Pharm clinical toxicology Flashcards Preview

ABBEY MSII U6 > Pharm clinical toxicology > Flashcards

Flashcards in Pharm clinical toxicology Deck (27):
1

opioid toxidrome

altered mental status, decreased RR, pinpoint pupils, decreased bowel sounds

2

what are the opioids?

heroin, fentanyl, codeine, hydrocodone, meperidien, oxycodone, methadone, buprinorphine

3

what is the competitive opioid receptor antagonist used in overdose?

naloxone (short half life)

4

what are the other opioid receptor antagonist?

nalmefene and naltrerxone (longer half lives)

5

naloxone associated opioid withdrawal

flu like symptoms (nausea, vomiting, diarrhea), piloerection ,yawning, irritability, NORMAL MENTAL STATUS, lasts 15-30 min

6

benzodiazepine toxidrome

depressed mental status, normal vital signs

7

benzodiazepine mechanism and what are they used to treat?

enhance the effect of GABA - treat anxiety, insomnia, agitation, seizures, muscle spasms, alcohol withdrawal
-also used to treat toxicity caused by other toxins that cause CNS stimulation such as anticholinergic toxins

8

what is the competitive non-selective benzodiazepine receptor antagonist? (used to treat overdose)

flumazenil

9

flumazenil dangers (benzo overdose drug)

can precipitate acute withdrawal and cause seizures

10

acetaminophen toxicity - mechanism?

hepatic necrosis and renal failure - when too much acetaminophen - broken down into different by product that is toxic to the liver

11

APAP (acetominophen) poisoning treatment

antidote = n-acetylcysteine (NAC) - best given within 8 hours of overdose

12

tricyclic antidepressant toxidrome

anticholinergic, catechol reuptake inhibitor, alpha adrenergic blocker (hypotension), GABA antagonist (seizures), sodium channel blocker (THE KILLER)

13

what effect does sodium channel blocker have?

wide QRS segment for heart action potential

14

antidote for tricyclic antidepressant overdose

sodium bicarbonate (replace sodium to overcome inhibition and alkalinization to reduce TCA affinity to its receptor in the myocardium)

15

anticholinergic toxidrome

mydriasis (dilated), dry, flushed skin, decreased bowel sounds, urinary retention, increased temperature, altered mental status (confusion, hallucinations, seizures)

16

what are the anticholinergics?

atropine, diphenhydramine, scopolamine

17

antidote for anticholinergic overdose

physostigmine (anticholinesterase)

18

cholinergic toxidrome

miosis, salivation, lacrimation, ruination, defecation, CNS excitation, bronchorrhea/spasm, fasciculations

19

what are the cholinergic agents

anticholinesterases (including nerve gases, organophosphates, carbamates, physostigmine, neostigmine) and cholinomimetics (bethanechol)

20

what is the cholinergic overdose antidote?

atropine (anticholinergic) for MUSCARINIC ONLY
and pralidoxime (enzyme regenerator) for NICOTINIC AND MUSCARINIC!

21

what is the DD for anion gap metabolic acidosis?

MUDPILES!
Methanol
Uremia
Diabetic ketoacidosis (all ketoacidosis)
Paraldehyde, phenformin, metformin
Iron, INH
Lactate (CO, CN, methemoglobinemia)
Ethylene glycol
Salicylate

22

what is used to treat methanol overdose?

femopizole and hemodialysis

23

calcium channel overdose clinical effects

-if nifedipine and other dihydropyridines (blood vessels) peripheral vasodilation, reflex tachycardia, hypotension
-if verapamil or diltiazem (heart and blood vessels) = hypotension d/t vasdilation, bradycardia, negative inotropic effects

24

amphetamines/cocaine toxicity

CNS stimulation, agitation, hallucinations, seizures, increased muscle activity = increased temp, increased CK, kidney injury

25

phencyclidine (PCP)/ketamine/DM toxicity

dissociative anesthetic = depends on dose
low = euphoria
medium = agitation, anesthesia, increased strength
high = CNS anesthesia

26

what are downers?

GABA agonists (GHB, roofies)

27

what do you give to someone too high on PCP/amphetamine like drugs

diazepam = calming effect