Flashcards in Emergency Medicine - Toxicology Deck (30):
Drugs that cause HTN
Sympathomimetics: Cocaine, amphetamines, designer drugs
Drugs that cause bradycardia
BB, CCB, digoxin, lithium
Causes of conjugate eye deviation - towards or away from lesion?
Stroke - towards. Seizure - away.
Causes of hemiparesis
Post-ictal, stroke, ICH
Drug therapy for the agitated patient
If drug induced, drug withdrawal, or unknown - give benzo (lorazepam, midazolam). If Dementia or psychiatric cause - give antipsychotic (haloperidol).
Effect of anticholinergic toxicity on HR
Effect of synpathomimetic toxicity on HR
Effect of sedative toxicity on HR
Effect of cholinergic toxicity on HR
Oral findings for anti cholinergic, sympathomimetic, sedative and cholinergic overdoses
No oral findings except for with cholinergics you get salivation
Effect of anticholinergic toxicity on BP
Effect of sympathomimetic toxicity on BP
Effect of sedative toxicity on BP
Effect of cholinergic toxicity on BP
How do pupils look with anti cholinergic toxicity
How do pupils look with sympathomimetic toxicity
How do pupils look with sedative toxicity
Dilated or constricted
How do pupils look with cholinergic toxicity
Suspect overdose of what agent in patient with dry flushed skin?
Suspect overdose of what agent in diaphoretic patient with piloerection?
Suspect overdose of what agent in patient with hypothermic skin?
Suspect overdose of what agent in patient with diaphoretic skin and constricted pupils?
Location of tension HA, migraines, cluster HA
Bilateral, unilateral, unilateral in orbital/supraorbital/temporal region
Pinpoint pupils, resp depression, lethargy, bradycardia, hypothermia, borderline hypotension
Way to remember anticholinergic toxicity
Blind as a bat, mad as a hatter, red at a beet, hot as a hare, full as a tick, dry as a bone, bowel loses tone and heart runs alone
Way to remember cholinergic toxicity
Dumb bells : diarrhea/diaphoresis, urination, miosis (constricted pupil), bradycardia, bronchorrhea, emesis, lacrimation, salivation/seizures
Also AMS, fasciculation, weakness
Examples of anticholinergic drugs
Diphenhydramine (OTC cold/sleep meds), antiparkinson meds benztropine, toxic jimsonweed
Cocaine, amphetamines, anorectics, otc stimulants, herbal stimulants
Organophosphates, carbamates (pesticides), donepezil (ACEi for Alzheimer's), physostigmine (MG, Alzheimer's, delayed gastric emptying), nerve gas agents