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Critical Care 1 > Toxicology > Flashcards

Toxicology Flashcards

1
Q

3 Stages of Tylenol overdose

A
  1. flu-like (N/V, abd pain, swat, pale)
  2. liver injury (RUQ pain, LFT elevate)
  3. peak liver enzymes (hepatic fialure (glucose/lactate/phosphate abnormal), encephalopathy, hypoglyemia, coma, death
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2
Q

late stage serious complications of tylenol overdose

A 
hepatic failure
encephalopathy
hypoglyvemia
coma
death
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3
Q

abnormal labs in tylenol overdose

A

LFT elevated
low glucose
phosphate abnormal

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4
Q

asprin overdose

A

N/V

tinnitis

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5
Q

acid base in asprin overdose

A

r. alkalosis

can progress to m. acidosis

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6
Q

cause of REye’s disease

A

pediatric asprin overdose

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7
Q

complications of asprin overdose

A

liver & brain damage
high ICP possible encephalopathy
hepatic encephalopathy

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8
Q

treatment of asprin overdose

A

sodium bicarb (b/c liver damage causes high ammonia) and dialysis

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9
Q

labs in asprin overdose

A

r. alkalosis progressing to m. acidosis

high lactate b/c liver damage

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10
Q

benzodiazepines

A 
diazepam = valium
lorazepam = ativan
midazolam = versed
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11
Q

treatment of benzodiazepine overdose

A

activated charcoal if ingested

flumazenil

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12
Q

Fluzemanil

A

benzo overdose

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13
Q

pushing Flumazenil too fast

A

seizures

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14
Q

antidoate for Beta Blocker overdose

A

glucagon

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15
Q

s/s of BB overdose

A 
low bp/hr
conduction delays
low glucose
p. edema
bronchospams
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16
Q

glucose in BB overdose

A

low glucose

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17
Q

overdose with low glucose

A

consider BB overdose

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18
Q

treat BB overdose

A

glucagon
pacing, atropiner
IVF for low bp

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19
Q

difference between BB and CaChB overdose s/s

A

both have low HR/BP/conduction delays
BB = low glucose
CaChab= high glucose

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20
Q

s/s CaChB overdose

A

low BP/HR/conduction delays
m. acidosis
high glucose

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21
Q

treatment of CaChB overdose

A

activated charcoal
atropine/pacing
IVF for low BP

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22
Q

s/s of digoxinoversoe

A

flu-like
yellow green halos
risk of high K
slurred upstroke on ERS

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23
Q

avoid if digoxin overdose

A

avoid electricity like pacing/cardioversion

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24
Q

EKG of digoxin overdose

A

slurred upstroke on ERS

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25
Q

use of phenytoin (DIlantin)q

A

seizures

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26
Q

s/s of phenytoin (Dilantin) overdose

A

SVT, coma, confusion, tremores

DI-like s/s

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27
Q

treat phenytoin (Dilantin) overdose

A

IVF/O2, supportative

maybe gastric lavage

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28
Q

s/s of cocaine overdose

A

chest pain, HTN, seizures, rhabdo

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29
Q

treat cocaine overdose

A

IVF, benzos

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30
Q

treat PCP

A

sedatives. no ketamine b/c delirum can worsen

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31
Q

risk of MDMA

A

overheading
low Na
serotonin syndrome

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32
Q

treat alkalis

A

copious water

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33
Q

treat anticholinergic

A

phyostigime

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34
Q

treat ASA

A

bicarb

35
Q

treatment BB

A

glucagon

36
Q

treat CaChB

A

Calcium gluconate

37
Q

treat cocaine

A

benzos

38
Q

treat coumadin

A

vitamin K

39
Q

treat pit viper

A

CroFab, FabAV

40
Q

treat cyanide

A

sodium thiosulfate, sodium nitrite/amyl nitrate

41
Q

treat phenytoin

A

supportative

42
Q

treat ethylene gluycol

A

IV ethonol or Femepizole

43
Q

treat heparin

A

protamine sulfate

44
Q

treat hydrocarbons

A

intubate

45
Q

treat hydrofluoric aicd

A

calcium gluconate

46
Q

treat INH

A

pyridoxine (vitamin B6)

