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Pharmacology: Kaplan, Uworld, FA > Toxicology > Flashcards

Toxicology Flashcards

1
Q

Toxicity of _________ causes
Miosis, salivation, sweats, GI cramps, diarrhea, muscle
twitches → seizures, coma, respiration failure

A

Ach inhibitors

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2
Q

AChE inhibitor toxicity is intervention & antidotes (Rx)

A

Respiratory support; atropine + pralidoxime Rx’s

for irreversible AChE inhibitors

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3
Q

________ toxicity causes ↑ HR, ↑ BP, hyperthermia (hot, dry skin), delirium,
hallucinations, mydriasis

A

Atropine and
muscarinic
blockers

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4
Q

Atropine and
muscarinic
blockers toxicity is Rx via

A

Control cardiovascular symptoms and
hyperthermia + physostigmine (crosses
blood–brain barrier)

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5
Q

______ toxicity sign/symptoms include: Nausea and vomiting, dyspnea with hyperventilation,
mydriasis, vertigo; cardiovascular signs prominent, ↓ BP,
syncope, ↑ HR, arrhythmias

A

Carbon
monoxide
(>10%
carboxyHb)

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6
Q

Rx Carbon
monoxide
(>10%
carboxyHb) toxicity with

A

Hyperbaric O2 and decontamination

humidified 100% O2 okay in mild overdose

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7
Q

_______ toxicity signs/symptoms include: Anxiety/agitation, hyperthermia (warm, sweaty skin),
mydriasis, ↑ HR, ↑ BP, psychosis, seizures

A

CNS stimulants

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8
Q

Rx CNS stimulant toxicity with

A

Control cardiovascular symptoms,
hyperthermia, and seizures— +/– BZs or
antipsychotics

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9
Q

______ toxicity signs/symptoms include: Lethargy, sedation, ↓ HR, ↓ BP, hypoventilation, miosis, coma,
respiration failure

A

Opioid

analgesics

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10
Q

Rx opioid analgesic toxicity with

A

Ventilatory support; naloxone at frequent

intervals

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11
Q

_________ toxicity signs/symptoms includes: Confusion, lethargy, hyperventilation, hyperthermia,
dehydration, hypokalemia, acidosis, seizures, coma

A

Salicylates

(ASA)*

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12
Q

Rx Salicylates

(ASA)* with

A

Correct acidosis and electrolytes: urinary

alkalinization, possible hemodialysis

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13
Q

______, ____ toxicity signs/ symptoms include: Disinhibition (initial), lethargy, ataxia, nystagmus, stupor,
coma, hypothermia, respiratory failure

A

Sedativehypnotics
and
ethanol

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14
Q

Rx Sedativehypnotics
and
ethanol with

A

Ventilatory support: flumazenil if BZs

implicated

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15
Q

toxicity of _________ signs and symptoms include: Agitation, confusion, hallucination, muscle rigidity,
hyperthermia, ↑ HR, ↑ BP, seizures

A

SSRIs

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16
Q

Rx SSRIs with

A

Control hyperthermia and seizures: possible
use of cyproheptadine, antipsychotics, and
BZs

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17
Q

toxicity _______ signs/symptoms include: Mydriasis, hyperthermia (hot, dry skin), 3 Cs (convulsions,
coma, and cardiotoxicity) → arrhythmias

A

Tricyclic

antidepressants

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18
Q

Rx Tricyclic

antidepressants toxicity with

A

Control seizures and hyperthermia, correct

acidosis and possible arrhythmias

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19
Q

the drugs with * indicates *More details in antiinflammatory section

A

Heavy metal poisoning is NEXT

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20
Q

Signs and symptoms of __________ poisoning include: Acute: gastroenteritis, hypotension, metabolic
acidosis, garlic breath, “rice water” stools,
torsades, seizures

Chronic: pallor, skin pigmentation (raindrop
pattern), alopecia, stocking glove neuropathy,
myelosuppression

A

Arsenic (wood preservatives,

pesticides, ant poisons)

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21
Q

Rx toxicity of Arsenic (wood preservatives,

pesticides, ant poisons) with

A

Activated charcoal, dimercaprol (EDT)

