Toxicology

Question 1

What is the antidote for acetaminophen toxicity?

Answer 1

NAC

Question 2

What is the antidote for anticholinergic toxicity?

Answer 2

physostigmine

Question 3

What is the antidote for arsenic, lead, and mercury toxicity?

Answer 3

dimercaprol, succimer, d-penicillamine

Question 4

What is the antidote for benzodiazepine toxicity?

Answer 4

flumazenil

Question 5

What is the antidote for a black widow spider bite?

Answer 5

latrodectus antivenin

Question 6

What is the antidote for beta-blocker toxicity?

Answer 6

glucagon, insulin and glucose

Question 7

What is the antidote for CCB toxicity?

Answer 7

calcium, glucagon, insulin and glucose

Question 8

What is the antidote for cyanide toxicity?

Answer 8

hydroxycobalamin

Question 9

What is the antidote for cyanide, hydrogen sulfide toxicity?

Answer 9

Na thiosulfate and nitrate

hydroxycobalamin

Question 10

What is the antidote for digitalis glycoside toxicity?

Answer 10

digoxin-specific Fab

Question 11

What is the antidote for ethylene glycol toxicity?

Answer 11

fomepizole, thiamine

Question 12

What is the antidote for hydrofluouric acid toxicity?

Answer 12

calcium gluconate

Question 13

What is the antidote for iron toxicity?

Answer 13

deferoxamine

Question 14

What is the antidote for lead toxicity?

Answer 14

DMSA, EDTA

Question 15

What is the antidote for methanol toxicity?

Answer 15

ethanol, fomepizole

Question 16

What is the antidote for isoniazid, hydrazine, and monomethylhydrazine toxicity?

Answer 16

pyridoxine

Question 17

What is the antidote for methemoglobin-forming agent toxicity?

Answer 17

methylene blue

Question 18

What is the antidote for opioid toxicity?

Answer 18

nalfemene, naloxone

Question 19

What is the antidote for organophosphate and carbamate toxicity?

Answer 19

atropine, protopam

Question 20

What is the antidote for a rattlesnake bite?

Answer 20

CroFab antivenin

Question 21

What is the antidote for serotonin syndrome?

Answer 21

Cyproheptadine

Question 22

What is the antidote for sulfonurea toxicity?

Answer 22

Octreotide

Question 23

What is the antidote for TCA toxicity?

Answer 23

Bicarbonate

Question 24

What is the antidote for valproic acid toxicity?

Answer 24

Carnitine

Question 25

What criteria do you need to look at the establish causation for toxicants?

Answer 25

The Hill Criteria

Question 26

How do most intoxications occur?

Answer 26

accidents!

Question 27

What do you do for the vast majority of patients in the ED?

Answer 27

Decontaminate only

Question 28

The culprit usually reflects _______

Answer 28

accessibility

Question 29

Examples of drugs that are toxic to children even in small amounts?

Answer 29

antimalarials, antidysrhythmics, benzocaine, B blockers, CCBs, camphor, clonidine, lomotil, lindane, methyl salicylate, opioids, theophylline, TCAs

Question 30

What are the rules of general patient management?

Answer 30

A - airway, B - breathing, C - circulation, DEFG - dont ever forget glucose! D - disability / Coma scale, G - get a basic set of observations

Question 31

How does charcoal (SDAC) work?

Answer 31

Eliminated in feces, absorbs drugs -- must protect airways!!

Question 32

What is the time window for charcoal?

Answer 32

within 1 hour

Question 33

What is the syrup of Ipecac? What is the concern with it?

Answer 33

It induces emesis but it will not be of use after 30 minutes; ALSO being looked at for cardiotoxicities

Question 34

What is a lavage?

Answer 34

Instilling several liters of H20 and then suctioning out; keep airways patent

Question 35

What is whole bowel irrigation?

Answer 35

Useful for enteric coating or sustained release; goes below stomach area into small and large intestine

Question 36

When is hemodialysis useful? What would it work on?

Answer 36

Useful for water soluble, low molecular weight, low plasma protein binding toxins; ex: methanol, ethylene glycol, salicylates, lithium, sotalol

Question 37

What is hemoperfusion? What would it work on?

Answer 37

Passage of blood through charcoal filter and removes high plasma protein binding toxins; ex: carbamazepine, phenobarbitol, theophylline, phenytoin

Question 38

Memorize slide 28

Answer 38

Do it

Question 39

What is the most toxic B blocker?

Answer 39

propanolol