Toxicology Flashcards
numonic
SLUDGEM
Cholinergics
S Salivation, sweating
L Lacrimation
(excessive tearing of
the eyes)
U Urination
D Defecation, drooling,
diarrhea
G Gastric upset and
cramps
E Emesis (vomiting)
M Muscle
twitching/miosis
(pinpoint pupils)
Chemical exposure routes
- Inhalation
- Absorption
- Ingestion
- Injection
Name of some poisons a patient could Inhale
natural gas, sewer gas,
certain pesticides, carbon monoxide, and chlorine
Types of poisons
Sedative-Hypnotic Drugs
diazepam,
secobarbital, temazepam, midazolam
Types of poisons
Sympathomimetics
mephedrone,
cocaine, methamphetamine
How do you manage paitents effected by poisons
- Always monitor ABCs
- Provide Oxygen
- Remove rings, watches, bracelets, necklaces
- Rapid transport
Signs & Symptoms
Opiates & Opioids
Codeine, morphine, heroin, fentanyl, oxycodone
- Hypoventilation
- Pinpoint pupils
- sedation
- hypotension
Signs & Symptoms
Sympathomimetics
Cocaine, meth, mephedrone
- Dilated pupils
- hypertension
- tachycardia
- hyperthermia
- agitation or seizures
Signs & Symptoms
Sedative-hypnotics
diazepam, secobarbital, temazepam, midazolam
- Slurred speech
- sedation or coma
- hypoventilation
- hypotension
Signs & Symptoms
Anticholinergics
atropine, diphenhydramine, chlorpheniramine,
doxylamine, Datura stramonium [jimsonweed])
- Tachycardia
- Hyperthermia
- Hypertension
- Dilated pupils
- Dry skin and mucous membranes
- Sedation, agitation, seizures, coma, or delirium
- Decreased bowel sounds
Signs & Symptoms
Cholinergics
organophosphates, pilocarpine, nerve gas
- Airway compromise
- SLUDGEM numonic
Signs & Symptoms
Inhaled Poisons
- burning eyes
- sore throat
- cough
- chest pain
- wheezing
- respiratory distress
- dizziness
- headache
- AMS
What are some types of Absorbed and surface contact poisons?
poison ivy or poison oak
may cause an itchy rash without being dangerous to the patient’s health.
Signs & Symptoms
Absorbed poisons
liquid or powder on a patient’s skin, burns, itching, irritation, redness of the skin in light-skinned people, history of exposure
If a dry powder poision/toxin has been spilled, what do you do?
thoroughly brush off the chemical (avoid creating a dust cloud), flush the skin with clean water for 15 to 20 minutes, and then wash the skin with
soap and water
If a liquid poision/toxin has been spilled, what do you do?
Flood the affected part for 15 to 20 minutes
If the patient has a chemical
agent in the eyes what do you do?
irrigate them quickly and thoroughly
To avoid contaminating the other eye as you irrigate the affected eye, make sure the fluid runs from the bridge of the nose outward
Name some ingestable poisons
liquids, household cleaners, contaminated food, plants, and, in most cases, drugs
True or false
Injected poisons cannot be diluted or removed from the body in the field
True
Signs & Symptoms
Poisoning by injection
weakness, dizziness, fever, chills, slow breathing, and unresponsiveness, or the patient may be easily excited.
Alcohol is a powerful what?
CNS depressant
Many abused inhalants produce several of the same CNS effects as what?
sedative-hypnotics
What is abused inhalants MOA?
these substances briefly displace oxygen in the brain and cause a rush of euphoria
Halogenated hydrocarbon solvents can make the heart hypersensitive to the patient’s own adrenaline, this puts the patient at high risk of what?
sudden cardiac death because of ventricular fibrillation; even the action of walking may release enough adrenaline to cause a fatal ventricular dysrhythmia
You must try to keep such patients from struggling with you or exerting themselves
Define
Hydrogen Sulfide
A highly toxic, colorless, and flammable gas with a distinctive rotten-egg odor
Hydrogen sulfide affects all organs, but it has the most impact on the lungs and CNS
Where does hydrogen sulfide naturally?
