Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Emergency Lectures > Toxicology > Flashcards

Toxicology Flashcards

1
Q

Intubation drug and dose if organophosphate poisoning?

A

Rocuronium

0.6mg/kg ideal BW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Intubation drug if hyperkalemia (like from digoxin toxicity)?

A

Rocuronium

0.6mg/kg ideal BW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What OD’s do we want to hyperventilate?

A

Acidotic patients

  • methanol
  • ethylene glycol
  • aspirin
  • iron
  • CN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What OD do we see QRS widening?

A

TCA’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can cause severe hypoxemia despite normal Pox?

A

CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What will methemoglobinemia read at Pox?

A

Will drop Pox to 85 but then stay there despite worsening O2 status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

First and 2nd step in treating hypotension?

A
  1. Give 2L NS or LR

2. Give IV NE @2-20 mcg/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hypotension + hypoglycemia seen with what OD?

- what also see

A

Beta-blocker

may also see bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hypotension + hyperglycemia?

A

CCB

may also see bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

QRS widening + tachycardia…think OD?

A

Sodium channel blockers

- treat w/ NaHCO3 (give Sodium bicarb)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How treat torsades?

A

Mg - 2g over 2 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ABCDE…what’s D? Always think???

A

Disability - neurologic

  • always check glucose finger stick
  • can give Thiamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How treat seizures? (letter D = disability)

A

Lorazepam 0.1mg/kg

Propofol + intubation if above ineffective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is E in ABCDE? What do we do?

A

Elimination

  • cut off clothes / shower
  • want to remove exposure
  • want to remove pills/weapons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are 2 things we might do to help with elimination?

A

Remove clothing
Give charcoal - does not help w/ elements
(Li, Fe, Pb, heavy metals)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When would we alkalize the urine? How?

A

PMS: phenobarbital, methanol, salicylates
METALS: methanol, ethylene glycol, Theophyline, Amanita mushrooms, Lithium, Salicylates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Give two ways to get rid of salicylates?

A

Alkanize with IV HCO3 2amp bolus + drip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Serum vs. Urine tox screen?

A

Serum: tylenol, aspirin, alcohol, TCA, benzos, barbiturate

Urine: MJ, cocaine, PCP, narcotics, amphetamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What OD things might be seen on Xray?

A

Abdomen: iron pills, heavy metals, crack vials

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Pt with confusion, diaphoresis, tachycardia, normal pupils, afebrile, slurred speech, combative?

A

Hypoglycemia
- can also have seizures

*always check finger stick w/ AMS

21
Q

Pt with respiratory distress, bradycardia, vomiting, diarrhea, diaphoresis, miosis?

A

Organophosphate poisoning = Cholinergic Toxidrome
SLUDGE + Killer B’s
Salivation, Lacrimation, Urination, Defecation, Emesis
Bronchorrhea + Bronchospasm + Bradycardia
(sputum production)

22
Q

Cholinergic Toxidrome - nicotinic?

A
  • fasciculations
  • muscle weakness
  • up to paralysis
23
Q

How do cholinergic OD pt’s die?

A

Killer B’s

Bronchorrhea + Bronchospasm + Bradycardia

24
Q

Pt with dilated pupils, tachycardia, HTN, febrile, wildly combative; complains of CP then has seizure?

A

Sympathomimetic Toxidrome:

  • all vitals elevated
  • agitation/mania

Think: cocaine, amphetamines, bath salts (cathionones)

