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Paramedic 02 > Toxicology > Flashcards

Toxicology Flashcards

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1
Q

Alcohol

Oxycodone

A

Most common substance abuse

Most licit abused is oxycodone

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2
Q

Posion

A

Substance that is toxic by nature no matter how it gets into the body or how much is taken

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3
Q

Drug

A

A substance that has some therapeutic effect when given in appropiate circumstance and dose

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4
Q

Overdose

A

When a drug, licit, or illicit, is taken in excess

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5
Q

Bioavailixbility

A

Describe the extent to which any drug is present in sufficient amounts to produce the desired effect

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6
Q

Toxicological emergencies

A

Fall into two categories,

Intentional and unintentional

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7
Q

Toddlers

A

Will put anything in their mouth, including dangerous medications

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8
Q

Chloral Hydrate

A

Also known as “knock out drops” are used to commit assault for decades

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9
Q

Rohypnol

A

Date Rape drug

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10
Q

Flunitrazepam

A

A powerful benzodiazepine that has both antegrade and retrograde amnesiac properties to erase memory for next 4-5 hours

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11
Q

Posion Center Number

A

18002221222

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12
Q

Four Methods of Absoprtion

A

Ingestion
Inhalation
Injection
Absorption

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13
Q

Ingested Posions

A

Immediate damage to tissues, or may be delayed for several hours

  • Look for stained fingers, lips, or tounge a
  • Sudden report of cramps, nausea, vomiting, and diarrhea
  • look for empty pill bottles
  • ingestion is usually a more forgiving time frame for identification and treatment
  • Goal: remove or neutralize the posion before it gains access to intestines
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14
Q

Inhaled Posions

A

First, the person will remained poisoned as long as they are exposed, as well as the paramedic
Second, atmosphere poisoning, you are likely to encounter more than one patient
-Home agents such as Clorox or Bleach are responsible for most inhalation Emergencies
-CO poisoning is a painless suicide
-CO can be caused by old furnaces as well
Inhaled substances reach the alveoli instantly gaining almost instant access to the circulatory system

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15
Q

Carbon Monoxide

A

Binds to hemoglobin 250x more readily than oxygen

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16
Q

Injection Poisioning

A

Sting, bites from insects and animals

IV drugs such as meth, heroin, cocaine

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17
Q

Absorption Posioning

A

When substance is absorbed through skin

E.g organophosphate

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18
Q

Toxidrome

A 
The Syndrome-like symptoms of a class or group of similar posionous agents
Are useful for remembering and management of different substances that fall under same clinical umbrella
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19
Q

Toxidrome Categories

A 
Stimulants
Narcotics
Cholinergics
Anticholinergics
Sympathomimetics
Sedative/Hypnotics
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20
Q

Stimulant Examples

A 
Amphetamine
Methamphetamine
Cocaine
Diet Aids
Nasal Decongestants
Bath Salts
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21
Q

Stimulants Signs and Symptoms

A

Restlessness, agitation, incessant talking

Insomnia, anorexia, dilated pupils, tachycardia, tachypnea, paranoia, seizure

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22
Q

Narcotic Examples

A 
Heroin
Opium
Morphine
Dilaudid (hydromorphine) 
Fentanyl
Oxycodone
Ambien
Secobarbital
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23
Q

Narcotic Signs and Symptoms

A

Constricted pupils, respiratory depression,

Needle tracks, drowsiness, coma

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24
Q

Sympathomimetic Examples

A

Pseudoephedrine, amphetamine, methamphetamine

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25
Q

Sympathomimetic Signs and Symptoms

A

Hypertension, tachycardia, dilated pupils, hyperthermia, seizures

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26
Q

Sedative/Hypnotic Examples

A

Phenobarbital, diazepam, midazolam, lorazepam

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27
Q

Sedative/Hypnotic Signs and Symptoms

A

Drowsiness, ataxia, slurred speech, ams, CNS depression, hypotension

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28
Q

Cholinergic Examples

A 
Acephate
Diazinon
Celthion
Cythion
Sarin
Parathion
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29
Q

