Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Systems- Acute stuff > Toxicology > Flashcards

Toxicology Flashcards

1
Q

What does toxicology involve?

A

ODs of medications and drugs

(Because your lips are venom you’re POISON)

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

Who may be able to give a good collateral history from a patient who just had an OD

A

Friends & family

Paramedics

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

What key bit of info would you try and get form paramedics regarding patients who had an OD?

A

If any drugs or medication packets were found nearby the poor bugger

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

What are the key bits of info you need to find out when taking a history of an OD

A

What was taken

How much

When

Was it taken all at once or staggered

Was alcohol involved

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

When someone presents to the ED with an OD, what do you need to consider?

A

If they have capacity

If their gonna leg it

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

What tool is used for assessing ODs

A

Toxbase tool

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

What does ‘Toxidrome’ mean?

A

The signs and symtpoms that indicate a specific class of poisoning

Just pattern recognition ehhhh

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

What is the very first thing you do for all patients who present with an OD

A

ABCDE assessment

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

So what do you look for in the ABCDE assessment for patient’s who have had an OD

A

A -> patency

B -> resp rate

C -> pulse & BP

D -> mental status, pupils, reflexes, seizures

E -> temperature, skin changes, musous membranes

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

When checking out the E in ABCDE for a patient whos had an OD, what do you look for with regards to skin?

A

If it’s sweaty or dry

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

What are the 4 main types of toxidromes

A

Adrenergic (sympathomimetic) drugs

Sedative-hypnotic drugs

Opioids

Anti-cholinergics

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

What is another term for adrenergic drugs

A

Sympathomimetics

(they mimic the effects of the sympathetic system ehhhh)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do sympathemimetic (adrenergic) drugs work?

A

Stimulate a & B adrenergic receptors

Prevent noradrenaline reuptake

Release noradrenaline

(keeps noradrenaline going strong)

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

How do adrenergic drugs affect noradrenaline?

A

They keep it presennt and active

(let’s it go a bit maaad ehhh)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do anticholinergic drugs work?

A

Block Na channels

Block a-adrenergic receptors

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

What are the 3 consitent features for pretty much all toxidromes?

(symtpoms to always guess ehh)

A

Altered mental state

Hallucinations

Delirium

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

What are the ECG signs for anti-cholinergic toxidromes?

A

Wide QRS

Prolonged PR and QT interval

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

What is the difference between anti-cholinergic and opioid toxidromes regarding what happens to the pupils?

A

Anti-cholingeric -> dilated & non-reactive

Opioid -> pin-point

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

What is the difference regarding what happens to reflexes for:

A. Adrenergic toxidromes

B. Sedative-hypoxic toxidromes

C. Anti-cholinergic toxidromes

A

A. Brisk

B. Reduced

C. Brish -> absent

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

What toxidromes casue hypertension and hypotension

A

Hypertension

Adrenergic

Anti-cholingeric

Hypotension

Sedative-hypoxic

Opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What toxidrome is being described here:

“Hot as a hare, dry as a bone, mad as a hatter”

A

Anti-cholinergic

Hot as a hare -> pyrexia

Dry as a bone -> dry skin

Mad as a hatter -> confusion ehhh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

For anti-cholingeric toxidromes, what are the indications to give 50ml of Sodium bicarbonate?

A

Metabolic acidosis

Prolonged QRS

Arrythmias

Still hypotensive after fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the key questions you need to think about regarding how an OD will be managed?

A

Do they need resus

What have they taken, how much and when

Have the paramedics brought anything

Do they need charcoal

What tests need to be done

Is there a specific antidotoe

What is the predictive clinical course

Is a psych assessment needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How would manage resp. depression that can occur in opioid ODs?

A

Fire in a nasopharyngeal airway

Give 15L of O2

Montitor CO2

Do an ABG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Why is it important to monitor CO2 and do an ABG for opioid ODs?

A

To check for acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Opioid ODs can cause hypoglycemia.

How can you treat hypoglycemia?

A

IV dextrose

(if you can’t give IV -> do IM glucagon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What can happen to BG levels for opioid ODs?

A

Hypoglycemia

28
Q

Why is charcoal often used for ODs?

A

As charcoal binds to the drug, limiting it’s effect

29
Q

What is a sign of warfarin OD, and how would you treat it?

A

Sign -> Haemorrhage

Treatment -> Vit. K

30
Q

Give examples of adrenergic drugs

A

Cocaine

Ampthetamines

Noval psychoactive substances

Decongestants

31
Q

Noval psychoactive agents are examples of adrenegric drugs, what are they also known as?

A

Legal highs

32
Q

Cocaine and amphetamines are examples of what type of drug?

