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Medications > Toxicology > Flashcards

Toxicology Flashcards

1
Q

Activated charcoal

A

Classification
Organic compound

Mechanism of Action
Activated carbon binds to selective ingested toxins, allowing them to be passed through the GI tract rather than be absorbed.

Indications
Toxic ingestion < 1 hour

Contraindications
GI obstruction, inability to protect airway, caustic (burn, toxic) ingestion

Dosage
25-100 g PO / NG

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2
Q

Albuterol sulfate / Proventil HFA, Ventolin HFA

A

Classification
Sympathomimetic, Bronchodilator

Mechanism of Action
Beta 2 receptor agonist which stimulates relaxation of bronchial smooth muscle resulting in bronchodilation

Indication
Bronchospasm, anaphylaxis, hyperkalemia

Contraindications Hypersensitivity

Dosage
2.5 mg nebulized with 3 mL inhalation saline

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3
Q

Atropine Sulfate / Atropen

A

Classification
Parasympatholytic, antimuscarinic

Mechanism of Action
Competitive acetylcholine antagonist at the muscarinic receptor increasing HR

Indications
Bradycardia
Organophosphate poisoning

Contraindications Hypersensitivity to Belladonna/Atropine

Cautions
SIVP can cause paradoxical bradycardia
Adults can tolerate 200-1000 mg, however < 10 mg can be fatal to children

Dosage
Bradycardia: 0.5mg IV/IO/IM every 3-5 min, up to 3 mg FAST PUSH

Organophosphate Antidote: 2-6 mg IV/IO/IM

Notes
Antidote: Physostigmine

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4
Q

Atropine & Pralidoxime / DuoDote, Mark 1 Kit

A

Classification
Antidote

Mechanism of Action
Atropine is a competitive acetylcholine antagonist, reversing parasympathetic effects. Pralidoxime stimulates acetylcholinesterase reactivation.

Indications
Organophosphate poisoning

Contraindications
Hypersensitivity, Myasthenia gravis

Cautions
SIVP can cause paradoxical bradycardia

Dosage 2 mg atropine and 600 mg 2-Pam IV / IM / SQ

Notes
Kits are sold with IM Autoinjectors

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5
Q

Calcium chloride

A

Classification
Essential electrolyte

Mechanism of Action
Positive inotropic agent

Indications
Hyperkalemia, hypocalcemia, Ca channel blocker OD, mag sulfate OD

Contraindications
V-Fib, digitalis use, hypercalcemia

Cautions
FIVP can cause hypotension and bradycardia. Tissue necrosis with extravasation

Dosage
500mg-1g of 10% solution SIVP over 5 minutes

Notes
Will precipitate if pushed through the same line as Sodium Bicarbonate

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6
Q

Cyanide antidote kit (Amyl Nitrite, Sodium Nitrite, Sodium Thiosulfate)

A

Classification
Antidote

Mechanism of Action
Amyl and Sodium Nitrite convert hemoglobin to methemoglobin, which binds to cyanide preventing absorption. Na Thiosulfate binds to cyanide creating thiocyanide which is excreted by the body

Indications
Cyanide poisoning

Contraindications
N/A

Side Effects
Nausea, headache

Untoward Effects
Methemoglobinemia

Cautions
Safety not established in pregnant and pediatric pts, but benefit > risk

Dosage Amyl nitrate: inhale for 30 seconds
Sodium nitrate: 10 mg/kg IV/IO over 2-5 minutes
Sodium thiosulfate: 12.5g IV/IO over 10 minutes

Notes
Pt should be supplied with supplemental O2

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7
Q

Dextrose 10, 25, and 50% Solutions / Dextrose

A

Classification
Antihypoglycemic, carbohydrate

Mechanism of Action
Increases BGL

Indications
Hypoglycemia, Hyperkalemia

Contraindications
Hypersensitivity to corn, Dehydration with delirium tremens, Intracranial or intraspinal hemorrhage

Dosage	
Hypoglycemia: 12.5 - 25 g IV/IO 	
Hyperkalemia: 25 g IV/IO
D25 - 2 ml / kg
D10 - 5 ml / kg
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8
Q

