Toxicology

Question 1

Anxiolytic medications

Answer 1

anti-anxiety drugs

• pneumonic: zine-pine-mine & ram-pam-lam*
• throazine, chlorpromazine, benzodiazepine, clomipramine
• lorazepam, alprazolam, citalopram
• haldol
• tranquilizers (librium and valium)

Question 2

Which medications causes falls in the elderly?

Answer 2

tranquilizers (librium and valium)

Question 3

What is the largest side effect cascade from anxiolytic medications?

Answer 3

shizo => wander => pill rolling tremor => tardive dyskinesia (excessive mouth and lip movements)

Question 4

Blood thinners

Answer 4

• pneumonic: in’s thins the blood*
• herapin
• warfarin
• coumadin
• aspirin
• vitamin C & E
• Dicumarol

Question 5

Blood thinner concerns

Answer 5

• internal hemorrhage

- avoid vitamin K

Question 6

Mushrooms

Answer 6

• psilocybin: hallucinogenic

- muscarine: poison

Question 7

Sedative/hypnotic drugs

Answer 7

Barbiturate: sleeping pills, respiratory depressant, miosis (miosis = turning off sympathetics)

Question 8

If a patient has dilated pupils, how is the ANS involved?

Answer 8

overstimulated sympathetics

Question 9

If a patient has constricted pupils, how is the ANS involved?

Answer 9

understimulated sympathetics

Question 10

Poisons

Answer 10

• organophosphates - (insecticide), blocks cholinesterase, causes runny eyes and nose
• — salivate, lacrimate, urinate, defecate = SLUD

Question 11

What is the antidote for organophosphates and carbamates?

Answer 11

atropine- too much causes dry eyes, nose, and mouth

Question 12

Most common gas poisoning?

Answer 12

Carbon monoxide - motors, cars, cigarettes

Question 13

What are the two nitrogen based gas poisonings?

Answer 13

nitrogen oxide - cigarettes and plants

nitrous oxide - anesthetic (dentist)

Question 14

Anabolic steroids

Answer 14

• cause liver damage

- early epiphyseal plate closure in children

Question 15

Carbon tetrachloride and chloroform

Answer 15

• causes acute liver failure (even if inhaled)

Question 16

Lead

Answer 16

batteries, paint, solder, pottery glaze, rubber, plastic toys, jewlery, dust in shooting galleries

Question 17

Acute lead poisoning

Answer 17

• metallic taste, abdominal pain, black stools, oliguria, collapse, coma

Question 18

chronic lead poisoning

Answer 18

• weight loss, fatigue, headache (encephalopathy), lead lines on gums (blue), anemia, irritable, vomiting, basophilic stippling, nerve tissue damage

Question 19

Treatment for lead poisioning

Answer 19

EDTA

Question 20

Mercury

Answer 20

crayons, toys, paint

Question 21

Petroleum distillates

Answer 21

Ipecac treatment**

Question 22

Electroshock is used for

Answer 22

dysthymia

Question 23

Depression drugs

Answer 23

• monamine oxide inhibitors (MAO): prevent breakdown of neurotransmitters, increase availability of synapses, certain foods cause hypertension
• tricyclics (Elavil)
• prozac - inhibits serotonin uptake (SSRI’s)
• lithium carbonate: manic depression

Question 24

What categories of antidepressants take 6 months to fully work?

Answer 24

MAO (monoamine oxide inhibitors) and tricyclics

Question 25

What antidepressant takes days-weeks to work?

Answer 25

prozac

Question 26

Analgesics/ symptom control for pain

Answer 26

NSAIDS - ibuprofen (GI irritation)

- salicylates (aspirin)

Question 27

NSAIDs

Answer 27

• acetaminophen (tylenol) - antipyretic and analgesic (liver damage [does not irritate mucosal linings])

Question 28

Overdose treatment for NSAIDS

Answer 28

• vomit within 4 hours

- N-acetylcysteine antidote

Question 29

Salicylates (aspirin)

Answer 29

• bleeding
• inhibits prostaglandins
• chronic use causes: tinnitus, GI bleeding, and kidney irritation

Question 30

Overdose treatment for salicylates (aspirin)

Answer 30

• vomit within 4 hours
• activated charcoal
• pump
• call poison control

Question 31

Reye’s syndrome

Answer 31

• Aspirin/salicylates
• post viral/influence in children (under 18)
• acute encephalopathy
• fatty infiltration of viscera
• hepatomegaly
• s/s: h/a, vomiting, amnesia, rash, seizures, lethargy

Question 32

Reye’s syndrome vs. Guillen Barre

Answer 32

Guillen Barre- ascending paralysis after viral infection
Reyes- post viral/influenza
there is no headache in Guillen Barre

Question 33

Streptomycin

Answer 33

• antibiotic

- hearing problems

Question 34

tetracycline

Answer 34

• antibiotic
• yellow teeth
• avoid dairy
• avoid sun
• binds with calcium

Question 35

Penicillin

Answer 35

• antibiotic
• anaphylactic shock
• rash

Question 36

Amoxicillin

Answer 36

• stunts GI neurotransmitters

- diminishes brain maturation (autism)

Question 37

Levaquin

Answer 37

• tendon tears and ruptures

Question 38

To retain natural flora with antibiotics, encourage

Answer 38

pro-biotics (lactobacillus and acidophilus)

Question 39

Acyclovir

Answer 39

• herpes

- lysine, valtrex

Question 40

allopurinol

Answer 40

chronic gout and Colchicine (acute gout)

-purine metabolism (organ meats, wine, cheese)

Question 41

Antabuse

Answer 41

• disulfiram (turns to aldehyde in the gut when alcohol is ingested)

Question 42

Dilantin

Answer 42

• taken to decrease seizure activity

Question 43

Digitalis

Answer 43

• strengthens heart contractions

Question 44

Propranolol

Answer 44

• ol = beta blocker

- migraines, heart arrhythmias, etc.

Question 45

Tagament

Answer 45

• taken for ulcers

Question 46

Lipitor

Answer 46

• decreases blood cholesterol

Question 47

Vioxx/celebrex

Answer 47

• cox-2 inhibitor

Question 48

Glucosamine, chondroitin sulfate

Answer 48

• disc