Toxicology POPCORN

Question 1

Which med toxicity?

• Seizures
• Prolonged PR
• Tx= Glucagon, Insulin-Glucose, Epi

Answer 1

Beta-Blockers

Question 2

Which med toxicity?

• Seizures
• Ileus
• AV dissociation
• Prolonged PR

Answer 2

Calcium channel blockers

Question 3

How do you tx calcium channel blocker toxicity?

Answer 3

CaCl, Glucagon, Insulin-Glucose, Lipid emulsion

Question 4

Which toxicity?

• Seizure
• Pinpoint pupils
• Sweating

Answer 4

Organophosphates (=pesticides)

Question 5

What does arsenic and organophosphates smell like?

Answer 5

GArlic=

Arsenic and Organophosphates

Question 6

What does sulfide smell like?

Answer 6

Rotton eggs

Question 7

What does Isopropyl alcohol smell like?

Answer 7

Acetone

Question 8

What does Chloral hydrate smell like?

Answer 8

Pears

Question 9

Activated charcoal should only be used within how many hours?

Answer 9

Within the 1st hour

Question 10

What is the most common EKG abnormality found in OD pt ?

Answer 10

Sinus Tachycardia

Question 11

Which toxidrome and what is the antidote?

• Hot
• Blind
• Dry
• Red (flushed)
• Mad agitated
• Fixed dilated pupils
• hyperthermic
• DRY ARMPITS

Answer 11

Anticholinergics (ex: Antihistamines, TCAs)

Antidote= Physostigmine (ACHase inhibitor)

Question 12

What syndrome?

• Myoclonus
• Agitation
• Diarrhea

Answer 12

Serotonin syndrome (combo of 2 SSRIs, Demerol, Lithium)

Question 13

The following is caused by which group of meds? What is the antidote?

• Pinpoint pupils
• Resp. Depression
• Hypotension
• Bradycardia

Answer 13

Opiates (Fentanyl, Heroin, Morphine, Codeine)

Antidote= Naloxone

(Hint: oPIates= PIn point pupils)

Question 14

What is the MC drug OD?

Answer 14

Acetaminophen

Question 15

Which med OD? What is the antidote?

• Liver necorsis
• Vomiting MCly seen in kids
• Toxic dose= 140mg/kg

Answer 15

Acetaminophen

Antidote= N-acetylcysteine

Question 16

Which group of meds can cause the following toxicities? What is the antidote?

• Respiratory Alkalosis
• Metabolic acidosis
• Hypokalemia

Answer 16

Salicylates (ASA, methylsalycylate/oil of wintergreen)

Antidote= Urine alkalization

Question 17

What is the antidote for a salicylate overdose? (ex: aspirin, methysalicylate/oil of wintergree)

Answer 17

Urine alkalization

Question 18

What causes the following toxicities?

• Metabolic acidosis
• Hypoglycemia
• Elevated anion gap
• Normal osmolarity gap
• Normal lactate
• VERY elevated ketosis

Answer 18

Ethanol

Question 19

How do you treat an ethanol toxicity

Answer 19

Fluids- Banana bag w/ MVI, thiamine, folate

Question 20

What do you see in the urine of someone who has consumed ethylene glycol (antifreeze). What is the tx?

Answer 20

Oxalate Crystalluria (If you use a woods lamp it will fluress purple)

Tx: IVF, Fomepizole (antidote)

Question 21

Which toxic alcohol has an anion gap metabolic acidosis with visual changes?

Answer 21

Methanol

(antidote=Fomepizole)

Question 22

Which med causes the following toxicities and what is the antidote?

• Yellow halos in vision
• Hyperkalemia
• Arrhythmia

Answer 22

Digitalis

Tx= Digibind

Question 23

What is the MCC of unintentional poisoning death and has the following sxs:

• Red skin
• Apnea

Answer 23

CO

Question 24

How do you tx CO poisoning?

Answer 24

100% O2

Question 25

What is the MCC of peds mortality from poisoning?

Answer 25

Iron

Question 26

Which med causes the following toxicities and is MC in kids? What is the antidote? * Metabolic acidosis * **_Vomiting_** * Organ failure

Answer 26

Iron Antidote= Deferoxamine (DFO)

Question 27

The following is the toxidrome for which group of meds? * ↑BP and HR * Delusions * Hyperthermia * Seizure * _**\*Diaphoresis\***_ * Piloerection * **Mydriasis** * Hyperreflexia

Answer 27

**_Sympathomimetics_** (Amphetamines, cocaine, pseudophedrine, caffeine, PCP) (note- This is the same as the anticholinergics but sympathomimetics have DIAPHORESIS)