25
How treat Sympathomimetic Toxidrome?
BENZOS + FLUIDS - give 2mg Lorazepam and repeat PRN - fluids to protect kidneys (from rhabdomyolysis)
26
Pt with cyanosis, pinpoint pupils, vomitus in mouth, atonal breathing, rhonchi, low temp, bradycardia?
Opioids - slow respirations (agonal breathing) - pinpoint pupils - coma
27
How treat opioid OD?
IV/IM naloxone 0.4mg / 1.0 / 2.0mg if critically ill **if fentanyl was added, need like 8-10mg
28
Pt with agonal respirations (bradypnea), bradycardia, BP 60/p and pupils 3mm and minimally reactive; coma?
Sedative-Hypnotic Toxidrome: - Benzos, barbs, alcohols, zolpidem Tx: supportive: intubate + IVF + pressors
29
Pt with CNS depression, mitosis, bradycardia, hypotension, bradypnea/apnea, hypothermia?
Sedatives
30
Pt with tinnitus + tachycardia, tachypnea, diaphoresis, vomiting?
Aspirin/Salicylate Toxicity: - respiratory alkalosis - blow off acid - metabolic acidosis - tinnitus - Nausea/vomiting (ALWAYS)
31
How treat salicylate OD?
Charcoal Alkalinization of urine Hemodialysis
32
Pt with lethargy, dry MM, hot-flushed skin, tachycardia, ST w/ wide QRS, hypoactive bowel sounds, palpable distended bladder, dilated pupils. Febrile
``` Anticholinergic Toxidrome: mad as red as hot as dry as blind as Full as a flask Tachy like a pink flamingo ```
33
What are sources of anticholinergics?
``` Antihistamines TCA's Anti-PD Antipsychotics Atropine/scopolamine Jimson weed/nightshade/mandrake ```
34
TCA Overdose EKG findings:
Sinus tachycardia Terminal R wave in aVR Wide QRS > 160ms (r wave in aVR is normally tiny)
35
How treat TCA overdose?
Charcoal Gastric Lavage if <1hour Intubate & hyperventilate Alkalize urine w/ NaHCO3 1-2meq/kg
36
How treat seizures from ??? overdose?
TCA overdose seizure | - treat w/ Lorazepam 0.1mg/kg
37
Pt with dizziness, bradycardia, hypotension, afebrile, pupils midrange and reactive; FS 206 rest normal
CCB - low, low, hyperglycemia BB - low, low, hypoglycemia
38
What do BB and CCB do to sugars?
BB - lowers sugars | CCB - raises sugars
39
How treat BB OD?
Atropine 0.5mg IV up to 3mg IVF bolus NaHCO3 for QRS widening (propranolol) Calcium gluconate
40
How treat CCB OD?
``` High dose insulin 1u/kg bolus + drup at 0.5-1 u/kg/hour Atropine 0.5mg IV up to 3mg IVF bolus NaHCO3 for QRS widening (propranolol) Calcium gluconate ```
41
Scooped ST depressions on EKG Nausea, vomiting, abdominal pain Neurologic: hallucinations, drowsy Also ???
Digoxin toxicity | - also chromatopsia (yellow halos around lights)
42
How treat digoxin toxicity?
Charcoal Atropine 0.5mg up to 3mg (every 3-5 minutes) Digibind - antibody frags
43
Stages of Acetaminophen Toxicity?
Initial 0-24hrs: mild nausea; asymptomatic Latent 1-2d: subclinical increase in LFT's Hepatic: 3-4d: RUQ pain, jaundice, acidosis, coagulopathy, renal failure (hepatorenal)
44
How treat Acetaminophen toxicity?
Tylenol OD - N-acetylcysteine <6 hours (NAC)
45
Pt with HA, dizziness, weakness, blurred vision, confusion, syncope/LOC Also: dysrhythmias, CP, SOB, N/V
CO poisoning
46
Why does car in garage kill you?
Carbon Monoxide - greater affinity for Hb than O2 so don't carry O2 - also blocks ATP - reduces myocardial contractility
47
Treat CO poisoning?
``` NBO at 100% Ventilatory support Get Blood gas Consider co-asphyxiant (cyanide in furniture coverings) Carboxyhemoglobin level w/ ABG HBO ```
48
When use hyperbaric oxygen in CO poisoning?
AMS / LOC / Seizure Hypotension MI Pregger w/ COHb > 15% (baby at risk)

Emergency Lectures (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions