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Toxic > General Tox and toxidromes > Flashcards

General Tox and toxidromes Flashcards

1
Q

Why is there a delay in ASA absorption?

A

Bezoar

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2
Q

When is dilution indicated for toxics?

A

for pH changes

Local irritant

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3
Q

How can gases cause hypoxia?

A

Decrease partial pressure of oxygen

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4
Q

When is irrigation of the eyes for 2 hours indicated?

A

If caustic substance contact. Otherwise shorter timeframe is possible

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5
Q

How soon does an allergic reaction happen to a bee sting?

A

within 30 minutes

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6
Q

What should be done with venomous bites?

A

Keep extremity slightly below heart level, and transport. Nothing else.

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7
Q

What is the single most frequently involved substance in poisoning fatalities?

A

Acetaminophen

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8
Q

What are the 8 drugs that can kill a 10 kg toddler with one pill?

A
  • Antimalarials
  • CCBs /BBs
  • Colchicine
  • Clonidine
  • Methyl Salicylates (oil of wintergreen)
  • Opioids
  • Sulfonylureas
  • TCAs
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9
Q

What is the antiarrhythmic of choice for tox overdoses?

A

Lidocaine

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10
Q

What is the vasopressor of choice for tox patients?

A

Levophed

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11
Q

When is gastric lavage indicated for the treatment of overdoses?

A

If very recent overdose

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12
Q

What are the risks of gastric lavage?

A

Aspiration
GI hemorrhage/perforation
Arrhythmias
Pneumothorax

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13
Q

What are the drugs that are NOT absorbed by activated charcoal? (4)

A
  • Alcohols
  • Acids/alkalis
  • Hydrocarbons
  • Fe and other metals
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14
Q

What are the four major intoxications that call for dialysis?

A

Methanol
Ethylene glycol
Salicylates
Li

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15
Q

What are the three major indicated for multiple doses of activated charcoal? (3)

A

ER
Drugs that slow motility
enterohepatic circulation

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16
Q

When is whole bowel irrigation indicated?

A

Drug packets

Fe tablets

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17
Q

What EkG effect is common with methadone?

A

QTc prolongation

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18
Q

What must be done after giving a pt naloxone? Why?

A

Watch them for a few hours, since naloxone has a short half life

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19
Q

What motility agent can cause an opiate overdose in kids?

A

Lomotil

20
Q

What is drug classically causes an opiate-like toxidrome?

A

Clonidine

21
Q

What is the MOA of clonidine?

A

Alpha-2 agonist

22
Q

What is the MOA of guanfacine?

A

Alpha-2 agonist

23
Q

What are the components of the DUMBELS mnemonic for muscarinic intoxication?

A 
Diarrhea
Urination
Miosis
Bradycardia/bronchorrhea
Emesis
Lacrimation
Salivation
24
Q

What are the components of the MTWHFS mnemonic for nicotinic overdose?

A 
Mydriasis
Tachycardia
Weakness
HTN
Fasciculations
Seizures
25
Q

What is the antidote for muscarinic intoxication? Nicotinic?

A 
Muscarinic = atropine
Nicotinic = 2PAM
26
Q

What are the symptoms of anticholinergic poisoning?

A

No see
No spit
No pee
No shit

Hot as a hare…

27
Q

What is the MOA of scopolamine?

A

Anticholinergic

28
Q

Why is a cholinergic never indicated for the treatment of an anticholinergic poisoning?

A

Arrhythmias

29
Q

What is the treatment for HTN and tachycardia in a tox pt?

A

Benzos (not BB since unopposed alpha)

30
Q

What are the two symptoms that differentiate between anticholinergic poisoning and sympathomimetic poisoning?

A

Decreased BS in anticholinergic

Sweating in sympathomimetic

31
Q

What are the components of the OTIS CAMPBELL mnemonic for drugs that cause toxic seizures?

A 
Oragnophosphates
TCAs
Isoniazid
Sympathomimetics
camphor, cocaine
Amphetamines
Methylxanthines
PCP
Benzo withdrawal
EtOH
Li
Lead
32
Q

Coma with stable vital signs is classic for which overdose?

A

benzos

33
Q

What are the three C’s over TCA overdose?

A

Coma
Convulsions
Cardiac arrhythmias

34
Q

Why must all APAPs be stat?

A

Because “normal” levels will be found in overdoses that don’t present until later, and may qualify for treatment

35
Q

What are the s/sx of phase 1 of acetaminophen OD, and what is the timeframe?

A

Nonspecific s/s

0-24 hours

36
Q

What are the s/sx of phase 2 of acetaminophen OD, and what is the timeframe?

A

Acute liver injury

24-72 hours

37
Q

What are the s/sx of phase 3 of acetaminophen OD, and what is the timeframe?

A

3-4 days
death, ARDS
maximal liver toxicity

38
Q

What are the s/sx of phase 4 of acetaminophen OD, and what is the timeframe?

A

Liver regeneration phase, and back to baseline

5 days after

39
Q

What are the five criteria for d/c a pt with acetaminophen OD?

A
  1. APAP non-detectable
  2. NAC has been administered for 24 hours (minimum)
  3. Pt is asx
  4. No lab evidence of organ damage
  5. Not prego
40
Q

How much ASA is in a teaspoon of wintergreen?

A

7000 mg

41
Q

What causes the fever with ASA intoxication?

A

Uncoupling of the e- chain

42
Q

What must be added to bicarb in the treatment of ASA overdose?

A

K+

43
Q

How well do ASA levels correlate with s/sx?

A

Not well

44
Q

How toxic is a packet of silica gel?

A

Not very

45
Q

How toxic is a book of matches in a kid?

A

Not very

46
Q

How toxic is the liquid from a green glow stick?

A

Not very

47
Q

How toxic if Hg from a thermometer?

A

Glass is more concerning

Toxic (12 decks)

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