Toxic causes of ... Flashcards
Toxic causes of respiratory failure
CNS depression - Alcohols - Antidepressant, antihistamine - Phenothiazines and sedative hypnotics - Barbituates, baclofen - Opioids, clonidine Ventilatory muscle failure - organophosphates, carbamates - Snakebite - Muscle relaxant - strychnine Pulmonary - Pulmonary aspiration / pneumonitis: hydrocarbons, GI contents, charcoal - non-cardiogenic pulmonary oedema - Cardiogenic pulmonary oedema - ARDS - Paraquat
Toxic causes of tachycardia
anticholinergics: benztropine
antihistamine: phenothiazines (chlorpromazine)
Atypical antipsychotics, TCA, MAO
Sympathomimetic: amphetamines, cocaine, caffeine, theophylline
Tramadol
Digoxin
Drug withdrawral
Toxic causes of bradycardia
beta blocker
Calcium channel blocker
Clonidine
Digoxin
Toxic causes of hypotension
Vasodilators
Myocardial depressants
Hypovolaemia / third space loss
Toxic causes of hypertension
Sympathomimmetic: amphetamines, cocaine, MAO inhibitors
Anticholinergics
Toxic causes of broad QRS
TCA Sodium channel blocker antiarrhythmics Propranolol Cocaine Local anaesthetics Dextropropoxyphene
Toxic causes of long QT
Antipsychotics Sotalol Antibiotics - macrolides Antihistamine - phenothiazines Antifungal - ketoconazole Methadone Arsenic Citalopram
Toxic causes of VF / VT
Sodium channel blockers Cocaine Digoxin Chloral Theophylline
Toxic causes of delirium
Alcohols Anticholinergic Sympathomimetics Salicylates Hydrocarbons Benzodiazepines / sedative hypnotics Hallucinogenic agents Serotonergic agents Withdrawal syndromes
Toxic causes of seizures
Sympathomimetics TCA Venlafaxine Bupropion Cocaine / LA Tramadol , pethidine Propranolol Theophylline Mefenamic acid
Toxic causes of hyperthermia
Sympathomimetic: amphetamine, cocaine Serotonin syndrome: SSRI, SNRI, MAOI Salicylate Neuroleptic malignant syndrome Malignant hyperthermia
Framework for risk assessment
RRSI DEAD Resuscitation Ris assessment Supportive care and monitoring Investigations Decontamination Enhanced elimination Antidotes Disposition
Specific elements of medication risk assessment
Agent Does Time since ingestion Clinical features / course Patient factors
Typical causes of anticholinergic toxidrome
Antihistamine Antipsychotics TCAs Benztropine Atropine Carbamazepine Plant poisoning
Typical features of anticholinergic toxidrome
Hyperthermia Dry skin, flushed Tachycardia Delirium Dilated pupils, blurred vision Urinary retention Ileus Dry mouth
Typical features of mixed cholinergic toxidrome
Lacrimation Salivation Bronchospasm Bronchorrhoea Hypo or hypertension Brady or tachycardia Mydriasis or meiosis Urinary incontinence Diarrhoea Fasiculations Muscle weakness, paralysis
Causes of mixed cholinergic toxidrome
Organophosphates
Carbamates
Chemical warfare agents
Causes of serotonin syndrome
SSRI, SNRI, MAO inhibitors TCAs Tramadol, fentanyl Amphetamines Lithium St johns wort
Causes of NMS
Dopamine antagonists (neuroleptics) Withdrawral of dopamine agonist
Symptoms of NMS
Hyperthermia Lead pipe rigidity Bradykinesia Alerted mental status Dystonia / abnormal posturing
Symptoms of serotonin syndrome
Hyperthermia Tachycardia Hyperreflexia Hypertonia / rigidity Clonus Hypertension
Agents suitable for multidose activated charcoal
Carbamazepine Dapsone Phenobarbitone Quinine Theophylline Amanita spp
Agents suitable for urinary alkalinisation
Salicylate
Phenobarbitone
Agents suitable for haemodialysis
Ethylene glycol Methanol Salicylate Lithium Valproic acid Theophylline