Cholinergic Signs and Symptoms

A

Increased salivation, lacrimation, diarrhea. Respiratory depression, apnea, seizures

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30
Q

Anticholinergic Examples

A

Atropine
Antihistamines
Antipsychotics

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31
Q

Anticholinergic Signs and Symtpoms

A

Dry, flushed skin, hyperthermia, dilated pupils, blurred vision, dramatic delirium

32
Q

Odor

A

Almonds: cyanide
Garlic: arsenic
Acetone: methyl alcohol

33
Q

Pupils

A

Constricted: narcotics, organophosphate
Dilated: barbiturates, atropine, amphetamine, cyanide, CO

34
Q

Mouth

A

Salivation: organophosphate, arsenic, mercury
Dry: atropine, amphetamines, diphenhydramine
Burns: iodine, plants, pine oil, acids

35
Q

Skin

A

Pruritus: Jimson weed
Dry, hot: atropine, CO
Sweating: organophosphate, arsenic, aspirin, amphetamine

36
Q

Respiratory

A

Depressed: narcotics, alcohol
Increased: Aspirin, cyanide, nicotine
Pulmonary Edema: CO, narcotics, organophosphates

37
Q

Drug Abuse

A

Use of drugs that cause physical, psychological, or social harm

38
Q

Habituation

A

Psychological dependence on a drug

39
Q

Physical Dependence

A

Physiological state of adaption to a drug, with tolerance and withdrawals to the drug

40
Q

Psychological Dependence

A

Emotion state of craving a drug to maintain a well being

41
Q

Tolerance

A

Physiological adaptation to the effects of a drug in which larger doses are required

42
Q

Potentiation

A

Enhancement of the effect of one drug by taking it with another

43
Q

Synergism

A

Two substances in which total effects are greater than the sum of the independent effects 2+2=5

44
Q

Alcohol

A

Mot widely abused drug in America

45
Q

Alcoholism

A

Drinking early in day
Drinking alone or in secret
Periodic Binges
Loss of Memory

46
Q

Delirium Termens

A

“Alcohol withdrawal syndrome” results in fever, disorientation, confusion, and seizures

47
Q

Effects of Alcohol

A

Have chronic malnutrition causing them to fall a lot

Decreases life span 10-20 years

48
Q

Alcohol Suscepitble Medical Problems

A 
Subdural Hematoma
GI bleeding
Pancreatitis
Hypoglycemia
Pneumonia
Burns
Hypothermia
Seizures
Dysrhythmia
Cancer
Esophageal Varices
49
Q

Acute Alcohol Intoxication

A

Give thiamine

50
Q

Delirium Termens

A

Usually 48-72 hours after last intake

Mortality as high as 15%

51
Q

Stimulants

A

Only takes days to become addicted and abuse drugs

Commonly recognized as wide eyed and thin as a rail

52
Q

Cocaine

A

Natural occurring alkaloid
“Blow, flake, lady, nose, candy, snow, toot”
-Local anasthetic and CNS stimulant and creates a euphoria
-Causes widened QRS and QT intervals

53
Q

Amphetamine-like Drugs

A

Include ecstasy, meth, and amphetamine
-most nasal decongestants and diet pills are members of this family
Meth: ingredients to make are available locally
Compared to cocaine very similar, however, meth last much longer, up to 12 hours

54
Q

Bath Salts

A

Contain active ingredient such as “Sudafed”

Can snort, smoke or ingest drug

55
Q

Management of Stimulant Abuse

A

Maintain maximum oxygen saturation levels, present seizures with adequate sedation and monitor vitals

  • Excessive pulse rates, preload can drop drastically
  • Consider beta blocker to lower pulse rate
  • Apply ice packs or mist patients skin for hyperthermia
56
Q

