TOXICDROMES Flashcards
WHICH TOXICDROME OCCURS < 12 HOURS?
SS
SS SYM?
HYPERRELEXIA, CLONUS, MYDRIASIS, HYPERACTIVE BS
WHICH TOXICDROME OCCURS 1-3 DAYS?
NMS
NMS SYM?
LEAD PIPE RIGIDITY, HYPOREFLEXIA, NORMAL PUPILS, NORMAL OR DECREASED BS
Drugs That Cause Seizures
(“Otis Campbell”) Organophosphates TCAs, trazodone, theophylline, tramadol Insulin, INH, iron, ibuprofen, imipenem Sulfonylureas, salicylates Carbamazepine, Camphor, cocaine, cyanide, caffeine Amphetamines, antihistamines Meperidine, mushrooms Propranolol, penicillin, propoxyphene Bupropion, baclofen, Benadryl Etoh withdrawal Lead, lidocaine, lindane, lithium, levaquin
Nicotinic Effect
Days of the week
Somnolence Mydriasis Tremors/tachycardia Weakness Th htn (hypertension) Fasiculation Seizures
Muscarinic Effect
(Dumbels)
Diarrhea Urination Miosis/Muscle weakness Bradycardia, bronchospasm, bronchorrea Emesis Lacrimation Salivation Sweating
Drugs Needing MDAC
(“Plenty Charcoal To Quickly Sequester Drugs”)
Phenobarbitol, phenytoin Carbamazepine, Chlorinated hydrocarbons Theophylline Quinine, Quinidine Salicylate Dapsone, depakote, digoxin, digitoxin
Causes of Anion Gap Metabolic Acidosis
(“MUDPILES CAT”)
Metformin, Methanol Uremia DKA Phenformin, Paraldehyde, Propylene glycol INH, Iron Lithium, Lead, Lactate Ethylene Glycol Salicylate, Starvation
Carbon monoxide, Cyanide
Alcoholic ketoacidosis
Toluene
Drugs that form concretions
Requiring whole bowel irrigation - (“BIGMESS”)
Barbituates
Iron
Glutethimide
Metals
Extended release, Enteric coated
Sustained release
Stuffers
Substances Not Well Absorbed by Charcoal/AC
(FLIPPA) Fluoride Lithium Iron Potassium Pesticides Alcohols
Serotonin Syndrome
My Hyper Dog Is The Dumbest Animal Around Here Myoclonus Hyperreflexia Diaphoresis Incoordination Tremor Diarrhea Agitation AMS Hyperthermia
Drugs that can be Dialyzed
I STUMBLED Isopropanol Salicyates Theophylline Uremia Methanol Barb/Bromides Lithium EG Depakote
Radiopaque
CHIPES Chloral hydrate Heavy metals Iron, Iodine Phenothiazines Enteric coated pills Solvents, halogenated
Substances Causing Methemoglobinemia
ABCD N Anesthetic, Azo, Aniline dyes Bactrim, Bromates Chloroquine, Chlorates Dapsone Nitrates/Nitrites, Naphthalene, Nitroglycerine
A 67 year old female presents to the ED anxious, tremulous, nausea, vomiting, dehydrated and seizures. LABS as follows: Na 131, CO2 18, KCL 3.8, PO4 1.5 mg/dl, BS 100. The patient was afebrile, HR 130’s, BP 90/50. Hemodialysis was recommended. The patient was recently started on furosemide.
Which of the following medications could have caused this presentation with chronic intoxication?
A. theophylline
B. lithium
C. valproic acid (Depakote®) D. digoxin
A
In which of the following scenarios would hemodialysis not be indicated?
A. Serum iron level 500 ug/dl , CO 2 – 17, BP 80/55
B. Ethylene Glycol Level 50 mg/dl , CO 2 – 14, Bun 35 & Cr 1.8 , comatose C. Theophylline level > 40 ug/ml, 68 years old with CHF & Liver disease
D. Valproate level > 1,000ug/ml , Ammonia level -120 , AST -100 , ALT 150
A
An adult hiking in the woods looking for herbal plants that could be used in medicine came across a plant and dug it up and consumed both the leaves and roots in a salad. He arrived in the Emergency room experiencing weakness, dizziness, as well as hypotension and tachycardia. Earlier
1. A 67 year old female presents to the ED anxious, tremulous, nausea, vomiting, dehydrated and seizures. LABS as follows: Na 131, CO2 18, KCL 3.8, PO4 1.5 mg/dl, BS 100. The patient was afebrile, HR 130’s, BP 90/50. Hemodialysis was recommended. The patient was recently started on furosemide.
General Management Principles
Laboratory and Ancillary Testing
symptoms of intense vomiting, abdominal cramping and headache had
improved. Which plant could have caused these symptoms? A. Foxglove
B. Pokeweed
C. Dogbane
D. Jimson Weed
B
Which of the following could cause headache, nausea, vomiting, respiratory depression, pulmonary edema, myocardial sensitization hepatic and renal injury could occur?
A. methane
B. carbon dioxide C. butane
D. Freon
D
A farmer was spraying the fence row when the sprayer hose broke and he delayed showering. His symptoms included: Vomiting, throat irritation as well as mild conjunctivitis and dermal irritation. Which of the following could have caused his symptoms?
A. Round up or Vantage B. Malathion
C. Diquat
D. Imidacloprid
A
Patient presents HR 145 BP 140/85 Pupils dilated Skin flushed, hot and dry Bowel sounds decreased Urinary retention Agitated T 101 F What drug would have been ingested? A. cocaine B. nicotine C. benztropine (Cogentin) D. bethanechol (Urecholine)
C
Which of the following drugs would not cause widening of the QRS?
A. amitriptyline B. lidocaine
C. digoxin
D. lamotrigine
C
A caller reports that she has been taking her high dose vitamin six times a day accidently for the last 3months. She is now experiencing fatigue, headaches, bone pain, alopecia, and skin lesions. Which vitamin could be responsible for her symptoms?
A. Vitamin D B. Vitamin C C. Vitamin A D. Vitamin B
C. Vitamin A
A 45 year old female presented in the ED with complaints of dizziness, tremor, paresthesias, and slurred speech. She states she unintentionally took her newly prescribed smoking cessation medication twice this morning. Her vitals and initial labs are as follows: HR 95 BP 100/72 RR 18 Temp 98.7 UDS- positive for amphetamines What is the medication she is taking? A. Tramadol (Ultram®) B. Venlafaxine (Effexor®) C. Bupropion (Wellbutrin®) D. Cyclobenzaprine (Amrix®)
C
