S2E5: Poisoned pt

Question 1

Cardiac arrhythmias causes

Answer 1

over dose of ephedrine, amphetamines, cocaine, digitalis, theophylline, TCAD

Question 2

cellular hypoxic death causes

Answer 2

cyanide, hydrogen sulfide, CO

Question 3

seizure & death causes

Answer 3

over dose of antidepressants, isoniazid, diphenhydramine, cocaine, amphetamine

Question 4

Tylenol OD effect

Answer 4

massive hepatic necrosis 48-72 hr post ingestion

Question 5

thiamine and glucose for…

Answer 5

wernick’s encephalopathy and hypoglycemia

Question 6

narcotic antagonist (narcan) for…

Answer 6

narcotic OD

Question 7

flumazenil for….

Answer 7

benzo OD (but careful if TCAD, seizure d/o, or benzo dependence, bc can cause seizures)

Question 8

HTN and tachycardia typical with…

Answer 8

amphetamines, cocaine, anticholinergics

Question 9

hypotension and bradycardia typical with…

Answer 9

CCB, Beta blockers, clonidine, sedative hypnotics

Question 10

hypotension and tachycardia typical with…

Answer 10

TCAD, trazodone, quetipine, vasodilators, beta agonists

Question 11

rapid respirations typical with…

Answer 11

salicylates, CO

Question 12

hyperthermia typical with…

Answer 12

anticholinergics, salicylates, drugs producing seizures

Question 13

hypothermia typical with…

Answer 13

CNS depressant drug

Question 14

miosis typical with…

Answer 14

narcotics, clonidine, phenothiazines, cholinesterase inhibitors, deep coma

Question 15

mydriasis (dilation) typical with…

Answer 15

amphetamines, cocaine, LSD, anticholinergics

Question 16

horizontal nystagmus typical with…

Answer 16

sedative hypnotics, phenobarbital, phenytoin, EtOH

Question 17

vertical and horizontal nystagmus typical with…

Answer 17

PCP

Question 18

ABG looks at…

Answer 18

oxygenation (low PO2 and high PCO2 is failure)

pH (acidosis = poor perfusion)

Question 19

electrolytes look at…

Answer 19

potassium

anion gap

Question 20

serum osm looks at…

Answer 20

chemicals dissolved in blood. Works for sodium, chloride, bicarb, proteins, sugar.

Question 21

Wide QRS typical with…

Answer 21

TCAD

Question 22

prolonged QT typical with…

Answer 22

quinidine, lithium, antipsychotics

Question 23

AV block typical with…

Answer 23

digoxin

Question 24

Ipecac instructions

Answer 24

w/in 30 min w 8 oz water. Only if poison control says so.

Question 25

Ipecac contraindications

Answer 25

corrosives, petroleum-based, rapid acting convulsant

Question 26

activated charcoal use

Answer 26

Most helpful (but not w corrosives)

Question 27

Urinary alkalinization (Sodium bicarb IV) use

Answer 27

if toxic substance is weak acid (phenobarbital or ASA). Enhances elimination.

Question 28

dialysis use

Answer 28

for ethylene glycol, methanol, EtOH, lithium, ASA, theophylline

Question 29

APAP max dose

Answer 29

kids: 150-200 mg/kg
adults: 7g

Question 30

APAP antidote

Answer 30

N-acetyl-cysteine

Question 31

anticholinergic OD tx

Answer 31

supportive, sedation

Question 32

anticholinergic antidote

Answer 32

physostigmine (give carefully and not with TCAD)

Question 33

TCAD antidote

Answer 33

sodium bicarb

Question 34

ASA max dose

Answer 34

> 200 mg/kg

Question 35

ASA OD tx

Answer 35

gastric lavage, activated charcoal.
IVF, IV sodium bicarb
Maybe dialysis if severe toxicity

Question 36

beta blocker OD tx

Answer 36

glucagon

Question 37

CCB OD tx

Answer 37

calcium

Question 38

cyanide antidote

Answer 38

activated charcoal
nitrates
hydroxycobolamin

Question 39

ethylene glycol (antifreeze) antidote

Answer 39

fomepizole (inhibits alcohol dehydrogenase)

Question 40

methanol antidote

Answer 40

fomepizole

same as ethylene glycol

Question 41

ethanol OD tx

Answer 41

supportive (IVF)

dialysis if severe

Question 42

benzo antidote

Answer 42

flumazenil (not good if benzo dependent)

Question 43

Hydrocarbon tx

Answer 43

resp support

Question 44

iron antidote

Answer 44

deferoxamine (desferal)