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7364 Critical Care Block 3 > Toxicology > Flashcards

Toxicology Flashcards

1
Q

What is the poison control center phone number?

A

1-800-222-1222

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2
Q

The American Association of Poison Control Centers (AAPCC) is associated with the ___

a. prescription drug monitoring programs
b. national poison data system

A

b. national poison data system

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3
Q

Classic toxidrome?

SACOS

A 
S - sympathomimetics
A - anticholinergics
C - cholinergics
O - opioids
S - sedative hypnotic
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4
Q

Consider treating sympathomimetic toxidrome with what class of meds?

A

benzos

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5
Q

3 drugs that can cause sympathomimetic toxidrome?

A

caffeine
cocaine
amphetamines

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6
Q

signs of cholinergic toxidrome?

SLUDGE

A 
S - salivation
L - lacrimation
U - urination
D - diarrhea
G - gastrointestinal distress
E - emesis
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7
Q

Cholinergic toxidrome is caused by ___ ACh

a. too much
b. deficit of

A

a. too much

Common causes:
cholinesterase inhibitors
nerve gases, pesticides

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8
Q

Cholinergic toxidrome causes ___ pupils

a. pinpoint
b. dilated

A

a. pinpoint

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9
Q

Sympathomimetic toxidrome causes __ pupils

a. pinpoint
b. dilated

A

b. dilated

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10
Q

Cholinergic toxidrome:

Muscarinic effects?

A
  • diarrhea
  • urination
  • miosis
  • BBB (bradycardia, bronchorrhea, bronchospasm)
  • emesis
  • lacrimation
  • salivation
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11
Q

Cholinergic toxidrome:

nicotinic effects?

A
  • mydriasis
  • tachycardia
  • weakness
  • HTN
  • fasciculations
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12
Q

___ is a nicotinic effect

a. miosis
b. mydriasis

A

b. mydriasis

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13
Q

___ is a muscarinic effect

a. miosis
b. mydriasis

A

a. miosis

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14
Q

What Tx for anticholinergic toxidrome induces cholinergic effects?

A

physostigmine

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15
Q

What class of drugs is used to Tx anticholinergic toxidrome?

A

benzos

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16
Q

opioid toxidrome causes __ pupils

a. miosis
b. mydriasis

A

a. miosis

pin point pupils

17
Q

Opioid toxidrome causes __ blood pressure

a. increased
b. decreased

A

b. decreased

18
Q

General approach followed by poison control centers for any AE or other poisoning?

RADAR

A 
R - recognition
A - assessment
D - definitive Dx
A - advice
R - reporting
19
Q

___ causes QTc prolongation

a. TCAs
b. antidepressants
c. non DHB CCBs

select all that apply

A

a, b

20
Q

___ causes PR prolongation

a. TCAs
b. antidepressants
c. non DHB CCBs

select all that apply

A

c. non DHB CCBs

21
Q

MOA of activated charcoal?

A

prevents absorption of xenobiotics

22
Q

Activated charcoal is pharmacologically inert and unabsorbed.

a. true
b. false

A

a. true

23
Q

activated charcoal adsorbs xenobiotics that are in the dissolved liquid phase via indirect contact

a. true
b. false

A

b. false

via DIRECT contact

24
Q

Poor candidates for activated charcoal?

PHAILS

A 
P - pesticides
H - hydrocarbons
A - acids/alkali
I - iron
L - lithium
S - solvents
25
Q

activated charcoal is typically not recommended if it has been more than __ to __ hours since ingestion of the poison

A

1, 2

26
Q

Single dose activated charcoal dose?

A

1g/kg of body weight

27
Q

Activated charcoal is more effective with a single dose of evacuant

a. true
b. false

A

b. false

ACalone is comparably effective toAC plus a single dose of evacuant

28
Q

whole bowel irrigation is achieved through administration of large amounts of osmotically balanced ___ solution

A

PEG electrolyte lavage

29
Q

Whole bowel irrigation is indicated for immediate release pharmaceuticals.

a. true
b. false

A

b. false

Primarily indicated for:

  • sustained release or delayed release
  • metals
  • xenobiotics with very slow absorptive phases
30
Q

Sodium bicarb __ to __ mEq/kg rapid initial infusion is used to increase the urinary pH to 7 to 8

A

1, 2

only works for xenobiotics that are acidic
only works for drugs that are predominantly renally eliminated

31
Q

___ may occur after administration of hypertonic sodium bicarb

a. hypernatremia
b. hyponatremia

A

a. hypernatremia

32
Q

Bicarbonaturia is associated with urinary potassium ___

a. losses
b. excess

A

a. losses

33
Q

Blockage of sodium channels can be detected by observing what?

A

prolonges QRS interval

34
Q

Hemodialysis is a suitable method of xenobiotic removal with Vd < __ L/kg

A

1

Low Vd < 1L/kg
single compartment PK
low protein binding
MW < 5000 Daltons
water soluble
35
Q

___ is an established effective Tx method of local anesthetic induced cardiovascular collapse

A

intravenous lipid emulsion

acts as a lipid sink and traps lipophilic drugs and draws them away from target tissues, especially the heart and brain

36
Q

Intravenous lipid emulsion:

Most case reports use __ % liposomal emulsion continuous infusion at a rate of __ mL/kg/hr

A

0.5

7364 Critical Care Block 3 (6 decks)

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