Toxicology Flashcards
1
Q
What are the features of anticholinergic toxidrome?
A
CVS:
- tachycardia, arrhythmias,
- hypotension/dehydration
Neuro:
- Mydriasis
- confusion
- seizures
Other:
- dry mouth
- flushed skin
- constipation/absent bowel sounds
- urinary retention
Hot as the desert Dry as a bone Blind as a bat Red as a beet Mad as a hatter
2
Q
Which drugs can be dialysed?
A
BLAST ME
B - barbiturates L - Lithium A - aminophylline S - salicylates T - Theophylline
M - Metformin/methanol
E - ethylene glycol
3
Q
What are the features of those molecules that cannot be dialysed?
A
- Heavily protein bound
- Large molecular weight >60kDa
- High volume of distribution
4
Q
What are the features of cholinergic toxidrome?
A
E.g. organophosphates/nerve agents
SLUDGE
S - salivation L - lacrimation U - urination D - diarrhoea G - Gastrointestinal upset E - Emesis
Other features:
CVS: Bradycardia, hypotension
Neuro: confusion, miosis
5
Q
What toxidromes are you aware of? What are their antidotes?
A
- Cholinergic - SLUDGE - Pralidoxime
- Anticholinergic - Amitriptyline - Physostigmine
- Sedative - benzos - Flumazenil
- Narcotic - opiate - naloxone
- Seratonergic - SSRI, tramadol, confusion, autonomic features, NM excitability - cyproheptadine
- Sympathomimetic - raised RR, HR, temp - beta blockers
6
Q
In which drugs are activated charcoal indicated?
A
Salicylates Digoxin Carbamazepine Barbiturates Theophylline/TCA Quinine
7
Q
What is the pathophysiology of cyanide poisoning?
A
Inhibits mitochondrial cytochrome oxidase, inhibiting cellular oxygen utilisation.
Causing tissue hypoxia.
Hydroxycobalamin is antidote
