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emergency medicine > Toxicology > Flashcards

Toxicology Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

what are 2 diagnostics to get immediately?

A

Urine dipstick
ECG

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2
Q

what are 4 agents that are parasympathetic toxidromes?

A

organophosphates
insecticides
tobacco
poison hemlock
mushrooms

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3
Q

inhibits the enzyme acetylcholinesterase which leads to acetylcholine accumulation and overstimulation of receptors.

A

parasympathetic (cholinergic) syndrome

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4
Q

patient presents with agitation/seizures, miosis, increased salivation, increased lung secretions, increased GI motility, increased sweating, and fasciculations/paralysis of muscles. Dx?
2 treatment options?

A

parasympathetic (cholinergic) syndrome

atropine / pralidoxime

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5
Q

what are 4 agents that are sympathomimetic toxidromes?

A

cocaine
amphetamines
PCP
catecholamines

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6
Q

CNS excitation with inhibition of norepi and dopamine reuptake

A

sympathomimetic syndrome

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7
Q

patient presents with agitation/combative, mydriasis, decreased salivation, decreased lung secretions, increased HR, decreased GI motility, increased sweating, and hyperthermia. Dx?
Treatment? (2)

A

sympathomimetic syndrome

active cooling
benzodiazepine
+/- IV fluids for rhabdomyolysis

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8
Q

what are 4 agents that are antimuscarinic (anticholinergic) toxidromes?

A

antihistamines (diphenhydramine)
antipsychotics
TCA
antiparkinsonian meds

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9
Q

patient presents with decreased sweat production, dry skin, hyperthermia, mydriasis with blurry vision, hallucinations, and cannot urinate. Dx?
Treatment?

A

antimuscarinic (anticholinergic) syndrome

supportive care + physostigmine

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10
Q

what are 4 agents that are sedative/hypnotic toxidromes?

A

benzodiazepines
ETOH
propofol
gabapentin

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11
Q

patient presents with decreased mental status, decreased rate of lung secretions, decreased HR, and hypothermia. Dx?
treatment?

A

sedative/hypnotic syndrome

supportive
+/- flumazenil

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12
Q

patient presents with seizures, AMS, mydriasis, increased rate of lung secretions, increased HR, and hyperthermia/tremors. Dx?
Treatment? (2)

A

sedative/hypnotic withdrawal

benzodiazepine
thiamine

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13
Q

patient presents with mydriasis/lacrimation of eyes, yawning, increased lung secretions, increase HR, N/V/D, and piloerection. Dx?
3 treatment options?

A

opioid withdrawal

clonidine (supportive)

methadone
buprenorphine

detox

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14
Q

why is gastric emptying with ipecac no longer used?

A

high risk of aspiration

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15
Q

reserved for cases with high morbidity and with sustained-release drugs.

A

gastric lavage

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16
Q

when can activated charcoal be considered?

A

if early < 1 hour

17
Q

what does activated charcoal fail to absorb?

A

“PHAILS”

Potassium
Heavy metals
Alcohols, Acids
Iron
Lithium
Solvents

18
Q

what is the antidote for acetaminophen?

A

N-acetylcysteine

19
Q

what can be done if acetaminophen was ingested less than 8 hours ago?

A

plot on nonogram

20
Q

what is the antidote for TCAs?

A

sodium bicarbonate

21
Q

what are 3 antidotes for beta-blocker?

A

epinephrine / norepinephrine
glucagon
insulin w/ glucose

22
Q

what are 4 antidotes for calcium channel blocker?

A

calcium chloride
epi / norepi
glucagon
insulin w/ glucose

23
Q

what is the antidote for iron?

A

deferoxamine

24
Q

what is the antidote for cyanide?

A

hydroxocobalamin

25
Q

what are 2 antidotes for organophosphates?

A

atropine
pralidoxime

26
Q

what are 2 antidotes for sulfonylureas?

A

dextrose
octreotide

27
Q

what is the antidote for hydrofluoric acid?

A

calcium

28
Q

what are 2 antidotes for methanol and ethylene glycol?

A

ethanol
fomepizole

29
Q

what is the antidote for opiates?

A

naloxone

30
Q

why is flumazenil not used for benzodiazepine overdose?

A

it can cause seizures

31
Q

what is the antidote for carbon monoxide?

A

oxygen / hyperbaric chamber

32
Q

what is the antidote for snakebite?

A

CroFab

33
Q

what should always be considered early in treating toxicities?

A

DONT

Dextrose
Oxygen
Naloxone
Thiamine

emergency medicine (12 decks)

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