sewers, swamps, volcanoes,
and crude petroleum
Define
Sympathomimetics
CNS stimulants that mimic the effects of the sympathetic (fight-or-flight) nervous system
These stimulants frequently cause hypertension, tachycardia, and dilated pupils
Patients experiencing Acute cocaine overdose are at high risk of what?
seizures, cardiac dysrhythmias, and stroke
Define
cocaine bugs
patients with “cocaine bugs” think that bugs are crawling out of their skin
Chronic cocaine abuse may cause hallucinations
How long does the effects of bath salts last?
up to 48 hrs
Name some adverse effects of bath salts
- teeth grinding
- appetite loss
- muscle twitching
- lipsmacking
- confusion
- gastrointestinal conditions
- paranoia
- headache
- elevated heart rate
- hallucinations
What is cannabinoid hyperemesis syndrome?
chronic marijuana use and extreme nausea and vomiting that is relieved only by a hot shower or bath
Name some common Hallucinogens
- Shroms
- LSD
- PCP
- Ketamine
- DMT
Define
Anticholinergic Agents
medications that block the
parasympathetic nerves
Signs & Symptoms
Anticholinergic Agents
patient will exhibit hyperthermia, dilated pupils, dry skin and mucous membranes, reddened skin, and agitation or delirium
“hot as a hare, blind as a bat, dry as a bone, red as a beet, and mad as a hatter.”
Define
Cholinergic Agents
They overstimulate the normal
body functions controlled by the parasympathetic nervous system.
These agents also occur in organophosphate insecticides, which are
commonly used for lawn and garden care
Signs & Symptoms
Cholinergic agent
exhibit excessive salivation or
drooling; mucous membrane oversecretion, resulting in a runny nose (rhinorrhea); excessive urination; excessive tearing of the eyes;
uncontrolled diarrhea; and an abnormal heart rate
Signs & Symptoms
Asprin poisoning
nausea, vomiting, hyperventilation, ringing in the ears, anxiety, confusion,
tachypnea, and hyperthermia, and are in danger of having seizures
What 2 alcohols are more toxic than ethyl alcohol?
Drinking alcohol
methyl alcohol and ethylene glycol
Where is methyl alcohol found?
in dry gas products and stove kits
Ethylene glycol is found where?
some antifreeze products
What causes food poisoning?
eating food that is contaminated by
bacteria
Define
Salmonellosis
a condition characterized by severe gastrointestinal symptoms within 72 hours of ingestion, including nausea, vomiting, abdominal pain, and diarrhea
Whats the most common cause of food poisoning?
ingestion of powerful toxins produced by bacteria, often in leftovers.
bacterium Staphylococcus
Signs & Symptoms
staphylococcal food poisoning
nausea, vomiting, and diarrhea
How long does it take for symptoms to start for someone experiencing staphylococcal food poisoning?
within 2 to 3 hours after ingestion or as long as 8 to 12 hours after ingestion.
The most severe form of toxin ingestion is
Botulism
results from eating improperly canned food, in
which the spores of Clostridium bacteria have grown and produced a
toxin
Signs & Symptoms
Botulism
blurring of vision, weakness, and difficulty in speaking and breathing
Symptoms of botulism may develop as long
as 4 days after ingestion or as early as the first 24 hours
Delirium tremens (DTs)
A severe withdrawal syndrome seen in
alcoholics who are deprived of ethyl alcohol; characterized by restlessness, fever, sweating, disorientation, agitation, and seizures; can be fatal if untreated
Define
Hallucinogen
An agent that produce false perceptions in any one of the five senses.
Define
Tolerance
The need for increasing amounts of a drug to obtain the same effect.
Define
Activated Charcoal
A medication used to treat certain poisonings by adsorbing (binding to) the poison in the gastrointestinal tract, preventing its absorption into the bloodstream.
Naloxone (Narcan)
An antidote that rapidly reverses the effects of opioid overdose (e.g., heroin, fentanyl, prescription pain medications)
Define
Withdrawal
The physiological and psychological symptoms that occur when a person stops using a substance to which they have developed dependence
What is a crucial initial step when approaching a patient who may have been exposed to hazardous materials?
Assessing scene safety.
Ensuring the safety of the EMS crew and the patient is paramount before initiating patient care
