Toxicology

Question 1

Define hormesis

Answer 1

Dose response relationship to an agent
- low dose amounts have a beneficial effect
- high dose amounts can produce functional inhibition or toxicity

Question 2

List the general presentation of toxicity in patients

Answer 2

• variable depending on drug & dose
• AMS
• incomplete/misleading history
• unexplained abnormal VS/labs
• withdrawal will OPPOSE a toxic effect but can MIRROR other toxidromes

Question 3

Describe the limitations of a urine drug screen

Answer 3

• detect metabolites not the actual compound
• false positives with some Rx/OTC drugs
• false negatives/undetected: K2, BZD, fentanyl
• can be fooled by water dilution, bleach, eye drops

Question 4

Describe the treatment for opioid toxicity

Answer 4

Naloxone (antidote)

Initiate Buprenorphine if: in/post withdrawal, COWS >6

Question 5

Describe the primary presentation of opioid toxicity

Answer 5

CNS depression, respiratory depression, miosis

Question 6

Describe the etiology of acetaminophen toxicity

Answer 6

Question 7

Describe the treatment for acetaminophen toxicity

Answer 7

Question 8

Describe the presentation of benzodiazepine toxicity

Answer 8

Question 9

Describe the treatment for benzodiazepine toxicity

Answer 9

Question 10

Describe the presentation of alcohol toxicity

Answer 10

Question 11

Describe the presentation & treatment of barbiturate toxicity

Answer 11

treatment: no antidote, dialyze

Question 12

Describe the presentation of Z-drug toxicity

Answer 12

Question 13

Describe the etiology of sympathomimetic toxicity

Answer 13

Question 14

Describe the presentation of sympathomimetic toxicity

Answer 14

Question 15

Describe the treatment of sympathomimetic toxicity

Answer 15

Question 16

Describe the presentation of anticholinergic toxicity

Answer 16

Question 17

Describe the treatment for anticholinergic toxicity

Answer 17

Question 18

Describe the presentation of cholinergic toxicity

Answer 18

Question 19

What is the antidote to cholinergic toxicity

Answer 19

atropine

Question 20

Describe the presentation of serotonin syndrome

Answer 20

Question 21

What is the treatment for serotonin syndrome

Answer 21

“benzos till they smile”

Question 22

Describe the presentation of salicylate toxicity

Answer 22

Question 23

Describe the workup for salicylate toxicity

Answer 23

Question 24

Describe the treatment for salicylate toxicity

Answer 24

Question 25

Describe the presentation of TCA toxicity

Answer 25

Question 26

Describe the treatment for TCA toxicity

Answer 26

Question 27

What hallucinogens may present with toxicity

Answer 27

• dextromethorphan
• LSD
• Ayahuasca