toxicology and antidotes Flashcards
topical exposure
remove contaminated clothing wash skin with soap and water for 10 mins
ocular exposure
remove contact lenses and rinse eye for 15 mins
for oral
drink small amount of water or milk
for inhaled exposure
move to fresh air
for button battery ingestion
2 teaspoon of honey or sucralfate
is ipeac syrup recommended for enducing emesis
NOPE
what is CABs
circulation airway breathing
what is the dose for activated charcoal
1g/kg
when is charcoal used
within 1 hour of ingestion
airway should be protected
when is activated charcoal contrarindicated
unconscious
cannot clear throat
cannot hold head upright
intestinal obstruction
acetaminophen
NAPQI
antidote NAC- n acetylcystine
phases in tylenol toxicities
phase 1- asymptomatic
phase 2- 24 to 48 hours elevated AST/ALT
phase 3 48-96 hepatic failure
phase 4 >96 hours recovers or recives transplant
NAC dose
17 times oral
3 times IV
opiod overdose
antidote- naloxone
anticholinergics
supportive care, tx with physostigmine inhibits acetylcholinesterase
anticoag apixaban and rivaroxaban
andexanet alfa or andexxa
antipsychotics
supportive care, benztropine for dystonias and bicarb for QRS widening
benzoos
flumazenil can cause seizures, when used in patients chronically
betablockers
glucagon
CCBs
calcium IV
cyanide
hydroxocobalamin (cyanokit)
digoxin
Digoxin immune fab (Digifab)
Ethanol alcohol
thaimine Vitamin B1 to prevent wernickes encephalopathy
can cause increase in anion gap
heavy metals 5FU
Dimercaprol or succimer for arsenic gold or mercury
penicilliamine = copper
hydrocarbons
do not induce vomitting
insulin or other hypoglycemics
dextrose injection
glucagon
isoniazid
pyridoxine
iron and aluminum
deferoxamine
organophosphates
antichoinesterase like atropine
for paralysis - pralidoxime
or combined
mtx
leucovirin levoleucovorin
which a folate
neostigmine
pralidoxime
Nicotine
abdominal pain, nausea
atropine,benzos
salicylates Bengay
sodium bi carb decrease drug reabsorption and increase excretion
stimulants
benzos
toxic alcohols
fomepizole
TCAs
sodium bi carbs
vasopressors for hypotenstion
valporic acid or topiramate induced hyperammonemia
levocarnitine (carnitor)
what is the rumack Matthew nomogram used for
NAPQI
animal bites
rabies vaccine
black widow spider
antiven
scorpion stings
antivenin
MOA of NAC
NAPq conversion to nontoxic metabolite
acting as a glutathione precursor
how to treat widening of QRS
sodium bi carb
heparin OD
protamine
dabigatran
idarucizumab (paxxbind)
isoniazid
pyridixone
vit b6
anticcholinergic effects
flushing
dry skin
blurry vision
tachy cardia
constipation
urinary retention