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Pedi-Boards > Toxicology > Flashcards

Toxicology Flashcards

1
Q

Acetaminophen - antidote

A

N-acetylcysteine (most effective within 16 hr of ingestion)

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2
Q

Anticholinergic - antidote

A

Physostigmine

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3
Q

Benzodiazepine - antidote

A

Flumanezil

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4
Q

B-blocking agents - antidote

A

Glucagon

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5
Q

Carbon monoxide - antidote

A

Oxygen (shorten half-life of carboxyhemoglobin)

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6
Q

Cyclic antidepressant - antidote

A

sodium bicarbonate (remember to follow K level and replete as needed)

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7
Q

Cyanide - antidote

A

Hydroxycobalamine (cause red discoloration of body fluids)

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8
Q

Digoxin - antidote

A

Digoxin specific antibody

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9
Q

Ethylene glycol or methanol - antidote

A

Fomepizole

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10
Q

Sulfonylurea - antidote

A

Octreotide

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11
Q

Iron - antidote

A

Deferoxamine - (watch for hypotension)

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12
Q

Isoniazid - antidote

A

Pyridoxine

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13
Q

Lead - antidote

A

EDTA or Dimercaprol (British anti-lewisite) or DMSA

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14
Q

Methemoglobulinemia - antidote

A

Methylene blue

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15
Q

Opiates - antidote

A

Naloxone

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16
Q

Organophosphate - antidote

A

Atropine or Pralidoxime

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17
Q

Symptoms of acetaminophen poisoning

A

Early (within 24 hours): asymptomatic, mild nausea, vomiting, diaphoresis, pallor, lethargy, malaise
Late (24–96 hours): hepatotoxicity, jaundice, coagulopathy, encephalopathy

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18
Q

Symptoms of alcohol poisoning

A

Ataxia, nystagmus, respiratory depression, disinhibition, somnolence

19
Q

Symptoms of CO poisoning

A

Altered mental status: confusion to coma
May have “cherry red” lips/skin
Severe toxicity: seizures, cardiac ischemia, pulmonary edema

20
Q

Symptoms of iron poisoning

A

Progression in time post ingestion:
30 min to 6 hr: Gastrointestinal (GI) phase: abdominal pain, vomiting, diarrhea, and GI bleeding
6 to 24 hr: Latent (relative stability) phase
6 to 72 hr: Shock and metabolic acidosis
12 to 96 hr: Hepatotoxicity
2 to 8 weeks: Bowel obstruction

21
Q

Symptoms of methemoglobulinemia

A

Cyanosis, headache, tachycardia, fatigue, dyspnea, lethargy
∗Hypoxia does not improve with supplemental oxygen

22
Q

Symptoms of salycylates

A

Tachypnea, tinnitus, nausea/vomiting, agitation, confusion, restlessness, pulmonary edema

23
Q

Symptoms of SSRI poisoning

A

Serotonin syndrome, vomiting, tremor, central nervous system (CNS) depression, seizure
Prolonged QTc in ECG

24
Q

Tricyclic antidepressant poisoning symptoms

A

Anticholinergic effects (see Table 18.4), CNS depression, tachycardia

25
Q

Causes of Anion Gap Metabolic Acidosis

A

(Mnemonic: MUDPILES CAT)
M—methanol, metformin
U—uremia
D—diabetic ketoacidosis
P—propylene glycol
I—isoniazid, iron, massive ibuprofen
L—lactic acidosis
E—ethylene glycol
S—salicylates
C—cellular asphyxiants (cyanide, carbon monoxide, hydrogen sulfide)
A—alcoholic ketoacidosis
T—Tylenol

26
Q

Causes of elevated osmolal gap

A

Alcohols: ethanol, isopropyl, methanol, ethylene glycol

27
Q

Causes of hypoglycemia

A

Mnemonic: HOBBIES)
H—hypoglycemics, oral: sulfonylureas, meglitinides
O—other: quinine, unripe ackee fruit
B—beta blockers
I—insulin
E—ethanol
S—salicylates (late)

28
Q

Causes of hyperglycemia

A

Salicylates (early)
Calcium channel blockers
Caffeine

29
Q

Causes of hypocalcemia

A

Ethylene glycol
Fluoride

30
Q

Causes of rhabdomyolysis

A

Neuroleptic malignant syndrome, serotonin syndrome
Statins
Mushrooms (Tricholoma equestre)
Any toxin causing prolonged immobilization (e.g., opioids, antipsychotics) or excessive muscle activity or seizures (e.g., sympathomimetics)

31
Q

Causes of radio-opaque substance on Abdominal XRAY

A

(Mnemonic: CHIPPED)
C—chloral hydrate, calcium carbonate
H—heavy metals (lead, zinc, barium, arsenic, lithium, bismuth)
I—iron
P—phenothiazines
P—Play-Doh, potassium chloride
E—enteric-coated pills
D—dental amalgam, drug packets

32
Q

Causes of acute seizures

A

“PLASTIC”
P—Phencyclidine, pesticides, phenol, propoxyphene
L—Lead, lithium, lindane, local anesthetics
A—Antidepressants, antipsychotics, anticonvulsants, antihistamines, abstinence syndromes
S—Salicylate, sympathomimetic, strychnine, solvents, shellfish (domoic acid)
T—Theophylline, tricyclic antidepressants, thallium, tobacco (nicotine)
I—Isoniazid, insulin (and other causes of hypoglycemia), insecticides
C—Camphor, cocaine, cyanide/carbon monoxide, chloroquine, cyclonite (C4 plastic explosive), cicutoxin

33
Q

Causes of prolonged QTc

A

Mechanism: K channel blockade
▪ Amiodarone

▪ Antipsychotics (typical and atypical)

▪ Arsenic

▪ Cisapride

▪ Citalopram and other selective serotonin reuptake inhibitors

▪ Clarithromycin, erythromycin

▪ Disopyramide, dofetilide, ibutilide

▪ Fluconazole, ketoconazole, itraconazole

▪ Loperamide, methadone

▪ Pentamidine

▪ Phenothiazines

▪ Sotalol

34
Q

Causes of widened QRS

A

Mechanism: Na channel blockade
▪ Tricyclic antidepressants

▪ Diphenhydramine

▪ Carbamazepine

▪ Cardiac glycosides

▪ Chloroquine, hydroxychloroquine

▪ Cocaine

▪ Lamotrigine

▪ Quinidine, quinine, procainamide, disopyramide

▪ Phenothiazines

▪ Propoxyphene

▪ Propranolol

▪ Bupropion, venlafaxine (rare)

35
Q

Causes sinus bradycardia

A

▪ Digoxin

▪ Cholinergic agent

▪ β-Blocker

▪ Calcium channel blocker

▪ Clonidine/ guanfacine

36
Q

Bitter almonds

A

Cyanide

37
Q

Acetone smell

A

Isopropyl alcohol, methanol, paraldehyde, salycylate

38
Q

Wintergreen

A

Methyl salycylate

39
Q

Garlic

A

Arsenic, thallium, organophosphate, selenium

40
Q

Violets

A

Turpentine

41
Q

Miosis (pinpoint pupil)

A

Narcotics (except propoxyphene, meperidine, and pentazocine), organophosphates, muscarinic mushrooms, clonidine, phenothiazines, chloral hydrate, barbiturates (late)

42
Q

Mydriasis (big pupil)

A

Atropine, cocaine, amphetamines, antihistamines, cyclic antidepressants, PCP, LSD

43
Q

Nystagmus

A

Phenytoin, barbiturates, ethanol, carbamazepine, PCP, ketamine, dextromethorphan

44
Q

Gum lines

A

Lead, mercury, arsenic

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