Pharmacology - Drug Toxiciology I & II - Christine Stork-Medicis Flashcards Preview

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Flashcards in Pharmacology - Drug Toxiciology I & II - Christine Stork-Medicis Deck (25):
1

Dx:
Pinpoint pupils;
Decreased bowel sounds;
Altered mental status;
Slow HR, BP down, temp down

Opioid Toxidrome

2

What is the half life of Naloxone?

15 minutes

3

Class: Naloxone

Mu/delta/kappa opioid receptor antagonist

4

MOA: Naloxone

Competitive inhibitor of mu, delta, kappa opioid

5

What is the toxidrome for benzodiazepines?

No respiratory depression if not mixed;
Mental status depression

6

MOA: Flumazenil

Competitive non-selective benzodiazepine receptor antagonist

7

Use: Flumazenil

Benzo OD;
Anti-Rohypnol

8

What are the symptoms of Stage I Acetaminophen toxicity?

Asymptomatic,
Mild GI irritation

9

What are the symptoms of Stage II Acetaminophen toxicity?

24-72 hours
LFT and renal fx abnormalities +/- RUQ pain

10

What are the symptoms of Stage III Acetaminophen toxicity?

72-96 hours
Hepatic necrosis +/- renal failure

11

What are the symptoms of Stage IV Acetaminophen toxicity?

4 days to 2 weeks
Resolution of organ fx

12

What is the antidote for acetominophen poisoning?

N-acetylcysteine (NAC)
Give within 8 hours of OD

13

MOA: N-acetylcysteine

Resupplies glutathione stores

14

What are signs of late Acetominophen toxicity?

Prothrombin time > 200s
Serum creatinine > 3.3
Hepatic encephalopathy
Blood pH 30

15

What toxidrome is being described?
No bowel sounds;
Dry flushed skin;
Dilated pupils;
Obtunded/altered;
Tachycardic;
Increased temperature

Anti-cholinergic toxidrome

16

What ECG findings are common in tricyclic OD?

Widened QRS complex

17

What is the antidote for wide QRS complex, as seen with tricyclic antidepressant OD?

Sodium bicarbonate

18

What is the antidote for anti-cholinergic OD?

Physostigmine

Administer slowly to prevent seizures

19

When is using Physostigmine as an antidote contraindicated?

After TCA exposure - cases of asystole reported

Can use benzodiazepines to sedate the patient until a decision can be made.

20

Name the toxidrome:
Salivation, lacrimation, urination, defecation, Pupils contricted, CNS excitation, muscle fasciculations, breathing spasm

Cholinergic toxidrome

Muscarinic and nicotinic

21

What is the antidote for cholinergic toxidrome, as with heavy pesticide exposure?

Pralidoxime

Enzyme regenerator;
Decreases atropine requirement

22

What is the antidote for methanol ingestions?

Fomepizole;
Dialysis

23

What is the antidote for ethylene glycol?

Dialysis

24

OD on Verapamil or Diltiazem can cause:

Bradycardia, Hypotension, Negative inotropy;

25

What is a unique antidote for calcium channel blocker OD?

High dose insulin

Other treatments include fluid replacement and vasopressors