Toxicology Slides

Question 1

Name the 5 classes of toxidromes

Answer 1

Anticholinergic
Cholinergic
Opioids
Sympathomimetic
Sedative-Hypnotic

Question 2

Type of med OD’s and toxicological sources we might encounter (10)

Answer 2

• Acetaminophen
• Salicylates
• NSAIDS
• B-Blockers
• Digitalis
• TCA
• toxic alcohols
• cocaine and methemphetamines
• Inhaled toxins
• Caustics

Question 3

4 stages of acetaminophen OD

Answer 3

-1- Pre injury
2-liver injury
3-max injury
4-recovery

Question 4

three sources of salicylates

Answer 4

ASA
Bengay
Tiger bomb

Question 5

S/S of salicylate OD

Answer 5

• Mixed Metabolic and respiratory acidosis and alkalosis
• Hyperventilation
• Tinnitus
• Vomiting/dehydration
• Hyperthermia
• Long QT

Question 6

NSAID presentation

Answer 6

GI disturbance

Light CNS depression

Question 7

B-Blocker OD effects

Answer 7

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.,

Question 8

B-Blocker symptamology

Answer 8

• bradycardia, AV blocks, long QT, VF/VT
• Hypotension
• Resp arrest
• Hypoglycaemia

Question 9

What is Digitalis?

Answer 9

-Older med, cardiac glycazide

Question 10

Digitalis S/S

Answer 10

• Increase membrane action potential resulting in increased automaticity=tachydysrythmias
• May also increase vagal tone causing S.bradycardia, impaired AV-Conduction

Question 11

Digitalis Tox antidote

Answer 11

Digibind

Question 12

Managment principles for Dig OD

Answer 12

• Manage arrhythmia as per CPG
• avoid pacing
• watch for hyperk!

Question 13

What are the 7 receptors involved in TCA od

Answer 13

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

Question 14

4 Characteristics of TCA OD ECG

Answer 14

S. TACH
Wide QRS
Long QT
RAD

BONUS–> Tall R wave in aVR

Question 15

Name 4 toxic alcohols

Answer 15

Methanol
Ethylene Glycol
Isopropyl alcohol
Ethanol

Question 16

Anion Gap equation + normal range

Answer 16

Na+ - (HCO3 + CL)

Normal range is 9-12

Question 17

Four stages of toxic alcohol exposure

Answer 17

1-Hallucinations, seizures, coma

2- Hypertension, tachycardia, tachypnea

3-Renal Failure

4- Long term effects and recovery

Question 18

What is cocaines main effect

Answer 18

Blocks catecholamine re-uptake

Question 19

Main effect of methemphetamines

Answer 19

stimulates Catecholamine release

Question 20

Name two types of inhaled toxins

Answer 20

Cyanide

CO

Question 21

MOA of organophosphate tox

Answer 21

-Organophosphate poisonings block acetylcholinesterase effects resulting in exaggerated acetylcholine effects (salivation).

Question 22

3 primary affects of organophosphate OD

Answer 22

• Hollow organs
• Sympathetic response
• Neuromuscular junction hyperactivity

Question 23

Organophosphate impact on hollow organs (10)

Answer 23

• Salivation
• Lacrimation
• Urine inct
• Diarrhea
• Diaphoresis
• GI-Upset
• Emesis
• Bronchorrhea
• Bronchoconstriciton
• Bradycardia

Question 24

Organophosphate affect on sympathetic NS

Answer 24

• Hypertension
• Mydriasis
• Tachycardia

Question 25

Organophosphate affect on neuromuscular junctions

Answer 25

• fasciculations
• Resp paralysis
• Coma and seizures