A

Adrenergic

33
Q

Give examples of sedative-hypoxic drugs

A

Benzodiazipeines

Barbituates

Ethanol

Zopidone (sleepign tablets)

34
Q

Give an exmaple of a benzodiazpine, which is a type of hypoxic-sedative drug?

A

Diazepam

35
Q

Baribituates are an example of sedative hypoxic drugs, what are they used to treat?

A

Epilepsy

36
Q

Give examples of opioids

A

Codeine

Heroin

Methadone

MST

37
Q

Heroin and methodone are what type of drug

A

Opioid

38
Q

What are opioids used to treat?

A

Chronic pain

39
Q

Give examples of anti-cholinergic drugs

A

TCAs (e.g. amitriptyline)

Antihistamine

Oxybutynin

Diphenhydramine

40
Q

If someone presents with an OD of one of their anti-depressants or medicine for their urinary incontinence, what is the likley toxidrome?

A

Anti-cholinergic

(anti-depressant -> TCA)

(urinary incontience drug -> oxybutynin)

41
Q

If someone presents with an OD after taking too much pain meds, what is the likely toxidrome?

A

Opioid

42
Q

If someone presents with an OD of hayfever and allergy tablets, what is the toxidrome that will occur?

A

Anti-cholinergic

43
Q

What are the clinical features for adrenergic (sympathomimetic) toxidromes?

A

Chest pain

Agitation

Tachycardia & tachypnoea

Sweating

Dilated pupils

Brisk refelexes

Arrythmias

Hypertension

44
Q

What are the clinical features of sedative-hypoix toxidromes?

A

Brachycardia & bradypnoea

Slurred speach

Nystagmus & blurred vision

Reduced reflexes

Hallucinations

Coma

45
Q

What are clinical features of opioid toxidromes?

A

Resp. depression

Bradycardia

Pinpoint pupils

Hypothermia

Seziures

46
Q

What are the clinical features of an anti-cholinergic toxidrome?

A

Pyrexia (hot as a hare)

Dry skin (dry as a bone)

Confusion (mad as a hater)

Tachycardia

Brisk (then absent) reflexes

Dilated & non-reactive pupils

Urine retention

47
Q

What types of toxidromes cause tachycardia and bradycardia?

A

Tachycardia

Adrenergic

Anti-cholinergic

Bradycardia

Sedative-hypoxic

Opioid

48
Q

How is an OD of an adrenergic drug managed?

A

Measure

CK levels

ECG

Temperature

Give

Diazepan

GTN infusion

Sodium bicarbonate

49
Q

What is sodium bicarbonate used to treat

A

Metabolic acidosis

50
Q

Levels of what should you always check in adrenergic drug ODs?

A

CK

51
Q

If CK levels are high in a adrenergic OD, what do you give?

A

IV fluids

52
Q

How is an OD of a sedative-hypnotic drug managed?

A

Intubate & protect airway

Ventilation support

Correct hypotension

Give flumazenil (if OD’ on benzo)

53
Q

How can you correct hypotension?

(need to do in sedative-hypoxic and opoiod ODs)

A

Give IV fluids

Lift legs

Vasopressors

54
Q

What is the main management goal for sedative-hypoxic toxidroems?

A

Protect the airway

55
Q

What is the ‘antidote’ for benzodiazpenie OD?

A

Flumazenil

56
Q

How is an OD of an opioid drug managed?

A

Give Naloxone

Give 15L oxygen

Set up a nasopharyngeal airway

Do a GCS assessment

Montiro CO2 and ABGs

57
Q

What is the ‘antidote’ for…

A. Adrenergic ODs

B. Sedative-hypoxic (benzo) ODs

C. Opioids

A

A. Diazepam

B. Flumazenil

C. Naloxone

58
Q

What are the 2 ways that you give naloxone?

A

IV or IM

59
Q

How long does naloxone last one given?

A

40mins approx

(so it’s long acting)

60
Q

How are anti-cholingeric ODs managed?

A

Give charcoal

Give glucahon (if hypotensive or in shock)

Give sodium bicarbonate (

Check CK and ECG

61
Q

What does diazpeam treat

A

Agitation

Arrythmias

62
Q

When would you give sodium bicarbonate in an anti-cholinergic OD?

A

If metabolic acidosis occurs

(same for adregenric OD)

63
Q

Alcohol OD would cause what type of toxidrome?

A

Sedative-hypoxic

(As alcohol is ethanol ehhhhh)

64
Q

What is the antidote for a benzo OD?

A

Flumanazil

65
Q

An OD of what is treated with alcohol?

A

Anti-freeze

Systems- Acute stuff (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions