poisoning substance Flashcards

1
Q

Explain different types of poisoning

A
  • Accidental – usually occurs in young children and the event may not be obvious and may only be found on detailed questioning.
  • Intentional – an act of deliberate self harm.
  • Non-accidental – if suspected it must be reported.

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2
Q

Toxidromes

A

Common toxidromes include:

  • Alcohol
  • Opioid
  • Cholinergic
  • Anticholinergic
  • Sympathomimetic
  • Sedative-hypnotic
  • Serotonin syndrome
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3
Q

The signs and symptoms of alcohol use include

A
  • Nausea/vomiting
  • Slurred speech
  • Confusion
  • Convulsions
  • Unconsciousness
  • Change in rational thinking
  • Hypoglycaemia
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4
Q
  • An opiate is a substance derived from opium.
  • Opioids refers to compounds related to opium.

Ambulance Care Practice p297

  • Opioids are a group of analgesic agents.
  • There are three types of opioid receptor mu, kappa and delta.
  • Opioids can act at these

Examples include receptors as agonists, antagonist or partial agonists.

A

Examples include

  • Morphine
  • Codeine
  • Tramadol
  • Heroin
  • Fentanyl
  • Methadone
  • Oxycodone
  • Hydrocodone
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5
Q

Opioids•Signs and symptoms

A

•Signs and symptoms

  • Miosis – constriction of the pupil of the eye
  • Altered level of consciousness
  • Respiratory depression
  • Nausea/vomiting can occur
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6
Q

Cholinergic

A

•Cholinergic drugs work on the parasympathetic nervous system.

These drugs enhance the actions of the neurotransmitter acetylcholine

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7
Q

Cholinergic Examples include:

A

Examples include:

Nicotine

Nerve agents e.g. sarin

Organophosphates

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8
Q

Cholinergic

Signs and symptoms

A

Signs and symptoms

  • Sweating
  • Lacrimation (crying)
  • Miosis
  • Rhinorrhoea
  • Frothing at mouth dues to salivation and bronchorrhoea
  • Vomiting
  • Bradycardia
  • Urinary incontinence
  • Diarrhoea
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9
Q

Anticholinergic

A

•Anticholinergic drugs work to enhance the sympathetic nervous system.

By blocking acetylcholine from sending chemical messages, anticholinergic cause a decrease in parasympathetic effects

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10
Q

Anticholinergic Examples include

A

Atropine

Antihistamines e.g. chlorphenamine, hydroxyzine, diphenhydramine

Antipsychotics e.g. chlorpromazine, olanzapine, thioridazine

Antispazmodics e.g. clidinium, hyocyamine, oxybutynin

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11
Q

Anticholinergic

Signs and symptoms

A

Mad as a hatter” (altered mental status manifested as agitation, delirium, hallucinations, abnormal picking movements, rarely seizures).

“Blind as a bat” (pupillary dilation with loss of accommodation)

“Red as a beet” (vasodilation with skin hyperemia);

“Hot as a hare” (anhidrosis with temperature elevation);

“Full as a flask” (urinary retention); “Stuffed as a pepper” (constipation); and

“Dry as a bone” (drying of mucosal surfaces and skin);

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12
Q

Sympathomimetic

Examples include

A

•Sympathomimetic drugs are agents which in general mimic responses due to stimulation of the sympathetic nerves.

Caffeine

Cocaine

Amphetamines

Ritalin

LSD

Theophylline

MDMA (‘ecstasy’)

Alcohol/drug withdrawal

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13
Q

Sympathomimetic

Signs and symptoms

A
  • Tachycardia
  • Hypertension
  • Mydriasis (dilated pupils)
  • Diaphoresis (sweating)
  • Piloerrection (‘goose bumps’)
  • Hyperthermia seizures
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14
Q

Sedative-hypnotic

A

•A drug that is used to reduce tension and anxiety and induce calm (sedative effect) or to induce sleep (hypnotic effect).

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15
Q

Sedative-hypnotic

Examples include

A

Examples include

  • Barbiturates – e.g thiopental, phenobarbital
  • Benzodiazepines - e.g diazepam, lorazepam
  • Z-drugs - e.g zopiclone, zolpidem
  • Drugs - e.g GHB
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16
Q

Sedative-hypnotic

Signs and symptoms

A
  • Altered level of consciousness
  • Slurred speech
  • Ataxia
  • Amnesia
  • Cardiovascular and respiratory depression
17
Q

Serotonin syndrome

A
  • A potentially life threatening syndrome that is precipitated by the use of a serotonergic drug.
  • Serotonin syndrome and its spectrum of symptoms are a product of the over activation of both the central and peripheral serotonin receptors as a result of high levels of serotonin.
18
Q

Serotonin syndrome

Examples include

A
  • Drug abuse – e.g. MDMA, amphetamines
  • Antidepressants – e.g. tricyclics, citalopram, fluoxetine, sertraline
  • Monoamine oxide inhibitors
19
Q

Serotonin Syndrome

Signs and symptoms

A
  • Delirium
  • Mydriasis
  • Sweating
  • Tachycardia
  • Clonus, myoclonus, hyperreflexia, increased limb tone
20
Q

Time critical features

A
  • Major ABCD problems
  • Cardiac and respiratory arrest
  • Decreased level of consciousness
  • Respiratory depression
  • Arrhythmias
  • Hypotension <70mmHg
  • Convulsions
  • Hypothermia
  • Swallowed crack cocaine