Toxicology ⚠️

Question 1

Yawning and Lille reaction are signs of which withdrawal

Answer 1

Opioid withdrawal (and mydriasis)

Question 2

Propofol withdrawal

Answer 2

Dopamine

Question 3

Tacrolimus side effects are related to what

Answer 3

Vasoconstriction. So HTN and prerenal AKI are hallmarks

Question 4

Neuroleptic Malignant Syndrome Tx

Answer 4

Dantrolene (ryanodine receptor antag) and cool them down. Can give benzo if they’re agitated, or DA ag.

Question 5

If abruptly stopping DA ag. What syndrome can occur

Answer 5

NLMalig syndrome

Question 6

Reflexes… Serotonin Syndrome vs Malig hyperthermia

Answer 6

Hyperflexia in the former.

Question 7

Main rhabdomyolisis out of Malig hyperthermia, serotonin syndrome, NMS

Answer 7

Former

Question 8

Serotonin syndrome Tx

Answer 8

Cyproheptadine, or benzos (more rapid acting). Active cooling and stop offending cause

Question 9

Opioid overdose first thing

Answer 9

Naloxone. Best first thing (usually before intubating)

Question 10

Patient with nystagmus, ataxia, confusion

Answer 10

Wernicke

Question 11

Cyanide poisoning cause what acid base disorder

Answer 11

Metabolic acidosis

Question 12

CN poisoning Tx

Answer 12

Hydroxycobalamine

Nitrate

Na Thiosulphate

Question 13

Fomipazole Tx used for?

Answer 13

Ethylene glycol and methanol poisoning

Question 14

Lactic acidosis and visual issues

Answer 14

Methanol

Question 15

Benzos tox Tx

Answer 15

Flumazenil

Question 16

Respiratory depression and coma like… no pupil findings

Answer 16

Benzos

Question 17

Are barbiturates reversible with flumazenil

Answer 17

No

Question 18

TCA toxidrome Tx

Answer 18

NaHCO3

Question 19

AntiCh toxidrome Tx

Answer 19

Physostigmine

Question 20

Dystonic reaction Tx

Answer 20

Diphenhydramine or benztropine

Question 21

Akathisia Tx

Answer 21

BB

Question 22

Parkinsonian signs from anti DA. Tx?

Answer 22

Give benztropine or DA ag

Question 23

Patient on L dopa gets psychotic signs…. Mx?

Answer 23

First try to lower dose of L-dopa, but if patient doesn’t improve or cannot handle this, do QUIETIPINE

Question 24

Quietapine SE.?

Answer 24

Cataracts

Question 25

CO poisoning Tx

Answer 25

Hyperbaric O2

Question 26

MetHb causes

Answer 26

Nitrates, dapson, malaria drugs, TMP SMX,

Question 27

MetHb Tx

Answer 27

Methylene blue

Question 28

Aspirin Tox Tx

Answer 28

NaHCO3. Dialyse if severe. Charcoal if recent

Question 29

BB tox Tx

Answer 29

Glucagon

Question 30

CCB toxicity Tx

Answer 30

Calcium compounds.

Question 31

Digoxin Tox Tx

Answer 31

AntiDigoxin fragment AB (digibind)

Question 32

Dabigatran Tox Tx

Answer 32

Idarucizumab

Question 33

Heparin sulphate Tox Tx

Answer 33

Protamine

Question 34

Can ocrteotide help with hypoglycaemia

Answer 34

Yes. Usually not the correct answer though

Question 35

How can ecstasy cause rhabdo

Answer 35

Person is dancing dancing dancing

Question 36

NDMA is what

Answer 36

Ecstasy’s

Question 37

Dantrolene MOA

Answer 37

Ryanodine receptor antagonist (a Ca channel)

Question 38

Propofol does what to fats

Answer 38

Causes hypertiglycsridemia! Can even cause pancreatitis

Question 39

How to prevent hemorrhagic cystitis from cyclophosphamide

Answer 39

MESNA (decreases the acrolein)

Question 40

How to decrease toxicity caused my PLT chemo drugs

Answer 40

Amifostine

Question 41

How to prevent cardiotoxicity from doxorubicin

Answer 41

Give Fe chelator, recall the cause of the cardio tox here