Toxicology Flashcards
Zero order kinetics
constant amount of drug is eliminated in a unit of time
-ethanol
First order kinetics
constant percent of the drug is eliminated in time
-most drugs
Ethanol
-Hyperosmolality
-Disulfiram inhibits ALDH = NVF
-EtG and EtS can be detected in urine
-PEth monitored for organ transplant pts
Methanol
-TX: administer ethanol
-Can be removed by dialysis
-Give 4-methylpyrazole to inhibit alcohol dehydrogenase
Isopropanol
-Twice effect on CNS as ethanol
-Metabolized to acetone
Ethylene Glycol
-Oxidized to glycolic acid and oxalic acid = CNS, cardio, renal
-TX: Ethanol, Bicarb, Ca, 4-methylpyrazole
Salicylate (aspirin)
-TX: hydration, glucose, K+, bicarb, hemodialysis
-Toxicity: acidosis
Acetaminophen
-Antidote: N-acetylcysteine
-Charcoal if early presentation
Benzodiazepines
-Antidote: Flumazenil
-CI: in co-ingestion of tricyclic AD (seizures)
Opiates
-TX: Naloxone
-SX: coma, decreased respiration, pinpoint pupils
Cocaine
-Usually detected as inactive metabolite benzoylecgonine in urine
-TX: Diazepam, ice baths
Designer meperidine drug __
caused severe Parkinson’s disease (MPTP)
Digoxin
-Overdoes TX with digoxin FAB (Digibind)
Carbon Monoxide
-Smoke inhalation
-TX is fresh air, O2
Iron Poisoning
Calculate elemental iron dose ingested
- 20 to 60 mg Fe/kg = moderate risk
- > 60 mg/kg has high risk for toxicity
- < 350 g/dl and no sx, no deferoxamine; use supportive care
- > 300 g/dl and sx, give deferoxamine (15 mg/kg/hr)
Antidote: deferoxamine (chelates iron) = vin rose color to urine
