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Paramedic 2 > Toxicology > Flashcards

Toxicology Flashcards

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0
Q

What is the most important thing to remember in regards to removing stingers?

A

Remove the stinger as soon as possible

Use a card to scrap the stinger out, do not use tweezers as this may squeeze or venom into the wound

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1
Q

Define venom

A

Toxin produced by snakes, spiders and some marine life

Delivered through fangs

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2
Q

What are the only 2 venomous spiders native to Ohio?

A

Brown recluse

Black widow

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3
Q

Most bites are ____ ______ until well after the fact.

A

Not Noticed

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4
Q

What are the 3 venomous snakes native to Ohio and 1 that may be found in Ohio?

A

The Eastern Massauge

Timber Rattle Snake

Northern Copperhead

Water Moccasins are not native but can be found in streams in Ohio

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5
Q

What is the major concern with related to snake bites?

A

Development of tissue necrosis and sepsis

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6
Q

Baby snakes are more dangerous when they bite compared to adult snakes, why?

A

Baby snakes have not learned to control how much venom they output in their bites

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7
Q

What is treatment for a snake bite?

A

Treat for shock, O2, keep warm

Locate wound and cleanse with soap or alcohol

Remove stinger

Remove constricting jewelry

Immobilize if on an extremity

Transport, medical direction

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8
Q

Define substance abuse

A

Use of pharmacological substances for purposes other than medically defined reasons

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9
Q

What are 5 identifiers for nonvenomous snakes

A

Head usually oval, but may be somewhat traingular

Pupils round

No pits-only- nostrils

Divided scales on the underside of the trail

Although many snakes vibrate their tail when upset, nonvenomous snakes never have rattles

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10
Q

Define addiction

A

Compulsive and overwhelming dependence on a drug; an addiction may be physiologic dependence, a psychological dependence, or both.

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11
Q

Define tolerance

A

The need to progressively increase the dose of a drug to reproduce the effect originally achieved by smaller doses.

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12
Q

Define withdrawl

A

Referring to alcohol or drug withdrawal in which the patient’s body reacts severely when deprived of the abused substance.

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13
Q

How many Americans have tried an illicit drug at least once?

A

28 Million People

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14
Q

How many Americans use illicit drugs regularly?

A

14.5 Million People

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15
Q

Define toxicology

A

Study of the detection, chemistry, pharmacological actions, and antidotes of toxic substances.

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16
Q

Define toxins

A

Any poisonous chemical secreted by bacteria or released following destruction of the bacteria; any chemical (drug, poison, or other) that causes adverse effects on an organism that is exposed to it.

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17
Q

What are the four routes for a toxin to enter the body?

A

Ingestion

Inhalation

Injection

Absorption

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18
Q

What is the most common route of entry for toxic exposure?

A

Ingestion

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19
Q

What medication is derived from the deadly night shade plant?

A

Atropine

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20
Q

With toxic ingestion, burns may occur where?

A

Lips, tongue, throat and esophagus

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21
Q

What is the phone number for Central Columbus Poison Control?

A

1-800-222-1222

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22
Q

Can inhalation be a route for rapid absorption?

A

Yes, due to absorption through the alveolar-capillary membrane in the lungs

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23
Q

Define organophosphates

A

Phosphorus-containing organic chemicals

Often used as pesticides

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24
Q

Define Decontamination

A

The process of minimizing toxicity by reducing the amount of toxin absorbed into the body.

Reduce the intake of toxin

Reduce absorption of toxin once in body (activated charcoal)

Enhance elimination of toxin (cathartics or whole bowel irrigation)

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25
Q

During secondary assessment of a toxicologic patient what are some important questions to ask?

A

What toxin patient was exposed to

When the exposure took place

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26
Q

During secondary assessment of an unresponsive patient what sort of exam should take place?

A

Rapid head to toe exam

27
Q

Activated charcoal is only effective for what kinds of poisonings and ineffective to what kinds of poisonings?

A

Effective for pills because the activated charcoal binds to solids

Ineffective for heavy metal and liquid poisonings

28
Q

Narcan is the antidote for what kind of overdose?

A

Opiates

29
Q

Atropine is the antidote for what kind of toxin?

A

Organophosphates

30
Q

Oxygen is the antidote for what kind of toxin?

A

Carbon Monoxide

31
Q

What is the dosage for Atropine Antidote for organophosphate poisoning?

A

Initial: 2-5 mg IV

32
Q

What are good questions to ask an ingestion poisoning patient?

A 
What did you ingest
When did you ingest
How much did you ingest
Did you drink any alcohol
Have you attempted to treat yourself
Have you ever been under psych care? if so why
What is your weight?
33
Q

What does the pneumonic SLUDGE stand for in relation to surface toxins?

A 
Salivate (Patient will be drooling)
Lacrima (Patient will have lots of tears)
Uticharia (Rashes and hives)
Diarrhea 
GI Complaints
Emesis (Vomiting)
34
Q

Describe Carbon Monoxide

A

Odorless, tasteless gas given out usually by incomplete combustion

Leading cause of poisonings in industrialized countries

35
Q

What is the danger of having Carbon Monoxide in the body?

