Poisonning Flashcards
clue for Phenylcyclidine poisonning(2)
combative bahavior
prominent nystagmus =vertical nystagmus
rx of intoxication wtih phenylcyclidine
Benzodiazepines
clue for TCA overdose
QRS prolongation(0,19)
what’s the approriate indication to assess severity of intoxication of TCA
duration of QRS complex
rx of TCA intoxication
sodium bicarbonate
risk of TCA intoxication(3)
VTAC
hypotension
seizures
enumerate anticholinergic effect(6)
ileus flushed skin dilated pupils dry mucous membrane urinary retention confusion
patient seen after ingestion of 14 acetaminophen first step?(3)
charcoal activated
plasma acetaminophen dans 4 hr
Na cetylcysteine within 8 h
patient with anticholinergic symptom dx?
diphenidramine poisonning
rx of diphenidramine intoxication?(2)
cholinesterase inhibitor
Physostigmine
chemical in the eye next step
flush eye with running water
firsr step in foreign body of the eye
search medical care is the first prioritiy
firsr step in cut or scrathes of the eye
search medical care is the first prioritiy
patient taking fluconazole and moxifloxacin torsades de pointes next step
MGS04
quid of torsades de pointes
polymorphic ventricular tachycardia with prolonged QT interval
drugs causing prolonged QT syndrome and possibly torsade de pointes(5)
TCA amiodarone sotalol moxifloxacin fluconazole
other condition predisposing to long QT syndrome
hypomagnesemia
cause of low magnesemia(2)
malnutrition
alcoholics
quid of opiod intoxication(2)
morphin
heroin
clue for opiod intox
bradypnee
antidote for opiod intoxication
naloxone
eye in opiod intox
can cause myosis
but not always
why opioid intox can not have myosis
because coingestion can cause normal pupil or even mydriasis
opiod taken alone which doesn’t cause myosis?(2)
meperidine
propoxyphene
triad for cannabis intoxication(3)
increase appetite
dry mouth
conjonctival injection
why cocaine can cause motor vehicle accident
decrease concentration
clue for benzodiapines intoxication(3)
slurred speech
drowsiness
unsteady gait
indication of benzodiazepines(4)
insomnia
seizures
anxiety
alcohol withdrawal
alcohol and phenytoin intox(2)
same symptom
plus
nystagmus
differenciation between benzodiapines and opiod intox(2)
pupil is normal=
no respiratory distress=
Benzodiazepine
quid of NMS
drug induced idiosyncratic reaction
clue for NMS(4)
fever
confusion
lead pipe rigidity
high creatine kinase level
what cause NMS
antagonist dopaminergic action
rx of NMS
dantrolene
action of bicarb in rx of antidepressant intox(2)
sodium load will alleviate depressant action on sodium channels by increasing the extra cellular NA+ concentration
2-alkalinazation of serum by decreasing drug avidity for sodium channels
when given bicarb sodium in TCA intox
when QRS > 0,10 s
drug of choice for alcohol withdrawal
chlordiazepoxide
the most serious problem in alcohol withdrawal
delirium tremens
symptom of delirium tremens(4)
HTA
agitation
hallucinations
fever
quid of chlordiazepoxide
benzodiazepine
quid of fluphenazine
typical antipsychotic like haloperidol
why fluphen causes hypothermia(2)
by inhibiting the body shivering mechanism
inhibiting autonomic thermoregulation
what to do during intake of typical antipsychotic
avoid prolonged exposure to cold
clue for opiod intox(4)
everything is decreased Hypotension low bowel sound bradypnea bradycardia mioisis
what happens in cocaine intox
everything is high++++
best clue for opiod intox
respiratory rate
clue for Co poisonning
Pinkish skin Hue
headaches
tachypnea
tachycardia
rx of co poisonning
hyperbaric O2
confirmatory dx
level of carboxyhemoglobin
ethylene glycol poisonning why flank pain (2)?
because oxalic acid binds to ca to forl calcium stone
deposition in kidneys
why renal failure in ethylene glycol poisonning
glycolic acid injures the renal tubules
substances accumulated in ethylene glycol poisonning
oxalic acid
glycolic acid
why hypocalcemia in ethylene glycol poisonning
calcium binds to acid
why anion gap acidosis in ethylene glycol poisonning
accumulation of oxalic acid and glycolic acid
rx of ethylene glycol poisonning (2)
ethanol
or fomepizole
action of ethanol
or fomepizole
inhibit alcohol deshydrogenase
role alcohol deshydrogenase
metablizes ethylene glycol to acid
principle of rx of ethylene glycol poisonning(3)
fomepizole
bicarb sodium to rx acidosis
hemodyalisis in case of renal injury
action of caustic substance ingestion
liquefaction necrosis
example of liquefaction necrosis
sodium hydroxyde
first step in rx of caustic ingestion(2)
decontamination of skin and clothing
IV hydration
second thing in rx of caustic ingestion(2)
if no oesophageal perforation and stable patient
perform endoscopy within 12-24 h
what to do if perforation is suspected
upper GI xray with contast substance
how to Dx perforation in caustic ingestion
xray thorax
patient stable and negative xray thorax next step
in caustic ingestion
upper GI endoscopy
in any vignette you see ethanol or ethylene glycol next step(2)
calculate
anion gap
osmolar gap
clue for methanol intoxication
optic disk heperhemia
opiod withdrawal(2)
abdominal cramps
diarrhee
in IV drug user
attention a c difficile infection and opiod withdrawal
look for the time 1 day of antibio is not sufficient to develop pseudomembranous colitis
look WBC if they are decreasing no C difficile infection
eye in opiod intox
myosis
eye in opioid withdrawal
mydriasis
drug used to rx NMS(3)
dantrolene
bromocriptine
amantadine
bblocker intoxication(4)
Bradychardia wheezing bronchospasm hypotension hypoglycemia libido problem
Med causing same symptom than B blovker minus wheezing(3)
ca blocker
digoxin
cholinergic agent
first step in bblocker intox(2)
fluid
atropine
second step in bblocker intox
glucagon
action of glucagon(3)
increase AMP cyclic
Increase intra cellular calcium
Increase cardiac contractility
clue for caustic ingestion(3)
white tongue
heavy salivation
dysphagia
what to rule out in any caustic ingestion
oesophageal perforation
stomach
consequence of oesophageal perforation
mediastinitis
consequence of stomach perforation
peritonitis
action of organophosphate
act as cholinergic
cholinergic effect(7)
salivation urination diarrhee bronchorrea bradycardia Myosis all glands are secreted
antidote of organophosphate
atropine
first thing to do in organophosphate intox(2)
remove clothes
wash the body
people at risk of organophosphate intox
farmer
why remove clothes in organophosphate intox
because of vomiting tou can have absorption of the substance through skin
quid of physostigmine in organophosphate intox
cholinestrase inhibitor
will worsen the intox
