Toxidromes

Question 1

Organophosphates: SLUDGE

Answer 1

Salivation
Lacrimation
Urination
Diarrhea
GI 
Emesis

Tx: atropine (blocks ACh)

Question 2

Tricyclics

Answer 2

Anticholinergic:
Blind as a bat, red as a beet, hot as a hare, dry as a bone, mad as a hatter

Dysrhythmias within 24 hrs

Tx: alkalinization of urine

Question 3

Beta blocker

Answer 3

Depressed sensorium
Bradycardia
Hypotension
Diaphoresis

Question 4

Hydrocarbons

Answer 4

Observation 6 hrs
Diffuse bilateral infiltrates
Potential ARDS

Question 5

Carbon monoxide

Answer 5

Singed nasal hairs
Normal pulse oximetry

Fatigue, headache, nausea, dyspnea, confusion

100% oxygen

Question 6

Ethylene glycol

Answer 6

Large anion gap, oxalate crystals on urinalysis

Phase 1: nausea, vomiting, tachycardia, hypertension, hypocalcemia, metabolic acidosis

Phase 2: coma, cardiorespiratory failure

Phase 3: renal failure (ATN)

Question 7

Iron

Answer 7

Toxic 50mg/kg

Phase 1: vomiting, diarrhea, abdominal pain
Phase 2 (6-24hrs): decreased GI symptoms
Phase 3: metabolic acidosis, coagulopathy, cardiovascular collapse
Phase 4: GI obstruction

Tx: deferoxamine

Question 8

Caustic substances

Answer 8

Caustic substance -> coughing, drooling, difficulty swallowing

Endoscopy within 48 hrs

Question 9

Organophosphates

Answer 9

Atropine

Question 10

Iron

Answer 10

Deferoxamine

Question 11

Methanol, ethylene glycol

Answer 11

Ethanol

Question 12

Carbon monoxide

Answer 12

Oxygen

Question 13

Methemoglobinemia

Answer 13

Methylene blue

Question 14

Acetaminophen

Answer 14

N-acetylcysteine

Question 15

Narcotics

Answer 15

Naloxone

Question 16

Anticholinergics

Answer 16

Physostigmine

Question 17

Tricyclics

Answer 17

Charcoal

Alkalinization

Question 18

Salicylates

Answer 18

Alkalinization of urine

Question 19

Salicylates

Answer 19

Fever, vomiting, coagulopathy, hyperpnea, tinnitus, seizures

Metabolic acidosis, hypokalemia, hypocalcemia