Toxidromes and Antidotes Flashcards
Trazodone pseudoephedrine Bupropion ranitidine All of them appear in Urine drug screen false positive for ……… addiction
Amphetamines
Tachycardia Hypertension Anhidrosis dry skin Mydriasis Red skin Drowsy Hyperthermia Urinary retention Mental stat- What class of drug patient take ? and what is the antidote ?
Antimscularnic
Anticholinergic
physostigmine
physostigmine is contraindicated?4
What we could give the patient ?
TCA overdose,wide QRS,seizure,bradycardia
benzodiazepines
Tachycardia Mydriasis • Tachypnea *****Sweating =opposed to dry skin in anticholinergic Hypertension. Hyperthermia . Seizure • Stroke • MI
Sympathomimetic
Decongestants
Pseudoephedrine
Cocaine, amphetamines
- Treat agitation, HIN, and seizures with benzodiazepines 2. Avoid pure B-blockers due to unapposed alpha agonism phlamine
Coma ,Pinpoint pupils ,Respiratory depression , bradycardia ,Hypotension ,Hypothermia ,Hyporeflexia &dry skin
Drug?
Antidote?.
For withdrawal ?
Opioid and heroin
Morphine – Fentanyl – Hydromorphone – Codeine – Oxycodone.
Antidote naloxone.
For withdrawal Clonidine.
Hyporeflexia,Apnea, GCs reduced ,Ataxia &Slurred speech no pinpoint eyes.
Drug?
Antidote?
Sedative-hypnotic
-Benzodiazepines(GABA agonism)
– Antipsychotics (H1 blockade)
– ETOH (GABA agonism)
Antidote Flumazenil.
sweating, crying ,pinpoint pupils ,running nose, frothing at the mouth,vomiting, salivation ,bradycardia and diarrhea.
Drug ?
Antidote?
Cholinergic toxidrome
• Medication: – Alzheimer's meds (donepezil) – Myasthenia gravis meds (pyridostigmine) • Chemicals: – Organophosphates – Carbamates Antidote atropine and 2PAM
Cyanide
Isoniazid
Methemoglobinemia
Antidote?
Hydroxocobalamin
Pyridoxine B6
Methylene blue
Agitation ,Diaphoresis ,Increased bowel sounds,Hyperreflexia ,Clonus ,Tachycardia ,Tremor & Autonomic instability; often hypertensive.
Drug ?
antidote?
serotonergicagents
Fluoxetine (SSRI)
Tramadol
Antidote:Cyproheptadine.
Differentiating neuroleptic malignant syndrome and serotonin syndrome malignant syndrome.
ne Serotonin syndrome Serotonergic agents : Hyperreflexia, myoclonus, ocular clonus ,no lab findings ,Symptoms seen within 24 hours of starting and resolves.
Neuroleptic malignant syndrome :Dopamine antagonists ,Severe rigidity (lead pipe), hyporeflexia , increased creatine kinase, leukocytosis, low serum iron hours and Slower in onset resolves of treatment
Z1-If systolic BP > 90mmHg or MAP >65 mmHg we will give pationt ………?
2- and if BGL : < 4mmol………?
1-inotropic support ( i.e.Adrenaline infusion
2-IV dextrose (Glucose)
Treatment if the patient
1-core temperature > 39*
2-core temperature <32*
3-Agitation
4-Seizure
5-if asymptomatic for 6 hours in ED
1-aggressive cooling
2-aggressive rewarming.
3-1st line: benzodiazepine.
2nd line : antipsychotic agents.
4-IV benzodiazepine ( except in Isoniazed toxicity —> Pyridoxine)
2nd: Barbiturates
5-discharge.
Activated Charcoal use for ……?
Contraindication?
Complication ?
what are the charcoal resistance substances ?
Paracetamol
LOC
Aspiration, vomiting
hydrocarbons and alcohol .
metals • lithium • iron • K • lead • arsenic • mercury
corrosive • acids • alkalis.
whole bowel irrigation use for ……… ?
Contraindications ?
Complications ?
body packers-iron overdose .
Loc .
aspiration ,nausea, vomiting and non anion gap metabolic acidosis .
Induced emesis (Syrup or Ipecac)……?
Contraindications?
Complications?
Less than 1 hour and charcoal resistant .
LoC.
Aspirations and diarrhea .
