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EMER 198 > LO5-6 Toxicology > Flashcards

LO5-6 Toxicology Flashcards

1
Q

o Carbon monoxide signs

A 
	Flu symptoms
	Unable to think clearly
	Bounding pulses
	Dilated pupils
	Pallor or cyanosis
	Cherry red skin is late sign and already dead
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2
Q

Toxidrome

A
  • Narcotics, cholinergics, anticholinergics, sympathomimetics, stimulants and sedative hypnotics
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3
Q

Stimulant drugs

A 
o	Amphetamine
o	Methamphetamine
o	Cocaine
o	Diet aids
o	Nasal decongestants
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4
Q

Stimulant s/s

A 
o	Restlessness
o	Agitation
o	Incessant talking
o	Insomnia
o	Anorexia
o	Dilated pupils
o	Tachycardia
o	Tachypnea
o	Hypertension/hypotension
o	Paranoia
o	Seizures
o	Cardiac arrest
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5
Q

Narcotic (opiate and opiod)

- Drugs:

A 
o	Heroin
o	Opium
o	Morphine
o	Hydromorphine (Dilaudid)
o	Fentanyl
o	Percodan
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6
Q

Narcotic (opiate and opiod)

-Signs and symptoms

A 
o	Pin point pupils
o	Respiratory depression
o	Needle tracts
o	Drowsiness
o	Coma
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7
Q

Sympathomimetic

- Drugs:

A

o Amphetamine

o Methamphetamine

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8
Q

Sympathomimetic

- Signs and symptoms

A 
o	Hypertension
o	Tachycardia
o	Dilated pupils
o	Hyperthermia
o	Seizures
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9
Q

Sedative and hypnotic - Drugs:

A

o Phenobarbital
o Diazepam (valium)
o Thiopental

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10
Q

Sedative and hypnotic -

- Signs and symptoms

A 
o	Drowsiness
o	Disinhibition 
o	Slurred speech
o	Confusion
o	Respiratory depression
o	CNS depression
o	Hypotension
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11
Q

Cholinergic

- Drugs

A 
o	Diazinon
o	Orthene
o	Parathion
o	Sarin
o	Tabun
o	VX
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12
Q

Cholinergic

- Signs and symptoms

A 
o	Increased salivation
o	Lacrimation
o	Gastrointestinal distress
o	Diarrhea
o	Respiratory depression
o	Apnea
o	Seizures
o	Coma
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13
Q

Anticholinergic

- Drugs

A

o Atropine
o Scopolamine
o Antihistamines
o Antipsychotics

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14
Q

Anticholinergic

- Signs and symptoms

A 
o	Dry
o	Flushed skin
o	Hyperthermia
o	Dilated pupils
o	Blurred vision
o	Tachycardia
o	Mild hallucinations
o	Dramatic delirium
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15
Q

Hydrocarbons

A
  • Typically inhalations of hydrocarbons are intentional and “recreational”
  • They provide a quick inexpensive high
  • Began in the early 1960s
  • Be very cautious when entering the patients environment after huffing
    Treatment
  • Remove from area
  • High flow o2
  • Transport
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16
Q

Toxic alcohols

A

ethylene glycol and methyl alcohol

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17
Q

ethylene glycol

A

antifreeze, coolant, de-icers, polishes and paints

o Lethal dose 2ml/kg

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18
Q

ethylene glycol 3 stages of toxicity

stage 1

A
  • CNS depression patient may appear intoxicated without the obvious odour of alcohol present
    • these symptoms progressed to include nausea vomiting seizures
    • stage one begins soon after ingestion and can last up to 12 hours
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19
Q

ethylene glycol 3 stages of toxicity

stage 2

A

cardio pulmonary symptoms begin to appear as the patient enters a second stage
• the patient may exhibit hypertension hypertension or tachycardia
• pulmonary injury may present as pulmonary edema, pneumonitis or acute respiratory distress syndrome
• stage two may develop between 12 and 24 hours

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20
Q

ethylene glycol 3 stages of toxicity

stage 3

A

flank pain, haematuria often characterized the third stage
• the kidneys are injured and acute renal failure may develop
• stage three may develop 24 to 72 hours after ingestion

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21
Q

methyl alcohol

A

paints, paint removers, windshield washer fluid, varnishes, antifreezes and canned fuels
o little as 30ml can cause death
o Symptoms begin from 12 to 18 hours after ingestion
- Doses as little as 2 tablespoons may prove to be lethal

22
Q

toxic alcohols signs and symptoms

A
  • Abdominal pain
  • Altered LOC
  • Heart dysrhythmias
  • Tachypnea
  • Many others
23
Q
  • Alcohol withdrawl seizures
A

o Occur within about 12-48 hours after a persons last drink

o Typically short lived and self resolving

24
Q
  • Delirium tremens
A

o Most serious and lethal complications of alcohol withdrawl
o Symptoms start typically around 48-72 hours after the last drink
o It happens when people stop cold turkey because the body cant adapt to the changes as fast as it is to stop drinking

