Toxidromes Flashcards
How to treat hypoglycemia, which GPCRs receptor is activated
Glucose or Glucagon, Gs»_space; cAMP
What’s the toxidrome? RR-4, bilateral miosis + Abnormal atriel blood gases
Opiods intoxication
whats the antidote for opiods overdose
Neloxone
Why opiods overdose casue Respiratory acidosis
Bradypnea»_space; CO2 accumulation
Whats the treatment for Wernicke Enchaplopathy
Thiamine (B1) after given Glucose
Whats the Toxidrime? Pt with multiple episodes of pancreatitis, nystagmus, troublewalking
Wernicke Encephalopathy
Whats the diagnosis? Pt with nitroprusside drip + metabolic acidosis?
Cyanide proisnig
Whats the best step in menegment of cyanide poisoning?
Hydroxocobalaimn and Soudium + Thiosulfate
Pt consumes Anti-freeze and is now complaining of flank pain, What is the toxidrome?
Oxalate nephrolithiasis secondary to ethyl glycol poisionning
How to treat benzodiazepine overdoze
Flumazenil
In which age groups BZ will not begiven with delirum?
Elderly
High Tm , dilated pupils, dry skin and suprapubcic fullnes + smoked a lot of weed, whats the toxidrome?
Anticholinergic toxcitiy
how to initally treat Anticholinergic toxicity?
Physostigmine
Pt with diarrhea, miosis, sweating, lacrimation, bronchospasm, whats the toxidrome?
Cholinergic toxidrome
What the first step in menegment of Anticholinergic Toxicity?
Atropine (1st), Pralidoxime (2nd)
Which receptor mediate Bronchospasm
M3 (Ach»_space; M3»_space; bronchoconstriction) Atropine causes Bronchodilation
whats the toxidrome? DM with Gastropheresis + muscle rigidity and fever
Metoclopramide
How to treat metoclopramide toxidrome?
- BNZ + Dopamine agonists (Cabergoline , Bromocroptine)
Which medication are given in NMS
- BZD
- Dopamine agonists- Bromocroptine (reverse dopamine blockage)
- Dantrolene sodium- muscle relaxant
Whats the toxidrome?
SSRI switches to MAOI + fever, myoclonus and diarrhea
Seratonin syn. secondary to indaquate washout-time.
how to menege Seratonin syn.?
BZD + Cyproheptadine
Whats the toxidrome? Pt started psy drug , with headace + vision changes and BP 240/120
Hypertensive Crisis»_space; Thyamine consumption on MAOI
How to treat Hypertensive crsis secondary to Maoi Thyamine toxicity?
Phentolamine (alpha- adernergic blocker)
Pt with diabetic gastroparesis + Upper extrimity rigidity.
whats the toxidrome?
Acute dystonia
what are the 4 extrapyramidal symtoptoms using Ap drugs?
Acute dystonia- 1-5 days
# Parkinsonism- 1-4 wks
# Akathesia- 5-60 days
# Tradive Dyskinesia- Month-yrs
how to manage Acute dystonia?
Bzd or Diphenhydramine
Pt started AP and feels restless, whats the symptom name? and how to manage?
Akathesia, Beta-blocker
Pt on typical-AP and perform repetitive movments of the tounges and face, whats the symptom name? and how to manage?
Tradive dyskinesia.
menegment: stop and swith to a-typical AP
Pt with HT, tachy, Myadriasis.
Whats the toxidrome? how to manage?
Sympathomimetics
managment: Alpha-1 blocker: Phentolamine (also for HT crisis), or alpha-beta blocker (Carvedilol)
Pt found unresponsive at home during winterm severe lactic acidosis. Whats the toxidrome? how to manage?
CO poisnening.
Managment: Hyperbaric Oxygen
pt planning to visit developing country and taking malaria prophylaxis. now hypoxic and cyanosis. whats the toxidrome? how to manage?
Metahemoglobinemia
managment: Methylene blue
Pt Hx of Mitral Stenosisand Afib present with Bloody bowl movment. Whats the toxidrome (Which medication cause is)? How to manage?
Warfarin Toxicity.
Manage: Pro-thrombin complex concentrate (PCC)
Pt with mental disorders present with elevetaed liver functions + high creatinine. Whats the poisning? how to manange?
Acetaminophen poisning
managment: N-acetylcystiene (Repleninshig glutathione in liver)
Pt triad to overdose _________ present with high respiratory rate and abnormal blood results. how to manage?
Aspirin toxicity-
manage: Sodium bicarbonate or dialysis of severe
Preeclampsia + treated + hyporeflxia and slow respiratory rate. Whats the toxidrome? how to manage?
Mg toxicity.
management: Calcium Gluconate (ייצוב הממברנה- היפרמגנזמיה / היפרקלמיה)
CHF exacerbation»_space; put on loop diuretics»_space; lots of Ventricular arrhyt. whats the toxidrome?
Digoxin toxicity.
manage: Anti-digoxin Fab Fragments
*The combined use of digoxin and diuretics should be avoided if possible. Interaction between digoxin and diuretics is one of the most common drug–drug interactions (DDI) *
Pt partying and took drug. now present with Hyperkalemia , Hypocalcemia and rising creatining. Whats the drug
MDMA (Ecstasy) + Rhabdomyalysis. Can treat with dantrolene
Pt going surgery becoming rigid and febrile. whats the toxidrome? how to manage?
Malignent hypertension.
Treatment: Dantrolene
someone receives general anesthesia with one or more of the following drugs: halothane, isoflurane, sevoflurane, desflurane or succinylcholine
Pt been on a ventilator (מכונת הנשמה) for a while and develop pancreatitis. whats the toxidrome?
Propofol
Pt with parkinson present with myoclonus and hyperthermia, whats the toxidrome?
MAO-B inhibitors
Pt with cancer drug starts having blood clots in urine. what happend and due to which drug?
Hemorrhagic cystitis secondary to cyclophospamide
Pt with cancer drug starts having hearing diffuclties + rising creatinine. due to which drug?
Cisplatine
