Toxicology II Flashcards
At what percent of Hb saturation with CO does the cherry red appearance occur?
40-60%
What are the ssx of CO poisoning at 0-10%?
None
What are the ssx of CO poisoning at 20-30%?
Slight HA, exertional dyspnea
What are the ssx of CO poisoning at 30-40%
Throbbing HA, fatigue, dizziness, SOB
What are the ssx of CO poisoning at 40-60%?
Weakness, confusion, cherry red appearance
At what level of CO binding do convulsions, coma, and respiratory distress happen?
Greater than 60%
What are the ssx of Warfarin overdose?
Hemoptysis, Hematuria, bruising, bleeding etc
What is the treatment for Warfarin overdose?
Injection of Vitamin K or fresh frozen plasma with prothrombin complex
What are the steps of the extrinsic pathway of coagulation?
12
11
9
10
What are the steps of the intrinsic pathway of coagulation?
3 7 10
What is the MOA of naloxone? How long does it last?
Acts on mu, kappa, and delta receptors competitively.
45 minutes
What is the MOA of naltrexone? How long does it last?
Acts on mu, kappa, and delta receptors competitively.
24-72 hours
What is the antidote for acute opiate overdose?
Naloxone
What is the use of naltrexone?
Maintenance with poisoning?
What is the use of methadone? MOA?
Opioid with lower withdrawal symptoms
What is methemoglobinemia? What causes it?
When Fe is in the ferric (fe3+ state)
Caused by exposure to various chemicals (nitrites, sulfa drugs)
What is the treatment for methemoglobinemia? MOA?
Methylene blue
Causes a direct chemical reduction of methemoglobin back to hemoglobin
What is the toxidrome of sympathomimetic (eyes, CNS, temp, BP)?
Mydriasis
HTN
Tremor
Hyperthermia
What are the three common sympathomimetics that are commonly overdosed on?
Cocaine
Amphetamines
PCP
What is the toxidrome of sedatives/hypnotic drugs (eyes, CNS, breathing, BP)?
Drowsy/coma
Decreased respirations
Miosis or mydriasis
Hypotension
What are the three common sedatives/hypnotics that are commonly overdosed on?
EtOH
Barbiturates
Benzos
What is the toxidrome of opioids drugs (eyes, CNS, breathing, BP)?
Coma
Depressed respiration
Pinpoint pupils
Opiate triad
What is the opiate triad?
hypothermia
Hypotension
Histamine release
What is the toxidrome of anticholinergic drugs? (CNS, pupils, skin, temp, urinary)?
Agitation Mydriasis Fever dry skin Flushing Urinary retention
What are the two classes of drugs that usually cause anticholinergic overdoses?
Anticholinergics
Antidepressants
Reduce ACh ssx = ?
Hot Dry Mad Red Blind
What are the two classes of drugs that usually cause cholinergic overdoses?
Organophosphates
Nicotine
What are the pupils like in cholinergic poisoning?
Pinpoint
What are the ssx of cholinergic poisoning?
Salivation Lacrimation Urination Diaphoresis GI motility Emesis
What is the toxidrome of TCA overdose (CNS, eyes, heart)?
Coma/agitation
Mydriasis
Dysrhythmias
Convulsions
What is the toxidrome for salicylates? (breathing, skin, ears, alk/acidosis, temp)
- to increases respiratory rate
- Diaphoresis
- Tinnitus
- Alkalosis, progressing to acidosis
- Hyperpyrexia
What are the ssx of acidic substance overdose?
Burns
bloody diarrhea
epigastric pain
What are the ssx of basic substance overdose?
Dysphagia/odynophagia
Thick emesis
Shock
What is the treatment for acidic substance overdose?
ABCs
Water
Analgesics
Emollients
What is the treatment for alkaline overdose?
ABCs
Water
Analgesic
NO lavage
What are the common household products that are acidic?
Cleaners, bleaches
What are the common household products that are basic?
Lye
Liquid plumber
Acids or bases cause rapid liquefactive necrosis?
Bases
What is the primary cause of chemical burns, acids or bases?
Bases
Which causes immediate buccal cavity/esophageal pain: acids or bases
Acids
Which is swallowed more often, acids or bases?
Bases
Which causes esophageal perforation: acids or bases?
Bases
Where do the primary effects of basic substances occur?
Esophagus and stomach
What is meperidine?
Opiate
Benzos are rarely fatal unless taken with what?
EtOH or other depressant
What is the antidote for benzo overdose? MOA?
Flumazenil GABA receptors antagonist
What are the ssx of acetominphen poisoning?
N/v
hepatic necrosis
What is the antidote for acetaminophen poisoning? MOA?
N-acetylcysteine
Increases glutathione
What is the chemical that is expended with acetaminophen overdose?
Glutathione
What is the treatment for cardiac dysrhythmia induced by cocaine?
Lidocaine
