PME3 Final Flashcards
What are the four classes of cardiovascular drugs?
I - sodium blockers
II - beta blockers
III - potassium blockers
IV - calcium blockers
What are the cardiovascular drugs toxicity signs and symptoms?
agitated
ALOC
seizures
bradycardia
hypotension
heart blocks
QRS widening
VF/VT
metabolic disturbances
electrolyte disturbances
weakness
nausea/vomiting
What is the cardiovascular drugs toxicity treatment approach?
treat symptomatically
consider:
A - suctioning, early advanced airway
B - oxygen, IPPV
C - 12 lead, serial printouts, pads on, IV fluids
D - IV access, IV fluids/glucose, maintain normothermia
CCP backup for atropine, adrenaline, sodium bicrbonate, calcium gluconate, magnesium sulphate
early hospital notification
What are the common sodium blocker drugs?
TCAs - ‘ine’ suffix
flecainide (CVS)
propafenone (CVS)
propranolol (CVS)
dextropropoxyphene (opioid)
What are the types of antidepressant drugs?
SSRIs
SNRIs
TCAs
MAOIs
What are the common SSRI drugs?
fluoxetine (prozac)
sertraline
citalopram
What are the common SNRI drugs?
venlafaxine (efexol)
desvenlafaxine
duloxetine
What are the common TCA drugs?
amitryptyline
imipramine (endep)
nortryptyline
What are the common MAOI drugs?
phenelzine
tranylcypromine
moclobemide
What are the serotonin syndrome signs and symptoms?
ALOC
agitation
hallucinations
tachypnoea
hypertension
tachycardia
diaphoresis
tremors
ocular/inducible/spontaneous clonus
muscle rigidity
hyperreflexia
hyperthermia
What is the antidepressant drugs toxicity treatment approach?
treat symptomatically
consider:
A - suctioning, early advanced airway
B - oxygen, IPPV
C - 12 lead, serial printouts, pads on
D - IV access IV fluids/IV fluids, maintain normothermia
CCP backup for sodium bicrbonate
Consult for GTN if significantly hypertensive
early hospital notification
What is the lithium drugs toxicity treatment approach?
treat symptomatically
consider:
A - suctioning, early advanced airway management
B - oxygen, IPPV
C - 12 lead, serial printouts, pads on
D - IV access IV fluids/glucose, maintain normothermia/aggressively cool hyperthermic Pt
CCP backup for sodium bicrbonate
early hospital notification
What is the anticonvulsant drugs toxicity treatment approach?
treat symptomatically
consider:
A - suctioning, early advanced airway management
B - oxygen, IPPV
C - 12 lead, serial printouts, pads on
D - IV access, IV fluids/glucose fluids, maintain normothermia/aggressively cool hyperthermic Pt
CCP backup for sodium bicrbonate
early hospital notification
What is the antipsychotic drugs toxicity treatment approach?
treat symptomatically
consider:
A - suctioning, early advanced airway management
B - oxygen, IPPV
C - 12 lead, serial printouts, pads on
D - IV access, IV fluids/glucose, maintain normothermia/aggressively cool hyperthermic Pt
CCP backup for sodium bicrbonate
early hospital notification
What are the antidepressant toxicity signs and symptoms?
agitated delirium
ALOC
seizures
lethargy
nystagmus
respiratory depression
tachycardia
hypotension
PR, QRS & QT widening
flat/inverted T waves
gastric irritation
urinary retention
hyperthermia
tremors
What are the lithium toxicity signs and symptoms?
ALOC
seizures
delirium
lethargy
nystagmus
respiratory depression
tachycardia
hypotension
QRS widening
QT prolongation
right axis deviation
gastric irritation
urinary retention
muscle rigidity
hyperthermia
What are the antipsychotics toxicity signs and symptoms?
ALOC
seizures
delirium
lethargy
nystagmus
respiratory depression
tachycardia
hypotension
QRS widening
QT prolongation
right axis deviation
gastric irritation
urinary retention
muscle rigidity
hyperthermia
What are the anticonvulsants toxicity signs and symptoms?
ALOC
seizures
delirium
lethargy
nystagmus
respiratory depression
tachycardia
hypotension
QRS widening
QT prolongation
right axis deviation
gastric irritation
urinary retention
muscle rigidity
hyperthermia
What are the ethanol toxicity signs and symptoms?
ALOC
disinhibition
ataxia
aggression/ABD
respiratory depression
hypotension
hypothermia
nausea/vomiting
What are the differential diagnosis of ethanol toxicity?
Encephalopathy
Head injury
Hypo-/hyperthermia
Intracranial infarction or haemorrhage
Metabolic disturbance
Overdose or other toxin
Post-ictal state
Psychosis
Sepsis
What is Wernicke Encephalopathy (WE)?
acute neuropsychiatric syndrome that develops in alcohol-dependent individuals as a result of thiamine (B1) deficiency
What is alcoholic ketoacidosis (AKA)?
medical condition that develops in the alcoholic patient in response to starvation
What are the alcoholic ketoacidosis (AKA) signs and symptoms?
hx of prolonged heavy alcohol misuse
bout of excessive intake terminated several days earlier by nausea, severe vomiting and abdominal pain
tachypnoea
tachycardia
hypotension
diffuse epigastric tenderness on palpation
What are the ethanol withdrawal syndrome signs and symptoms?
insomnia
visual hallucinations
seizures
delirium
tachycardia
hypertension
nausea
anorexia
coarse tremor
hyperreflexia
What is the ethanol toxicity treatment approach?
treat symptomatically
consider:
A - suctioning, early advanced airway management
B - oxygen, IPPV
C - early 12 lead, serial print outs, pads on
D - IV access, IV fluids, antiemetic
What are the theophylline and caffeine toxicity signs and symptoms?
