toxicity tx

Question 1

Toxin on front, Tx on back!

Answer 1

Tx

Question 2

AChE inhibitors, Organophosphates

Answer 2

Atropine, Pralidoxime

Question 3

Amphetamines (basic)

Answer 3

NH4Cl (ammonium chloride) to acidify urine

Question 4

Antimuscarinic, Anticholinergic agents

Answer 4

Physostigmine, Control Hyperthermia

Question 5

Arsenic

Answer 5

Dimercaprol, Succimer

Question 6

Benzos

Answer 6

Flumazenil

Question 7

beta-blockers

Answer 7

Saline, Atropine, Glucagon

Question 8

Carbon Monoxide

Answer 8

100% O2, hyperbaric O2

Question 9

Copper

Answer 9

Penicillamine, Trientine

Question 10

Cyanide

Answer 10

Nitrite + Thiosulfate, hydroxycobalamin

Question 11

Digitalis (Digoxin)

Answer 11

Anti-dig Fab Fragments

Question 12

Gold

Answer 12

Penicillamine, Dimercaprol (BAL) Succimer

Question 13

Heparin

Answer 13

Protamine sulfate

Question 14

Iron

Answer 14

deFEroxamine, deFErasirox, deFEriprone

Question 15

Lead

Answer 15

EDTA, dimercaprol, Succimer, Penicillamine

Question 16

Mercury

Answer 16

DiMERCaprol, Succimer

Question 17

Methanol, ethylene glycol (antifreeze)

Answer 17

Fomepizole, ethanol, dialysis

Question 18

Methemoglobin

Answer 18

METHylene blue, Vit C

Question 19

Opioids

Answer 19

Naloxone

Question 20

Salicylates

Answer 20

NaHCO3 (alkalinizes urine), dialysis

Question 21

TCAs

Answer 21

NaHCO3

Question 22

Warfarin

Answer 22

Vit K (delayed effect), fresh frozen plasma (immediate)

Question 23

Tetrodotoxin

from Pufferfish

Answer 23

Primarily supportive

Question 24

Ciguatoxin

from Reef fish ie Barracuda, Snapper, Moray eel

Answer 24

Primarily supportive

Question 25

Histamine (Scombroid poisoning)

from spoiled dark-meat fish ie Tuna, mahi-mahi, mackerel, and bonito

Answer 25

Antihistamines.

Albuterol and Epi if needed

Question 26

Tetrodotoxin: action?

Answer 26

Highly potent, binds fast voltage-gated Na+ channels in cardiac/nerve tissue, preventing depolarization
(from pufferfish)

Question 27

Tetrodotoxin: symptoms?

Answer 27

Nausea, diarrhea, paresthesias, weakness, dizziness, loss of reflexes
(from pufferfish)

Question 28

Ciguatoxin: Action?

source?

Answer 28

Opens Na+ channels -> depolarization.

from Reef fish ie Barracuda, Snapper, Moray eel

Question 29

Ciguatoxin Sx?

Answer 29

mimic Cholinergic poisoning

Question 30

Toxin from spoiled dark-meat fish ie Tuna, mahi-mahi, mackerel, and bonito has what MOA?

Answer 30

Bacterial histidine decarboxylase cnvts histidine to histamine (Scombroid poisoning)

Frequently misdiagnosed as fish allergy

Question 31

Toxin from spoiled dark-meat fish ie Tuna, mahi-mahi, mackerel, and bonito –> Sxs?

Answer 31

mimics anaphylaxis: acute burning sensation of mouth, flushed face, erythema, urticaria, itching.
May progress to bronchospasm, angioedema, hypoTN