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High Yield Pharm unit 6 > toxicology > Flashcards

toxicology Flashcards

1
Q

what toxic agent?

decreased BP, decreased RR, pinpoint pupils, decreased bowel soudns

A

opiods

altered mental status, decreased HR, decreased temp can also be seen

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2
Q

which of the opiods are synthetic? why is this significant

A

fentayl
meperidine
buprinophine

important because these can require more of the antedotes than the natural opioids (like mohprine and codeine)

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3
Q

what is the opioid receptor antagonist that is used medically

A

naloxone

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4
Q

flu like symptoms (N/V, diarrhea), piloerection, yawning, irritability. normal mental status

whats going on with this patient

A

opioid withdrawal

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5
Q

depressed mental status, NORMAL vital signs

what did the patient overdose on?

A

benzodiazepine

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6
Q

what is the competitive non selective benzo receptor antagonist that can be used?

who is a good patient for this

A

flumazenil

a young child that you suspect overdosed on a benzo. dont want to give to someone that you suspect benzo tolerance

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7
Q

what is the one drug you should test for in anyone that tried committing suicide with pills

A

acetaminophen

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8
Q

with a acetaminophen toxicity, what symptoms do you see first

A

can be asymptomatic or GI irritation for the first day

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9
Q

what is the predominant organ that is affected by acetaminophen in day 1-4

A

liver!

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10
Q

what metabolite is the “bad” guy that causes the damage in acetaminophen toxicity

A

N-acetyl-benzoquinonemine

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11
Q

what is the antidote for acetaminophen toxicity?

A

N acetylcysteine (NAC)

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12
Q

NAC is 100% successful in acetaminophen poisoning if given within…

A

first 8 hours

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13
Q

if NAC is given past the 8 hour window, there are still some benefits, how does NAC do this?

A 
	supplies sulfhydryl groups
	antioxidant
	improves microcirculation
	supplies glutathione
	anti inflammatory properties
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14
Q

dry mucous membranes, dry flushed skin, no bowel movements
dilated pupils
dysrhythmia

A

so you see some anticholinergic effects plus a dysrhythmia

think tricyclic antidepressant

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15
Q

what kills you in a TCA overdose

A

the Na channel blockade!!

ventricular depolarization gets blocked, widened QRS complex

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16
Q

whats the antidote for TCA poisoning

A

Na bicarbonate

to overcome the Na channel blockade

17
Q

what are some symptoms of an anticholinergic toxidrome

A

mydriasis, dry flushed skin, decreased bowel sounds, urinary retention, increased temp, altered mental status (confusion, hallucinations, seizures)

18
Q

what are some anticholinergic agents

A

atropine, benadryl (diphenhydramine), scopalamine, TCA antidepressants

19
Q

what is the antidote for a toxicity of anticholinergics

A

phyostigmine

anticholinesterase inhibitor

20
Q

which drug with anticholinergic properties can you NOT give phyostigmine too in the case of an overdose

A

TCA antidepressants

21
Q

not oriented
sweating, vomiting, diarrhea, miosis

plus CNS bronchorrhea/spasm and fasiculations

A

Cholinergic! plus the muscle symptoms are due to a nicotinic agent

22
Q

what is the antidote for a cholinergic toxidrome

A

atropine

23
Q

what is the antidote for a nicotinic toxidrome

A

pralidoxime

24
Q

what is the metabolite that kills in methanol poisoning

A

formac acid

25
Q

what is the metabolite that kills in ethylene glycol poisoning

A

glycolic acid

26
Q

how can you treat a toxidrome with methanol or ethylene glycol

A

you want to competitively inhibit ADH (can do this with ethanol or more preferably fomepizole)

27
Q

what are some indications for dialysis in a methanol or ethylene glycol poisoning

A
  • methanol or ethylene glycol level greater than 25-50
  • metabolic acidosis
  • coma
  • hemodynamic instability
28
Q

if patient took some BP medications and presents with hypotension AND bradycardia (4)

A

BBB
CCB
a2 agonist
digoxin

29
Q

what can you do for a toxidrome with a CCB

A

calcium salts, glucagon (acts like a beta agonist) and high dose insulin, amrinone (phosphodiesterase inhibitor), vasopressors

30
Q

what BBB causes the “most trouble” because of its stabilizing effect

A

propranolol

31
Q

how does digoxin work

A

• Blocking Na/K ATPase.. Enhances intracellular Na… ultimately increase intracellular Ca

32
Q

what are the effects of a digoxin toxicity seen before the drug distributes

A

N/V

hyperkalemia

33
Q

what are effects of digoxin toxicity after the drug distributes

A

hypotension
bradycardia
dysrhythmias
death

34
Q

what can you give in a digoxin toxicity

A

digibind (digoxin specific FAB fragment)

35
Q

what “upper” can you see seizures with

A

cocaine

High Yield Pharm unit 6 (11 decks)

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