Penicillamine or succimer

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22
Q

Signs and symptoms of __________ poisoning include:
Acute (mainly children): severe GI distress →
necrotizing gastroenteritis with hematemesis and
bloody diarrhea, dyspnea, shock, coma

A

Iron (medicinal for anemias

and prenatal supplements)

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23
Q

Rx toxicity of Iron (medicinal for anemias

and prenatal supplements) with

A

Gastric aspiration + carbonate

lavage, deferoxamine IV

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24
Q

Signs and symptoms of __________ poisoning include: Acute: nausea and vomiting, GI distress and pain,
malaise, tremor, tinnitus, paresthesias,
encephalopathy (red or black feces)

Chronic: multisystem effects: anemia (↓ heme
synthesis), neuropathy (wrist drop), nephropathy
(proteinuria, failure), hepatitis, mental retardation
(from pica), ↓ fertility and ↑ stillbirths

A

Lead (tap water, leaded paint
chips, herbal remedies, gas
sniffing, glazed kitchenware,
etc.)

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25
Q 
Rx toxicity of:
Lead (tap water, leaded paint
chips, herbal remedies, gas
sniffing, glazed kitchenware,
etc.) with
A 
Decontamination—gastric lavage
\+ dimercaprol (severe) or EDTA or
succimer (penicillamine if unable to use
dimercaprol or succimer)
Children: succimer PO
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26
Q

Signs and symptoms of __________ poisoning include:

Acute: vapor inhalation: chest pain, dyspnea,
pneumonitis

Acute: inorganic salt ingestion: hemorrhagic
gastroenteritis, acute tubular necrosis, shock

Chronic: organic Hg—CNS effects, ataxia,
paresthesias, auditory and visual loss, loosening of
teeth

A 
Mercury (elemental in
instruments); salts used in
amalgams, batteries, dyes,
electroplating, fireworks,
photography
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27
Q 
Rx toxicity of: Mercury (elemental in
instruments); salts used in
amalgams, batteries, dyes,
electroplating, fireworks,
photography with
A 
Succimer PO or dimercaprol (IM)
Activated charcoal for oral ingestion,
then support with succimer PO or
dimercaprol (not IV) → causes
redistribution of Hg to the CNS
→↑neurotoxicity
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28
Q

NEXT

A

ANTIDOTES

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29
Q

what _____ is used for Rx AChE inhibitors—physostigmine, neostigmine, and pyridostigmine; organophosphates,
including insecticides, such as malathion and parathion poisoning

A

Atropine + pralidoxime (for

irreversible AChE inhibitors)

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30
Q

what ____ is used for Rx of Iron and iron salts poisoning

A

Deferoxamine

31
Q

what____ is used for Rx of Digoxin immune F(ab) poisoning

A

Digoxin

32
Q

what ____ is used for Rx of Arsenic, gold, mercury, lead; oral succimer for milder lead and mercury toxicity

A

Dimercaprol (BAL)

33
Q

what ___ is used for Rx of Backup in lead poisoning, then for rarer toxicities (Cd, Cr, Co, Mn, Zn)

A

EDTA

34
Q

what ___ is used for Rx of Theophylline, beta agonists poisoning

A

Esmolol

35
Q

what _____ is used for Rx of Methanol or ethylene glycol poisoning

A

Ethanol, fomepizole

36
Q

what ____ used for RX of Benzodiazepines, zolpidem, zaleplon poisoning

A

Flumazenil

37
Q

what ____ is used for Rx of Opioid analgesics poisoning

A

Naloxone

38
Q

what ___ is used for Rx of Carbon monoxide poisoning

A

Oxygen

39
Q

what ____ is used for Rx of Copper (e.g., Wilson’s disease), iron, lead, mercury poisoning

A

Penicillamine

40
Q

what ____ is used for Rx of Anticholinergics: atropine, antihistamine, antiparkinsonian—not tricyclics poisoning

A

Physostigmine

41
Q

what _____ is used for Rx of Heparins poisoning

A

Protamine

42
Q

what ___ is used for Rx of Warfarin and coumarin poisoning anticoagulants

A

Acute: Fresh plasma
Chronic: Vitamin K

43
Q

what ____ is used for Rx of Nonspecific: all oral poisonings except Fe, CN, Li, solvents, mineral acids, or corrosives poisonings

A

Activated charcoal

44
Q

NEXT

A

NATURAL MEDICINALS

45
Q

“______” medicinals are available without prescription and are considered to be nutritional
supplements rather than drugs

A

Natural

46
Q

_______products are marketed without FDA review of
safety and efficacy, and there are no requirements governing the purity or the chemical identities of
constituents.