47
Q

treat iron

A

Desferal

48
Q

treat methanol

A

IV ethanol, Fomenizole

49
Q

treat organophosphates

A

atropine & 2-PAM

50
Q

atropine & 2-PAM

A

organophosphates

51
Q

treat alcohol overdose

A

IV ethanol or Fomepizole

52
Q

Fomepizole

A

alcohol overdose

53
Q

Desferal

A

iron overdose

54
Q

amyl nitrite/sodium nitrite/sodium thiosulfate

A

cyanide

55
Q

glucagon as an antidote

A

BB

56
Q

what does a tricyclic antidepressant overdose look like

A

anticholinergic-like

57
Q

EKG of tricyclic antidepressant overdose

A

widened QRS with prolonged QT

58
Q

treatment of tricyclic antidepressant overdose

A

bicarb, IVF
target pH is 7.5-7.55
vasopressors if refractory low bp

59
Q

how to give rx for iron overdose

A

Desferan creates rose colored urine and normal once yellow again

60
Q

Antizole

A

treat toxic alcohols

61
Q

ABG of toxic alcohols

A

lethal anion-gap acidosis over 16

62
Q

aka antiffreeze

A

ethylene glycol

63
Q

ethylene glycol

A

antifreeze

64
Q

windshield wiper fluid

A

methanol

65
Q

methanol

A

windshield wiper fluid

66
Q

treat alcohol overdose

A

IV ethanol, Antizol, hemodialysis

67
Q

complication of hydrocarbons

A

chemical pneumonitis. decreaed viscosity causes aspiration

DO NOT induce vomiting

68
Q

toxidrome of pesticides

A

organophosphate = cholinergic toxidrome

69
Q

s/s of cholinergic toxidrome

A

SLUDGE/DUMBELS
oraganophosphates
neve gases like sarin & Vx

70
Q

SLUDE/DUMBELS

A

cholinergic toxidrome/organiophosphates

defecation (GI distress/emesiss)

71
Q

nerve gas s/s

A

cholinergic toxidrome

SLUDGE/DUMBELS

72
Q

Vx s/s

A

cholinergic toxidrome

SLUDGD/DUBELS

73
Q

DUMBBELS

A 
diarrhea
urination
miosis
bronchorrhea
bronchospasm
emesis
lacrimination
laxation
sweating
74
Q

other s/s of nerve gas & organophosphates

A

SLUDGE/DUMBBELS

nicotinic stimulation = tachycardiat, HTN, fasciculations, paralysis of respiratoyr muscles

75
Q

death from nerve gas/organophosphates

A

paralysis of respirtory muscles

76
Q

treat organophosphate overdose

A

atropine to decrease aireay secreations
pralidoxime
2-PAM (crowbar organophophate off of ACh)
benzos for seizures

77
Q

how does 2-PAM work

A

crowbar that takes the organophosphate off of ACh

*for organophosphate/nerve agent/cholinergic

78
Q

atropine overdose

A

anticholinergic

79
Q

benadryl overdose

A

anticholinergic

80
Q

tricyclic antidepressant overdose

A

anticholinergic

81
Q

`mad as a hatter….

A

anticholinergic overdose

82
Q

anticholinergic toxierome s/s

A 
mad as a hatter - AMS
blind as a bat -mydrisasis
red as a beet
hot as a hare
dry as a bone
83
Q

rx for anticholinergic overdose

A

benadryl/atropine, tricyclic antidpressants…
atropine for secreations
physostigimine pushed 1mg/min

84
Q

most important intervention for poisionings/overdose

A

revert back to ABC & antidote

Critical Care 1 (14 decks)

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