Toxicology Flashcards
7 physical exam signs for tox
Vitals
Sympathomimetic toxidrome
Mydriasis
Sweaty
Anticholinergic toxidrome
- to finish)
Blind as a bat, mad as a hatter, red as a beet, hot as a hare, dry as a bone
NMS
Mechanism?
Classic symptoms? (2)
Antidote?
too little dopamine
lead pipe rigidity, slow onset
Bromocriptine or Amantadine
Serotonin Syndrome
Mechanism Classic symptoms (2) Antidote?
Excess serotonin
Hyperreflexic, LE > UE involvement
Cyproheptadine PO
Malignant Hyperthermia
Mechanism
Ryanodine receptor abnormal
Fam hx +
Dantrolene
Opioid toxidrome (4)
Slow HR
Slow RR
MS depressed
Miotic
DDx opioid toxidrome
Clonidine Liquor Opioids Sedative - Hypnotics Stroke, Structural Sepsis
Mydriasis Causes (3)
Sympathomimetic, Anticholinergic, Withdrawal
Miosis Causes (4)
COPS
Cholinergic, Opioids, Phenothiazine, Sedative-Hypnotic
Cholinergic Toxidrome
Mnemonic?
AchE inactivated by toxin
DUMBELLS
4 Killer Bs
Bronchorrhea, Bronchospasm, Bradycardia, Baralysis
SLUDGE
Salivation, Lacrimation, Urination, Defecation, GI distress, Emesis
Cholinergic Toxidrome
Tx? (3)
Benzo if seizure
Atropine (competitive anagonist Ach at musc.-R)
Pralidoxime (removes Ach off receptor)
Decontamination vs Elimination
Decontamination: AC, WBI, Gastric Lavage
Elimination: Ion trapping, dialysis, exchange transfusion
Do not give charcoal (4)
Hydrocarbons (
Alcohols (poorly bounds, rapidly absorbed)
Heavy metals (poorly bound)
Acids/Bases/Caustics (impaired scope)
Calculation for Anion Gap
What is normal
Causes of high AG (mnemonic)
** most common
Na - Bicarb - Chloride
Normal <12
Methanol (other toxic alcohols) Uremia **DKA**(other ketosis - starvation, alcoholic) Paraldehyde Iron, INH Lactate Ethanol Salicylates
