Intoxications (Corrie) Flashcards
1
Q
Good history
A
- What
- How much
- Active ingrediant
- When
- Species, breed, weight
- treatment so far
- symptoms, changes
- pre-existing conditions
2
Q
Poison control centers
A
- case number!
3
Q
Tox at clinic
A
- FRONT OF LINE
- multi-pet
- whos the naughty one?
- make all vomit
- put in separate cages
- Assess
- exam, bloodwork (IV cath) EKG
- Stabilize if necessary
- respiratory distress - tube if necessary
- seizures
- obtunded/comotose
- INTUBATE IF NEEDED
- Don’t forget to do full physical
4
Q
Testing
A
- Min database
- CBC
- Chem
- U/A: SG and sediment
- Coagulation testing
- Imaging
- Specific drug testing
5
Q
Decontamination
A
- Prevent further absorption
- Speed up removal
- excretion
- elimination
- Tme limits
- Extended decontamination
- long acting and sustained release
- enterohepatic circulation
6
Q
Ocular decon
A
- no time limit
- flush for 20-30 min
- medial to lateral
- stain corneas
- and stain next day
- lubricate
- even if negative stain
7
Q
Topical decon
A
- No time limit
- Bath
- repeatedly
- mild dishwashing detergent
- be conscientious about lowering body temp
- young/old
- debilitated
8
Q
Oral decon dos
A
- Things that you make vomit
- Recent or unknown exposure
- prefer less than 2 hours
- slow movement through stomach
- large meal
- substance that stays in stomach
- asymptomatic patient
- Recent or unknown exposure
9
Q
oral decon don’ts
A
- Don’t make vomit
- corrosive agent
- hydrocarbon toxicant: oils
- symptomatic/unstable patient
- medical and/or physical contraindications
- brachycephatics
- megaesophagus
- emetic agents non-gratis (DON’T USE THESE)
- syrup of ipecac
- salt, mustard, dish detergent, milk, etc
10
Q
Decon
Oral at home considerations
A
- communicate that there are contraindications (DOCUMENT)
- stable enough
- Contraindications in hx
- distance from hospital
- financial concerns
- species
- marijauna - antiemetic properties
- nothing safe for cats at home
- Informed decision-document
11
Q
Oral decon
hydrogen peroxide
A
- Use the 3%
- no higher concentrations
- 1-5 mls/kg, 1 tsp, 1 tsp = 5 mls
- can repeat 1 x wait 10-15 minutes
- cats bad-ish
- 10 mls/cat
- don’t admin with explosives
12
Q
Oral decon
Apomorphine
A
- Apomorphine
- dopamine receptor stimulation in CRTZ
- not recommended for cats
- 0.03-0.04 mg/kg IV, IM, SQ
- can go higher
- must be filtered
- use in conjunctival sac
- rinse copiously
- anti-emetic after emesis
- Naloxone if deleterious sides effects
- 0.04 mg/kg IV, IM, SQ
13
Q
Decon oral
Cats
A
- xylazine (20mg/ml)
- 0.44 mg/kg IM
- be careful of 100 mg/ml
- dexmedetomidine
- 5 mcg/kg SQ
14
Q
Decon
Gastric lavage
A
- Why
- if emesis doesn’t work
- large amounts of material
- bezoar, concretions, foreign body
- when aspiration a concern
- underlying medical/physical contraindication
- toxicants with narrow margin safety
- caustic and petroleum distillates
- avoid with concurrent sharp FB
15
Q
Decon
Gastric lavage: technique
A
- Labor intensive and costly
- IV cath, sedation/gen anesth, intubation
- multiple lavages
- activated charcoal
- recovery and suportive care
16
Q
Decon
activated charcoal
about
A
- Binds instead of absorbs
- Negative charge
- Large surface area
- indigestible
17
Q
charcoal reliabel for
A
reliable
- organic compounds
- pesticides
- mercury
- fertilizer
- many pharm drugs
- NSAIDS
- illegal drugs
18
Q
Charcoal unreliable for
A
- Unreliable
- strong acid and bases
- heavy metals
- xylitol
- alcohols
- sodium
- arsenic
- iodine
- boric acid
- hydrocarbons
19
Q
Charcoal
A
- first time use with sorbitol
- Timing
- within an hour
- 6 hour cutoff….?
- long acting medication
- enterohepatic circulation
- Combination with cathartic
- speed through GI
- palatability
- usually only first dosing
- can cause probs
20
Q
sorbitol contraindicated
A
- dehyrdation
- diabetes mellitus
- diabetes insipidus
