Poisoned pt

Question 1

initial considerations for all pts

Answer 1

airway, C spine protection, ventilation and circulation

Question 2

all pts with altered mental status should get

Answer 2

thiamine

glucose

Question 3

if thiamine and glucose don’t work, pt gets

Answer 3

naloxone

Question 4

Things to get in a hx

Answer 4

try to identify the agent of poisoning

what were they dping immediatly propr to becoming ill

Question 5

sweating, pupilarty constriction, lacrimation, wheezing, cramping, vomiting, beadycardia, hypotension, diarrhea, depressed respiration

Answer 5

cholinergic/anticholinesterase syndrome

Question 6

can cause cholinergic/anticholinesterase syndrome

Answer 6

organophostphates, carbamates

Question 7

dry mouth, dysphagia, blurred near vision, tachycardia, dry skin, hyperthermia, flushing, tachycardia, seziures, hallucinations, delusions

Answer 7

anticholerginic (antimuscurinic) syndrome

Question 8

can cause anticholerginic (antimuscurinic) syndrome

Answer 8

atropine, scopallamine, TCAs, jimson weed, some mushrooms

Question 9

dysphonias, dysphagia, rigidty, tremor, toricollis, lanyngospasm

Answer 9

extrapyramidal syndrome

Question 10

can casue extrapyramidal syndrome

Answer 10

antidopamenogeric drugs, also strycninie and tetanus

Question 11

hypoxia, headache, altered mental status, n/c, cardiac dysfunction, acidoscis

Answer 11

hemoglobinopathy syndrome

Question 12

causes hemoglobinopathy syndrome

Answer 12

CO (especially in the winter)

Question 13

flu like sx

Answer 13

metal fever

Question 14

pinpoint pupils, respiratpry depression, and hypotension

Answer 14

opoid intox

Question 15

nervous, tremor, sweating, hypertension, tachycardia

Answer 15

sympathomimetic excess

Question 16

mydriasis, piloerection, runny nose, lacrimation

Answer 16

opioid withdrawal

Question 17

withdrawal from these can cause life threataning sx

Answer 17

non opioid CNS depressant withdrawal

Question 18

altered mental atatis, hypereflexia, spacity, hypertsnsion and hyperthermia

Answer 18

serotonin sydrome

Question 19

can cause wide QRS

Answer 19

TCAs, phenothiazinesm antidysrythmics

Question 20

can cause sinus bradycardia

Answer 20

digitalis, beta blockers, CCBs, cholingernic toxicants

Question 21

metabolic acidosis can be caused be

Answer 21

asprin, methaon, ethylene glycol, iron

Question 22

tx for seziures in a toxicological setting

Answer 22

benzos, then phenobarbitol and diprivan if needed

Question 23

tests to order in suspected poisoning

Answer 23

electrilytes, BUN, creatinine, glucose, blood gases, LFTs, EKG. EXTRA BLOOD

Question 24

serum levels needed to manage:

Answer 24

acetominephen, ethenol. iron, theiphylline, digoxin, asprin, alchohols

Question 25

can neurilize iodine

Answer 25

starch

Question 26

can neutralize HF

Answer 26

calcium saklts

Question 27

antidote for iron

Answer 27

deferozamine

Question 28

antidote for organophosphates/carbamates

Answer 28

atropine

Question 29

antidote for cyanide

Answer 29

hydroxocobalmin

Question 30

antidote for methanol or ethykene glycol

Answer 30

ethanol or methyl pyrazole

Question 31

anitdote for CO

Answer 31

O2

Question 32

sntidoe for TCA

Answer 32

sodium bicarb

Question 33

when you can attempt elimination for poisoning

Answer 33

refractory hyptension/seziures/arrhyhmias in theophylline
deterioration despite full supportive care
overwhelming dose (ex: methanol)
impairment of elimination routes (ex: kidney failure)
severe disease preceding poisoning

Question 34

ways of treating posining by elimination

Answer 34

repeated doses of charcol, forced diurssis, ion trapping in urine, hemodyalsis, hemoperfusion, hemofiltration, plasmapherisis, exchange transfusion