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ABIM > Toxidromes > Flashcards

Toxidromes Flashcards

1
Q

What is the MOA of anticholinergics?

A

They block acetylcholine from binding to muscarinic receptors and thus inhibit parasympathetic nervous system function

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2
Q

what is the mnemonic for anticholinergic syndrome?

A

mad as a hatter
blind as a bat
hot as a hare
dry as a cracker

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2
Q

What are three classes of medications that can cause anticholinergic overdose?

A

TCAS, antihistamines, overactive bladder medications (oxybutynin, tolterodine, trospium)

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3
Q

What is the MOA of cholinergic medication?

A

enhance or mimix acetylcholine; active PNS.

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4
Q

What is the mnemonic for cholinergic overdose?

A

DUMBBELLS
Diarrhea
Urination
Miosis
Bronchorrhea
Bradycardia
Emesis
Lacrimation
Salivation/sweating

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5
Q

What are two sources of cholinergic poisoning?

A

organophosphates and nerve agents (-stigmines)

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6
Q

Treatment of cholinergic poisoning?

A

Atropine
Pralidoxime

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7
Q

How does sympathomimetic overdose present?

A

Fight or flight:
tachycardia, hypertension, midryiasis, diaphoresis, hyperthermia, agitation

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8
Q

What OTC agents can cause sympathomimetic overdose?

A

ephedrine containing products

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9
Q

which illicit substances can cause sympathomimetic overdose ?

A

cocaine, methamphetamine, amphetamine, MDMA , ecstasy

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10
Q

main symptom of sympathomimetic poisoning?

A

extreme hypertension

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11
Q

pupils in anticholinergic toxicity?

A

dilated and non reactive

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12
Q

Which 5 classes of medications can cause serotonin syndrome?

A
  1. anti-depressants ( SSRI, MAOi)
  2. stimulants (cocaine, MDMA, meth, triptans)
  3. opioids (fentanyl, tramadol, meperidine)
  4. herbs (st. john’s wort, ginseng, nutmeg)
  5. others (lithium, valproate, dextromethorphan, linezolid, zofran, reglan)
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13
Q

symptoms of serotonin syndrome?

A

Hyperthermic, hyperreflexia, hypertension, hypertonic muscles, hyperactive BS

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14
Q

Diagnostic tool for serotonin syndrome?

A

Hunter criteria (Se 84% Sp 97%)

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15
Q

antidote for serotonin syndrome?

A

cyproheptadine

16
Q

what causes neuroleptic malignant syndrome?

A

dopamine blockers or cessation of dopamine agonist (parkinson’s tx)

17
Q

Which three drug classes cause NMS?

A
  1. antipsychotics (haloperidol, clozapine, olanzapine, risperidone, quetipaine)
  2. anti-emetics (reglan, compazine, droperidol)
  3. dopamine agonist WITHDRAWAL (carbidopa/levodopa, bromocriptine)
18
Q

symptoms of NMS?

A

lead pipe rigidity
brady-reflexia
AMS
catatonia
hyperthermia

19
Q

treatment for NMS?

A

restart DA agonist if held
dantrolene
bromocriptine

20
Q

what causes malignant hyperthermia?

A

inhaled anesthetics or succinylcholine in a patient with genetic mutation in ryanodine receptor

21
Q

symptoms of malignant hyperthermia?

A

hyperthermia >42
Rigor mortis rigidity
Hyporeflexia
Hypercarbia

22
Q

antidote for malignant hyperthermia

A

dantrolene
aggressive cooling

23
Q

antidote for beta blocker tox?

A

glucagon

24
Q

antidote for CCBs?

A

calcium, glucagon, insulin/dextrose

25
Q

antidote for CO2 ?

A

oxygen, hyperbaric oxygen

26
Q

antidote for cyanide poisoning?

A

hydroxycobalamin or a cyanide kit

27
Q

antidote for digoxin?

A

digibind Fab fragments

28
Q

antidote for hydrofluoric acid?

A

calcium

29
Q

antidote for iron?

A

deferoxamine

30
Q

antidote for isoniazid

A

pyridoxine

31
Q

antidote for local anesthetic?

A

IV lipid emulsion

32
Q

antidote for methanol/ethylene glycol

A

ethanol or fomepizole

33
Q

antidote for methemoglobinemia

A

methylene blue

34
Q

antidote for opioids

A

naloxone

35
Q

antidote for organophosphate / insecticide?

A

atropine and pralidoxime

36
Q

antidote for snake bite (crotalidae)

A

crotalidae immune Fab

37
Q

antidote for sulfonylureas

A

glucose, octreotide

38
Q

antidote for TCAs?

A

sodium bicarb and hypertonic saline

ABIM (1 decks)

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