Toxicology Flashcards
Adrenergic toxidrome
Cocaine and amphetamines
Decreased sleep and appetite Restlessness Increased BP and HR Dilated pupils Increased reflexes and bowel sounds also HAs, dizziness, dysphoria, tremors, GI, loss of libido
Acute ethanol intoxication
Hypothermia Hypotension Bradycardia Ataxia Respiratory depression Hypoglycemia
Inhalant exposure
Volatile hydrocarbons: gasoline, glue, lighter fluid, typewriter correction
Nitrite compounds: nitrous oxide and amyl nitrate
Transient euphoria followed by short-lived sedative symptoms, such as lethargy, lightheadedness, sluggish pupils, and bradycardia
High doses causes confusion and delirium
Symptoms resolve in 15-30 min
Can get perioral dermatitis due to hydrocarbons drying around mouth
Phencyclidine exposure (PCP)
tachycardia, hypertension, agitation, seizures, and nystagmus
Nicotine toxicity
Muscarinic: Salivation, lacrimation, diarrhea, wheezing, bradycardia
Nicotinic: weakness, paralysis, and muscle fasiculations
Timeline for activated charcoal
Within an hour
What doesn’t charcoal absorb?
Electrolytes, iron, EtOH, cyanide, solvents, water-insoluble, hydrocarbons, lead
One pill can kill
Classes of drugs
Beta blockers Ca channel blockers Antidepressants Anticonvulsant Antiarrhythmics Salicylate Oral hypoglycemic Opiates
TCA side effects
Anticholinergic Widened QRS Right axis deviated Prolonged PR Abnormal T/TS Sinus tachycardia SVT, Vtach, Vfib
Can last for days
Anticholinergic pneumonic
Dry as a bone Red as a beet Blind as a bat Mad as a hatter Hotter than Hades
Mydriasis (dilated)
Anticholinergics, antihistamines, amphetamines, cocaine, LSD, MAOI
Miosis (constricted)
opiates, clonidine, organophosphates, valproic acid
When do you get Tylenol levels?
At 4 hours
Doesn’t matter before this
Organophosphate toxidrome
SLUDGE
weakness, fasciculations, HTN, tachycardia
Delirium, seizures, coma
Hydrocarbon exposure
Gasoline, kerosene
Monitor for at least 6 hours
Treatment focused on respiratory stabilization
Get CXR 6 hours after, if good dc
