Toxicology Flashcards
1
Q
Examples of MAO inhibitors
A
- MAOI: phenelzine, selegiline, rasagiline, tranylcypromine
- Linezolid
- Tedizolid
2
Q
Examples of serotonergic medications
A
- SSRI, SNRI, TCA
- Amphetamine derivatives
- Dextromethorphan
- Meperidine
- Tramadol
3
Q
Effects of tramadol
A
- Inhibits reuptake of serotonin and norepinephrine
- Stimulate opioid receptor
4
Q
S/sx of serotonin syndrome
A
- AMS
- agitatioin
- autonomic instability (nausea)
- clonus
- diarrhea
- hyperreflexia
- seizures
- sweating
- shivering
- tachycardia
- tremor
5
Q
Serotonin syndrome presents in a similar fashion as what?
A
neuroleptic malignant syndrome
6
Q
What class of medication is neuroleptic malignant syndrome associated with?
A
antipsychotics
7
Q
What labs can possibly differentiate between neuroleptic malignant syndrome and serotonin syndrome?
A
CK and myoglobin because in neuroleptic malignant syndrome you have significant dystonic reaction of the muscle which can lead to muscle breakdown
8
Q
Treatment of serotonin syndrome
A
- Supportive measures
- Cyproheptadine (5HT1a receptor antagonist): 12mg, then 2mg Q2h OR 4-8mg Q6H PRN
9
Q
Sources of cyanide
A
- metal plating on jewelry
- fires with combustion byproducts within a closed space
- foods: almons, apricot pits, cassava, cherries, seeds
- nitroprusside infusions
10
Q
Pathyphys of cyanide toxicity
A
metabolic acidosis secondary to interrupting mitochondria
11
Q
Physical presentation of cyanide toxicity
A
- flushed/red skin
- cyanosis
- agitated or confused
- tachycardia
- “bitter almond” smelling breath
12
Q
Treatment for cyanide toxicity
A
- Nithiodote: nitrate + thiosulfate -> pulls cyanide out of mitochondria -> thiosulfate turns cyanide into thiosulfate which is excreted in urine; multiple doses; ADE methemoglobinemia, neuropsychiatric symptoms
- Cyanokit: hydroxocobalamin -> binds to cyanide and turns it into cyanocobalamin which is excreted in urine; one time infusion; ADE HTN, rash, red skin/urine