Furosemide / Lasix

A

Classification
Loop Diuretic

Mechanism of Action
Inhibits the reabsorption of Na and Cl in the Loop of Henle, increasing excretion of H2O and electrolytes via urine

Indications
CHF, pulmonary edema, hypertensive crisis

Contraindications Hypersensitivity to sulfonamides, Hypotension, Anuria, hypokalemia

Side Effects
Nausea, vomiting, abdominal pain, diarrhea, urination

Untoward Effects
Hypotension, hypokalemia, hypocalcemia, hypomagnesemia

Cautions
Pts with ESRD, DM, or liver disease. FIVP can cause ototoxicity

Dosage
CHF: 0.5-1 mg / kg SIVP
HTN: 40-80 mg SIVP / IO not more than 20 mg / min

Notes
Pregnancy Class C

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9
Q

Glucagon / GlucaGen

A

Classification
Antihypoglycemic, hormone

Mechanism of Action
Stimulates glycogenolysis in the liver resulting in an increase in BGL

Indications
Hypoglycemia, Beta blocker overdose

Contraindications
Hypersensitivity, insulinoma, pheochromocytoma

Side Effects
Hyperglycemia, nausea, vomiting

Untoward Effects Seizures, coma, hypotension, hypertension, tachycardia

Cautions
May increase myocardial O2 demand, HR, and BP in pts with cardiac disease

Dosage
Hypoglycemia: 1 mg IV/IO/IM/Sub-Q

Beta Blocker Antidote: 2-10 mg IV/IO

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10
Q

Hydroxocobalamin / CyanoKit

A

Classification
Antidote

Mechanism of Action
Binds to cyanide to form cyanocobalamin (B12), which is excreted through urine

Indications
Cyanide poisoning

Contraindications
N/A

Side Effects
Nausea, vomiting, headache, erythema, chromaturia

Untoward Effects
Hypertension

Cautions
Pregnant and pediatric pts

Dosage
5 g in 100 mL NS over 15 min,
repeat x1 if necessary

Notes		
Pregnancy class not established, but benefit is greater than risk
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11
Q

Naloxone / Narcan

A

Classification
Opioid antagonist

Mechanism of Action
Competitive opioid receptor antagonist resulting in reversal of narcotic effects on the CNS

Indications
Opioid overdose

Contraindications
Hypersensitivity

Side Effects
Opioid withdrawal symptoms, nausea, vomiting, diaphoresis, agitation

Untoward Effects
Anaphylaxis, seizures, hypertension, V-tach, V-Fib, pulmonary edema

Cautions
The half life of narcan is approx. 30-90 mins and additional doses may be required to prevent return of narcotic effects

Dosage
0.4 - 2 mg IV/IO/ET/IM/Sub-Q
2 mg IN via MAD, 1 mg per nare

How Supplied
0.4 mg / mL single use vial,
and 4 mg / 10 mL multi-use vials
2 mg / 2 mL syringe with MAD for IN

Notes
Pregnancy category B

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12
Q

Sodium Bicarbonate

A

Classification
Essential electrolyte, Antacid

Mechanism of Action
Binds with carbonic acid to maintain pH homeostasis

Indications
Acidosis, DKA, hyperkalemia, Salicylate, TCA, DPH and cocaine OD

Contraindications
Hypersensitivity, Alkalosis

Side Effects
Gastric distention, belching, edema

Untoward Effects
Alkalosis, Hypernatremia, Hypocalcemia, Hypokalemia

Cautions Pts with CHF or renal disease

Dosage
1 mEq/kg SIVP / IO
Repeat 0.5mEq/kg in 10 minutes if needed

Notes		
Pregnancy class C
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13
Q

Thiamine / Vitamin B1

A

Classification
Vitamin

Mechanism of Action
Combines with ATP to metabolize carbohydrates

Indications
Wernicke’s encephalopathy, Korsakoff psychosis, beriberi / thiamine deficiency

Contraindications
Hypersensitivity

Side Effects
Itching, rash, diaphoresis, nausea

Untoward Effects
Anaphylaxis, cyanosis, pulmonary edema

Cautions
Can be administered before, with or after dextrose in hypoglycemic AMS pts

Dosage
100 mg IV/IO

Notes		
Pregnancy class A
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Medications (9 decks)

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