Toxicology Flashcards
Poison
Any substance that impairs health or causes death by its chemical action when it enters the body or come in contact with skin
Toxicology
Study of toxins, antidotes, and the effects of toxins on the body
Antidote
Substance that will neutralize or counteract the effects of poison
Common Antidotes
- Naloxone = Narcotic OD
- Oxygen = Carbon Monoxide poisoning
- Atropine 2 Pam Chloride = Pesticide/ Nerve gas exposure
Ingestion
- Drug/ substance swallowed/ absorbed into GI tract/ small intestine
- Slow onset
- Most common
- Find out what they took, how much, when and their weight
Ingestion SxSx
- Swelling or burns around the mouth
- Nausea/ vomiting/ diarrhea
- ALOC
- Abdominal pain
- Others, depending on drug
What does Activated Charcoal do?
Trade names:
- Actidose, Actidose- aqua
Actions:
- Binds to poisons in the stomach, not allowing them to be get absorbed in the blood stream
Activated Charcoal Side effects
- Black stools
- Vomiting
- Repeat dose if patient vomits
Activated Charcoal Indications and Contradictions
Indications:
- Ingestion
- Within one hour of ingestion
Contradictions
- Inability to swallow
- ALOC
- Acids or alkalis (bleach, ethyl alcohol)
- Cyanide
Activated Charcoal Dose
- 1gm/ kg
- Adults: 30- 100g
- Children: 12.5- 25g
Inhalation
- Breathing in a poison
- Rapid onset
Inhalation SxSx
- Dyspnea
- Chest pain
- Airway or breathing sounds (Stridor, Hoarseness, Coughing, Wheezing, Crackles)
- Neurological issues (Dizzy, Headache, ALOC,, Seizures)
What is Injection and some examples?
- Injected under the skin, into a muscle, or directly into a blood stream
- Bites and stings
- Drugs
Injections SxSx
- Injection site swelling
- Euphoria
- Nausea/ vomiting
- Weakness/ Fever/ Chills
What is Absorption?
- Poison enters through skin or mucous membranes
- Plant or chemicals
Absorption SxSx
- Liquid or powders on skin
- Burns/ blisters
- Rash
- Itching/ redness/ swelling
What is Carbon Monoxide poisoning and examples?
- Colorless, tasteless, odorless gas
- Binds to RBC at a much higher affinity than hemoglobin, so hemoglobin cannot bind
- Causes: incomplete combustion (furnaces, water heaters, gas stove, fire places, car exhausts)
Carbon Monoxide poisoning SxSx
- Headache
- Nausea/ vomiting
- Confusion
- Cherry red lips/ skin (Late sign)
Skins are still pink because RBC’s are fully saturated
Pesticide Exposure/ SLUDGEM
- includes insecticides and nerve agents
- Salvation
- Lacrimation
- Urination
- Defecation
- GI upset
- Emesis (vomiting)
- Miosis (construction of pupils)
Drug Abuse
Self admin of drugs or medications in a manner not approved by medical or social norms
Overdose
Poisoning with drugs or alcohol
Withdrawal
Period of abstinence from a drug to which the body has become accustomed
Tolerance
Larger doses required to get the same effect
Drugs/ Alcohol Withdrawal Stage ONE
- 8 hours from last drink
- Nausea, insomnia, sweating, tremors
Drugs/ Alcohol Withdrawal Stage TWO
- 8-72 hours from last drink
- Worsening symptoms
- Hallucinations start
Drugs/ Alcohol Withdrawal Stage THREE
- 48 hours plus from last drink
- Same S/S
- Seizures can happen in this stage
Drugs/ Alcohol Withdrawal Stage FOUR
- 1-14 days since last drink
- Delirium Tremens/ DT’s
- True medical emergency, life threatening
- Loss of memory, hallucinations, fevers, sweating, insomnia, confusion, psychosis
- Can last three days
What are Opioids?
- Depressant derived from opium or synthetics
What are examples of opioid/ narcortics?
- Heroin
- Fentanyl
- Morphine
- Vicodin/ Hydrocodone
- Percocet/ Oxycontin/ Oxycodone
- Dilaudid
Opioids SxSx
- Respiratory depression or arrest
- Pinpoint pupils
- Hypotension
Naloxone/ Narcan Indications and Contradictions
Indications:
- Suspected Opioid OD with respiratory depression (less than 12 or arrest)
Contradictions:
- Known hypersensitivity
Naloxone/ Narcan Actions and Side effects
Actions:
- Opioid antagonist
- Binds to opioid receptors site to reverse respiratory depression
Side effects:
- Possible acute withdrawal
Naloxone/ Narcan Dosage
Intranasal= 2 mg (1mg per nostril)
CNS Stimulant
- Excite the CNS
- Cocaine, crack, meth, PCP, diet pills, MDMA/ ecstacy
Examples of CNS stimulants
- Cocaine
- crack
- meth
- PCP
- diet pills
-MDMA/ ecstacy
CNS Stimulant SxSx
- Excitable
- Nervous
- Hypertension
- Dilated Pupils
- Tachycardia
CNS Depressant
- Depress the CNS
Examples of CNS depressants
- Alcohol
- Benzodiazepines (Xanax/ Alprazolam, Ativan, Valium)
CNS Depressant SxSx
- Euphoria
- Drowsy
- Dilated pupils
- Sluggish
- Bradypnea
What are Hallucinogens
- Cause hallucinations, psychedelic drugs
Examples of Hallucinogens
- LSD
- PCP
- Bath salts
- MDMA
- Ketamine
- Mushrooms
Hallucinogens SxSx
- Anxiety/ Paranoia
- Violent behavior
- Hallucinations
- Dilated pupils
- Tachycardia
Why are skins red in carbon monoxide poisoning?
RBC are fully saturated with carbon monoxide molecules because they are more adhesive than oxygen. Late sign.
