Toxicology Flashcards

1
Q

home elimination strategy that is not recommended

A

syrup of ipecac

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2
Q

elim strategy best used within 1 hour of ingestion

A

activated charcoal

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3
Q

activated charcoal dose

A

1 g/kg

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4
Q

activated charcoal AEs

A

vomiting, black tarry stool

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5
Q

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

A

whole bowel irrigation
1-2 L/hr

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6
Q

2 nonpharm elimination methods

A

orogastric lavage
hemodialysis

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7
Q

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

A

symapthomimetic/adrenergic

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8
Q

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

A

anticholinergic

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9
Q

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

A

opioid

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10
Q

toxidrome with decrease mental, hyporeflexia, low BP HR RR

A

sedative-hypnotic

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11
Q

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

A

cholinergic

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12
Q

drugs levels should always be obtained for

A

APAP
salicylates

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13
Q

what is not recommended for elimination in children

A

syrup of ipecac, gastric lavage

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14
Q

which elim methods CAN be used in children

A

charcoal
WBI

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15
Q

APAP OD in children treatment

A

AC within 1 hour
NAC

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16
Q

treatment options for ethylene glycol/methanol OD in children

A

ethanol or fomepizole

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17
Q

FDA recommends what for cough/cold products in children

A

avoid in <6 years

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18
Q

naloxone dose if non-opioid dependent

A

IV 0.4 mg

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19
Q

naloxone dose if opioid dependent

A

IV 0.04 mg and titrate

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20
Q

AEs of naloxone

A

runny nose, pulmonary edema

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21
Q

how can you prevent/manage pulmonary edema from naloxone

A

NTG, positive pressure vent.
give smaller initial doses

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22
Q

loperamide OD treatment if resp depression? CV distrubances?

A

resp- naloxone
CV- mag, sodium bicarb, isoproterenol

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23
Q

primary treatment for benzo OD

A

monitoring, supportive care

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24
Q

2 main scenarios where flumazenil is used

A

procedural sedation
unintentional pediatric exposure

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25
Q

benzo toxidrome

A

sedative hypnotic

26
Q

TCA OD toxidrome

A

anticholinergic

27
Q

are any elimination methods used for TCA OD?

A

orogastric lavage, charcoal

28
Q

main treatment for TCA OD

A

hypertonic sodium bicarbonate

29
Q

other treatments for TCA OD complications

A

dysrhythmias- mag, lidocaine
hypotension- vasopressors
seizures- benzos

30
Q

should physostigmine be used in TCA OD

A

NO- asystole

31
Q

bupropion OD toxidrome

A

sympathomimetic

32
Q

are any elim methods used for bupropion OD?

A

orogastric lavage, AC, WBI

33
Q

treatment for bupropion OD

A

supportive, lipid emulsion, ECMO

34
Q

antidote for serotonin syndrome

A

cyproheptadine

35
Q

labs that are indicative of toxic alcohol OD

A

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

36
Q

ADH inhibitors for toxic alcohol OD

A

ethanol
fomepizole

37
Q

AEs of ethanol

A

CNS inebriation, thrombophlebitis, GI

38
Q

fomepizole AEs

A

HA nausea dizzy

39
Q

supplements for methanol OD? ethylene glycol?

A

methanol– folic acid
EG– mag, thiamine, pyridoxine

40
Q

differentiating diagnostic for CCB vs BB OD?

A

glucose elevated in CCB OD

41
Q

toxidrome for CCB/BB OD

A

bradycardia
hypotension

42
Q

are any elimination methods used for antiHTN OD

A

AC, WBI

43
Q

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

A

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

44
Q

glucagon AE

A

vomiting

45
Q

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

A

> 100 mg/dl

46
Q

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

A

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

47
Q

presentation of ACUTE digoxin toxicity

A

NVS, HA, confusion, halos/colors, hyperkalemia

48
Q

are any elim methods used for digoxin OD

A

activated charcoal

49
Q

when is digifab used in ACUTE OD

A

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

50
Q

when is digifab used for CHRONIC OD

A

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

51
Q

recommended dose of digifab for ACUTE OD

A

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

52
Q

recommended dose of digifab for CHRONIC OD

A

5 vials in adults, 3 vials in children

53
Q

what is a bezoar? what is effect?

A

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

54
Q

main treatment for ASA OD

A

ion trapping with sodium bicarbonate
dextrose

55
Q

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

A

hemodialysis

56
Q

what is the main drug class used for treat cannabinoid tox

A

benzos

57
Q

5 treatment options for hyperemesis syndrome for cannabinoids

A

hot showers
capsaicin
haloperidol/zofran
benzos
supportive- fluids

58
Q

clinical effects of sympathomimetic tox

A

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

59
Q
A
59
Q

main class used to manage sympathomimetic OD?
others?

A

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

60
Q

how to treat cocaine or amphetamine OD

A

benzos