Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Elaina: Emergency 2 > ED 2 Toxicology > Flashcards

ED 2 Toxicology Flashcards

(47 cards)

Start Studying
1
Q

what does the mnemonic MUDPILES stand for?

A 
Methanol
Uremia
DKA
Propylene Glycol
Infection/Isoniazid (TB drug)
Lactic Acidosis
Ethylene glycol/ethanol
Salicylates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

which 2 key features will clue you into an aspirin overdose?

A

Kussmal breathing

Tinnitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

serum levels of what level represent potentially life threatening aspirin toxicity?

A

over 500 mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what lab values will change first with aspirin ingestion?

A

LFT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how often should you draw serum salicylate levels when monitoring potential overdose? why?

A

every 2 hours in acute, single dose OD

we don’t know when the full impact will be

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

at ____ hours post ingestion, your patient likely has fully absorbed the ASA

A

6 hours

careful with serum levels less than 6 hours post ingestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what lab is essential to order in an ASA overdose? why?

A

arterial blood gases

will often see sever metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the two treatments of choice in aspirin overdose?

A

DIALYSIS

alkalinize urine to 7.5-8 (give bicarb)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when can you perform gastric lavage in an ASA overdose until?

A

60 minutes post ingestion

someone correct me i wasn’t listening and i don’t know if we still do this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the max daily dosage for an adult taking acetaminophen?

A

4 grams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

why do children under 5 fare better in terms of acetaminophen overdose?

A

they have more glutathione in their liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

describe the symptoms seen in phase 1 of acetaminophen OD. how long will these occur for?

A

asymptomatic to N/V, subclinical bump in LFT

lasts 0-24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

describe the symptoms seen in phase 2 of acetaminophen OD. how long will these occur for?

A

RUQ pain, N/V, continued increase in LFT

18-72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

describe the symptoms seen in phase 3 of acetaminophen OD. how long will these occur for?

A

jaundiced, coagulopathy, liver necrosis, renal failure, fatality

72-96 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the KEY thing to keep in mind when worrying about an acetaminophen overdose?

A

these patients will get sick DAYS later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

when do you draw levels when monitoring an acetaminophen overdose?

A

immediately and at 4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

when does max absorption of acetaminophen occur?

A

4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what level should you draw continuously throughout a patient’s stay to monitor mortality in a suspected acetaminophen overdose?

A

lactate level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how should ABG of an acetaminophen overdose look?

Study These Flashcards
A

normal! normal pH

if its not normal, assume other ingestion

20
Q

what is the TOC for acetaminophen overdose? when should you give it by?

Study These Flashcards
A

n-acetylcystine loading and maintenance dose

give within 8 hours or ANYTIME when pregnant

21
Q

what are the 4 criteria for liver transplant in an acetaminophen overdose?

Study These Flashcards
A

1) pH less than 7.3
2) grade 3+ encephalopathic
3) PT greater than 100
4) serum creatinine over 3.4

22
Q

who do we use the rumack-matthew nomogram for?

Study These Flashcards
A

tool to monitor probable acetaminophen serum levels vs. time in our OD patient

23
Q

patient presents with tremor rigidity, hyperreflexia, anxiety, and agitation. you suspect serotonin syndrome – what levels should you draw?

Study These Flashcards
A

creatinine kinase levels to check for rhabdomyolysis

24
Q

how do we treat serotonin syndrome?

Study These Flashcards
A

benzodiazepines
BP control
fluid for rhabdomyolysis control
cooling

25
when is peak absorption for tricyclic antidepressants? what is a toxic dose?
peak absorption 1 hour toxic dose 10-20mg/kg
26
most common TCA that we see overdose in? who should you avoid this med in?
amitriptyline avoid in pt with uncontrolled mental illness or HX of suicide attempts
27
what signs should make you worry about impending TCA overdose?
anticholinergic toxidrome hyperthermia, confusion, dry mouth, urinary retention, grabbing invisible objects, dilated pupils, flushed skin, tachycardia, shaking
28
what does the SALT toxidrome of TCA overdose look like?
shock altered mental status wide QRS terminal R wave in AVR
29
what is the TOC for TCA overdose?
give bicarb until serum pH is 7.4+ intubation in severe OD: can hyperventilate patient on vent!
30
which three ODs cause severe metabolic acidosis?
ethylene glycol, TCA, ASA
31
TCA overdose will be initially _____ but will crash very shortly after
initially asymptomatic
32
when is the peak effect with the following routes of opiate administration? 1) IV 2) IM 3) PO
IV: 10 minutes IM: 30-45 minutes PO: 90 minutes
33
which routes of ingestion do we worry most about with opiate overdose, as they are very hard to control with narcan?
dilaudid and methadone (long acting) narcan's half life is very short
34
key finding of opiate overdose?
respiratory depression, bradypnea, hypoxia should NOT see cardiac issues unless down for a LONG time
35
what lab should you draw in any patient who presents to the ER unresponsive?
finger stick blood sugar
36
_____ promotes aggression and may require restraining the patient upon administration
narcan
37
if your patient had an oral OD of opiates, what should you consider?
GI decontamination
38
if opiate OD patient is still altered after administration of narcan, what must you assume?
other ingestion vs. anoxic brain injury
39
OD on CCB verapamil will cause what two physiologic responses?
vasodilation (hypotension) and bradycardia
40
which verapamil formulation is most dangerous? how will these patients present?
extended release -- VERY sick, one of worst ODs you will see
41
onset of OD overdose in verapamil?
15 minutes - 2 hours OD with over 1 gram
42
what are the 3 treatments you give for verapamil overdose?
1) CaCl 10 percent 2) pacing 3) pressor support
43
which substance is relatively benign until it is metabolized into glycolic acid?
ethylene glycol
44
how will an ethylene glycol OD present?
1) initially no abnormalities 2) altered mental status 3) kussmal breathing 4) very sick
45
what should your workup of your ethylene glycol OD consist of?
look at serum osmolality vs. calculated anion gap serum osmol should be equal to calculated osmol, if its not you're in trouble
46
what is the conversion factor for ethylene glycol?
6.2
47
what is the treatment of choice for ethylene glycol overdose?
1) bicarb to correct acidosis (7.4+) 2) fomepizole TOC 3) end game is dialysis

Elaina: Emergency 2 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions