toxidromes Flashcards
what physiological changes effect bioavailability?
- slower gastric emptying
- slower peristalsis
- lower blood protein levels
- decreased renal fx.
which neurotransmitter is preganglionic?
acetlycholine
which neurotransmitter is postganglionic?
acetylcholine for PSNS
norepi for SNS
what is cholinergic toxicity?
excessive activation of the PSNS (rest and digest) which causes excessive stimulation of muscarinic receptors and paralysis of skeletal muscles
what are the symptoms of cholinergic toxicity?
- N/V
- Diarrhea
- diaphoresis
- blurred vision
- tremors
- bradycardia, hypotension, and bronchoconstriction
what is the treatment for cholinergic toxicity?
- atropine
- pralidoxime (2-PAM)
what is anticholinergic toxicity?
excessive blockage of the PSNS
symptoms of anticholinergic toxicity?
- deliriam
- dialated pupils
- flushed skin
- hyperthermia
- dry skin
- urinary retention
treatment for anticholinergic toxicity
- induce vomiting
- gastric lavage
- physostigmine
what are the neuromuscular S/S of serotonin syndrome?
- muscle twitching and rigidity
- hyper-reflexia
- tremors
- ataxia
what are the ANS S/S of serotonin syndrome
- hyperthermia
- tachycardia/dysrhthmias
- diaphoresis/ flushed skin
- dialated pupils
what are the mental status S/S of serotonin syndrome?
- confusion, agitation, coma, disorientation, and hallucinations
what are the symptoms of stimulants?
- increased HR, BP, and RR
- pallor and hiphoresis
- dilated pupils
- anxiety, delusions, and paranoia
- hyper-reflexia
what are examples of benzodiazepines?
- diazepam (valium)
- Ativan (lorazepam)
- Clonazepam
- midazolam
what are examples of antipsychotics
- haloperidol (haldol)
- olanzapine (zyprexa)
what is the mechanism of sedative/hypnotic drugs?
they are CNS depressants
what are examples of hallucinogens?
- phencyclidine
- LSD
- ketamine
- mescaline (peyote)
- psilocybin (mushrooms)
what are the effects of hallucinogens
- self harm
- tachycardia
- pupil dilation
-sweating and tremors
what are Cardiovascular S/S of arsenic poisoning?
- reduced blood flow
- hypotension
- hypovolemia
- artthythmias
what arrhythmias can you see with arsenic poisoning?
- peaked t waves
- AV blocks
- asystole
what are the GI symptoms of Arsenic poisoning?
- Pain
- N/V/D
- garlic breath
what are Dermal S/S of arsenic poisoning?
- facial edema
- hyperpigmentation
cyanide poisoning S/S
- N/V
- dizzyness / Altered LOAs
_ tachycardia /palpitations - dyspnea
- seizure, coma, death
for bite injuries what life/limb/function threat should be considered for bite injuries as per the BLSPCS
- anaphylaxsis
- shock
- CNS toxicity
- Local tissues necrosis
effects of cocaine use?
- tachycardia
- arrhythmias
- seizures
- respiratory arrest
- 24x more likely to have a heart attack in an hour following use
what is the mechanism of amphetamines and bathsalts?
sympathomimetics
what are examples of amphetamines?
- ritalin and Adderall
what are the effects of amphetamines?
- increased mental alertness and euphoria
- sweating
- tachycardia
- jittery and nervousness
-pupil dilation - weightloss
the degree of the QRS broadening on ECG is correlated with adverse effects. what effect can you predict with QRS >100ms
seizures
the degree of the QRS broadening on ECG is correlated with adverse effects. what effect can you predict with the QRS>160
ventricular arrhythmias
what can be used to treat TCA overdose?
- sodium bicarb
what are examples of TCAs
- amytriptyline (elavil)
- Nortriptyline (aventyl)
what is the treatment for Beta blocker OD
5-10mcg/kg IV glucagon
or
high dose euglycemic therapy
what ECG changes could you see on betablocker OD
- AV blocks
- prolonged QT and PR intervals
- widened QRS
what are Calcium Channel blockers OD S/S
- bradycardia
- hypotension
- hyperglycemia
what ECG changes would you see with a digoxin OD
- ST depression (dig scoop)
- flat, inverted, or biphasic T waves
- short QT
- SVT with slowventricular response
what is the dose that is related to riskd of CNS and GI symptoms in NSAID OD
100 - 300mg/kg
what is the dose related to risk of Multi system organ failure in NSAID OD?
> 300mg/kg
what is the lethal dose of ASA in adults?
10 - 30g
what is the lethal dose of ASA in children?
4g
what are the signs of NSAID OD?
- acidosis
- respiratory depression
- diaphoresis
- dehydration
- vasodilation
- hypotension
hepatotoxicity develops from chronic overuse of Tylenol. what is that dose for adults and children respectivly?
- 4g/day
- 75mg/kg/day
what is the acute OD dose for Tylenol for children and adults?
-over 6g
- 200mg/kg
what is the mechanism of datura flower (jimsonweed)?
its an anticholinergic
what is the mechanism of magic mushrooms?
cholinergic and hallucinogen
what are examples of date rape drugs/sedatives
GHB and rohypnol
