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Toxicology By DP > General Principles > Flashcards

General Principles Flashcards

1
Q

criteria used to determine whether the exposure is nontoxic are as follows:

A

(1) an unintentional exposure to a clearly identified single substance,
(2) an estimate of the dose is known, and
(3) a recognized information source (e.g., a poison control center) confirms the substance as nontoxic in the reported dose

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2
Q

True or false

Asymptomatic patients with nontoxic exposures may be discharged after a short period of observation, providing they have access to further consultation and a safe discharge destination.

A

True

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3
Q

What are the three antidotes  indicated before cardiopulmonary stabilization

A

Naloxone for opiate toxicity,
cyanide antidotes for cyanide toxicity, and
atropine for organophosphate poisoning

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4
Q

are often administered empirically as a cocktail in cases of altered mental status

A

TONG

thiamine

oxygen

naloxone

glucose

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5
Q

administered for sodium channel–blocker toxicity with cardiovascular complications, such as wide QRS complex tachydysrhythmias

A

Sodium bicarbonate

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6
Q

Drug-induced seizures are treated with titrated doses of__________________, with the exception that isoniazid-induced seizures require____________.

A

IV benzodiazepines

pyridoxine

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7
Q

second-line agents for benzodiazepine-resistant seizures (once isoniazid-induced seizures are excluded)

A

Propofol and barbiturates

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8
Q

What is the intervention for Calcium channel blocker or beta-blocker overdose?

A

High-dose insulin infusion

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9
Q

What is the intervention for Local anesthetic agents Lipophilic cardiotoxins overdose?

A

IV lipid emulsion

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10
Q

Antidote for  Hydrogen sulfide

A

Sodium nitrite (3% solution)

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11
Q

Antidote for  Hypermagnesemia

A

Calcium gluconate 10%
9 milligrams/mL elemental Ca

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12
Q

Antidote for  Calcium channel blockers

A

Calcium chloride 10%
27.2 milligrams/mL elemental Ca

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13
Q

Antidote for  Nitroprusside

A

Hydroxocobalamin

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14
Q

Antidotes for Clonidine

A

Naloxone

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15
Q

Antidote for Isoniazid

A

Pyridoxine

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16
Q

Used for Urinary alkalinization

A

Sodium bicarbonate

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17
Q

Wernicke’s syndrome Wet beriberi antidote

A

Thiamine

18
Q

True or false

There is no role for phenytoin in the treatment of toxin-induced seizures; it has neither theoretical nor proven efficacy, and it may worsen toxicity.

A

True

19
Q

Agitation is treated with titrated doses of___________

____________________are often used as second-line agents for toxin-induced agitation ‘

A

benzodiazepines

antipsychotic agents

20
Q

True or false

 First genera- tion antipsychotics, such as haloperidol have been associated with QT- interval prolongation and cardiac dysrhythmias

A

True

21
Q

Patients with core temperatures of ______C (>102.2°F) require aggressive active cooling measures to prevent complications

A

> 39°

22
Q

core temperature ______C (<90°F) is an indication for active rewarming

A

<32°

23
Q

Several toxidromes associated with hyperthermia are treated with specific pharmaceutical agents:

  1. sympathomimetic
  2. serotonin
  3. neuromuscular malignant syndrome
A
  1. benzodiazepines
  2. cyproheptadine
  3. bromocriptine
24
Q

is a nontoxic, diagnostic, and therapeutic antidote. It is a competitive opioid antagonist administered IV, IM, or intranasally to reverse opioid-induced deleterious hypoventilation

A

Naloxone

25
Q

Patients should be observed for_________ after adminis- tration of IV naloxone.

A

2 to 3 hours

26
Q

True or false

 serum acetaminophen concentration is a routine screening test in poisoned patients because early acetaminophen poisoning is often asymptomatic and does not have a readily identifiable toxidrome at the time when antidotal treatment is most efficacious.

A

True

27
Q

Identify the toxidrome

Altered mental status, mydriasis, dry flushed skin, urinary retention, decreased bowel sounds, hyperthermia, dry mucous membranes
Seizures, arrhythmias, rhabdomyolysis

A

Anticholinergic

Atropine, Datura spp., antihistamines, antipsychotics

28
Q

Identify the toxidrome

 Salivation, lacrimation, diaphoresis, vomiting, urination, defecation, bronchorrhea, muscle fasciculations, weakness
Miosis/mydriasis, bradycardia, seizures

A

Cholinergic

Organophosphate and carbamate insecticides Chemical warfare agents (sarin, VX)

29
Q

Identify the toxidrome

 CNS depression, ataxia, dysarthria, odor of ethanol

A

Ethanolic

30
Q

Identify the toxidrome

 Dystonia, torticollis, muscle rigidity Choreoathetosis, hyperreflexia, seizures

A

Extrapyramidal

Risperidone, haloperidol, phenothiazines

31
Q

Identify the toxidrome

 Hallucinations, dysphoria, anxiety Nausea, sympathomimetic signs

A

Hallucinogenic

Phencyclidine
Psilocybin, mescaline Lysergic acid diethylamide

32
Q

Identify the toxidrome

 Altered mental status, diaphoresis, tachycardia, hypertension Dysarthria, behavioral change, seizures

A

Hypoglycemic

Sulfonylureas, insulin

33
Q

Identify the toxidrome

Lead-pipe muscle rigidity, bradyreflexia, hyperpyrexia, altered mental status Autonomic instability, diaphoresis, mutism, incontinence

A

Neuromuscular malignant

Antipsychotics

34
Q

Identify the toxidrome

Miosis, respiratory depression, CNS depression Hypothermia, bradycardia

A

Opioid

Codeine, heroin, morphine

35
Q

Identify the toxidrome

Altered mental status, respiratory alkalosis, metabolic acidosis, tinnitus, tachypnea, tachycardia, diaphoresis, nausea, vomiting
Hyperpyrexia (low grade)

A

Salicylate

Aspirin
Oil of wintergreen (methyl salicylate)

36
Q

Identify the toxidrome

 CNS depression, ataxia, dysarthria Bradycardia, respiratory depression

A

Sedative/hypnotic

Benzodiazepines Barbiturates

37
Q

Identify the toxidrome

Altered mental status, hyperreflexia and hypertonia (>lower limbs), clonus, tachycardia, diaphoresis
Hypertension, flushing, tremor

A

Serotonin

SSRIs
MAOIs
Tricyclic antidepressants Amphetamines Fentanyl
St. John’s wort

38
Q

Identify the toxidrome

Agitation, tachycardia, hypertension, hyperpyrexia, diaphoresis Seizures, acute coronary syndrome

A

Sympathomimetic

Amphetamines Cocaine Cathinones

39
Q

Alkalis produce greater injury than acids due to deep tissue penetration via liquefaction so that prolonged irrigation Of how long may be required?

A

(1 to 2 hours)

40
Q

primary indication for urinary alkalinization is

A

moderate to severe salicylate toxicity when criteria for hemodialysis have not been met.

41
Q

Admission is indicated if__________________________. In most cases, a ______hour observation period is sufficient to exclude the development of serious toxicity.

A

the patient has persistent and/or severe toxic effects or will require a prolonged course of treatment

6-hour

Toxicology By DP (10 decks)

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