Tox

Question 1

beta blocker and CCB tox

decon

tx

Answer 1

decon: charcoal if early, whole bowel irrig if sustained release

GIG

glucagon

insulin/glucose

intralipid?

(in CCB use IV Ca Cl)

Question 2

Camphor tox

• what is it
• signs
• tx

Answer 2

Vicks vapo rub, camphor oil, old moth balls

neuro sxs, severe can cause seizures that are difficult to stop

-BZD

Question 3

lomotil tox

-tx

Answer 3

lomotil (immodium):

atropine and opioid (opioid sx is stronger)

tx: naloxone

atropine effects usu only temp

Question 4

Amanita mushroom tox:

-how different from other mushroom toxiciity?

tx

Answer 4

• important clue: no initial GI tox, unlikely other toxic mushrooms
• think tylenol poisoning with delayed effects. 6-10h after ingestion. then sxs of n/v/d/jaundice, elevated lfts
• NAC, high dose PCN, liver transplant

Question 5

methyl salicylate

-what’s it found in

tx

Answer 5

• more potent than aspirin. found in icy hot patch, muscle pain relief, oil of wintergreen
• tx like ASA tox
• Na HCO3, dialysis if necessary
• activated charcoal

Question 6

TCA tox:

what cardiovascular sx to know (2)

Answer 6

1. arrythmias–NaHCO3
2. hypotension severe, from alpha blocking (vasodilation). give NE pressors

also AMS, coma, agitation

Question 7

theophylline tox

mech, sxs

tx

Answer 7

hyperstimulation of B1 and B2 receptors, with CNS hyperexcitation

sxs: agitation/tremor/anxiety

severe sxs: hypotension, arrhythmias, sz

tx: activated charcoal works well, multiple doses

BZD for sz

Beta blockers (paradoxical) can bring BP back up (use esmolol to titrate)