Toxicity Flashcards
what factors can affect patient response to a drug?
- clinical factors
- administration
- pharmacokinetics (ADME)
- pharmacodynamics
what possible effect could a genetic polymorphism in liver enzymes have?
decreased CYP2D6 enzyme leads to reduced metabolism of specific drugs, posing a risk for toxicity and a reduced metabolism of prodrugs
what considerations do we need to take regarding pharmacotherapy for preganant people?
- they have an altered GI function, causing drugs to take longer to absorb
- they have a higher blood volume causing higher HR, decreased PPB and higher GFR
- most drugs can cross into the placenta and into the breast milk, reaching the fetus
what are the most common drug toxicities?
- ASA
- tylenol
- opioids
- benzodiazepines
- alcohol
- THC
- cocaine
define toxidromes
collection of symptoms and signs that are characteristics of a particular type of poisoning or overdose
what s&s are in the ASA (Aspirin) toxidrome?
- Confusion
- Tachycardia
- Tachypnea
- Hyperthermia
- Diaphoresis (excessive sweating)
- Vomiting
what s&s are in the acetaminophen toxidrome?
- Abdominal pain
- Loss of appetite
- Nausea/vomiting
- Diaphoresis
- Somnolence (drowsiness)
what s&s are in the opioids toxidrome?
- Bradypnea or apnea
- Bradycardia
- Somnolence or coma
- Pupils constricted
- Sedation
what s&s are in the cocaine toxidrome?
- Agitation
- Tremors
- Tachycardia
- Hyperthermia
- Diaphoresis
- Pupils dilated
what is the mechanism of action of cocaine and other stimulants?
they block sodium channels, increasing NE, E and dopamine
what s&s are in the cannabis toxidrome?
neurocognitive effects of variable presentation such as:
* seizures
* nausea/vomiting
* acute psychosis
* LOC changes
* changes in VS
compare the routes of administration of cannabis
inhalation has a faster onset of action and higher bioavailability compared to oral administration
what are the main ingredients of cannabis?
THC and CBD
what is the effect of THC?
Causes CNS and vital sign instability
what is the effect of CBD?
Modulates effects of THC at receptors
what is the treatment for cannabis toxicity?
supportive tx, no specific plan
define algorithms
Provide a guideline of treatment depending on time since administration of drug
what treatments do we use for toxicity?
- algorithms
- utilization of ADME
- supportive tx to stabilize
- adsorption
- induce metabolism
- increase elimination
- antagonism
define adsorption
binding of a drug to decrease absorption of a toxic drug
what are the s&s of alcohol toxicity?
- Facial flushing
- Headache and dizziness
- Tachycardia
- Shortness of breath
- Low blood pressure and body temperature
- Unconsciousness
- Vomiting and nausea
what is the mechanism of action of alcohol?
causes CNS effects by acting as a GABA agonist and glutamate inhibitor
what is the treatment for alcohol toxicity?
metadoxine via IV administration to induce ADH metabolism
what drugs are poorly adsorbed by activated charcoal?
- cyanide
- ethanol
- ethylene glycol
- iron
- isopropanol
- lithium
- methanol
- strong mineral acids and alkali
what is the pediatric blood volume?
80 mL/kg of body weight
