Toxicology (W6) Flashcards
What is a toxidrome
A collection of S/S that suggest a specific poisoning
In the face of an altered LOA, what should you always assess
CBG
What pts should you specifically be cautious for child abuse when they are poisoned/OD
-pts <5 y/o or intellectually developed
-pts <1 y/o
PNS: __ & __
Rest & digest
Symptoms of a stimulated PNS
Decreased HR, conduction velocity, FOC (is mediated by the vagus nerve)
SNS: __ or __
Fight or flight
Symptoms of a stimulated SNS
Increased HR, conduction velocity, FOC (mediated by sympathetic nerves)
What are the neurotransmitters for the PNS, and SNS
PNS: acetylcholine
SNS: epinephrine and norepinephrine
What are the drug toxicologies that act on the ANS
-cholinergic drugs
-anticholinergic drugs
-adrenergic drugs
What are the 4 routes of drug absorption
Inhalation, injection, ingestion, dermal
Why is inhalation the shortest acting route of drug delivery (2-3 mins)
It provides direct access to the bloodstream via alveoli
Injection can include IV access (30-60 sec) or IM access (10-20 mins), and can cause immediate effects that impact the body how
They can be local/allergic/systemic effects
Ingestion can take from 30-90 mins, although what are some big concerns to consider
-can be absorbed into bloodstream before showing S/S
-caustic substances [alkali or acidic] can show immediate effects
The dermal/topical route can vary, from minutes to hours but what is key to remember
-can include opiates (duragesic) and organophosphates (pesticides)
-decontamination may be required
What are some terms associated with drug abuse
Drug abuse/habituation/drug addition/physical dependence/psychological dependence/tolerance/withdrawal syndrome
What are some processes that can be used for decontamination
Emesis induction, gastric lavage, activated charcoal, bowel irrigation (in hospital)
What is the theory behind fluid bolusing a poisoned pt
Fluid in large volume = increased urine output = rapid clearance of poison
What is the specific antidote for Narcotics
Naloxone
What is the specific antidote for Acetaminophen
N-acetylcysteine (Mucomyst)
What is the specific antidote for Iron
Deferoxamine
What is the specific antidote for Ethylene Glycol, Methanol
Ethanol, Fomepazole
What is the specific antidote for Cyanide
Amyl nitrate, Sodium nitrate, Na thiosulfate
What is the specific antidote for Organophosphates
Atropine, Pralidoxime (2-PAM)
What is the specific antidote for Digitalis
Digibind
