poisoning

Question 1

anticholinergic (TCA, antihistamines)

Answer 1

Mad as a hatter (Altered mental status)
Blind as a bat (mydriasis)
Hot as Hades
Red as a beat
Dry as a bone

Question 2

cholinergic

Answer 2

treat with atropine, PAM, decontaminate

This is the classic mnemonic SLUDGE:

Salivation
Lacrimation
Urination
Diaphoresis and defecation
Gastrointestinal upset
Excessive bradycardia or tachycardia (muscarinic or nicotinic)

Question 3

when to use activated charcoal?

Answer 3

Charcoal acts by adhering to most toxins, impairing toxin absorption,
and enhancing elimination. Some toxins (i.e., heavy metals such as lithium, lead, and
iron) do not bind to charcoal. Consequently, charcoal is not indicated in isolated heavy
metal injections. Also, charcoal is contraindicated in patients with unprotected airways
(risk of aspiration) and in caustic ingestions as the black color of the charcoal interferes
with the endoscopic evaluation that often follows caustic ingestion

Question 4

TCA toxicitty

Answer 4

evelop prolongation of the PR and QRS intervals on the EKG. Other pharmacologic actions of TCAs include: GABA-A antagonism, inhibition of amine (NE, 5-HT) reuptake, alpha-adrenergic blockade, and anti-muscarinic/anti-histaminic effects.

Question 5

benzo overdose

Answer 5

treatment is supportive first
protect the airway
often dont have to go to flumazenil

Question 6

cocaine toxicity treatment

Answer 6

benzos

-helps with agitation and increased adrenergic tone

Question 7

acetominophen tox

Answer 7

treat with activated charcoal
140mg/kg is toxic dose
n-actylcysteine check at 4 hour

Question 8

clonidine toxicity mimics what?

Answer 8

opioid toxicity

Question 9

methemoglobinemia

Answer 9

nitrates/nitrites, local anesthetics, dapsone cause

• blood is dark
• methylene blue is the antidote
• moves the O2 shift to the left causing hemoglobin to give up O2 less to the tissues