Toxicology Flashcards
(33 cards)
what are 2 diagnostics to get immediately?
Urine dipstick
ECG
what are 4 agents that are parasympathetic toxidromes?
organophosphates
insecticides
tobacco
poison hemlock
mushrooms
inhibits the enzyme acetylcholinesterase which leads to acetylcholine accumulation and overstimulation of receptors.
parasympathetic (cholinergic) syndrome
patient presents with agitation/seizures, miosis, increased salivation, increased lung secretions, increased GI motility, increased sweating, and fasciculations/paralysis of muscles. Dx?
2 treatment options?
parasympathetic (cholinergic) syndrome
atropine / pralidoxime
what are 4 agents that are sympathomimetic toxidromes?
cocaine
amphetamines
PCP
catecholamines
CNS excitation with inhibition of norepi and dopamine reuptake
sympathomimetic syndrome
patient presents with agitation/combative, mydriasis, decreased salivation, decreased lung secretions, increased HR, decreased GI motility, increased sweating, and hyperthermia. Dx?
Treatment? (2)
sympathomimetic syndrome
active cooling
benzodiazepine
+/- IV fluids for rhabdomyolysis
what are 4 agents that are antimuscarinic (anticholinergic) toxidromes?
antihistamines (diphenhydramine)
antipsychotics
TCA
antiparkinsonian meds
patient presents with decreased sweat production, dry skin, hyperthermia, mydriasis with blurry vision, hallucinations, and cannot urinate. Dx?
Treatment?
antimuscarinic (anticholinergic) syndrome
supportive care + physostigmine
what are 4 agents that are sedative/hypnotic toxidromes?
benzodiazepines
ETOH
propofol
gabapentin
patient presents with decreased mental status, decreased rate of lung secretions, decreased HR, and hypothermia. Dx?
treatment?
sedative/hypnotic syndrome
supportive
+/- flumazenil
patient presents with seizures, AMS, mydriasis, increased rate of lung secretions, increased HR, and hyperthermia/tremors. Dx?
Treatment? (2)
sedative/hypnotic withdrawal
benzodiazepine
thiamine
patient presents with mydriasis/lacrimation of eyes, yawning, increased lung secretions, increase HR, N/V/D, and piloerection. Dx?
3 treatment options?
opioid withdrawal
clonidine (supportive)
methadone
buprenorphine
detox
why is gastric emptying with ipecac no longer used?
high risk of aspiration
reserved for cases with high morbidity and with sustained-release drugs.
gastric lavage
when can activated charcoal be considered?
if early < 1 hour
what does activated charcoal fail to absorb?
“PHAILS”
Potassium
Heavy metals
Alcohols, Acids
Iron
Lithium
Solvents
what is the antidote for acetaminophen?
N-acetylcysteine
what can be done if acetaminophen was ingested less than 8 hours ago?
plot on nonogram
what is the antidote for TCAs?
sodium bicarbonate
what are 3 antidotes for beta-blocker?
epinephrine / norepinephrine
glucagon
insulin w/ glucose
what are 4 antidotes for calcium channel blocker?
calcium chloride
epi / norepi
glucagon
insulin w/ glucose
what is the antidote for iron?
deferoxamine
what is the antidote for cyanide?
hydroxocobalamin
