Toxicology Flashcards
Antidote to acetaminophen toxicity
N-acetyl cysteine
Antidote to aspirin toxicity
Bicarbonate to alkalinize the urine
Antidote to carbon monoxide toxicity
100 percent oxygen, hyperbaric in some cases
Antidote to digoxin toxicity
Digoxin-binding antibodies
Antidot to ethylene glycol toxicity
Fomepizole or ethanol
Antidote to methanol toxicity
Fomepizole or ethanol
Antidote to methemoglobinemia
Methylene blue
Antidote for neuroleptic malignant syndrome
Bromocriptine
Dantrolene
Antidote to opiate toxicity
Naloxone
Antidote to organophosphate toxicity
Atropine
Pralidoxime
Antidote to TCA toxicty
Bicarbonate protects the heart
Antidote to phenothiazines
Diphenhydramine
Benztropine
Antidote to lead
EDTA (ethylenediaminetetraacetetic acid)
Dimercaprol (BAL)
Succimer
Antidote to warfarin
Fresh frozen plasma (FFP)
Vitamin K
Antidote to anticholinergics
Physostigmine
Antidote to arsenic, mercury
Dimercaprol (BAL)
Succimer
Antidote to beta-blockers
Glucagon
Antidote to atropine
Physostigmine
Antidote to cyanide
Sodium nitrite
Thiosulphate
Antidote to heparin
Protamine sulfate
Antidote to nitrites
Methylene blue
Antidote to iron
Deferoxamine
A 14-year-old boy is hospitalized for acute cholinergic toxicity after having been exposed to pesticides in a local orchard. Without treatment, what neuromuscular effects might he have experienced?
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 1992-1995). McGraw-Hill. Kindle Edition.
Muscle fasciculations, weakness, and paralysis.
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 1992-1995). McGraw-Hill. Kindle Edition.
Hyperthermia.
List likely toxin/drug ingested
- Amphetamines
- Anticholinergics
- ASA
- Cocaine
- Neuroleptics
- Nicotine
- PCP
- SSRIs
- Thyroid medication
Use the mneumonics “TA CAN SPAN”
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2002-2003). McGraw-Hill. Kindle Edition.
*
Hypothermia.
List likely toxin/drug ingested
- Alcohol
- Barbiturates
- Carbon monoxide
- Sedative-hypnotics.
Use the mneumonics “SCAB”
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Location 2004). McGraw-Hill. Kindle Edition.
Tachycardia
List likely toxin/drug ingested
- Amphetamines
- Anticholinergics
- Cocaine
- PCP
- Thyroid medication
- TCAs
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2005-2006). McGraw-Hill. Kindle Edition.
Bradycardia
List likely toxin/drug ingested
- β-blockers
- Calcium channel blockers (CCBs)
- Cholinergics
- Clonidine
- Digitalis
- Opiates
- Parasympathomimetics.
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2007-2008). McGraw-Hill. Kindle Edition.
Tachypnea
List likely toxin/drug ingested
- Organophosphates (eg, pesticides)
- Salicylates.
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Location 2009). McGraw-Hill. Kindle Edition.
Respiratory depression
List likely toxin/drug ingested
- Barbiturates
- Benzodiazepines
- Opiates
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2010-2014). McGraw-Hill. Kindle Edition.
** Hypertension**
List likely toxin/drug ingested
- Amphetamines
- Anticholinergics
- Cocaine
- PCP
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2010-2014). McGraw-Hill. Kindle Edition.
Hypotension
List likely toxin/drug ingested
- Alcohol
- β-blockers
- CCBs
- Digitalis
- Opiates
- Organophosphates
- Sedative-hypnotics
- TCAs.
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2010-2014). McGraw-Hill. Kindle Edition.
List the likely toxin or drug based on the breath odor
- Violets
- Pear
- Bitter almonds
- Garlic
- Mothballs
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2017-2023). McGraw-Hill. Kindle Edition.
