Toxicology

Question 1

what is a toxidrome?

Answer 1

term given to the syndrome when exposed to a toxin

Question 2

what are the main toxidromes?

Answer 2

• opioid
• anticholinergic
• cholinergic
• sympathomimetic
• sedative/hypnotic

Question 3

name an opiate substance?

Answer 3

heroin

Question 4

what are the signs of an opioid overdose?

Answer 4

pinpoint pupils, reduced HR, reduced RR, reduced GCS

Question 5

what is the management for opioid overdose?

Answer 5

naloxone

Question 6

what are 2 examples of an anticholinergic drug?

Answer 6

amitriptyline, antihistamines

Question 7

signs of anticholinergic overdose?

Answer 7

hyperthermia
agitated/hypervigilant
dilated pupils
dry flushed skin
tachycardic
hypertensive
urinary retention

Question 8

what is the quote to remember anti-cholinergic overdose

Answer 8

‘hot as hades, mad as a hatter, blind as a bat, dry as a bone, red as a beet’.

Question 9

name 2 cholinergic substances?

Answer 9

• organophosphate pesticides (farmers)
• some mushrooms

(uncommon presentation)

Question 10

signs of cholinergic overdose?

Answer 10

confusion
miosis
brady or tachycardia
SLUDGE (salivation, lacrimation, urination, diarrhoea, GI upset, emesis).

Question 11

name some sympathomimetic substances?

Answer 11

cocaine
amphetamines
MDMA
caffeine

Question 12

signs of sympathomimetic overdose?

Answer 12

tachycardia, hypertension, hyperthermia, agitation, mydriasis (dilated pupils), diaphoresis (excessive sweating)

Question 13

name 2 sedative substances?

Answer 13

• benzodiazepines
• anxiolytics/sleeping tablets

Question 14

signs of sedative overdose

Answer 14

bradycardia, hypothermia, reduced RR, reduced GCS

Question 15

ECG what are you looking for?

Answer 15

prolonged QTc/arrhythmia

Question 17

what tests are you ordering?

Answer 17

bloods including paracetamol/salicylate
blood gases - including acid base status