Marijuana and Canabis Compounds

A
  • Does not produce true hallucinogens

- Results in bronchodilator and slight tachycardia

57
Q

Spice

A

Can produce deliriums and produce psychotic long term and short term effects

58
Q

Hallucinogens

A

Causes distortion of perception

59
Q

LSD

A

Non habit forming drug

  • primarily affects senses rather than altering physiologic functions
  • “I was watching music play”
  • Effects are mostly sympathomimetic in nature
60
Q

PCP

A 
"Phencyclidine"
-Also called angel dust or dust
-Classified as a dissociative anesthetic
-slurred speech, staggering gait, hypertension
-experience a mind-body separation
Can cause patients to be ver violent ! 
Haldol IM for sedative
61
Q

Ketamine

A

Physically and psychologically addicting

Used as an elephant tranquilizer

62
Q

Peyote and Mescaline

A

Native tribes use for religious purposes

  • experience hallucinations of outer experiences
  • support abc’s
63
Q

Psilocybin Mushrooms

A

Cause hallucination effects

-nausea, vomiting, tachycardia, hypertension

64
Q

*Sedative Hypnotic

A

Reduce anxiety and calm agitated patients, used as sleep aids, in either cases, they function primarily as CNS depressants

65
Q

Barbituates

A

Long Hx use as sleep aids, anti anxiety and seizure control medications
“Barbitals”
-management: oxygen, 12 lead, IV
IF SHOCK present, rapidly infuse 1-2 L of fluid.
For LONG ACTING such as Phenobarbital, administer BiCarb 1meq/kg to help alkaline the urine and traps the drug in its ionized form.
Lasix can also be used to deplete body of urine and bring closer to an alkalytic state
Activated Charcoal can also be used

66
Q

Benzodiazepines

A

Used to treat anxiety, seizures, d alcohol withdrawal (ambien) easy to buy

  • CNS depressant
  • management: oxygen, 12 lead, IV romazicon, contraindicated for head injury and increased ICP
67
Q

Narcotics, Opiates, Opiods

A

Is a drug that produces sleep, or AMS

68
Q

Opiate

A

Natural drugs derived from opium

69
Q

Opiod

A

Refers to non-opium derived synthetics
Produces effects on CNS by binding with receptor sites in the brain and other tissues
Management: abc! Bag and ventilate in necessary. Administer Narcan .4-2mg

70
Q

Narcs example

A

Oxycodone, morphine, fentanyl, codeine. Heroin, hydrocodone, Demerol, robitussin

71
Q

Cardiac Medications

A

Types of Antidysrhythmics

72
Q

Type 1

A

Lidocaine
Na Channel Blocker affecting depolarization and impulse conduction
In certain cases, BiCarb may be used for QT prolongation, bradycardia and hypotension by reversing the inhibition of fast Sodium channels within cardiac cells

73
Q

Type 2

A

Beta-adrenergic and Beta-Blocker medications
Control pulse rate and BP
Hypotension, AMS, bradycardia
HYPOGLYCEMIA AND HYPERKALEMIA occur with beta overdoses
Management: IV Glucagon, Epinephrine infusion, pacing

74
Q

Type 3

A

Block cell potassium channels causing prolongation of cardiac action potential
E.g Amiodarone
Hypotension, bradycardia

75
Q

Type 4

A

Ca channel blocker medications
Verapimil or Cardizem (ca channel blockers)
Slow calcium influx into present cells in the heart, blood vessels and other types of smooth muscles.
OD treatment is calcium

76
Q

Organophosphates

A

Insecticides used in agriculture and nerve gases in the military
Except effects at neuromuscular junctions of Nerves and release acetylcholine.
Management: oxygen, IV, 12 lead, atropine 1mg up to 3mg

77
Q

Carbon Monoxide

A

Odorless, tasteless gas and is 250x more affinity to bind with hemoglobin than oxygen
Assessment: cherry red skin color, pressure in the head, unable to think clearly
Management: highest concentration oxygen available. Hyperbaric chamber.

Paramedic 02 (27 decks)

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