Toxicology

Question 1

Poison

Answer 1

Any substance that impairs health or causes death by its chemical action when it enters the body or come in contact with skin

Question 2

Toxicology

Answer 2

Study of toxins, antidotes, and the effects of toxins on the body

Question 3

Antidote

Answer 3

Substance that will neutralize or counteract the effects of poison

Question 4

Common Antidotes

Answer 4

• Naloxone = Narcotic OD
• Oxygen = Carbon Monoxide poisoning
• Atropine 2 Pam Chloride = Pesticide/ Nerve gas exposure

Question 5

Ingestion

Answer 5

• Drug/ substance swallowed/ absorbed into GI tract/ small intestine
• Slow onset
• Most common
• Find out what they took, how much, when and their weight

Question 6

Ingestion SxSx

Answer 6

• Swelling or burns around the mouth
• Nausea/ vomiting/ diarrhea
• ALOC
• Abdominal pain
• Others, depending on drug

Question 7

What does Activated Charcoal do?

Answer 7

Trade names:
- Actidose, Actidose- aqua

Actions:
- Binds to poisons in the stomach, not allowing them to be get absorbed in the blood stream

Question 8

Activated Charcoal Side effects

Answer 8

• Black stools
• Vomiting
• Repeat dose if patient vomits

Question 9

Activated Charcoal Indications and Contradictions

Answer 9

Indications:
- Ingestion
- Within one hour of ingestion

Contradictions
- Inability to swallow
- ALOC
- Acids or alkalis (bleach, ethyl alcohol)
- Cyanide

Question 10

Activated Charcoal Dose

Answer 10

• 1gm/ kg
• Adults: 30- 100g
• Children: 12.5- 25g

Question 11

Inhalation

Answer 11

• Breathing in a poison
• Rapid onset

Question 12

Inhalation SxSx

Answer 12

• Dyspnea
• Chest pain
• Airway or breathing sounds (Stridor, Hoarseness, Coughing, Wheezing, Crackles)
• Neurological issues (Dizzy, Headache, ALOC,, Seizures)

Question 13

What is Injection and some examples?

Answer 13

• Injected under the skin, into a muscle, or directly into a blood stream
• Bites and stings
• Drugs

Question 14

Injections SxSx

Answer 14

• Injection site swelling
• Euphoria
• Nausea/ vomiting
• Weakness/ Fever/ Chills

Question 15

What is Absorption?

Answer 15

• Poison enters through skin or mucous membranes
• Plant or chemicals

Question 16

Absorption SxSx

Answer 16

• Liquid or powders on skin
• Burns/ blisters
• Rash
• Itching/ redness/ swelling

Question 17

What is Carbon Monoxide poisoning and examples?

Answer 17

• 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)

Question 18

Carbon Monoxide poisoning SxSx

Answer 18

• Headache
• Nausea/ vomiting
• Confusion
• Cherry red lips/ skin (Late sign)

Skins are still pink because RBC’s are fully saturated

Question 19

Pesticide Exposure/ SLUDGEM

Answer 19

• includes insecticides and nerve agents
• Salvation
• Lacrimation
• Urination
• Defecation
• GI upset
• Emesis (vomiting)
• Miosis (construction of pupils)

Question 20

Drug Abuse

Answer 20

Self admin of drugs or medications in a manner not approved by medical or social norms

Question 21

Overdose

Answer 21

Poisoning with drugs or alcohol

Question 22

Withdrawal

Answer 22

Period of abstinence from a drug to which the body has become accustomed

Question 23

Tolerance

Answer 23

Larger doses required to get the same effect

Question 24

Drugs/ Alcohol Withdrawal Stage ONE

Answer 24

• 8 hours from last drink
• Nausea, insomnia, sweating, tremors

Question 25

Drugs/ Alcohol Withdrawal Stage TWO

Answer 25

- 8-72 hours from last drink - Worsening symptoms - Hallucinations start

Question 26

Drugs/ Alcohol Withdrawal Stage THREE

Answer 26

- 48 hours plus from last drink - Same S/S - Seizures can happen in this stage

Question 27

Drugs/ Alcohol Withdrawal Stage FOUR

Answer 27

- 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

Question 28

What are Opioids?

Answer 28

- Depressant derived from opium or synthetics

Question 29

What are examples of opioid/ narcortics?

Answer 29

- Heroin - Fentanyl - Morphine - Vicodin/ Hydrocodone - Percocet/ Oxycontin/ Oxycodone - Dilaudid

Question 30

Opioids SxSx

Answer 30

- Respiratory depression or arrest - Pinpoint pupils - Hypotension

Question 31

Naloxone/ Narcan Indications and Contradictions

Answer 31

Indications: - Suspected Opioid OD with respiratory depression (less than 12 or arrest) Contradictions: - Known hypersensitivity

Question 32

Naloxone/ Narcan Actions and Side effects

Answer 32

Actions: - Opioid antagonist - Binds to opioid receptors site to reverse respiratory depression Side effects: - Possible acute withdrawal

Question 33

Naloxone/ Narcan Dosage

Answer 33

Intranasal= 2 mg (1mg per nostril)

Question 34

CNS Stimulant

Answer 34

- Excite the CNS - Cocaine, crack, meth, PCP, diet pills, MDMA/ ecstacy

Question 35

Examples of CNS stimulants

Answer 35

- Cocaine - crack - meth - PCP - diet pills -MDMA/ ecstacy

Question 36

CNS Stimulant SxSx

Answer 36

- Excitable - Nervous - Hypertension - Dilated Pupils - Tachycardia

Question 37

CNS Depressant

Answer 37

- Depress the CNS

Question 38

Examples of CNS depressants

Answer 38

- Alcohol - Benzodiazepines (Xanax/ Alprazolam, Ativan, Valium)

Question 39

CNS Depressant SxSx

Answer 39

- Euphoria - Drowsy - Dilated pupils - Sluggish - Bradypnea

Question 40

What are Hallucinogens

Answer 40

- Cause hallucinations, psychedelic drugs

Question 41

Examples of Hallucinogens

Answer 41

- LSD - PCP - Bath salts - MDMA - Ketamine - Mushrooms

Question 42

Hallucinogens SxSx

Answer 42

- Anxiety/ Paranoia - Violent behavior - Hallucinations - Dilated pupils - Tachycardia

Question 43

Why are skins red in carbon monoxide poisoning?

Answer 43

RBC are fully saturated with carbon monoxide molecules because they are more adhesive than oxygen. Late sign.