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EM Final Study Guide > Toxicology > Flashcards

Toxicology Flashcards

1
Q

What is syrup of ipecac? When to use?

A

Induces vomiting to remove poison out of top of GI tract

- No role in ED setting

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2
Q

How does activated charcoal work?

A

Adsorbs poison from GI tract so it can be passed in feces

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3
Q

How do cathartics and whole bowel irrigation work?

A

Move Poison through GI tract to there is no time to absorb

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4
Q

When are cathartics recommended in ingestion?

A

Not recommended in any setting

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5
Q

Contraindication lavage in ingestion?

A

Ingestion of:

  1. Corrosive agent
  2. Hydrocarbons
  3. Unprotected air: intubated or reflex intact
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6
Q

When is activated charcoal contraindicated?

A
  1. Corrosive agent
  2. Hydrocarbons
  3. Unprotected air: intubated or reflex intact
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7
Q

Indications of activated charcoal?

A
  • Tylenol
    1. Lipophilic substance
    2. Non polar substance
    3. Phenytoin
    4. Nortriptyline
    5. Aminophylline
    6. Phenobarbital / phenylbutazone
    7. Carbamazepine
    8. Digoxin / dapsone
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8
Q

When is whole bowel irrigation a good choice?

A
  1. Foreign body ingestion
  2. Iron Lead
  3. Slow release pharmaceuticals
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9
Q

Antidote tricyclic ingestion?

A

Sodium bicarb

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10
Q

Antidote organophosphate ingestion?

A

Atropine

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11
Q

Antidote digoxin ingestion?

A

Digoxin Ig

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12
Q

Antidote CCB ingestion?

A
  1. Calcium chloride

2. Glucagon

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13
Q

Antidote beta adrenergic ingestion?

A
  1. Glucagon
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14
Q

What are anticholinergics that can be ingested?

A
  1. TCAs
  2. Diphenhydramine
  3. Antihistamines
  4. Antipsychotics
  5. Jimson weed
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15
Q

Presentation anticholinergic ingestion?

A 
“Hot as a hare, red as a beet, dry as a bone, blind as a bat and mad as a hatter, heart runs alone, bowel sounds gone”
1 Fever
2. Flushed, dry skin
3. Dilated pupils
4. Agitated
5. Tachycardia
6. Hypoactive bowel sounds
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16
Q

What are cholinergics that can be ingested?

A
  1. Nerve agents
  2. Organophosphate
  3. Insecticides
17
Q

Presentation cholinergic ingestion?

A 
"DUMBbbELLSss"
Diarrhea
Urination
Miosis
Bradycardia, bronchorrhea, bronchospasm
Emesis
Lacrimation, laryngospasm
Salivation, sweating, secretions
18
Q

Presentation sedative hypnotic ingestion?

A
  1. Hypothermia
  2. Bradypnea
  3. Normal pulse - bradycardia
  4. Hypotension
  5. Drowsiness, lethargy, coma, ataxia
  6. Midsize or miosis, nystagmus
  7. Hyporeflexia
  8. Dysarthria
19
Q

Presentation black widow bite?

A
  1. Local: target skin lesion

2. Systemic: painful muscle cramping, hypertension, tachycardia

20
Q

How do you calculate osmolality?

A

Calculated osmolality = 2 (Na) + BUN/2.8 + glu/18

21
Q

When is glucagon used in ingestion?

A
  1. B-adrenergic blocker toxicity

2. CCB toxicity

22
Q

How does N-acetyl cysteine work?

A

N-acetylcysteine (NAC)

  • Sulfhydryl group donor
  • Substitutes for natural sulfhydryl group donor, glutathione
  • Increase glutathione synthesis
23
Q

How is anion gap calculated?

A

= ([Na] + [K]) − ([Cl] + [HCO−)

24
Q

When can fomepizole be used?

A
  1. Ethylene glycol toxicity

2. Methanol toxicity

25
Q

What is the coma cocktail for ingestion?

A
  1. Place on 100% O2 non rebreather
  2. POC fingerstick blood glucose
  3. Narcan 0.4 to 2mg IV to reverse opiates
26
Q

When is charcoal not useful?

A
  1. Metals: such as iron
  2. Booze
    3 Hydrocarbons

EM Final Study Guide (29 decks)

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