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Accelerated Paramedic > Ch 28- Toxicology > Flashcards

Ch 28- Toxicology Flashcards

(75 cards)

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1
Q

What is illicit vs licit drugs?

A

Illegal vs legal

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2
Q

What is a drug?

A

A substance that has some therapeutic effect when given in appropriate circumstances and dose

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3
Q

What is toxicology poison?

A

Substance whose chemical action could damage structures or impair function when introduced into body

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4
Q

What is a toxin?

A

Poison or harmful substance produced by bacteria, animals or plants

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5
Q

What is an overdose?

A

Drug taken in excess

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6
Q

What is half life?

A

Amount of time needed for average person to metabolize half of the substance

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7
Q

What is an antidote?

A

Something that counteracts effect of the poison

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8
Q

What are the routes of entry?

A

Ingestion, inhalation, injection, absorption

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9
Q

Ingestion

A

Via GI tract
Consider ingestion if pt: report sudden abd cramps, n/v, diarrhea
Amount of time in stomach may vary from person to person
Activated charcoal to induce vomiting is not indicated
Activated charcoal w/ sorbitol may be indicated
Gastric lavage may be performed at he hospital
Drug “mules” can have ingestion of drugs if container fails

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10
Q

Inhalation

A

Breathing in substance
Be scene safety aware; inhalation hazard can effect responder
Carbon Monoxide is example of inhaled toxin
Inhalation will be quick to produce s/s
Can produce wide range of s/s—-call poison control if needed

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11
Q

Injection

A

Toxin entrance into body generally via stings/bites
Can produce local or systemic reaction
Includes misuse of IV drugs

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12
Q

Absorption

A

Poison gaining access through skin
Can be caused by pesticides like organophosphate

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13
Q

What is a toxidrome?

A

Syndrome like symptoms associated with/ class or group of similar poisonous agents

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14
Q

LOOK AT PAGES 1664 AND 1665 TABLES 28-1 AND 28-2

A
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15
Q

What is drug misuse?

A

Use of drug that causes physical, psychological, economic, legal or other social harm to the user or others affected by user’s behavior

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16
Q

What is habituation?

A

Physical or psychological dependence on a drug

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17
Q

What is physical dependence?

A

Physiologic state of adaptation to a drug caused by chronic use, usually characterized by tolerance to the effects of the drug and withdrawal if use of the drug is stopped, especially abruptly

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18
Q

What is tolerance?

A

Physiologic adaptation to the effects of a drug; requires increasingly larger dosages to achieve same effect

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19
Q

What is withdrawal syndrome?

A

Predictably set of s/s usually involving altering CNS activity; occur after abrupt cessation of a drug or rapid decrease in the usual dosage of a drug

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20
Q

What is drug addiction?

A

Chronic disorder characterized by compulsive use of substance that results in physical, psychological, economic, legal., or social harm to user. Continues to use substance despite the harm

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21
Q

What is antagonist?

A

Molecule that blocks the ability of a given chemical to bind to its receptor, preventing biologic response

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22
Q

What is potentiation?

A

Enhancement of the effects of one drug by another drug

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23
Q

What is synergism?

A

Action of 2 drugs that total effects is greater than the sum of the independent effects of the 2 substance.

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24
Q

What history taking should take place?

A

What is the substance?
When was the substance ingested, injected, absorbed, inhaled?
How much was taken, injected, absorbed, inhaled?
What else was taken
Has the pt vomited or aspirated?
Why was the substance taken?