Anxiety
insomnia
seizures
Tachypnoea
ST, SVT, AF, VT, refractory hypotension.
Hypokalaemia
hyperglycaemia
What is the theophylline and caffeine toxicity treatment approach?
treat symptomatically
correct metabolic derangements
What are the metformin toxicity signs and symptoms?
Fatigue
irritability
ALOC
seizures
coma
dyspnoea/tachypnoea/hyperpnoea
dysrhythmias
tachycardia
hypotension
nausea/vomiting
abdominal pain
decreased urine output
renal failure
hypothermia
What is the metformin syndrome treatment approach?
treat symptomatically
consider:
A - suctioning, early advanced airway management
B - oxygen, IPPV
C - early 12 lead, serial print outs, pads on
D - IV access, glucose, maintain normothermia
CCP backup
early hospital notification
What is the paracetamol overdose treatment approach?
May be asymptomatic; do NOT leave behind
treat symptomatically
consider:
A - suctioning, early advanced airway management
B - oxygen IPPV
C - early 12 lead, serial print outs, pads on
D - IV access, glucose
Early sitrep, request backup if ALOC
early hospital notification; consider bypass
Rapid transport
What is the NSAID overdose treatment approach?
May be asymptomatic; do NOT leave behind
treat symptomatically
consider:
A - suctioning, early advanced airway management
B - oxygen, IPPV
C - early 12 lead, serial print outs, pads on
early sitrep, request backup if ALOC
early hospital notification; consider bypass
Rapid transport
What are the paracetamol (third stage) toxicity signs and symptoms?
Irritability
weakness
ALOC
Seizures
coma (due to encephalopathy)
Tachycardia
hypotension
Coagulopathy (either prolonged or DIC)
Electrolytic derangement
Anorexia
nausea/, vomiting
diarrhoea
jaundice
Blood sugar instability
hypoglycaemia
renal failure
What are the NSAID toxicity signs and symptoms?
CNS depression
coma
haemorrhagic stroke risk
heamatemesis
tachycardia
hypotension
nausea/vomiting
abdo pain
renal failure
haematuria
malaena
electrolyte derangement
coagulopathy
thrombocytopenic purpura (rare)
What are the opioid toxicity signs and symptoms?
CNS depression
miosis
loss of airway reflexes
respiratory depression
apnoea
bradycardia/tachycardia
hypotension
nausea/vomiting
hypothermia
skin necrosis
What is the opioid overdose treatment approach?
treat symptomatically
consider:
verbal de-escalation/QPS/physical restraint/EEA
A - suctioning, early advanced airway management
B - oxygen, IPPV, naloxone
C - early 12 lead, serial print outs, pads on
D - IV access, IV fluids, glucose
Early sitrep, request backup if ALOC
early hospital notification; consider bypass
Rapid transport
What are the benzodiazepine toxicity signs and symptoms?
ALOC
drowsiness
slurred Speech/ataxia
bradyponea
bradycardia
hypotension
hypothermia
What is the carbon monixide toxicity treatment approach?
treat symptomatically
100% oxygen delivery regardless SPO2
early 12 lead, serial print outs, pads on
IV access
Early sitrep, request backup
Rapid transport
What is the benzodiazepine overdose treatment approach?
treat symptomatically
consider:
verbal de-escalation/QPS/physical restraint/EEA
A - suctioning, early advanced airway management
B - oxygen, IPPV
C - early 12 lead, serial print outs, pads on
D - IV access, IV fluids, glucose
Early sitrep, request backup
early hospital notification; consider bypass
Rapid transport
What is the hydrofluoric acid toxicity treatment approach?
FULL PPE
remove soiled clothing, copiously irrigate
treat symptomatically
A - check and recheck
B - check and recheck
C - early 12 lead, serial print outs, pads on
D - bilateral IV access, opioid pain relief, ice packs if topical
Early sitrep, request CCP backup for 2.5% calcium gluconate
early hospital notification
What are the carbon monoide toxicity signs and symptoms?
headache
ALOC
seizures
coma
cortical blindness
dyspnoea/tachypnoea
pulmonary oedema
respiratory depression
SpO2 reading may be high
hypotension
tachycardia
haemodynamic instability
cardiac dysrhythmias
renal failure
hypo/hyperglycaemia
ataxia
What are the hydrofluoric toxicity signs and symptoms?
Significant pain
ALOC
anxiety
confusion
headaches
seizures
Tremors
ataxia
musocal bleeding (if inhaled)
ulceration (if inhaled)
haemoptysis (if inhaled)
laryngeoedema/spasm (if inhaled)
stridor (if inhaled)
wheezing (if inhaled)
hyperkalaemia
QT prolongation
peaked T waves,
TdP/VT
liquefactive necrosis
ulceration
renal failure
