Toxicology Flashcards
Therapeutic Index
LD(50) / ED(50)
Organophosphate (Acetylcholinesterase Inhibitor) Antidote
Pralidoxime
MOA: binds to organophosphates and permites rapid excretion
usually adminsitered w/ atropine to block muscarinic effects of PNS
Cyanide Antidote
amyl nitrite (inhaled) + sodium nitrite (IV) + sodium thiosulfate (IV) + O2
MOA: converts hemoglobin to methemoglobin –> combines w/ CN to form nontoxic cyanmethemoglobin –> thiocyanate
Lead Poisoning Antidote
DMSA / succimer
5 day Tx for adults
19 day Tx for children
Botulinism Antidote
Trivalent Antitoxin (A, B, E)
MOA: neutralizing antibody
Single 10 mL vial
Ethylene glycol / methanol Antidote
Fomepizole
MOA: blocks alcohol dehydrogenase
can use hemodialysis as adjuct Tx
Carbon Monoxide Tx
Artificial respiration w/ pure O2; hyperbaric O2 chamber if symptomatic
Warfarin Antidote
Receptor Competitor Tx
Vitamin K (phytonadione)
Severe bleeding: prothrombin complex, fresh frozen plasma infusion
Opioid Antidote
Receptor Competitor Tx
Naloxone (competetive inhibitor); duration: 45 mins.
Naltrexone: (competitive inhibitor); duration: 24-72 hours
Methemoglobinemia Antidote
Receptor Competitor Tx
Methylene Blue
MOA: causes a direct chemical reduction of methemoglobin back to hemoglobin
Rx: excess methemoglobin (exposure to nitrites, sulfa drugs)
Sympathomimetic Toxidrome
Mydriasis
HTN, tremor, hyperthermia
Drugs: cocaine, amphetamines, PCP
Sedative / Hypnotic Toxidrome
Coma
↓ respiration
miosis or mydriasis
hypotension
Drugs: alcohol, barbiturates, benzodiazepines
Opioid / Opiate Toxidrome
“opiate triad”:
Coma
↓ respiration
pinpoint (miosis)
hypothermia, hypotension, histamine release
Drugs: opiates, morphine, codeine, propoxyphene, oxycodone, hydrocodone
Anticholinergic Toxidrome
CNS agitation
mydriasis
fever, dry skin, flushing, urinary retention
Drugs: anticholinergics, antidepressants
Cholinergic Toxidrome
Pinpoint (miosis)
SLUDGE
(salivatioin, lacrimation, urination, diarrhea, emesis)
Drugs: organophosphates, nicotine