A

Carbon monoxide has a 250 times stronger affinity to bind with hemoglobin than oxygen

Becomes carboxyhemoglobin when bound with hemoglobin and disallows oxygen from binding with the hemoglobin

36
Q

CO-oximetry measures what values

A

Oxygen Saturation (SpO2)
Carboxyhemoglobin percent (SpCO)
Methemoglobin percent
Pulse rate

37
Q

What treatment will maximize hemoglobin oxygen saturation in the field?

A

CPAP

38
Q

Cyanide is found in high in high levels where?

A

Combustion of plastics, wool, silk, synthetic rubber, polyurethane and asphalt

Found frequently in structural firefighting

39
Q

What are signs and symptoms of cyanide poisoning?

A

Burning sensation in the throat and mouth

Headache

HTN and Tachycardia followed by hypotension and arrhythmias

Pulmonary Edema

Seizures/coma

Elevated lactate

40
Q

Medications ending in the suffix “-olol” are what kinds of medications?

A

Beta blockers

41
Q

Medications ending in the suffix “-pril” are what kind of medications?

A

ACE Inhibitors

42
Q

Medications ending in the suffix “-dipine” are what kind of medications?

A

Calcium Channel Blockers

43
Q

Medications ending in the suffix “-semides/-thiazides” are what kind of medications?

A

Diuretics

44
Q

What are signs and symptoms of cardiac medication poisonings?

A

Nausea and vomiting

Headache, dizziness and confusion

Profound hypotension

Cardiac arrhythmias (Bradycardia)

Heart conduction blocks

Bronchospasm and pulmonary edema (Especially in beta blockers)

45
Q

In cardiac medication poisonings what is contraindicated even in bradycardia?

A

Atropine because they may not respond to the atropine

46
Q

What are antidotes for cardiac medication poisonings?

A

Calcium for calcium channel blockers

Glucagon for beta blockers

digoxin-specific fab (digibind) for digoxin

47
Q

What are signs and symptoms of caustic substance poisoning?

A

Facial burns

Pain in lips, mouth, throat and gums

Drooling, trouble swallowing

Hoarseness, Stridor, shortness of breath

Shock from bleeding and vomiting

48
Q

Where are hydrocarbons found?

A

Commonly associated with fuels

Lighter fluid, paint, glue, lubricants, solvents, aerosol propellants

49
Q

What are signs and symptoms of hydrocarbon poisoning?

A

Burns due to local contact

Wheezing, dyspnea and hypoxia

Pneumonitis from aspiration inhalation

headache, dizziness

Delay in reflexes

Cardiac arrhythmias

50
Q

What are signs and symptoms associated with tricyclic antidepressant poisoning?

A

Dry mouth

blurred vision

Urinary retention

Constipation

51
Q

What is treatment of tricyclic antidepressant poisoning?

A

Mag-Sulfate

If suspect mixed overdose with benzodiazepines, DO NOT USE FLUMAZENIL

52
Q

Flumazenil is contraindicated in overdose with benzodiazepines, why?

A

Flumazenil is a benzodiazepine receptor antagonist and may put the patient into a seizure state. Flumazenil will then further stop similar medications (Versed, Ativan etc.) from working.

53
Q

Lithium is used for treatment of what?

A

Bipolar Disorder

54
Q

What is the toxicity range of salicylates?

A

300 mg/kg toxicity range depending if the pills are coated or not coated

55
Q

Aspirin is contraindicated in patients under what age and why?

A

Under 19 years of age

Risk of Reyes Syndrome (Brain Swelling)

56
Q

What is the toxicity range for acetaminophen?

A

150 mg/kg considered toxic

57
Q

What treatment is indicated for acetaminophen poisonings?

A

Activated charcoal

58
Q

What’s the dosage for benadryl for anaphylaxis?

A

25-50mg iv

59
Q

What is the dosage for solumedrol for anaphylaxis?

A

125 mg iv

60
Q

What is gastric lavage?

A

removing an ingested poison by repeatedly filling and emptying the stomach

also known as “pumping the stomach”

61
Q

In situations where a poisoning patient will “clamp down” with his teeth it is prudent to do what?

A

Use RSI to secure an airway and prevent aspiration as opposed to waiting for the patient to deteriorate to a point where intubation can be placed without the aid of neuromusuclar blockers

62
Q

If chronic alcoholism is suspected consider what drug?

A

Administration of 100 mg of thiamine IV to address possible encephalopathy

63
Q

What are signs and symptoms of inhaled poisoning?

A

Dizziness,headache, confusion, seizures, hallucinations, coma

Tachypnea, cough, hoarseness, stridor, dyspnea, retractions, wheezings, chest pain or tightness, crackles or rhonchi

arrhythmias

64
Q

What is the top priority for a inhaled poisoning?

A

Removing the patient from the source of the poisoning

Paramedic 2 (17 decks)

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