Toxicology: Treatments [according to Master the Boards] Flashcards

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1
Q

When would you use Gastrointestinal Emptying and when not?

A
Gastric lavage may occasionally be useful in the first hour of ingestion. 
NOT in:
Altered mental status:
Caustic ingestion
Acetaminophen overdose
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2
Q

When would you use Ipecac and when not?

A

there is no benefit in

using ipecac in the hospital

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3
Q

When would you use Cathartics and when not?

A

Cathartic agents such as sorbitol are always a wrong answer.

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4
Q

When would you use Forced Diuresis

and when not?

A

always a wrong

answer.

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5
Q

What kind of solution is used to do a Whole Bowel Irrigation?

A

polyethylene glycol electrolyte

solution (GoLYTELY)

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6
Q

When would you use Whole Bowel Irrigation

and when not?

A

almost always wrong.

Indications:

  • massive iron ingestion,
  • lithium, and
  • swallowing drug-filled packets (e.g., smuggling)
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7
Q

The best initial management of altered mental status of

unclear etiology is____________?

A

an opiate antagonist and glucose-

Naloxone and dextrose.

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8
Q

___________ reverses

benzodiazepines, but can cause ______ from instant withdrawal

A

Flumazenil reverses
benzodiazepines, but can cause seizures from instant withdrawal.

Ojo: una parte del libro dice “don’t give FMZ”

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9
Q

Psychiatric consultation is indicated when ___________

A

the/an overdose is from a

suicide attempt,

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10
Q

BUT Psychiatric consultation is a wrong answer, WHEN___

A

specific antidotes and diagnostic tests are needed.

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11
Q

When would you use Charcoal and when not?

A

should be given to anyone with a pill overdose.
it is not dangerous in
anyone.

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12
Q

Acetaminophen overdose Treatment is

A

If a clearly toxic amount of acetaminophen has been ingested (more than 8–10 grams), the answer is N-acetylcysteine.

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13
Q

Acetaminophen overdose (passed 24hs)

A

there is no therapy.

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14
Q

Acetaminophen overdose w. unclear amount of ingestion

A

get a drug level.

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15
Q

Aspirin Overdose Treatment is

A

alkalinizing the urine, which increases the rate of aspirin

excretion

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16
Q

Treatment of TCA overdose

A

is with sodium bicarbonate. which protects the heart

17
Q

Caustics

A

Use water in high volumes. Endoscopy is

performed to assess the degree of damage.

18
Q

Carbon Monoxide Poisoning

A

100% oxygen,
Severe disease is treated with hyperbaric
oxygen.

19
Q

Methemoglobinemia

The best initial therapy is

A

100% oxygen.

20
Q

Methemoglobinemia.

The most effective therapy is

A

methylene blue, which decreases the half-life of

methemoglobin.

21
Q

Methemoglobinemia. most

accurate test is

A

methemoglobin level.

22
Q

Organophosphate (Insecticide) Poisoning and Nerve Gas.

Initial treatment and Especific.

A

Pralidoxime is the specific antidote for organophosphates.
Pralidoxime reactivates acetylcholinesterase. BUT It does not work as
instantaneously as atropine.

23
Q

Digoxin Toxicity

A
  • Control potassium
  • give digoxin-specific antibodies when CNS and
    cardiac involvement.
24
Q

Lead Poisoning most accurate test is

A

lead level

25
Q

Lead Poisoning best initial diagnostic test is

A

increased

level of free erythrocyte protoporphyrin

26
Q

Lead Poisoning Treatment

A

Chelating agents:
Succimer (oral)
Ethylenediaminetetraacetic acid (EDTA) and dimercaprol
(BAL) [parenteral]

27
Q

Mercury Poisoning

A

Chelating agents such as dimercaprol and

succimer are effective

28
Q

Toxic Alcohols: Methanol and Ethylene Glycol

A

fomepizole and dialysis.

29
Q

Snake Bites

A

Pressure
Immobilization decreases movement of
venom
Antivenin

30
Q

Black widow Spider Bites

A

Calcium, antivenin

31
Q

Brown recluse Spider Bites

A

Debridement, steroids,

dapsone

32
Q

Dog, Cat, and Human Bites

A
  • Amoxicillin/clavulanate

- Tetanus vaccination booster if more than 5 years since last injection