Toxicology Flashcards
4 yo boy is seen after rattlesnake bite to his hand. He is nauseated and vomits once. HR is 104, BP 95/59. He is alert but has progressive swelling around his hand and fingers. He receives an initial loading dose of CroFab (ovine) and is admitted. The BEST next step in management is:
A) administer Maintainence antivenom
B) observe and elevate the hand
C) obtain CBC, coags, renal function testing
D) perform pressure immobilization
A. For crofab (ovine antivenom), Maintainence dosing needed as opposed to anavip (equine) which has a longer half life and does not necessarily need maintenance dosing.
D is specifically NOT recommended for crotalidae bites. C is true but should have already been done.
16yo is confused, temp 39.5, HR 130, has dilated pupils and dry MM. he is incoherent and grabbing at things no one else sees. He was fine this morning per parents. What is the treatment for his condition?
A) dantrolene
B) NAC
C) physostigmine
D) cefepime
E) atropine
C. Has anticholinergic poisoning —mad as a hatter, blind as a bat, hot as a hare, dry as a bone, full as a flask (urine retention), red as a beet. This med is acetylcholinesterase inhibitor, can increase ACH in synaptic cleft to overcome med inhibition.
Dantrolene is for malignant hyperthermia. Atropine for organophosphate poisoning.
Match the following
A) ethanol
B) methanol
C) ethylene glycol
- Main ingredient in antifreeze
- Treat with supportive care
- Causes visual symptoms/blindness
- Main ingredient in windshield washer fluid
- Treat with bicarbonate, fomepizole, folate
A. Ethanol, 2
B. Methanol, 3,4,5
C. Ethylene glycol, 1, 5
If a teenager presents with agitation, delirium, and bruxism (teeth grinding), what should you suspect?
MDMA ingestion
A patient with respiratory alkalosis plus metabolic acidosis ingested what drug?
Salicylates
Treat: supportive, activated charcoal if <90min, Alkalinize the urine with IV bicarbonate
