Exam 3 - Cannabinoids, Sympathomimetics, and Pediatrics

Question 1

What are characteristics of CB1 receptors? CB2?

Answer 1

CNS, motor activity, thinking, pain; periphery, immune modulation (anti-inflammatory)

Question 2

What are the most abundant phytocannabinoids? (2)

Answer 2

THC and CBD

Question 3

What are the “wanted” clinical effects of phytocannabinoids?

Answer 3

mood elevation/euphoria, relaxation, creative thinking, increase sensory awareness, appetite stimulation, nausea suppression

Question 4

What are the “paradoxical” clinical effects of phytocannabinoids?

Answer 4

STM difficulties, agitation/feeling tense/anxiety, dizziness/lightheadedness, confusion, loss of coordination

Question 5

What is the MOA of THC?

Answer 5

CB1 receptor partial agonist

Question 6

What are the lab abnormalities in those who overuse THC? (2)

Answer 6

decreased potassium, increased BG, creatinine and creatinine kinase, WBCs

Question 7

What is the treatment for agitation in cannabinoid toxicity?

Answer 7

BZDRAs

Question 8

What is the treatment for seizures in cannabinoid toxicity?

Answer 8

BZDRAs (maybe antiepileptics)

Question 9

What is the treatment for dehydration in cannabinoid toxicity?

Answer 9

IV crystalloids

Question 10

What is the treatment for HTN/tachycardia in cannabinoid toxicity?

Answer 10

BZDRAs (maybe antihypertensives)

Question 11

Explain the pathophysiology behind excessive vomiting from chronic cannabinoid use? (2)

Answer 11

desensitization and downregulation of CB1 receptors that have antiemetic effects, and alteration in transient receptor potential vanilloid subtype 1 (TRPV1)

Question 12

What are treatments for cannabis hyperemesis syndrome? (5)

Answer 12

hot showers, topical capsaicin, haloperidol (ondansetron inferior), BZDRAs, supportive care

Question 13

What are treatments for an adrenergic/sympathomimetic toxidrome? (6)

Answer 13

elimination strategies, BZDRAs, antihypertensives, fluids, antipsychotics, sodium bicarbonate

Question 14

What are treatments for a cocaine overdose? (2)

Answer 14

BZDRAs, supportive care

Question 15

What are treatments for an amphetamine overdose? (2)

Answer 15

BZDRAs, supportive care

Question 16

What is the treatment for a bath salts overdose?

Answer 16

supportive care

Question 17

How many pediatric poisonings occur each year?

Answer 17

1 million (in <6 years of age)

Question 18

What are the most common pediatric ingested toxins? (3)

Answer 18

analgesics, cosmetics, household cleaning substances

Question 19

What are signs of a toxic exposure in children? (4)

Answer 19

altereld LoC, metabolic disturbances, neurologic dysfunction, cardiac/pulmonary distress

Question 20

What decontamination methods are not recommended in pediatrics? (3)

Answer 20

orogastric lavage, syrup of ipecac, MiraLAX

Question 21

What is the dosing for activated charcoal for toxin exposure in pediatrics?

Answer 21

0.5-1 g/kg within 1 hr of toxin ingestion

Question 22

What is the dosing for whole bowel irrigation for toxin exposure in pediatrics?

Answer 22

0.5 L/hr (small) up to 1.2-2 L/hr (older) for 4-6 hrs

Question 23

To prevent hyponatremia in children, NAC should be diluted to what concentration?

Answer 23

40 mg/mL

Question 24

What is the treatment for household cleaners/caustic exposures in pediatrics?

Answer 24

supportive care

Question 25

What is the treatment for foreign body ingestions in pediatrics (e.g., batteries)?

Answer 25

surgical removal (if esophageal impaction suspected)

Question 26

What is the treatment for cough/cold preparation ingestions in pediatrics?

Answer 26

activated charcoal