Lecture 10 - Poison Control Pt 2

Question 1

What are the 4 key history taking questions

Answer 1

what, when, how much, what is the patients weight

Question 2

What are important steps in history taking

Answer 2

obtain all prescription bottles, count pills, identify all unknown tablets, search home and belongings

Question 3

What are the steps in a toxicology physical exam

Answer 3

vital signs, skin, pupils, bowel sounds, neurologic exams

Question 4

What does miotic mean

Answer 4

small pupil

Question 5

What does mydriatic mean

Answer 5

big pupil

Question 6

What odor is associated with cyanide

Answer 6

bitter almonds

Question 7

What odor is associated with water hemlock

Answer 7

carrots

Question 8

What odor is associated with zinc or aluminum phosphide

Answer 8

fishy

Question 9

What odor is associated with ethanol, acetone, isopropyl alcohol and chloroform

Answer 9

fruity

Question 10

What odor is associated with arsenic, DMSO, organophosphates and yellow phosphorous

Answer 10

garlic

Question 11

What odor is associated with toluene and solvents

Answer 11

glue

Question 12

What odor is associated with paraldehyde and chloral hydrate

Answer 12

pear

Question 13

What odor is associated with hydrogen sulfide, DMSA, N-acetylcystine

Answer 13

rotten eggs

Question 14

What odor is associated with nitrobenzene

Answer 14

shoe polish

Question 15

What odor is associated with methyl salicylate

Answer 15

wintergreen

Question 16

What is a toxidrome

Answer 16

a constellation of clinical signs and symptoms that will help identify the specific toxin ingested

Question 17

What are common toxidromes

Answer 17

sedative/hypnotic, opioid, cholinergic, anticholinergic, sympathomimetic

Question 18

What are included in the sedative/hypnotic toxidrome

Answer 18

quaaludes, benzodiazepines, barbiturates, ethanol

Question 19

What do sedatives/hypnotics cause

Answer 19

general anesthesia, loss of awareness and reflex activity

Question 20

What are the features of a sedative/hypnotic

Answer 20

normal pupils
RR decreased
BP/HR slight decrease
Skin normal
mental status sedated
bowel sounds normal

Question 21

What drugs fall into the opioid toxidrome

Answer 21

heroin, morphine, codeine, oxycodone, fentanyl, opium, hydromorphone, percocet, tramadol

Question 22

What do opioids cause

Answer 22

pronounced respiratory depression, triad of symptoms (pinpoint pupils, unconscious, respiratory depression)

Question 23

What are the features of opioids

Answer 23

small fixed pupils
RR decreased
BP/HR slightly decreased
Skin normal
mental status euphoria to coma
bowel sounds decreased

Question 24

What falls into the cholinergic toxodrome

Answer 24

organic phosphorous compounds, carbamates, mushrooms

Question 25

What do cholinergics cause

Answer 25

patient is 'wet', CNS involvement, skeletal muscle weakness, pupils are mitotic

Question 26

What are the features of cholinergics

Answer 26

pupils are small fixed and lacrimation RR normal or increased HR can be decreased or increased Skin is wet Mental status confusion, drowsiness, coma, seizures Bowel sounds increased

Question 27

What is a pneumonic to remember for cholinergics

Answer 27

SLUDGE and the killer Bs salivation lacrimation urination diarrhea gastrointestinal distress emesis bromchorrhea bronchospasm bradychardia

Question 28

What drugs fall into the anticholinergic toxodrome

Answer 28

antihistamines, antipsychotics, antidepressants, among others

Question 29

What are the features of anticholinergics

Answer 29

pupils are big, fixed, blurred RR normal HR increased skin is dry, hot, flushed mental status delirium, coma, seizures bowel sounds decreased

Question 30

What drugs fall in the sympathomimetic toxodrome

Answer 30

amphetamines, cocaine, ephidrine, methamphetamine, phenylpropanolamine, pseudoephedrine

Question 31

What do sympathomimetic drugs cause

Answer 31

CNS effects, elevated BP, dilated pupils, piloerection

Question 32

What are the features of sympathomimetics

Answer 32

pupils are large and reactive RR increased BP/HR increased skin is wet metnal status agitation delirium psychosis bowel sounds increased