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Pharm for final > Toxicology > Flashcards

Toxicology Flashcards

1
Q

When assessing poisoned patients, which drugs cause Mydriasis (Dilated)

A

Adrenergic agonists

Anticholinergics

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2
Q

When assessing poisoned patients, which drugs cause Miosis (Constricted)

A

Sympatholytics

Cholinergics

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3
Q

Acetone odor

A

Ketosis, ethanol, isopropyl alcohol, salicylates

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4
Q

Acrid (pear like) odor

A

Paraldehyde, chloral hydrate

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5
Q

Acrid (aldehyde like) odor

A

Carbon monoxide

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6
Q

Almond odor

A

Cyanide, amygdalin, apricot pits

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7
Q

Carrots odor

A

Cicutoxin (water hemlock)

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8
Q

Disinfectant odor

A

Phenol, creosote

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9
Q

Rotten eggs odor

A

Hydrogen sulfide, mercaptans, disulfiram

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10
Q

Rotten fish odor

A

Zinc/aluminum phosphide

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11
Q

fruit-like odor

A

Amyl nitrite, alcohol, isopropyl alcohol

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12
Q

Garlic odor

A

DMSO, organophosphates, phosphorous, arsenic, arsine gas, thallium

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13
Q

Mothballs odor

A

Camphor

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14
Q

Peanuts odor

A

Rodenticides

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15
Q

Wintergreen odor

A

Methylsalicylate

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16
Q

Syrup of Ipecac

A

Onset 15-20 min
95% vomit in 20 min, 30% reduction in bioavailablity at 1 hour
Side effects:
Acute: Diarrhea, Drowsiness
Chronic: Cardiac arrhythmias, neuropathy, muscle weakness

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17
Q

Lavage

A 
Orogastric retrieval of substance
30% reduction in bioavailability at 1 hour
Lavage fluid- saline
End point- clear returns
Indications-same as general
18
Q

Lavage:contraindications and ADRs

A

Contraindications same EXCEPT
Can lavage patients with CNS Depression if intubated and cuffed with endotracheal tray.
If seizures are controlled and patient is intubated (but don’t lavage if seizure uncontrolled)
DO NOT lavage patients with underlying pathology of esophagus or stomach (ulceration, Chrons)
ADRS
Aspiration (that’s why you provide airway), esophageal/gastric bruising, fluid/electrolyte imbalance (can worsen the situiation. Monitor this), EKG changes, hypoxia, esophageal rupture

19
Q

Activated charcoal

A

Will NOT bind: Low molecular weight, charged compounds; cyanide, bromide, potassium, ethanol, methanol, iron, lithium, alkaline corrosives, mineral acids
Highly concentrated solutions; gasoline, kerosene, alcohols
Efficacy 40% reduction in bioavailability at 1 hour
Cathartics: Promote movement of AC bound drug through GI tract
May cause hypovolemia and electrolyte imbalance
ADR: Vomiting, constipation, aspiration, GI obstruction, charcoal empyema, GI perforation

20
Q

Whole Bowel Irrigation

A 
Reserved for: 
Substances not adsorbed to AC
Very large ingestions
Significant GI hemorrhage
Intestinal obstruction
Unprotected airway
Hemodynamic instability
Endpoint: clearing of rectal effluent
Solutions used: Golytely
21
Q

Multiple Dose Activated Charcoal

A

Interrupts entero-enteric and entero-hepatic recirculation of poison and or poison metabolite
1gm/kg initially followed by ½ g / kg every 2-6 hours
Indications
Theophylline (used to be used for asthma, not anymore, crazy kinetics), carbamazepine, phenobarbital overdose
Contraindications
Ileus, intestinal obstruction, unprotected airway
ADR
Pulmonary aspiration, constipation, fluid and electrolyte imbalance

22
Q

Ion Trapping

A 
Change pH of urine to ionize poison preventing reabsorption
Weak acids (salicylate, phenobarbital) admin sodium bicarb to achieve a urine pH of > 7
23
Q

Chelator: Dimercaprol (BAL)

A

Uses:As, Hg, Pb, Cd
Toxicity: Hypertension, tachycardia

24
Q

Chelator: Penicillamine

A

Uses: Cu, Pb, Hg, As
Toxicity: Allergic reactions

25
Q

Chelator: DMSA (succimer)
Uses:
Toxicity:

A

Uses: Pb, As, Hg
Toxicity: gas, ab pain

26
Q

Chelator: Edetate Calcium Disodium (EDTA)

A

Uses: Pb
Toxicity: Nephrotoxicity

27
Q

Chelator: Deferoxamine

:

A

Uses: Fe
Toxicity: Hypotension, anaphlyactoid reaction, ARDS

28
Q

Antivenins/Biologic Agent: Crotalidae Antivenin

A

Rattlesnake envenomation

29
Q

Lactrodectus antivenin

A

black widow spider envenomation

30
Q

Elapidae Antivenin

A

Eastern and Texas coral snake envenomation

31
Q

Trivalent botulinum

A

Botulism types A, B and E

32
Q

Digoxin Immune Fab

A

Digoxin and Digitoxin

33
Q

Pharmacologic antagonist agents: (List)

A 
N-acetylcysteine
Naloxone
Flumazenil
Atropine
Fomepizole
34
Q

Antivenin/biologic agents (list)

A 
Crotalidae Antivenin
Lactrodectus antivenin
elapidae antivenin
trivalent botulinum
digoxin immune fab
35
Q

Chelators (list)

A 
dimercaprol (BAL)
penicillamine
DMSA (Succimer)
Edetate calcium disodium (EDTA)
Deferoxamine
36
Q

N-acetylcysteine

A

Used for acetaminophen poisoning.

Prevents NAPQI binding at hepatocyte

37
Q

Naloxone

A

For opioid poisoning. Opioid receptor antagonist

38
Q

Flumazenil

A

For benzodiazepine poisoning. Benzodiazepine receptor antagonist.

39
Q

Atropine

A

For organophosphate and pesticide poisoning. Muscarinic receptor antagonist

40
Q

Fomepizole

A

For methanol and ethylene glycol poisoning. Blocks metabolite formation

Pharm for final (11 decks)

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