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Sydney Child Health Program > 23.3 Toxicology > Flashcards

23.3 Toxicology Flashcards

1
Q

one pill can kill, dangerous ingestions?

A 
amphetamines
beta blockers
CCBs
digoxin
opioids
sulphonylureas
TCA
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2
Q

pesticides which ones?

A

paraquat: 1 mouthful

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3
Q

what is the acronym DEAD?

A

decontamination
elimination
antidotes
deposition

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4
Q

after ABCs what to watch out for?

A

full neuro exam
urinary retnetion
skin
bowel sounds

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5
Q

which drug levels are helpful?

A 
paracetamol
if indicated
phenytoin
carbamazepine
valproate
phenobarbitone
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6
Q

anticholinergic toxidromes?

A 
blind as a bat
mad as a hatter
red as a beet
hot as a hare
dry as a bone
bowel and bladder lose their tone, Retention
heart runs alone
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7
Q

anticholinergic toxidromes, which causes agitated delirium?

A

plants

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8
Q

pills that cause anticholinergic toxidromes present?

A

usually partially sedated

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9
Q

anticholinergic toxidromes pupils?

A

dilated

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10
Q

anticholinergic toxidromes bladder?

A

retention usually, IDC can be beneficial

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11
Q

common causes of anticholinergic toxidromes?

A 
anti-histamines
TCA
phenothiazine
plants: datura, brugmansia
benztropine (for dystonia)
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12
Q

Cholinergic crisis classically think?

A

secretions

organophosphates

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13
Q

Cholinergic crisis acrynoym for secretions?

A

DUMBELS

diarrhoea
urination
miosis
bradycardia, bronchorrea
emesis
lacrimation
salivation
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14
Q

sympathomimetic syndrome is?

A 
hot, sweaty patient
hypertension
tachy
dilated pupils
agitation
sweating
hyperthermia - treat
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15
Q

sympathomimetic toxidrome causes?

A
  • cocaine
  • methamphetamines
  • ecstasy, MDMA
  • synthetic ‘marijuana’
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16
Q

serotonin toxicity key examination findings?

A

hyperreflexia, clonus

sweating
hypertension
dilated pupils

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17
Q

serotonin toxicity causes?

A

usualyl a combo of:

SSRIs/SNRIs
MAOIs
tCAs
tramadol
opiates
amphetamines/MDMA
18
Q

opioids toxidrome

A
  • respiratory depression
  • sedation
  • pinpoint pupils
19
Q

opioids toxidrome when give naloxone indication?

A

the resp rate and the sats

20
Q

supportive care of poisoned patient sedation ?

A

benzodiazepines

21
Q

supportive care of poisoned patient seizures?

A
  • IV benzos

- not phenytoin

22
Q

supportive care of poisoned patient body temp?

A

warm

cool control quickly

23
Q

supportive care of poisoned patient renal function?

A

hydration

dialysis

24
Q

GI decontamination main use?

A

activated charcoal

25
Q

why not GI decontamination with vomiting?

A

tears and ruptures

26
Q

how much GI decontamination activated carcoal measurement?

A

1g/kg

mix with water, orally or NGT

27
Q

indications for charcoal?

A
  • within 1 hour of ingestion, or if slow release
  • cooperative patient
  • alert and protected airway
28
Q

contraindications for charcoal?

A

-Metals: LI, K, alcohols, hydrocarbons, corrosives
““MACH””
-low GCS
-ileus

29
Q

whole bowel irrigation indications?

A
  • lots of slow release
  • body packers
  • metals
30
Q

enhanced elimination, 3 kinds?

A
  • multi dose activated charcoal
  • urinary alkalinisation (ion trapping, mainly for aspirin)
  • haemodialysis
31
Q

when to use enhanced elimination?

A
  • methanol/antifreeze
  • lithium
  • aspirin - severe only
  • theophylline
  • alproic acid severe
  • carbamazepine
32
Q

what is toxic dose of paracetamol?

A

> 200mg/kg

33
Q

paracetamol when to take the measurement?

A

4 hours post to get peak

34
Q

paracetamol antidote?

A

NAC

35
Q

redback spider bite treatment?

A

mainly analgesia

antivenom rare

36
Q

funnelweb spider bites?

A
  • most uncommon bite
  • needs ANTIVENOM
  • look at tongue for fasciculation (can’t fake it)
37
Q

brown snake characteristic of bite?

A
  • early collapse
  • consumptive -coagulopathy
  • most common cause of death
38
Q

Do’s for envenomation?

A

remove from danger
immobilise
keep still
apply pressure bandage

39
Q

dangers of antivenom?

A

equine-derived, allergenic, can get anaphylaxis

40
Q

treatment of box jelly fish?

A

remove tentacles, vinegar

anti-venom available

41
Q

bluebottle sting treatment?

A

hot water without burning?

put both feet in the bucket of water as control to prevent burns

Sydney Child Health Program (113 decks)

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