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Poisoning Flashcards

1
Q

Signs

A
  • Coma
  • Toxicity
  • Metabolic acidosis
  • Heart rhythm problems
  • GI signs
  • Convulsions
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2
Q

Systemic & Pulmonary Poisoning

A

1- Hydrocarbons:
Aspiration Pneumonia, NO lavage or inducing vomiting
2- Caustic:
GI signs and burns, Low fever
3- Alkali:
Liquefactive necrosis in esophagus, if recent infection or dilation antibiotic
4- Acidic:
Pulmonary, Coagulative necrosis, Less damage

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3
Q

Metabolic Acidosis

A
  • Check ABG, Electrolytes, Urine pH
  • Methanol, Ethylene Glycol
  • Immediate
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4
Q

Anion Gap Metabolic Acidosis

A

MUDPILES
Methanol/Metformin
Uremia
Diabetic ketoacidois
Paraldehyde/Phenformin
Isoniazid/Iron
Lactic acidosis (Cyanide, CO)
Ethanol/Ethylene glycol
Salicylate/Starvation/Seizures

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5
Q

Hypoglycemia

A

HOBBIES
Hypoglycemics: Sulfunylureas
Other: Quinine
Beta Blockers
Insulin
Ethanol
Salicylates

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6
Q

Hyperglycemia

A
  • Salicylates
  • Isoniazid
  • Iron
  • Phenothiazines
  • Sympathomimetics
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7
Q

Hypocalcemia

A
  • Oxalates
  • Ethylene Glycol
  • Fluoride
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8
Q

Radiopaque Substance on KUB

A

CHIPPED
Chloral hydrate/Ca Carbonate
Heavy metals
Iron
Phenothiazines
Play-Doh/Potassium chloride
Enteric coated pills
Dental amalgam

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9
Q

Arrhythmias

A
  • QT Prolonged: Phenothiazines, Antihistamines
  • Wide QRS: Quinidines, TCAs
  • Sinus Bradycardia: Digoxin, Cyanide, Cholinergics, Betablockers
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10
Q

Toxic Syndromes

A
  • Acetaminophen
  • Amphetamines, Cocaine, Sympathomimetics
  • Anticholinergics
  • CO
  • Cyanide
  • Ethylene Glycol
  • Iron
  • Narcotics
  • Cholinergics
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11
Q

Acetaminophen syndrome

A
  • Vomit
  • Diarrhea
  • Pale
  • Late jaundice (Liver failure) 72-96h
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12
Q

Amphetamines, Cocaine, Sympathomimetics

A
  • Tachycardia
  • Hypertension
  • Hyperthermia
  • Psychosis & Paranoia
  • Seizure
  • Mydriasis
  • Aggression
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13
Q

Anticholinergics

A
  • Mania
  • Delirium
  • Fever
  • Red & Dry skin
  • Dry mouth
  • Tachycardia
  • Mydriasis
  • Urinary Retention
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14
Q

CO

A
  • Headaches
  • Vertigo
  • Coma
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15
Q

Cyanide

A
  • Coma
  • Seizure
  • Hyperpnea
  • Bitter almond smell
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16
Q

Ethylene Glycol

A
  • Metabolic Acidosis
  • Hyperosmolarity
  • Hypocalcemia
  • Oxalate Crystaluria
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17
Q

Iron

A
  • Bloody vomit
  • Hypotension
  • Liver Failure
  • Leukocytosis
  • Hyperglycemia
  • CHIPPED
  • Yersinia sepsis
18
Q

Narcotics

A
  • Coma
  • Respiratory Depression
  • Hypotension
  • Pinpoint Pupil
  • Bradycardia
19
Q

Cholinergics (Nicotine, Organophosphates)

A
  • Myosis
  • Drooling
  • Frequency
  • Lacrimation
  • Bronchospasm
  • Muscle Weakness
  • Nausea, Diarrhea
  • Coma
  • Confusion
  • Pulmonary edema
  • Bradycardia
20
Q

Poisoning Treatment

A

1- Supportive
2- Clear GI
3- Other

21
Q

Supportive treatment

A
  • ABC
  • Decreased consciousness + Suspicion of poison:
    1- Glucose 1g/kg IV
    2- O2 100%
    3- Naloxan
22
Q

Clearing GI

A
  • Ipecac syrup
  • Gastric lavage
  • Active charcoal
  • Laxatives
  • PEG-ES (Polyethylene Glycol-Electrolyte Solution)
23
Q

Active Charcoal

A

1hr after swallowing
Repeated doses in life threatening poisoning
NOT effective:
- Heavy Metals
- Hydrocarbons
- Caustic
- Alcohols
- Glycol
- Water-soluble Solutions
- Prohibited with Laxatives

24
Q

Other Treatments

A
  • Constant supportive care
  • Special Antidote
  • Active blood detoxification
25
Q

Tissue Damaging Poisons

A
  • Methanol
  • Aspirin
  • Acetaminophen
  • Theophylline
  • Iron
  • Ethylene Glycol
26
Q

Active blood detoxification

A

= Hemoperfusion or Dialysis
- For tissue damaging poisons
- Preventing Long Supportive Care

27
Q

Lethal substances that interfere with O2 delivery

A
  • CO
  • Hydrocarbons
  • Opioids
28
Q

Lethal substances that interfere with Heart Activity

A
  • Ca channel blockers (amlodipine,…)
  • Adrenergics
  • TCAs
29
Q

Acetaminophen antidote

A

NAC
Most effective in 16h

30
Q

Benzodiazepin antidote

A

Flumazenil
Seizure & Arrhythmia

31
Q

Beta Blocker antidote

A
  • Atropine
  • Isoproterenol
32
Q

Ca channel blockers antidote

33
Q

CO antidote

34
Q

TCAs antidote

A

Sodium Bicarbonate

35
Q

Iron antidote

A

Deferoxamin
Hypotension

36
Q

Lead antidote

A
  • EDTA
  • Dimercaprol
  • Succimer
    Weakly control for liver and bone marrow toxicity
37
Q

Nitrite / Methemoglobinemia antidote

A

Methylene Blue
blood change in severe forms
high dose causes methemoglobinemia

38
Q

Opiates antidote

39
Q

Organophosphates antidote

A
  • Atropin
  • Pralidoxime
40
Q

Sympathomimetics antidote

A
  • Phentolamine
  • Beta Blockers
  • Antihypertensives
    Needs vital sign control

Pediatrics (12 decks)

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