One pill can kill Flashcards
What drug commonly used in the treatment of RA can kill a small child with a single dose?
Choloroquine
Which is more toxic: chloroquine or hydroxychloroquine
Chloroquine
How does chloroquine toxicity present?
Sudden deterioration
What is the role of activated charcoal in the treatment of chloroquine toxicity?
If early, then consider. If late then too much increased risk of aspiration
What is the treatment for chloroquine overdose?
Benzos
What are the three major sulfonylureas?
Glipizide
Glimepirde
Glyburide
What may occur with administration of dextrose in cases of sulfonylurea overdose?
May cause insulin to spike, precipitating hypoglycemia and the need for more. Endless cycle
What, besides glucose replacement, can be used to treat sulfonylurea OD?
Octreotide
What hematologic side effect is classically associated with benzocaine use?
Methemoglobinemia
What is methemoglobinemia?
When Fe2+ goes to Fe3+ state in hb
What intoxication causes the appearance of chocolate colored blood?
Methemoglobinemia
What are the classic drugs that cause methemoglobinemia? (4)
Dapsone
Nitroprusside
-caines
Pyridium
If the pulse ox read a constant 85% in the case of a known intoxication, what disorder should be suspected?
Methemoglobinemia
What is the treatment for methemoglobinemia, and how does it work?
methylene blue
Strong oxidizer
Which two antimitotics can kill with low doses?
Colchicine
Podophyllotoxin
What is the lowest fatal dose of colchicine?
7 mg
What are the s/sx of phase 1 of colchicine overdose?
Severe GI symptoms, followed by hemodynamic changes
What are the s/sx of phase 2 of colchicine overdose?
Confusion/coma
ascending peripheral neuropathy
MSOF
What are the s/sx of phase 3 of colchicine overdose?
Rebound leukocytosis
CV collapse
What are the s/sx of podophyllotoxin ingestion?
Same as colchicine, but no alopecia
What causes the immediate and delayed pain sensation with HF exposure?
H+ will cause immediate (iff high potentcy HF)
F- causes delayed symptoms
What is the treatment for HF burns? MOA?
Calcium gluconate (topically or injected). Ca binds F.
What is a major complication associated with H2O2 ingestion?
Air embolus
What are the s/sx of h2o2 ingestion?
nonspecific s/sx, air embolus
What are the s/sx of camphor oil ingestion?
Seizures
respiratory failure
HA, dizziness
What is the treatment for camphor oil ingestion?
benzos, good supportive care
What is the MOA of CN poisoning?
binds to cytochrome aa3, restricting the use of ATP
Why is venous blood bright red with CN poisoning?
No oxygen usage since the ETC is inhibited
What are the general lab findings with CN poisoning?
Anion gap acidosis
lacticacidosis
What is the classic treatment for CN poisoning, and how does this work?
Sodium nitrite will generate Fe3+, to take CN off of the cytochrome aa3.
What is the newer treatment for CN poisoning?
Cyanokit: contained hydroxocobalamin, which will bind CN to create cyanocobalamin (vitamin B12)
What is the toxic metabolite of methanol, and what organ in body does this have a predisposition for?
Formic acid Optic nerve (leads to blindness)
What is the toxic metabolite of ethylene glycol, and what classic complication does this cause?
Oxalic acid
Oxalic acid renal stones, leading to renal failure
Envelope-like renal stones = which intoxication?
Ethylene glycol
What is the metabolite of isopropanol? S/sx?
Acetone
AMS, cerebral edema
Decreased cardiac contractility
Which alcohol can classically cause putaminal hemorrhage?
Ethylene glycol
What intoxications are ethanol and/or fomepizole used for?
Methanol
Ethylene glycol
(not propanol)
What are the three phases of diethylene glycol intoxication?
I: n/v
II: renal failure
III: lethargy/coma
What is propylene glycol metabolized to?
Lactate
What is the treatment for propylene glycol intoxication?
benzos
ADH inhibitor
Dialysis
