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Flashcards in 41 toxicology Deck (18)
1

3 steps in initial approach to poisoning

1. treat patient, not poison
2. remember it is the dose, not the substance
3. clinical manifestations may be delayed a long time

2

5 general steps

1. ABC
2. give universal antidotes if indicated
3. Hx, Phx, ID toxidromes
4. consider decontamination
5. reassess

3

parts of Phx after stable

1. appearance
2. vitals
3. menatla status
4. trauma signs
5. seizure
6. infection
7. chronic substance abuse

4

4 classic toxidromes

1. anticholinergic
2. cholinergic
3. sympathomimetic
4. narcotics and sedatives

5

Sx of anticholinergic

- hyperthermia
- dilated pupils
- dry
- agitated
- hallucinations
- seizures
- tachycardia
- urinary retention
ileus

6

causes of antichol

- antihistamines
- atropine
- diphenhydramine
- TCAs

7

Sx of cholinergic

- salivation, seizures
- lacrimation
- incontinence
- diaphoresis
- bronchospasm
- bronchorrhea
- bradycard
- emesis, exitation

8

causes of cholinergic

- carbamate
- nerve gases
- organophosphates

9

Sx of sympathomimetic

- hyperthermia
- dilated pupils
- diaphoresis
- seizures
- tachycardia
- exitations
- HT

10

causes of sympathomimetics

- tylenol
- ASA
- cocaine
- LSD
- PCP
- theophyllines
- alc and sedative withdrawal

11

Sx of narcos and sedaties

- CNS depression
- resp depression
- hypotension
- miosis

12

causes of narcos

- barbituates
- benzos
- booze
- GHB
- opiods

13

anion gap formula

Na- (HCO3 + Cl)
normal

14

causes of anion gap

MUDPILES
Methanol
Uremia
DKA, also alc KA and starvation KA
Paraldyhyde
INH
Lactic acidosis
Ethylene glycol
Salicylate
CO
CYanide
Toluene

15

formula for osmolar gap

(measured - calculated)
2(Na) + BUN + Glucose + 1.25xethanol
normal should be -14-10

16

causes of increased osmolar gap

ethylene glycol
isopropyl alcohol
glycerol
mannitol
methanol
sorbitol

17

see table 4, p200 for antidotes

do it

18

what are 3 methods of enhanced elim

1. multiple dose activated charcoal
2. dialysis
3. urine alkalization