poisoning substance Flashcards
Explain different types of poisoning
- Accidental – usually occurs in young children and the event may not be obvious and may only be found on detailed questioning.
- Intentional – an act of deliberate self harm.
- Non-accidental – if suspected it must be reported.
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Toxidromes
Common toxidromes include:
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- Alcohol
- Opioid
- Cholinergic
- Anticholinergic
- Sympathomimetic
- Sedative-hypnotic
- Serotonin syndrome
The signs and symptoms of alcohol use include
- Nausea/vomiting
- Slurred speech
- Confusion
- Convulsions
- Unconsciousness
- Change in rational thinking
- Hypoglycaemia
- An opiate is a substance derived from opium.
- Opioids refers to compounds related to opium.
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Ambulance Care Practice p297
- Opioids are a group of analgesic agents.
- There are three types of opioid receptor mu, kappa and delta.
- Opioids can act at these
Examples include receptors as agonists, antagonist or partial agonists.
Examples include
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- Morphine
- Codeine
- Tramadol
- Heroin
- Fentanyl
- Methadone
- Oxycodone
- Hydrocodone
Opioids•Signs and symptoms
•Signs and symptoms
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- Miosis – constriction of the pupil of the eye
- Altered level of consciousness
- Respiratory depression
- Nausea/vomiting can occur
Cholinergic
•Cholinergic drugs work on the parasympathetic nervous system.
These drugs enhance the actions of the neurotransmitter acetylcholine
Cholinergic Examples include:
Examples include:
Nicotine
Nerve agents e.g. sarin
Organophosphates
Cholinergic
Signs and symptoms
Signs and symptoms
- Sweating
- Lacrimation (crying)
- Miosis
- Rhinorrhoea
- Frothing at mouth dues to salivation and bronchorrhoea
- Vomiting
- Bradycardia
- Urinary incontinence
- Diarrhoea
Anticholinergic
•Anticholinergic drugs work to enhance the sympathetic nervous system.
By blocking acetylcholine from sending chemical messages, anticholinergic cause a decrease in parasympathetic effects
Anticholinergic Examples include
Atropine
Antihistamines e.g. chlorphenamine, hydroxyzine, diphenhydramine
Antipsychotics e.g. chlorpromazine, olanzapine, thioridazine
Antispazmodics e.g. clidinium, hyocyamine, oxybutynin
Anticholinergic
Signs and symptoms
Mad as a hatter” (altered mental status manifested as agitation, delirium, hallucinations, abnormal picking movements, rarely seizures).
“Blind as a bat” (pupillary dilation with loss of accommodation)
“Red as a beet” (vasodilation with skin hyperemia);
“Hot as a hare” (anhidrosis with temperature elevation);
“Full as a flask” (urinary retention); “Stuffed as a pepper” (constipation); and
“Dry as a bone” (drying of mucosal surfaces and skin);
Sympathomimetic
Examples include
•Sympathomimetic drugs are agents which in general mimic responses due to stimulation of the sympathetic nerves.
Caffeine
Cocaine
Amphetamines
Ritalin
LSD
Theophylline
MDMA (‘ecstasy’)
Alcohol/drug withdrawal
Sympathomimetic
Signs and symptoms
- Tachycardia
- Hypertension
- Mydriasis (dilated pupils)
- Diaphoresis (sweating)
- Piloerrection (‘goose bumps’)
- Hyperthermia seizures
Sedative-hypnotic
•A drug that is used to reduce tension and anxiety and induce calm (sedative effect) or to induce sleep (hypnotic effect).
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Sedative-hypnotic
Examples include
Examples include
- Barbiturates – e.g thiopental, phenobarbital
- Benzodiazepines - e.g diazepam, lorazepam
- Z-drugs - e.g zopiclone, zolpidem
- Drugs - e.g GHB