A

Herbal (botanic)

47
Q

______ is Clinically used for ↓ Cold symptoms by ↑ ILs and TNF

A

Echinacea

48
Q

Side effects of Echinacea include

A

GI distress, dizziness, headache

49
Q

Side effects of Echinacea are?

A

GI distress, dizziness, headache

50
Q

______ is Clinically used for Hyperlipidemias, cancer
(evidence is weak) works via Inhibits HMG-CoA
reductase and ACE

A

Garlic

51
Q

Side effect of garlic are?

A

Allergies, hypotension, antiplatelet actions; use

caution when used with anticoagulants

52
Q 
\_\_\_\_\_\_ is Clinically used for Intermittent claudication;
Alzheimer disease (evidence
is weak)
works via  Antioxidant, free radical
scavenger, ↑ NO
A

Gingko

53
Q

side effects of Gingko are?

A

Anxiety, GI distress, insomnia, antiplatelet
actions; use caution when used
with anticoagulants

54
Q 
\_\_\_\_\_\_ is Clinically used for 
Possible ↑ in mental and
physical performance
(evidence is weak) via
Unknown mechanism
A

Ginseng

55
Q

side effects of Ginseng are?

A

Insomnia, nervousness, hypertension, mastalgia,

vaginal bleeding

56
Q

______ is Clinically used for Symptomatic treatment of
BPH; works via 5α-reductase inhibitor
and androgen receptor
antagonist

A

Saw palmetto

57
Q

side effects of Saw palmetto are?

A

GI pain, decreased libido, headache, hypertension

58
Q

____________ is Androgen precursor advocated for treatment of AIDS (↑CD4 in
women), Alzheimer disease and “aging,” diabetes,
hypercholesterolemia, and SLE (↓in symptoms and “flare-ups”
in women)

A

Dehydroepiandrosterone

DHEA

59
Q

side effects of Dehydroepiandrosterone

(DHEA) are?

A 
Women: androgenization and
concern regarding CV disease
and breast cancer
Men: feminization in young and
concern in elderly regarding
BPH and cancer
60
Q

_______ is a Serotonin metabolite used for “jet-lag” and sleep disorders

A

Melatonin

61
Q

side effects of Melatonin

A

Drowsiness, sedation, headache

Contraindicated in pregnancy,
in women trying to conceive
↓LH), and in nursing mothers
(↓prolactin

62
Q

Chronic poisoning with ______ will result in a multitude of effects including inhibition of heme
synthesis and accumulation of δ-aminolevulinate in the plasma

A

lead

63
Q

Arsenic poisoning is associated

with _______ breath and changes in ________ pigmentation

A

Garlic; skin

64
Q

________ causes auditory and visual
loss and loosening of the teeth, while inhaled mercury vapor can cause interstitial pneumonitis
and neurological effects.

A

Organic mercury

65
Q

_______ chelates iron and is the antidote in iron

poisoning

A

Deferoxamine

66
Q

______ is useful for a variety of metals including lead, arsenic, and mercury.

A

Dimercaprol

67
Q

______ is a back-up in lead poisoning.

A

EDTA

68
Q

_______ is useful in copper poisoning, and succimer is

preferred for lead poisoning in kids.

A

Penicillamine

69
Q

snake poisoning leads to coagulation & CNS @ Nn receptor Rx with____?

A

giver fresh plasma to stop bleeding

70
Q

Rx phenytoin (class IB anti-arrhythmic) toxicity (cadriotoxicity)

A

Sodium bicarbonate

71
Q

Amphetamines toxicity Rx___?

A

to Rx symptoms give: Beta-blockers

to excrete out in urine give: ascorbic acid

72
Q

NSAID toxicity Rx with___?

A

sodium bicarbonate

73
Q

mushroom posioning aka muscarnic posioning Rx with__?

A

atropine

Pharmacology: Kaplan, Uworld, FA (9 decks)

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