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25
What is alcohol disorder?
Medical condition characterized by physical and psychological addiction to ethanol that can range from mild to severe
26
What are the warning signs of alcohol disorder?
Consuming large quantities of alcohol or over long period of time Spending considerable time in activities necessary to obtain alcohol, use alcohol, or recover from effects Causing or exacerbating social/interpersonal problems due to alcohol use Reducing social, occupational, or recreational activities due to alcohol use Continuing to use alcohol even after acknowledging physical and psychological problems that are caused/exacerbated by alcohol use
27
When does physical dependence on alcohol occur?
Regular consumption of large quantities of alcohol
28
What nervous system does alcohol have the most effect on?
CNS
29
What is acute alcohol intoxication?
Acute intoxication from alcohol
30
What is the most acute risks of alcohol intoxication?
Resp depression and aspiration from vomiting Assess airway- suction as needed Provide O2 as needed Assist ventilation- do not force ventilation, will cause gastric DISTENTION and increase risk of vomiting Assess BG Monitor ECG rhythm Obtain IV access- fluid resuscitate as necessary based on vitals Administer Thiamine to prevent Wernicke-korsakoff syndrome
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32
What are withdrawl seizures?
person drinking heavily for long time, stops suddenly Can occur within 12-48hrs after last drink Treatment same as approach to intoxicated individual Prolonged seizures usually respond to lorazepam
33
What are delirium tremors?
Potential lethal complication of alcohol withdrawal Starts 48-72hrs after last alcohol intake S/s: confusion, tremors, restlessness, fever, diaphoresis, tachycardia, hypotension Susceptible to hallucinations Treatment: protect patient from injury and support cardiovascular system Physical restraints my be needed Iv insertion w/ fluid challenge may be needed
34
How do stimulants work?
Enhance release of catecholamines, stimulating CNS CNS excitation can create agitation, anxiousness, delirium, dilated pupils
35
What is Cocaine?
Naturally occurring alkaloid extracted from the leaves of erythromycin coca plant Grows in South America
36
What does cocaine do?
Local anesthetic and nervous system stimulant Enhances release and activity of neurotransmitters, norepinephrine, dopamine and serotonin Dopamine: causes euphoria feeling Norepinephrine: stimulation of sympathetic nervous system, increase hr, BP, hyperthermia
37
38
Cocaine vs crack cocaine?
Cocaine: water soluble, can be applied topically, snorted, swallowed or injected Crack cocaine: cocaine cut with baking soda and water, cooked, turns into smokable cocaine
39
What is cocaine crash?
Cocaine has worn off, pt experiences depression, irritability, exhaustion
40
What is cocaine washout?
Hypoactive state related to lack of synaptic neurotransmitters
41
What is amphetamine?
Stimulant, crank, ice, MDA, Adam, MDMA, Eve, ecstasy
42
What is methamphetamine?
Low cost, long acting, stimulant that is highly addictive
43
What is the clinical presentation of amphetamine or methamphetamine abuse?
Almost identical to pt w/ cocaine abuse Amphetamine effects last longer than cocaine
44
What is synthetic cathiones?
Emerging group of drugs similar to MDMA Chemical compound derived from khat plant, originates in east africa Flakka, cloud nine, white lightning are examples Can be ingested, snorted, smoked, or injected Associated w/ paranoia, hallucinations, incredible strength, excited delirium, bizarre behaviors, tachycardia, diaphoresis, nausea, hyperthermia
45
What are s/s of stimulant misuse?
Dysrhythmias, vascular events, hypertension, hyperthermia, seizures, agitation
46
How do you treat stimulant misuse?
Supportive care Manage ABCs Maintain oxygen Proper monitoring Initiate IV access and manage hypotension w/ NACL Assess need for medication admin Chemical restraint may be needed for excited delirium and bizarre behavior Aggressive cooling may be indicated due to hyperthermia Seizures should be treated w/ benzos Neuromuscular blockade may be needed to control motor activity d/t hyperthermia, acidosis, rhabdo (likely need online med control)
47
What is marijuana?
Dried leaves and flower buds of cannabis sativa
48
What is the primary psychoactive ingredient in marijuana?
Delta 9 or THC
49
What does marijuana cause?
Increased sensory perception and euphoria; can cause anxiety and panic
50
What are the short term effects of marijuan?
Tachycardia, balance and coordination problems, increased appetite, conjunctival injection, dry mouth, possible memory loss
51
How long does euphoria from marijuana last?
Around 4-6HRS
52
How do you assess and manage THC?
Scene size up, ABCs, manage life threats Rarely life threatening Can cause panicked/anxiousness d/t euphoria spatial disorientation, altered sense of reality Pt may have hyperemesis- treat w/ fluids an anti emetics
53
What is spice? How to treat?
Synthetic cannabinoid Active substance blend of chemicals that are sprayed on plant like material for smoking Generally more dangerous than marijuana Treat w/ supportive care, manage symptoms, fluids/anti emetics as needed
