Toxicology-Notes Flashcards
Caustic ingestion…workup, complications?
includes endoscopy within 24 hours
complications: perforation, strictures/stenosis in 2-3 weeks
ulcers, cancer
Lead poisoning?
sideroblastic anemia (decreased heme synthesis)
microcytic
lead lines on bone radiograph
increased ferritin, decreased TIBC. Iron deficiency-see increased TIBC
abdominal pain, anorexia, vomiting
What are some of the neuro symptoms of lead poisoning?
ADHD aggression delinquency encephalopathy neuropathy
What is the treatment for lead poisoning?
remove source chelation therapy DMSA (succimer) can add EDTA dimercaprol
What are the clinical features of iron poisoning?
abdominal pain vomiting diarrhea hypotensive shock metabolic acidosis
can cause hepatic necrosis, pyloric stenosis
diagnosis: anion gap metabolic acidosis
radiopaque pills
What is the treatment for iron poisoning?
whole bowel irrigation
deferoxamine
supportive care
What is the treatment of acetaminophen overdose?
may be asymptomatic for 24 hours
pediatric >150mg/kg. Single dose>7.5g
give charcoal if less than 4 hours since ingestion
any evidence of liver injury–>give N-acetyl cysteine.
If you get acid/base in your eyes..which one can you recover from?
you can’t recover from base. causes corneal scarring.
Acid/alkali ingestion…what do you do?
upper endoscopy to evaluate for a stricture
What do you give when you take anticholinesterases, organophosphates?
atropine
pralidoxime
What do you give after ingestion of antimuscarinic/anticholinergic agents?
physostigmine
Toxin arsenic, mercury, gold…treatment?
succimer
dimercaprol
Antidote for beta blockers?
glucagon
What do you do when you take barbiturates/phenobarbital?
urine alkalinization
dialysis
activated charcoal
supportive care
Benzos can be fixed with what?
flumazenil
