Toxicology Slides Flashcards
Name the 5 classes of toxidromes
Anticholinergic Cholinergic Opioids Sympathomimetic Sedative-Hypnotic
Type of med OD’s and toxicological sources we might encounter (10)
- Acetaminophen
- Salicylates
- NSAIDS
- B-Blockers
- Digitalis
- TCA
- toxic alcohols
- cocaine and methemphetamines
- Inhaled toxins
- Caustics
4 stages of acetaminophen OD
-1- Pre injury
2-liver injury
3-max injury
4-recovery
three sources of salicylates
ASA
Bengay
Tiger bomb
S/S of salicylate OD
- Mixed Metabolic and respiratory acidosis and alkalosis
- Hyperventilation
- Tinnitus
- Vomiting/dehydration
- Hyperthermia
- Long QT
NSAID presentation
GI disturbance
Light CNS depression
B-Blocker OD effects
B1-Effects=decreased inotropy, chronotropy, and dromotropy
B2 effects= vasodilation, glycolysis, bronchodilation
A1 effects may be present causing further vasodilation
Older medication may cause sodium channel blockade.,
B-Blocker symptamology
- bradycardia, AV blocks, long QT, VF/VT
- Hypotension
- Resp arrest
- Hypoglycaemia
What is Digitalis?
-Older med, cardiac glycazide
Digitalis S/S
- Increase membrane action potential resulting in increased automaticity=tachydysrythmias
- May also increase vagal tone causing S.bradycardia, impaired AV-Conduction
Digitalis Tox antidote
Digibind
Managment principles for Dig OD
- Manage arrhythmia as per CPG
- avoid pacing
- watch for hyperk!
What are the 7 receptors involved in TCA od
1-Na+ channel 2-A1 receptors blocked 3-Inhibition of NE and Serotonin 4-Muscarinic receptor blockade 5-Histamine receptor blockade 6-K+ efflux blockade 7- Indirect GABA blockade
4 Characteristics of TCA OD ECG
S. TACH
Wide QRS
Long QT
RAD
BONUS–> Tall R wave in aVR
Name 4 toxic alcohols
Methanol
Ethylene Glycol
Isopropyl alcohol
Ethanol
Anion Gap equation + normal range
Na+ - (HCO3 + CL)
Normal range is 9-12
Four stages of toxic alcohol exposure
1-Hallucinations, seizures, coma
2- Hypertension, tachycardia, tachypnea
3-Renal Failure
4- Long term effects and recovery
What is cocaines main effect
Blocks catecholamine re-uptake
Main effect of methemphetamines
stimulates Catecholamine release
Name two types of inhaled toxins
Cyanide
CO
MOA of organophosphate tox
-Organophosphate poisonings block acetylcholinesterase effects resulting in exaggerated acetylcholine effects (salivation).
3 primary affects of organophosphate OD
- Hollow organs
- Sympathetic response
- Neuromuscular junction hyperactivity
Organophosphate impact on hollow organs (10)
- Salivation
- Lacrimation
- Urine inct
- Diarrhea
- Diaphoresis
- GI-Upset
- Emesis
- Bronchorrhea
- Bronchoconstriciton
- Bradycardia
Organophosphate affect on sympathetic NS
- Hypertension
- Mydriasis
- Tachycardia
Organophosphate affect on neuromuscular junctions
- fasciculations
- Resp paralysis
- Coma and seizures
