Poisoning Flashcards
Acetaminophen toxicity
Sx:
- stage 1, nonspec GI
- stage 2 RUQ tenderness, LFTs increased, hepatic necrosis and lysis
- stage 3, fulminant liver failure, lactic acidosis, coag
- stage 4, recovery treatment with NAC
Antidotes: n-acetyl-l-cysteine which inactivates toxic metabolite through replenishing glutathione
Toxic alcohols (methanol, ethylene glycol)
ethanol and fomepizole to block formation of toxic metabolites
carbon monoxide poisoning
Binds hemoglobin, blocks O2 use
- number one cause of fatal intoxication in US
Sx: headache, worsening CNS impairment coma and death
Tx: oxygen (in hyperbaric chamber)
cyanide tox
Binds cytochomes, blocks O2
Tx: hydroxocobalamin or nitrite and thiosulfate
- converts cyanide to nontoxic metabolite
heroin/opioids tox
naloxone, possible withdrawal
iron tox
corrosive effect on GI tract in children
Tx: deferoxamine
- chelator
inorganic lead tox
Multiorgan tox
Tx: dimercaptrol, succimer, EDTA chelator
Elemental or inorganic mercury, arsenic tox
Tx: dimercaptrol, succimer
- chelator
pesticides (anticholinesterases)
Tx: atropine, pralidoxime
salicylate tox
Leads to: mild CNS actions in adults including hyperventilation tinnitus, resp alkalosis, sweating, nausea and vomiting
Severe in children
- uncoupling of oxidative phosphorylation, hyperthermia, metabolic acidosis, hypoglycemia, CNS excitation, CNS depression
Tx: bicarbonate
- correct metabolic acidosis
- manage ABCs, cool patient, restore fluids, electrolytes, glucose
TCA, quinidine, thiridizine tox
Tx: bicarbonate
- increased pH reduces cardiotoxicity
fetal damage estrogens, androgens
Diverse hormones and hormonal analogs with effects to alter cell differentiation
fetal damage warfarin and methotrexate
Agents that interfere with vitamin metabolism
- warfarin impairs vit K
- methotrexate impairs folate metabolism
fetal damage ACE inhibitors, ARBs
Agents that impair organ function in developing fetus
Isoretinoin
Synthetic retinoid
Use: severe cystic acne
Side effect: fetal damage
