Emergency Medicine - Toxicology

Question 0

Drugs that cause bradycardia

Answer 0

BB, CCB, digoxin, lithium

Question 1

Drugs that cause HTN

Answer 1

Sympathomimetics: Cocaine, amphetamines, designer drugs

Question 2

Causes of conjugate eye deviation - towards or away from lesion?

Answer 2

Stroke - towards. Seizure - away.

Question 3

Causes of hemiparesis

Answer 3

Post-ictal, stroke, ICH

Question 4

Drug therapy for the agitated patient

Answer 4

If drug induced, drug withdrawal, or unknown - give benzo (lorazepam, midazolam). If Dementia or psychiatric cause - give antipsychotic (haloperidol).

Question 5

Effect of anticholinergic toxicity on HR

Answer 5

Increased HR

Question 6

Effect of synpathomimetic toxicity on HR

Answer 6

Increased HR

Question 7

Effect of sedative toxicity on HR

Answer 7

Bradycardia

Question 8

Effect of cholinergic toxicity on HR

Answer 8

Variable

Question 9

Oral findings for anti cholinergic, sympathomimetic, sedative and cholinergic overdoses

Answer 9

No oral findings except for with cholinergics you get salivation

Question 10

Effect of anticholinergic toxicity on BP

Answer 10

Variable BP

Question 11

Effect of sympathomimetic toxicity on BP

Answer 11

High BP

Question 12

Effect of sedative toxicity on BP

Answer 12

Low bp

Question 13

Effect of cholinergic toxicity on BP

Answer 13

Variable bp

Question 14

How do pupils look with anti cholinergic toxicity

Answer 14

Dilated

Question 15

How do pupils look with sympathomimetic toxicity

Answer 15

Dilated pupils

Question 16

How do pupils look with sedative toxicity

Answer 16

Dilated or constricted

Question 17

How do pupils look with cholinergic toxicity

Answer 17

Constricted pupils

Question 18

Suspect overdose of what agent in patient with dry flushed skin?

Answer 18

Anticholinergic

Question 19

Suspect overdose of what agent in diaphoretic patient with piloerection?

Answer 19

Sympathomimetic agent

Question 20

Suspect overdose of what agent in patient with hypothermic skin?

Answer 20

Sedative

Question 21

Suspect overdose of what agent in patient with diaphoretic skin and constricted pupils?

Answer 21

Cholinergics

Question 22

Location of tension HA, migraines, cluster HA

Answer 22

Bilateral, unilateral, unilateral in orbital/supraorbital/temporal region

Question 23

Pinpoint pupils, resp depression, lethargy, bradycardia, hypothermia, borderline hypotension

Answer 23

Opioid overdose

Question 24

Way to remember anticholinergic toxicity

Answer 24

Blind as a bat, mad as a hatter, red at a beet, hot as a hare, full as a tick, dry as a bone, bowel loses tone and heart runs alone

Question 25

Way to remember cholinergic toxicity

Answer 25

Dumb bells : diarrhea/diaphoresis, urination, miosis (constricted pupil), bradycardia, bronchorrhea, emesis, lacrimation, salivation/seizures

Also AMS, fasciculation, weakness

Question 26

Examples of anticholinergic drugs

Answer 26

Diphenhydramine (OTC cold/sleep meds), antiparkinson meds benztropine, toxic jimsonweed

Question 27

Sympathomimetic drugs

Answer 27

Cocaine, amphetamines, anorectics, otc stimulants, herbal stimulants

Question 28

Cholinergic drugs

Answer 28

Organophosphates, carbamates (pesticides), donepezil (ACEi for Alzheimer’s), physostigmine (MG, Alzheimer’s, delayed gastric emptying), nerve gas agents

Question 29

Sedatives

Answer 29

Anticonvulsants, barbs, benzos, GHB, methaqualone, etoh