Toxicology Flashcards
What 4 stages define the progression of drug use?
- Experimentation
- Regular use
- Tolerance
- Dependency/addiction
What are the 4 stages of Liver damage? Abuse of what common substance causes liver damage?
Alcoholism is very damaging to the liver. The 4 stages of damage are:
1. Inflammation
2. Fibrosis
3. Cirrhosis
4. Liver failure
A patient appears confused and restless. They tell you they just developed a fever and have been seeing things that aren’t there. Their only abnormal vital sign is hypotension and they have no injuries. What substance have they potentially been abusing?
These symptoms are typical of delirium tremens as a result of alcohol withdrawal.
A patient has had to be restrained by police before you arrive. The police state that the Pt “took 3 tasers and kept coming, it took 4 officers to bring them down.” The Pt appears agitated. What drug have they likely been using?
Phencyclidine (PCP) a.k.a “angel dust” (a.k.a “angle” dust according to Logan).
What is the difference between an opiate and an opioid?
Opiate: naturally derived (heroin, morphine, and codeine)
Opioid: synthetic (hyrdo/oxycodone, fentanyl, methadone)
What is the typical presentation of a patient who has overdosed on opioids/opiates?
DLOC, respiratory depression/absence, bradycardia, hypotension, constricted pupils.
What is the etiology behind carbon monoxide poisoning?
The carbon monoxide (CO) molecules bind preferentially to hemoglobin, preventing oxygen from being bound. Patients can present as having 100% SpO2 but in reality they are hypoxic.
If a toxidrome enhances the effects of the parasympathetic nervous system (ex: organophosphates) how will an exposed patient present?
Wet. They may have excessive urination, sweating, salivation, emesis, diarrhea, etc.
If a toxidrome inhibits the effects of the parasympathetic nervous system (ex: antihistamines, antidepressants) how will an excessively exposed patient present?
Dry. May be flushed but won’t be sweating or peeing or pooing excessively.
If a patient experiences excessive exposure to chlorine gas, how will they present?
Depending on the concentration and duration of exposure, they may have urticaria and pruritus from the reaction of chlorine with water on your skin (forms hydrochloric acid).
Besides supporting a patient’s ABCs, what might be your most important course of action when treating a Pt you suspect to be suffering a toxicological emergency?
Try to figure out what they were exposed to! (but not at the expense of rapid transport)