54
What is hallucinogen?
Substance that impairs judgement, alter user’s perception of reality, creates unrealistic sensation of images or sounds that are not actually present
55
How are hallucinogens classified?
naturally occurring- Synthetic- LSD, PCP, Ketamine
56
What is LSD? How do you assess and treat?
Fungus that contaminates rye flour and wheat Usually ingested orally in tablet, capsule, or liquid May result in synesthesias (crossing of senses, tasting colors) Effects are mostly sympathomimetic: mild tachycardic, palpitation, dilated pupils, and sweating Management is generally supportive Limit sensory stimulation Don’t use lights and sirens
57
What is phencyclidine? How to assess? How to treat?
PCP; aka angel dust, rocket fuel; dissociative anesthetic that has hallucinogen properties No medical purpose Works at NMDA receptor Typically smoked or snorted S/s include: slurred speech, staggering gait, tachycardia, hypertension, staring blankly, horizontal nystagmus Display extraordinary strength, sense of invincibility, lack of awareness to pain Care focuses on: calming pt, addressing wounds, IM sedatives may be necessary,
58
What is ketamine? What does it do? How to assess? How to treat?
Dissociative anesthetic Short acting Used for procedural sedations, management of agitate and violent behavior Works at NMDA receptor; bind to my-opioid receptor Low doses: mild inebriation, euphoria, increase sociability Higher doses: nausea, difficulty moving, significant hallucinations Manage ABCs manage life threats Provide O2 as needed IV access Provide safe transport Benzos can help calm agitated pt who is experiencing delirium
59
What is peyote and mescaline? What’s it do? How to assess and treat?
Hallucinogen found in southwest us Mescaline found in small peyote cactus Causes psychedelic feeling : flashes of color, commonly in geometric patterns Dry plant can cause gastric irritation w/ severe vomiting May experience out of body feeling Prehospital care: supportive, provide o2 as needed, safe transport. Consider fluids and anti emetics if pt is vomiting
60
What is psilocybin mushrooms? What’s do they do? How to assess and treat?
Hallucinogenic mushrooms Have bitter taste and are usually combined with other liquids/food to disguise flavor Effects similar to LSD, occurring within 30mins, lasting 4-6HRS S/s: weakness, drowsiness, nausea, vomiting, dilated pupils, mild tachycardia, mild hypertension Seizure and hyperthermia have occurred in some pt’s Management: supportive care, manag ABCs, monitor vitals, ECG, consider IV for facilitate SZ control w/ benzos Diazepam (Valium), Lorazepam (Ativan), or Midazolam (Versed)
61
What do sedative-hypnotic drugs do?
CNS depressant Produce range of effects from light sedation to total anesthesia High potential for misuse High risk of drug diversion
62
What are barbiturates? What does they do? How to assess and treat?
Act as CNS depressant Anxiolytics, anti convulsants, hypnotics Analgesic effects have also been associated with/ barbiturates Similar to alcohol in terms of dependence and withdrawl Potentiate GABA receptor to inhibit cellular excitation Increased dosage cause widespread CNS depression Ultra short active barbs Preferred for airway management and stopping SZ Long acting barbs preferred for sustained therapeutic level of med over long period of time Assessment findings reflect dosage; similar to alcohol intoxication S/s: decreased alertness, nystagmus, ataxia, mental confusion, slurred speech, increased lethargy leading to unresponsive At risk for vomiting and aspiration Treatments: manage ABCs, support ventilation, suction when needed, prevent aspiration, pulse ox and capno, IV access, 250ml crystalloid bolus, persistent hypotension use vasopressor,
63
What are benzodiazepines? What does they do? How to you manage them?
Sedative-hypnotic family Used to treat anxiety, sz, withdrawal symptoms Effects GABA pathways similar to barbiturates, results in sedation and reduced anxiety
64
Common Opoids
Morphine Codeine Tramadol Heroine Fentanyl Methodone Oxycodone Hydrocodone
65
Common Anticholinergics
Atropine Scopolamine Antihistamines
66
Common Cholergic
Organic Phosphates Compounds: Carbamates Arecholine Pilocarpine Urecholine Choline
67
Common Sympathomimetics
Caffeine Cocaine Methamphetamines Amphetamines Ritalin LSD Theophylline MDMA
68
Common Sedative-Hypnotics
Anti-anxiety meds Muscle relaxers Anitepileptics Preanesthetic meds Barbituates Benzodiazepines
69
S/S of Anticholenergic meds
Increased HR/BP Warm/Dry Skin Dilated Pupils
70
S/S of Cholinergic Agents
Pinpoint Pupils Diaphoresis Increased Bowel sounds/issues
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S/S of Opioid Use
Decreased HR/BP Decreased RR Cool/Dry Skin Pinpoint Pupils
72
S/S Sympathomimetic/Stimulant Use
Elevated BP/HR Elevated RR Warm/Wet Skin Dilated Pupils Increased Bowel Sounds/Issues Anxious/Agitated Delirium Thin Appearance Track Marks
73
S/S of Sedative-Hypnotic drug use
Decreased HR/BP Decreased RR Cool/Dry skin
74
If it ends in -LAM or -PAM, it is most likely a…..
Benzodiazepine
75
Which class of drug is a CNS depressant?
Barbituates

Accelerated Paramedic (49 decks)

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