- Violets: Turpentine
- Pear: Chloral hydrate
- Bitter almonds: Cyanide
- Garlic: Arsenic, DMSO, organophosphates
- Mothballs: Camphor, naphthalene
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2017-2023). McGraw-Hill. Kindle Edition.
List the likely toxin or drug based on the pupilary constriction (miosis)
- Clonidine
- Opiates
- Pontine bleed
- Sedative-hypnotics
Use “COPS”
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2025-2033). McGraw-Hill. Kindle Edition.
List the likely toxin or drug based on the pupilary dilatation (mydriasis)
- Amphetamines
- Anticholinergics
- Cocaine
Remember with “Affordable Care Act (ACA)”
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2025-2033). McGraw-Hill. Kindle Edition.
List the likely toxin or drug based on pulmonary edema
- Cocaine
- Ethylene glycol
- Opiates
- Organophosphates
- Salicylates
- Toxic inhalations (chlorine, nitric oxide, phosgene)
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2025-2033). McGraw-Hill. Kindle Edition.
- List the likely toxin or drug based on increased bowel movement
- List the likely toxin or drug based on decreased bowel movement
- Increased: Sympathomimetics, opiate withdrawal
- Decreased: Anticholinergics, opiate toxicity
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2025-2033). McGraw-Hill. Kindle Edition.
List the likely toxin or drug based on the following skin findings:
- Needle tracks
- Diaphoresis
- Jaundice
- Alopecia
- Cyanosis
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2036-2045). McGraw-Hill. Kindle Edition.
- Needle tracks: Opiates
- Diaphoresis: Organophosphates, salicylates, sympathomimetics
- Jaundice: Acetaminophen (after liver failure), mushroom poisoning
- Alopecia: Arsenic, chemotherapeutic agents, thallium
- Cyanosis: Drugs causing methemoglobinemia (eg, aniline dyes, “caine” anesthetics, chlorates, dapsone, nitrates/nitrites, sulfonamides)
Le, Tao; Bhushan, Vikas; Herman Bagga (2010-09-21). First Aid for the USMLE Step 3, Third Edition (First Aid USMLE) (Kindle Locations 2036-2045). McGraw-Hill. Kindle Edition.
List the symptoms and signs of cholinergic toxicity
- Diarrhea
- Urination
- Miosis
- Bradycardia
- Bronchospasm
- Emesis
- Lacrimation
- Salivation
Usemenumonic: DUMBBELS
Examples of cholinergics
- Muscarine-containing mushrooms
- Organophosphates
- Pilocarpine
- Pyridostigmine
List the symptoms and signs of anticholinergic toxicity
- Fever
- Skin flushing
- Dry mucous membrane
- Psychosis
- Mydriasis
- Tachycardia
- Urinary retention
“Hot as a hare, red as a beet, dry as a bone, mad as a hatter, blind as a bat”
Examples of anticholinergics
- Antihistamines
- Antipsychotics
- Atropine
- Jimson weed
- Scopalamine
- TCAs
List the symptoms and signs of opioid toxicity
- Coma
- Respiratory depression
- Miosis
- Bradycardia
- Hypothermia
- Diminished bowel sounds
Examples of opioids
- Heroin
- Morphine
- Oxycordone
List the symptoms and signs of sedative-hypnotic toxicity
- CNS depression
- Respiratory depression
- Coma
Examples of sedative-hypnotics
- Alcohol
- Barbiturates
- Benzodiazepines
List the symptoms and signs of hallucinogenic toxicity
- Disorientation
- Panic
- Seizures
- HTN
- Tachycardia
- Tachypnea
Examples of hallucinogenics
- Amphetamines
- Cocaine
- PCP
List the symptoms and signs of extrapyramidal medications toxicity
- Tremors
- Torticollis
- Trismus
- Rigidity
- Oculogyric crisis
- Opisthotonus
- Dysphosia
- Dysphagia
Examples of extrapyramida medications
- Haloperidol
- Meteclopramide
- Phenothiazines