils constricted
lethargic
increased bowel sounds
wet skin
Bradycardia, bronchospasms

Question 8

Opioid: vitals, pupils, mental status, bowl sounds, skin, complications

Answer 8

RR-, BP -, HR -, T-
Pupils constricted
Depressed mental status
decreased bowel sounds
normal or cold skin
respiratory depression

Question 9

Sedative-hypnotic: vitals, pupils, mental status, bowl sounds, skin, complications

Answer 9

RR -, BP -, HR -, T-
pupils normal
depressed mental status
decreased bowel sounds
normal or cold skin
respiratory depression

Question 10

What is the test and antidote for carbon monoxide poisoning?

Answer 10

blood gas and cooximetry
oxygen (competes with CO for Hb, CO is exhaled out)

Question 11

What is the test and antidote for acetaminophen?

Answer 11

serum acetaminophen
N-acetylcysteine (NAC)

Question 12

What is the test and antidote for methonal, ethylene glycol

Answer 12

alcohol and metabolites
ethanol or fomepizole

Question 13

What is the test and antidote for opiods

Answer 13

urine drug test
Naloxone

Question 14

What is the test and antidote for organophosphates

Answer 14

plasma cholinesterase activity
atropine

Question 15

What is the test and antidote for digoxin

Answer 15

serum digoxin
digibind

Question 16

What is the test and antidote for arsenic, lead, mercury

Answer 16

serum heavy metals
chelation therapy

Question 17

What is the test and antidote for nitrites and nitrates

Answer 17

co-oximetry
methylene blue (reduces methemoglobin to hemoglobin)

Question 18

Immunoassays are the standard drug screen, what are some considerations?

Answer 18

1. immunoassays only detect what you are looking for or whatever binds the antibody.
2. can be automated and cheap enough to and multiple parallel assays
3. impractical to test for everything (need 100s of antibodies)
4. all findings generally need to be confirmed

Question 19

What is the best test to detect EVERYTHING?

Answer 19

Gas chromatography mass spec

Question 20

What is a breath sample good for?

Answer 20

DUI (alcohol)

Question 21

What is a urine test good for?

Answer 21

drug monitoring: opioids

Question 22

What is blood (serum) test good for?

Answer 22

acute toxicity, DUI, forensic investigation

Question 23

What is vitreous fluid and hair test good for?

Answer 23

forensic investigation