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Pharm > Toxicology > Flashcards

Toxicology Flashcards

1
Q

Most poisonings involve children under what age?

A

6

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2
Q

Most poisoning death occur in what age range?

A

40-49

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3
Q

What poisonings will cause a patient to smell like rotten eggs?

A

Hydrogen sulfide, mercaptans, disulfiram

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4
Q

What poisonings will cause a patient to smell like garlic?

A

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

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5
Q

What poisoning will cause a patient to smell like wintergreen?

A

methylcalicylate

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6
Q

Poisoning with what will cause the patient to smell like peanuts.

A

Rodenticides

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7
Q

Poisoning with what will cause a patient to smell like mothballs?

A

camphor

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8
Q

A patient will smell like disinfectants if they OD on what?

A

phenol

creosote

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9
Q

A patient will smell like acrid (aldehyde like) if they have what type poisoning.

A

Carbon monoxide

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10
Q

A patient will smell acrid (pear like) with what type poisoning?

A

Paraldehyde, chloral hydrate

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11
Q

What type lab is an assessment of poison concentration in tissues and is useful for antidotes?

A

Quantitative labs

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12
Q

What type lab tests for the presence of a toxin and is expressed as present or absent?

A

Qualitative

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13
Q

For radiopaque compounds what should you do to assess toxicity?

A

Get a radiograph

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14
Q

What does gastrointestinal decontamination reduce?

A

Poisons bioavailability

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15
Q

Does GI decontamination have an improvement in morbidity or mortality?

A

No

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16
Q

What are some contraindications of GI decontamination.

A

Rapid onset of seizures
Rapid onset of CNS depression
Alkaline corrosives (acid controversial)
loss of gag reflex

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17
Q

Where is emesis usually used with toxicity?

A

Rurall settings where there will be a dealy of >1 hour before the patient gets to an ER

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18
Q

How long is the onset for syrup of Ipecac

A

15-20 minutes

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19
Q

What does a lavage do?

A

Orogastric retrieval of substance

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20
Q

Where do you stop a lavage?

A

When there are clear returns

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21
Q

When can you lavage a patient w/ CNS depression

A

If intubated and cuffed with endotracheal tray

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22
Q

Should you lavage patient with underlying pathology of esophagus or stomach?

A

Nope

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23
Q

What type compounds will activated charcoal not bind?

A

low molecular weight charged compounds

highly concentrated solutions

24
Q

What are some compounds activated charcoal won’t bind.

A 
Cyanide
bromide
potassium
ethanol
methanol
iron
lithium
alkaline
corrosives
mineral acids 
gasoline
kerosenes, alcohols
25
Q

What should you use whole bowel irrigation on

A 
Substances not absorbed to AC
Very large ingestions
Significant GI hemorrhage
Obstruction
Unprotected airway
hemodynamic instability
26
Q

What solution is used for whole bowel irrigation

A

Golytely

27
Q

What is the endpoint of whole bowel irrigation

A

Clearing of rectal effluent

28
Q

What are ways to enhance eliminiation

A 
Multiple dose activated charcoal
ion trapping
hemodialysis
forced diuresis
exchanged transfusions
29
Q

What does multiple dose activated charcoal interrupt

A

Enetro-enteric and entero-hepatic recirculation of poison or poison metabolite

30
Q

What are 3 OD indications for multiple dose activated charcoal.

A

Theophylline
Carbamazepine
Phenobarbital OD

31
Q

What are some ADRs of multiple dose activated charcoal.

A

Pulmonary aspiration, constipation, fluid and electrolyte imbalance

32
Q

What does ion trapping do?

A

change pH of urine to ionize poison preventing reabsorption

33
Q

For salicylate and phenobarbital (weak acids) what should you administer for ion trapping.

A

Sodium bicarb to achieve a urine pH > 7

34
Q

What is dimercaprol (BAL) used as a chelator for

A

AS
Hg
Pb
Cd

35
Q

What is penicillamine used as a chelator for

A

Cu
Pb
Hg
As

36
Q

What are 2 toxicities of dimercaprol (BAL)

A

HTN

tachycardia

37
Q

What is EDTA (edetate calcium disodium) used as a chelator for

A

Lead

38
Q

what is a toxicity of EDTA

A

Nephrotoxicity

39
Q

What is deferoxamine used as a chelator for

A

Fe

40
Q

What are some ADRs of deferoxamine

A

Hypotension
anaphlyactoid rxn
ARDS

41
Q

What antivenin is used for a rattlesnake bite

A

Crotalidae antivenin

42
Q

What is used for a black widow bite

A

lactrodectus antivenin

43
Q

What is used to treat eastern and texas coral snake bites

A

Elapidae antivenin

44
Q

What is used to treat botulism types A, B, and E

A

trivalent botulinum

45
Q

What is used to treat digoxin immune Fab

A

Digoxin and Digitoxin

46
Q

What is used to treat acetaminopehn poisoning.

A

N-acetylcysteine

47
Q

How does N-acetylcysteine work

A

Prevents NAPQI from binding at hepatocyte

48
Q

What do you use to treat opioid poisoning

A

Naloxone

49
Q

What is naloxone

A

Opioid receptor antagonist

50
Q

What is used to treat benzodiazepine OD

A

Flumazenil

51
Q

What is flumazenil

A

Benzodiazepine receptor antagonist

52
Q

What is used to treat organophosphate and pesticides poioning

A

Atropine

53
Q

What is atropine

A

Muscarinic receptor antagonist

54
Q

What is used to treat methanol and ethylene glycol poisoning

A

Fomepizole

55
Q

What does fomepizole block

A

Metabolite formation

Pharm (29 decks)

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