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Emergency Medicine > Acute Intoxication & OD > Flashcards

Acute Intoxication & OD Flashcards

1
Q

tx wernickes encephalopathy

A

thiamine (B1)

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2
Q

tx opiod od

A

narcan - naloxone

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3
Q

tx hypoglycemia

A

glucose

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4
Q

if pt is tachypnea think OD from___

A

salicylates

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5
Q

if pt is bradypnea think OD from __

A

opiods

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6
Q

shallow breaths?

A

opiod OD

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7
Q

kussmaul like breaths?

A

salicylates

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8
Q

large pupils mean…

A

anticholinergic or sympathomimetic toxidrome

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9
Q

small pupils

A

opioid

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10
Q

nystagmus horizontal think..

A

ethanol, ketamine

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11
Q

nystagmus rotary or vertical think..

A

PCP, some stimulants

PCP (phencyclidine)

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12
Q

hyperpyrexia goes with what 4 toxidromes?

A

anticholinergic, stimulants, serotonin syndrome, sympathomimetic

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13
Q

hypothermic toxidrome goes with

A

opioid, sedative-hypnotics

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14
Q

if their dry its..

A

anticholinergic

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15
Q

if they are moist think

A

cholinergic

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16
Q

everything up think..

A

sympathomimetic, anticholinergics, stimulants , hallucinogens

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17
Q

everything physiologically down think

A

depressed temp, HR, BP, RR, lethargy/coma

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18
Q

mixed effects? BP and HR up but RR down…

A

polysubstance, metabolic poisons, salicylates

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19
Q

before giving activated charcoal what do you have to consider?

A

MS, risk of aspiration and airway

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20
Q

concern for __ with using activated charcoal

A

bezoars

21
Q

when is hemodialysis used to detox?

A

salicylates, methanol, ethylene glycol, lithium, mushrooms, isopropyl alocohol

22
Q

MATHS mnemonic is ..

A 
Sx for any sympathomimetic toxidrome 
mydriasis 
agitation 
tachycardia 
hypertension 
seizure (and sweating)
23
Q

when are BB avoided?

A

if suspected sympathomimetic OD .. concerns of unopposed alpha stimulation

24
Q

toxic dose of APAP

A

150 mg/kg

25
Q

sx stage I APAP OD

A

N/V, most asymptomatic

26
Q

sx stage II APAP OD

A

latent stage 24-48 hrs

RUQ pain, increased AST/ALT/bilirubin INR

27
Q

sx stage III APAP OD

A

liver failure, RUQ pain, V, jaundice, coagulopathy, hypoglycemia, renal failure, metabolic acidosis

28
Q

sx stage IV APAP OD

A

resolution of hepatic dysfunction

OR death / transplant

29
Q

tx APAP od

A

n-acetylcysteine - no CI

30
Q

NAC loading dose IV

A

150 mg/kg

Maintance rate: 50 mg/ kg over 4 hours

31
Q

when do you stop NAC dose?

A

stop when APAP is undetectable, AST/ALT less than 100 and INR is less than 1.5

OR there is transplant or death

if given within 8 hours, hepatotoxicity is uncommon and death is rare

32
Q

when admit APAP od pts?

A 
known toxicity / potential tox level 
hepatic damage lab evidence
unknown time of ingestion 
unknown ingestion time with APA 
if it was intentional self harm
33
Q

toxic dose of salicylates

A

over 150 mg / kg

34
Q

lethal dose of salicylates

A

480 mg / kg

35
Q

antidote for salicylates

A

NONE .. there is none

36
Q

early sx salicylate od

A

N/V, tinnitus, diaphoresis, confusion, deafness, tachypnea, vertigo, respiratory alkalosis (direct stimulation)

37
Q

late sx salicylated od

A

anion gap met. acidosis, ALOC, pulmonary edema, hypoglycemia (severe), hepatic and renal dysfunction, seizures, death

38
Q

fastest way to kill pt with ASA overdose is__

A

sedation for agitation

39
Q

ASA tx

A

activated charcoal with sorbitol
empiric dextrose
bicarb, supplemental K+

40
Q

start dialysis for many reasons including if ph is less than

A

7.19

41
Q

barbiturate od tx

A

abc/acls

aggressive fluids, pressors prn, supportive care etc

42
Q

____ causes permanent retinal injury, blindness and parkinsonian syndrome

A

methanol OD

43
Q

___ od causes fruity breath ketosis without acidosis

A

isopropanol

44
Q

2nds most common alcohol od

A

isopropanol

45
Q

with ___ od urine may flouresce

A

ethylene glycol (antifreeze)

46
Q

fatal dose ethylene glycol

A

2 ml / kg

47
Q

sx first 12 hours antifreeze od

A

CNS depression, vomiting, sz, coma, tetany

48
Q

sx 12-24 hours antifreeze od

A

cardiopulmonary, hypotension, tachydysrhythmias, ARDS

49
Q

sx 24-73 hrs

A

nephrotoxic, oliguria, renal failure, ATN, calcium oxalate cyrstalluria

Emergency Medicine (19 decks)

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