Acute poisoning

Question 1

3 timeframes of poison exposure

Answer 1

1. acute
2. chronic
3. acute on chronic

Question 2

top 3 products

Answer 2

1. pain meds
2. sleeping pills
3. household products

Question 3

treatment steps for poisoned PT

Answer 3

1. remove from harm
2. ABCs
3. treat PT, not poisoning
4. minimize absorption
5. enhance elim
6. use antagonism or antidote if possible

Question 4

action of charcoal

Answer 4

help adsorb the product

Question 5

where is charcoal not used (3)

Answer 5

1. low molecular weights (alcohols)
2. metals, highly ionized salts
3. Pt has unprotected airways

Question 6

ratio of charcoal

Answer 6

10:1

Question 7

when to induce vomiting

Answer 7

not usually done anymore - maybe if right after

Question 8

when to lavage

Answer 8

only if very toxic substance has recently been taken (<1hour)

Question 9

when to use whole bowel irrigation

Answer 9

metals or enteric coated drugs

Question 10

how can metabolism be targeted

Answer 10

for agent that need to be bioactivated (glycol) to toxic species, slow the metabolism

Question 11

2 ways to enhance elimination

Answer 11

1. bicarb to elim acidic species

2. hemodyalisis

Question 12

N-acetycysteine fixes

Answer 12

• thiol donor

Question 13

naloxone fixes

Answer 13

opiods

Question 14

calcium fixes

Answer 14

CCBs

Question 15

glucagon fixes

Answer 15

B-blockers, CCBs

Question 16

fomepizole fixes

Answer 16

ADH

Question 17

digoxin fabs

Answer 17

digoxin toxicity

Question 18

deferoxamine fixes

Answer 18

iron OD

Question 19

atropine fixes

Answer 19

anti-muscarinic

Question 20

what is anion gap formula and when to tell

Answer 20

Na - Cl- bicarb (>12)

Question 21

what is osmolar gap formula and when to tell

Answer 21

OSM - 2xNa - BUN - gluc

Question 22

5 causes of elevated OSM gap

Answer 22

ME DIE
Methanol
Ethylene glycol
Diuretics (mannitol)
Isopropyl alc
Ethanol

Question 23

what is para symp toxidrome

Answer 23

DUMBBELS
Diarrhea
Urination
Miosis, muscle weakness
Bronchospasm
Bradycardia
Emesis
Lacrimation
Salivation

Question 24

Muscarinic toxidrome

Answer 24

SLUDGE
Salivation
Lacrimation
Urination
Diarrhea
GI upset
Emesis

Question 25

Nicotinic toxidrome

Answer 25

``` Muscle fasciculations Cramping Hypertension Tachycard Pupil dilation Pallor ```

Question 26

Anticholinergic mneumonic

Answer 26

``` mad as a hatter dry as a bone red as a beet hot as a hare blind as a bat ```