One pill can kill

Question 1

What drug commonly used in the treatment of RA can kill a small child with a single dose?

Answer 1

Choloroquine

Question 2

Which is more toxic: chloroquine or hydroxychloroquine

Answer 2

Chloroquine

Question 3

How does chloroquine toxicity present?

Answer 3

Sudden deterioration

Question 4

What is the role of activated charcoal in the treatment of chloroquine toxicity?

Answer 4

If early, then consider. If late then too much increased risk of aspiration

Question 5

What is the treatment for chloroquine overdose?

Answer 5

Benzos

Question 6

What are the three major sulfonylureas?

Answer 6

Glipizide
Glimepirde
Glyburide

Question 7

What may occur with administration of dextrose in cases of sulfonylurea overdose?

Answer 7

May cause insulin to spike, precipitating hypoglycemia and the need for more. Endless cycle

Question 8

What, besides glucose replacement, can be used to treat sulfonylurea OD?

Answer 8

Octreotide

Question 9

What hematologic side effect is classically associated with benzocaine use?

Answer 9

Methemoglobinemia

Question 10

What is methemoglobinemia?

Answer 10

When Fe2+ goes to Fe3+ state in hb

Question 11

What intoxication causes the appearance of chocolate colored blood?

Answer 11

Methemoglobinemia

Question 12

What are the classic drugs that cause methemoglobinemia? (4)

Answer 12

Dapsone
Nitroprusside
-caines
Pyridium

Question 13

If the pulse ox read a constant 85% in the case of a known intoxication, what disorder should be suspected?

Answer 13

Methemoglobinemia

Question 14

What is the treatment for methemoglobinemia, and how does it work?

Answer 14

methylene blue

Strong oxidizer

Question 15

Which two antimitotics can kill with low doses?

Answer 15

Colchicine

Podophyllotoxin

Question 16

What is the lowest fatal dose of colchicine?

Answer 16

7 mg

Question 17

What are the s/sx of phase 1 of colchicine overdose?

Answer 17

Severe GI symptoms, followed by hemodynamic changes

Question 18

What are the s/sx of phase 2 of colchicine overdose?

Answer 18

Confusion/coma
ascending peripheral neuropathy
MSOF

Question 19

What are the s/sx of phase 3 of colchicine overdose?

Answer 19

Rebound leukocytosis

CV collapse

Question 20

What are the s/sx of podophyllotoxin ingestion?

Answer 20

Same as colchicine, but no alopecia

Question 21

What causes the immediate and delayed pain sensation with HF exposure?

Answer 21

H+ will cause immediate (iff high potentcy HF)

F- causes delayed symptoms

Question 22

What is the treatment for HF burns? MOA?

Answer 22

Calcium gluconate (topically or injected). Ca binds F.

Question 23

What is a major complication associated with H2O2 ingestion?

Answer 23

Air embolus

Question 24

What are the s/sx of h2o2 ingestion?

Answer 24

nonspecific s/sx, air embolus

Question 25

What are the s/sx of camphor oil ingestion?

Answer 25

Seizures respiratory failure HA, dizziness

Question 26

What is the treatment for camphor oil ingestion?

Answer 26

benzos, good supportive care

Question 27

What is the MOA of CN poisoning?

Answer 27

binds to cytochrome aa3, restricting the use of ATP

Question 28

Why is venous blood bright red with CN poisoning?

Answer 28

No oxygen usage since the ETC is inhibited

Question 29

What are the general lab findings with CN poisoning?

Answer 29

Anion gap acidosis | lacticacidosis

Question 30

What is the classic treatment for CN poisoning, and how does this work?

Answer 30

Sodium nitrite will generate Fe3+, to take CN off of the cytochrome aa3.

Question 31

What is the newer treatment for CN poisoning?

Answer 31

Cyanokit: contained hydroxocobalamin, which will bind CN to create cyanocobalamin (vitamin B12)

Question 32

What is the toxic metabolite of methanol, and what organ in body does this have a predisposition for?

Answer 32

``` Formic acid Optic nerve (leads to blindness) ```

Question 33

What is the toxic metabolite of ethylene glycol, and what classic complication does this cause?

Answer 33

Oxalic acid | Oxalic acid renal stones, leading to renal failure

Question 34

Envelope-like renal stones = which intoxication?

Answer 34

Ethylene glycol

Question 35

What is the metabolite of isopropanol? S/sx?

Answer 35

Acetone AMS, cerebral edema Decreased cardiac contractility

Question 36

Which alcohol can classically cause putaminal hemorrhage?

Answer 36

Ethylene glycol

Question 37

What intoxications are ethanol and/or fomepizole used for?

Answer 37

Methanol Ethylene glycol (not propanol)

Question 38

What are the three phases of diethylene glycol intoxication?

Answer 38

I: n/v II: renal failure III: lethargy/coma

Question 39

What is propylene glycol metabolized to?

Answer 39

Lactate

Question 40

What is the treatment for propylene glycol intoxication?

Answer 40

benzos ADH inhibitor Dialysis