Poisoning Flashcards
The most commonly ingested medications in poisoning are
*opioids
*benzodiazepines
*acetaminophen
*ibuprofen
*diphenhydramine
In the emergency department, the best method to deactivate a swallowed poison is
administration of activated charcoal, either orally or by NG tube.
is supplied as a fine black powder that is mixed with water for administration
Activated Charcoal
is an over-the-counter medication used for fevers that is frequently involved in childhood poisoning.
Acetaminophen (Tylenol)
Acetaminophen poisoning symptoms:
Develops the following:
*anorexia
*Nausea
*vomiting
liver may feel tender on palpation as
liver toxicity occurs
A mucolytic agent and the specific antidote for acetaminophen poisoning
Activated Charcoal or acetylcysteine
prevents hepatotoxicity by binding with the breakdown product of acetaminophen so that it will not bind to liver cells.
Acetylcysteine
If the child is admitted to an observation unit due to Acetaminophen poisoning,what to do?
*continue to observe for jaundice, tenderness over the liver
*assess ALT and AST levels
ingestion of a strong alkali
caustic poisoning
component in toilet bowl cleaners or hair care produces
“lye”
After a caustic ingestion, the child has immediate
pain in the mouth and throat and drools saliva
This can occur as quickly as 20 minutes after a burn due to caustic poisoning
Pharyngeal Edema
What analgesic is given for caustic poisoning
IV Morphine
may be ordered to determine whether the aspirated poison has caused an esophageal perforation
Chest X-ray
For caustic poisoning, _______ is done to assess the lungs and esophagus
A laryngoscopy and Esophagoscopy under conscious sedation
may be necessary to provide a patent airway
Intubation or tracheostomy
was once a mainstay of therapy to reduce esophageal stricture
the use of corticosteroid such as Dexamethasone (Decadron)
is corrosive to the gastric mucosa and leads to signs and symptoms of gastric irritation in the child
large amounts of Iron
The immediate effects of Iron poisoning
include nausea, vomiting, diarrhea, and abdominal pain.
Long-term effects of Iron poisoning
includes gastric scarring from fibrotic tissue formation.
is performed to remove pills not yet absorbed
Stomach Lavage
may be given to help the child pass enteric-coated iron pills before they can be activated
Cathartic
can help decrease gastric irritation for Iron poisoning
Soothing compound such as Maalox or Mylanta (aluminum hydroxide and magnesium hydroxide) or a proton pump inhibitor
If a child has ingested a potentially toxic dose of iron, a ________ can be used to remove excess iron from the body
exchanged transfusion
administrating this can be effective as this combines with iron and permits excretion from the body in the urine
IV or IM deferoxamine
Deferoxamine cause urine to turn to
color orange
When lead enters the body, what will it do?
it interferes with red blood cell functioning
plumbism
Lead poisoning
the most serious effect of toxic lead content
lead encephalitis or inflammation of brain cells
children in lower socioeconomic households built before ____ are at greater risk of lead poisoning
1978
lead poisoning is said to be present when the child has serum levels greater than
5ug/dL
ingestion of lead and chronically elevated lead levels can be identified through
radiology of the intestinal tract and long bones
the usual sources of ingested lead are
*lead-based paint
*lead-contaminated dust
lead was banned from paint in _____
1978
remove the lead from soft tissues and bones
Chelating agent
children with lead levels greater than 10 to 20 ug/100 mL will be prescribed with
oral chelating agent such as Dimercaptosuccinic acid (DMSA) or succimer
Children with blood levels of greater than 45 ug/100 mL are treated with
stronger chelation therapy such as dimercaprol or edetate calcium disodium
IM injection of edetate calcium disodium (CaEDTA) is painful and should be combined with
0.5 mL of procaine for administration
CaEDTA is so effective that has a side effect of
removing calcium from the body
______ has the advantage over CaEDTA of being able to remove lead from red blood cells as well as other tissues
Dimercaprol (BAL)
