Toxicology

Question 1

home elimination strategy that is not recommended

Answer 1

syrup of ipecac

Question 2

elim strategy best used within 1 hour of ingestion

Answer 2

activated charcoal

Question 3

activated charcoal dose

Answer 3

1 g/kg

Question 4

activated charcoal AEs

Answer 4

vomiting, black tarry stool

Question 5

elimination method best for XR products and body packers?
dose?

Answer 5

whole bowel irrigation
1-2 L/hr

Question 6

2 nonpharm elimination methods

Answer 6

orogastric lavage
hemodialysis

Question 7

toxidrome w/ alert mental, increases in everything, tremors, seizures

Answer 7

symapthomimetic/adrenergic

Question 8

toxidrome with decreased mental, agitated, dry, NO BOWEL sounds, increase in all other vitals

Answer 8

anticholinergic

Question 9

toxidrome with decrease mental, decrease in all vitals, no bowel, hyporeflexia

Answer 9

opioid

Question 10

toxidrome with decrease mental, hyporeflexia, low BP HR RR

Answer 10

sedative-hypnotic

Question 11

toxidrome with decreased mental, SLUDGE, BBB, increase bowel sounds, decrease pupil HR BP

Answer 11

cholinergic

Question 12

drugs levels should always be obtained for

Answer 12

APAP
salicylates

Question 13

what is not recommended for elimination in children

Answer 13

syrup of ipecac, gastric lavage

Question 14

which elim methods CAN be used in children

Answer 14

charcoal
WBI

Question 15

APAP OD in children treatment

Answer 15

AC within 1 hour
NAC

Question 16

treatment options for ethylene glycol/methanol OD in children

Answer 16

ethanol or fomepizole

Question 17

FDA recommends what for cough/cold products in children

Answer 17

avoid in <6 years

Question 18

naloxone dose if non-opioid dependent

Answer 18

IV 0.4 mg

Question 19

naloxone dose if opioid dependent

Answer 19

IV 0.04 mg and titrate

Question 20

AEs of naloxone

Answer 20

runny nose, pulmonary edema

Question 21

how can you prevent/manage pulmonary edema from naloxone

Answer 21

NTG, positive pressure vent.
give smaller initial doses

Question 22

loperamide OD treatment if resp depression? CV distrubances?

Answer 22

resp- naloxone
CV- mag, sodium bicarb, isoproterenol

Question 23

primary treatment for benzo OD

Answer 23

monitoring, supportive care

Question 24

2 main scenarios where flumazenil is used

Answer 24

procedural sedation
unintentional pediatric exposure

Question 25

benzo toxidrome

Answer 25

sedative hypnotic

Question 26

TCA OD toxidrome

Answer 26

anticholinergic

Question 27

are any elimination methods used for TCA OD?

Answer 27

orogastric lavage, charcoal

Question 28

main treatment for TCA OD

Answer 28

hypertonic sodium bicarbonate

Question 29

other treatments for TCA OD complications

Answer 29

dysrhythmias- mag, lidocaine hypotension- vasopressors seizures- benzos

Question 30

should physostigmine be used in TCA OD

Answer 30

NO- asystole

Question 31

bupropion OD toxidrome

Answer 31

sympathomimetic

Question 32

are any elim methods used for bupropion OD?

Answer 32

orogastric lavage, AC, WBI

Question 33

treatment for bupropion OD

Answer 33

supportive, lipid emulsion, ECMO

Question 34

antidote for serotonin syndrome

Answer 34

cyproheptadine

Question 35

labs that are indicative of toxic alcohol OD

Answer 35

metabolic acidosis high osmol gap rule of lactic acid, ketones, renal methanol & ethylene glycol levels

Question 36

ADH inhibitors for toxic alcohol OD

Answer 36

ethanol fomepizole

Question 37

AEs of ethanol

Answer 37

CNS inebriation, thrombophlebitis, GI

Question 38

fomepizole AEs

Answer 38

HA nausea dizzy

Question 39

supplements for methanol OD? ethylene glycol?

Answer 39

methanol-- folic acid EG-- mag, thiamine, pyridoxine

Question 40

differentiating diagnostic for CCB vs BB OD?

Answer 40

glucose elevated in CCB OD

Question 41

toxidrome for CCB/BB OD

Answer 41

bradycardia hypotension

Question 42

are any elimination methods used for antiHTN OD

Answer 42

AC, WBI

Question 43

what are the steps of things done for antiHTN OD (9 CCB, 10 BB)

Answer 43

fluids atropine calcium glucagon--- BB OD ONLY high dose insulin & glucose vasopressors inotropes cardiac pacing intralipid VA-ECMO

Question 44

glucagon AE

Answer 44

vomiting

Question 45

where do you want to maintain glucose levels when treating antiHTN OD

Answer 45

>100 mg/dl

Question 46

what can be used for clonidine OD if there is resp depression

Answer 46

high dose naloxone 5-10 mg bolus +/- infusion

Question 47

presentation of ACUTE digoxin toxicity

Answer 47

NVS, HA, confusion, halos/colors, hyperkalemia

Question 48

are any elim methods used for digoxin OD

Answer 48

activated charcoal

Question 49

when is digifab used in ACUTE OD

Answer 49

k>5, level >20 mcg/L, progressing toxicity

Question 50

when is digifab used for CHRONIC OD

Answer 50

post-dist level >6 mcg/L, progressing/severe toxicity

Question 51

recommended dose of digifab for ACUTE OD

Answer 51

1 vial binds 0.5 mg so calculate or if unknown ingestion- 10 vials

Question 52

recommended dose of digifab for CHRONIC OD

Answer 52

5 vials in adults, 3 vials in children

Question 53

what is a bezoar? what is effect?

Answer 53

concretion of ASA slowly releasing it into the GIT may not see high levels bc of it can give charcoal

Question 54

main treatment for ASA OD

Answer 54

ion trapping with sodium bicarbonate dextrose

Question 55

what is used for ASA OD if levels >100 ACUTE or >60 CHRONIC, or severe presentation

Answer 55

hemodialysis

Question 56

what is the main drug class used for treat cannabinoid tox

Answer 56

benzos

Question 57

5 treatment options for hyperemesis syndrome for cannabinoids

Answer 57

hot showers capsaicin haloperidol/zofran benzos supportive- fluids

Question 58

clinical effects of sympathomimetic tox

Answer 58

INC BP HR RR temp pupil bowel sound diaphoresis agitated hyperalert tremor seizures

Question 59

main class used to manage sympathomimetic OD? others?

Answer 59

benzos Na bicarb/lidocaine for dysrhythmia fluids for rhabdo cooling methods AC for elim

Question 60

how to treat cocaine or amphetamine OD

Answer 60

benzos