Poisoning And Overdoses Flashcards
What is a poison?
A substance which upon contact or being introduced into an organism, impairs or prevents normal metabolic processes from taking place. This affects organs and tissues.
What is an overdose?
An excessive dose, it causes acute physical or mental effects occur.
What are 4 routes of entry?
Inhalation
Absorption
Injection
Ingestion
What is inhalation?
Anything airborne that can be breathed in
Fairly rapid
Most frequent route
What is absorption?
Skin and mucous membrane
Includes the eye
Generally slower
Intact skins provide barrier to some but not all poisons.
What affects absorption into systemic circulation?
Affected by blood flow/temp to area.
Lipid soluble chemicals more likely to absorb easily through skin.
What is Ingestion?
Patient had been awake to take it
Slow absorption
Intentional
Unintentional
Occurs most in children
What is injection?
Subcutaneosly, Intramusculary, Intravenously.
IV drug use
Accidental high pressure injection
Through a laceration
Prescribed medication.
What are the factors that effect the degree of poisoning?
Concentration
Exposure time
Affinity for tissue
Sensitivity of the exposed tissue
Route of entry
Age
Liver ability
What are some types of alcohol?
Isopropanol
Methanol
Ethanol (ETOH)
ETOH withdrawal
What is alcohol ADME?
A - PO, absorbed parenterally through inhalation, PR or IV
D - Distributes equally through water carrying potential spaces.
M - metabolizes to Acetaldehyde to ketones.
E - 5% is sweat, urine and respiration. The rest is metabolized.
What is the MOA of alcohol?
Binds to GABA, this receptor protein causes CNS depression.
Constant use affects areas responsible for coordination, memory, logic, consciousness, respiration and airway protection.
What is isopropanol?
Rubbing alcohol
Antifreeze
Skin lotions
Cleaning products
It has 2-3 times the potency of ethanol and causes more damage to cells.
What is methanol?
Is an industrial solvent therefore found in cleaning supplies.
Windshield washer fluid.
What does methanol turns into?
Methanol turns into formaldehyde.
This causes irreversible systemic tissue damage including eyes, CNS, kidneys, GI and liver destruction.
What is ethanol?
Alcohol
Aftershave
Perfumes
Mouthwashes
What is alcohol withdrawal?
Chronic alcohol use causes loss of GABA receptors which leaves more excitatory receptors.
What is the timeline of alcohol withdrawal?
8 hrs - mild symptoms
24-72hrs - moderate symptoms develop, seizures. Worsening mild symptoms.
Up to 7 days - symptoms peak
DT may occur spontaneously
Seizures are highly possible.
Over 7 days - symptoms taper off. May last several weeks.
What are symptoms of delirium tremens?
Agitation
Delirium
Hallucinations.
What are sympathomimetics?
Cocaine
Crack cocaine
Amphetamines
Meth
MDMA
What does a sympathomimetics do?
Causes an increase in serotonin, NE and dopamine in the CNS which leads to feelings of euphoria, excitement and energy.
What is a major concern for sympathomimetics?
Cardiotoxicity and agitation.
What symptoms for sympathomimetics?
Tachycardia
Tachypnea
Mydriasis
Hyperthermia
Diaphoresis
Chest pain
Bruxism
HTN
What is the strongest type sympathomimetics?
Meth - 1250 units of dopamine released in 20 hours.
Why are seizures caused by MDMA?
Because of the hyponatremia due to the excessive water intake.
What are types of depressants?
Codeine
Fentanyl
Morphine
Demerol
Heroin
What do depressants do?
The opiods in the body stimulate Mu, Kappa and Delta receptors.
Causes decreased LOC
Respiratory depression
Miosis
Hypotension
What effects do benzodiazepenes have?
Sedation
Striated muscle relaxation
Anticonvulsant effects
Vasodilation
What are examples of benzodiazepine?
Valium, Ativan, Versed and Rophynol.
Should you encourage vomiting with household poisons like bleach?
NO.
What does cyanide poisoning inhibit?
It inhibits the mitochondrias ability to create ATP from oxygen.
What inhibits cyanide poisoning and gels inactivate it?
Vitamin B 12.
What are some salicylates?
They are used to treat inflammation.
ASA
Bengal topical
Oil of wintergreen
Pesto bismol.
What is the lethal dose of acetaminophen?
150mg/kg
What is the lethal dose of TCAs?
8 times the lethal dose.
What anticholinergic effects do TCA’s have?
Dry as bone
Red as a beet
Mad as a hatter
Hot as a hare
Blind as a bat
What is CCCA with TCA’s?
Coma
Convulsions
Cardiac arrhythmia
Acidosis
