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PHM 702- Toxicology > Sympathomimetics OD > Flashcards

Sympathomimetics OD Flashcards

1
Q

MoA of sympathomimetics

A

Inhibition of NE and dopamine reuptake, or increased release of neurotransmitters

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2
Q

Examples of sympathomimetics

A

Cocaine, amphetamines, bath salts, pseudoephedrine, nootropics

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3
Q

What receptors do sympathomimetics act on?

A

Alpha-1, alpha-2, beta-1, beta-2

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4
Q

Effects of sympathomimetics on alpha-1 receptors

A

vasoconstriction, increased peripheral resistance, increased BP, mydriasis, increased closure of internal sphincter of the bladder

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5
Q

Effects of sympathomimetics on beta-1 receptors

A

tachycardia, increased lipolysis, increased myocardial contractility, increased release of renin

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6
Q

Sympathomimetic toxidrome: what does it increase?

A

BP, pulse, RR, temperature, pupil size, bowel sounds, diaphoresis

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7
Q

Sympathomimetic toxidrome: what does it do to mental status?

A

Agitated, hyperalertness

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8
Q

Sympathomimetic toxidrome: what else can it do?

A

Tremors, seizures

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9
Q

Cocaine: a typical line is how much?

A

20-30mg

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10
Q

Ingestion of 1g of cocaine is what?

A

Fatal

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11
Q

Effects of cocaine

A

Euphoria, seizures, dysrhythmias, HTN

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12
Q

What else can cocaine do?

A

Coronary artery spasm MI

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13
Q

Effects of cocaine in a coronary artery spasm MI

A

ST elevation, will see a high troponin value

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14
Q

What can cocaine sometimes get laced with?

A

Levamisole

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15
Q

Effects of levamisole

A

neutropenia, vasculitis, purpura

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16
Q

How do people smuggle cocaine across borders?

A

body packers

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17
Q

Management of cocaine OD

A

BZDs, supportive care

18
Q

MoA of amphetamines

A

releases catecholamines

19
Q

Clinical manifestations of amphetamines

A

adrenergic effects (similar to cocaine, just longer lasting)

Agitation, seizures, hyperthermia, HTN, delirium

20
Q

Management of amphetamine OD

A

BZDs, barbiturates, anti-hypertensives, supportive care

21
Q

Chemically speaking, what happens when you change the backbone structure of epinephrine?

A

The drug will have profoundly different effects depending on what you do to it

22
Q

Bath salts are what?

A

Synthetic cathinones

23
Q

Effects of bath salts

A

agitation, tachycardia, insomnia, paranoia, seizures, violent, unpredictable behavior

24
Q

Management of bath salt OD

A

supportive care

25
Q

General management for sympathomimetic OD: elimination strategies

A

AC

26
Q

General management for sympathomimetic OD: BZDs

A

Use if the patient is agitated, needs to be restrained, can help with HTN

May need higher doses

27
Q

General management for sympathomimetic OD: anti-hypertensives

A

Add on to BZDs if they don’t work and the patient is super hypertensive and is in tachycardia

28
Q

General management for sympathomimetic OD: fluids

A

If the patient is sweaty/has a lot of fluid loss

29
Q

General management for sympathomimetic OD: APS

A

use if the patient is REALLY agitated

30
Q

Which APS can you use in sympathomimetic OD management?

A

Haldol, olanzapine

31
Q

General management for sympathomimetic OD: electrolyte management

A

replace electrolytes as needed

32
Q

General management for sympathomimetic OD: ice baths

A

if the patient is hyperthermic

33
Q

What else can you use if the patient is hyperthermic?

A

ice packs, cool fluids, BZDs, antipyretics

34
Q

General management for sympathomimetic OD: when to use sodium bicarb

A

If the patient is in acidosis, has a wide QRS complex seen on EKG (dysrhythmia)

35
Q

What else can you use for dysrhythmias in sympathomimetic OD?

A

Lidocaine

36
Q

General management for sympathomimetic OD: airway protection

A

If the patient is extremely agitated, irate, needs high doses of sedatives

37
Q

General management for sympathomimetic OD: rhabdomyolysis

A

Give fluids, watch CK values

38
Q

Structure of Wellbutrin is similar to what?

A

A cathinone (bath salt)

39
Q

Structure of pseudoephedrine is similar to what?

A

Amphetamine

40
Q

Significance if a patient ODs on Wellbutrin or pseudoephedrine

A

Because these drugs have similar structures to other sympathomimetics, OD’ing on one of these will result in the patient presenting with similar findings of a sympathomimetic or adrenergic toxidrome

PHM 702- Toxicology (12 decks)

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