25
Q

Delirium tremens s/s

A

confusion, tremors, restlessness, hallucinations, hypotension (secondary to dehydration)

26
Q

Organophosphates and carbamates

A
  • Toxidrome: cholinergic
  • Include agents like sarin gas, pesticides and many household products
  • These agents prevent the breakdown of acetycholine. Thus over stimulating the parasympathetic nervous system
  • Decontamination is the first priority
27
Q

Organophosphates and carbamates s/s

A
  • Confusion
  • Restlessness
  • Tremors
  • Motor weakness
  • Seizures
  • watery
28
Q
  • DUMBELS
A

diaphoresis and diahrea, urination, miosis, bronchospasm bradycardia, emesis, lacrimation, salivation

29
Q

cyanide

A
  • typically used for ore extraction, fumigation of structures
  • was used in WWII and in US gas chambers
  • amyl nitrate is the antidote
  • very quick
  • smell of burnt almonds on patients breath
  • respirations rapid and laboured early and slow down
  • initially hypertension then hypotension
30
Q

caustics

A
  • strong acid ph below 2.0
  • strong alkalide ph above 12.0
  • common in industry, agriculture, and the home
  • ingestion may produce burns and difficulty swallowing
  • will present as severe burns
  • try and find the bottle of it look at it but don’t take it
  • is it on shirt, floor, did they spit it up
31
Q
  • barbiturate
A

resemble alcohol intoxication

o tolerance builds quickly
o at risk of life threatening withdrawal symptoms

32
Q
  • benzodiazepines
A

produce potent CNS depression and may interfere with a patient airway
o at risk of life threatening withdrawal symptoms
o commonly used to treat anxiety, seizures, and withdrawals

33
Q

benzodiazepines overdose symptoms

A

CNS depression- LOC, confusion, slurred speech, hypotension, resp depression, bradycardia

34
Q

narcotics

A
  • common uses for narcotics include analgesia

- used for pain management, recreational drug

35
Q

narcotics s/s

A
  • CNS effects- uforia, hypotension, n/v, bradycardia, seizures, pin point pupils
36
Q
  • opiate

- opioid

A
  • opiate= drugs derived from opium or the poppy

- opioid= derived from non-opium derived synthetics

37
Q

Stimulants

A
  • Can be taken orally, smoked or injected
  • Enhance the release of catecholamines which stimulate the CNS
  • Stimulates the body- excite the body- increased heart rate, body temp, resp rate
  • The most life-threatening presentation of stimulant abuse includes dysrhythmias, vascular events, hypertension, hyperthermia, seizures and agitation
38
Q
  • Cocaine s/s
A

o Causes widening of the QRS in an ECG and dysrhythmias
o Hypotension
o Tachycardia followed by bradycardia

39
Q

Management of stimulant abuse

A
  • Establish airway
  • Provide supplemental oxygen to maintain saturation levels greater than 94%
  • Establish vascular access
  • Apply ECG monitor, pulse ox and end title
  • Manage hypertension with fluid
  • Transport
40
Q

Hallucinogens

A
  • Include drugs like LSD, PCP, ketamine, shrooms and marijuana
  • Produce psychedelic effects
41
Q

o Selective serotonin reuptake inhibitors (SSRIs)

A

 Huge GI upset

 Seizures- short in nature

42
Q

Selective serotonin reuptake inhibitors (SSRIs) s/s

A

for tachycardia, mild hypertension and lethargy also nausea, vomiting and tremors dilated pupils agitation hypertension or hypertension

43
Q

o Tricyclic antidepressants (TCAs)

A

 More common
 High high doses sympathomemic effects
 Wide QRS
 Cross the blood brain barrier easily

44
Q

Tricyclic antidepressants (TCAs) s/s

A

anticholinergic effects such as dilated pupils, dry mouth, dry skin, fever, confusion, tachycardia
 Wide QRS

45
Q

Cardiac medications

- Classified as:

A

o Antiarrhythmics
o Beta blockers
o Calcium channel blockers
o Cardiac glycosides

46
Q

Cardiac medications - Signs and symptoms

A

o Bradycardia
o Hypotension
o Weakness
o Confusion

47
Q

Treatment

A
  • LOC ABC
  • Suction
  • IV
    o Fluid bolus if indicated
    o Stick with 250 and reassess
  • Poison center
  • Antidote if you have it
  • Notify hospital of it
  • Cardiac monitor
  • Many set of vitals
  • Rapid transport
48
Q
  • Habituation
A

psychological and or physical dependence on a drug

49
Q
  • Potenation
A

enhancement of the effect of one drug by another drug

50
Q
  • Synergism
A

the action of two substances in which the total effects are greater than the sum of the independent affects of the two substances ex 2 + 2= 5

51
Q
  • Ask the following in overdoses
A 
o	What is the agent 
o	When was the poison ingested, injected, absorbed or inhaled
o	How much was taken
o	Has the pt vomited or aspirated 
o	Why was the substance taken

EMER 198 (4 decks)

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