Toxicology Flashcards by Korey koper

Phenobarbital OD: Tx ?

Urinary alkalinization (like ASA)

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Tricyclic antidepressant OD: Tx. : Hypotension ?

norepinephrine

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BB tx if hypotensive ?

Norepi.

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Theophylline OD: H and P ?

Nausea

Tremor

Hypotension

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SSRI OD tx consider ?

Cyproheptadine– antiserotonin

Chlorpromazine– antagonist of 5-HT2A receptors

Benzodiazepines– relaxation

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INR should be 2-3 ( if it is 5 and they are not bleeding ?

then stop the dose or lower the dose

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Anticholinergic OD: Wide Complex Tachy tx. ?

Sodium bicarbonate

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CCB OD first line ?

Calcium glutinate

chloride

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Antipsychotic OD: typical patient tx. ?

IV fluids

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MAOI OD H and P: Initial ?

headache, agitation, irritability, nausea, palpitations, and tremor. sinus tachycardia, hyperreflexia, hyperactivity, fasciculations, mydriasis, hyperventilation, nystagmus, and generalized flushing

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Dig. EKG ?

Bradyarrhythmia

Scooped ST segment (Salvadore Dali mustache)

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Clonidine OD: tx. ?

Naloxone

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MAOI OD H and P: Moderate ?

opisthotonus, muscle rigidity, diaphoresis, chest pain, hypertension, diarrhea, hallucinations, combativeness, confusion, marked hyperthermia, and trismus

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Opiate overdose class drugs ?

Hydrocodone
Oxycodone
Morphine
Fentanyl
Hydromorphone

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Dig. OD ?

Bradycardia

Hypotension

yellow-green halos around objects

Hallucination

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Potassium for Dig. OD ?

elevated

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Theophylline aka ?

Methylxanthine

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Lithium OD hx. and PE ?q

muscle fasciculations (viper snake)

Ataxia

muscle weakness

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BB tx consider ?

Insulin

glucose infusions

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BB first line tx. ?

glucagon

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Digoxin OD if hyperkalemia ?

Calcium chloride/ gluconate

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MAOI OD class drugs ?

Phenelzine

Selegiline

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MAOI OD H and P: Severe ?

coma, seizures, bradycardia, hypotension, hypoxia, and worsening hyperthermia

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Tricyclic antidepressant OD: H and P : initial ?

drowsiness, confusion, slurred speech, ataxia, dry mucous membranes and axillae, sinus tachycardia, urinary retention, myoclonus, and hyperreflexia

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Digoxin OD typical tx. ?

digoxin-specific Fab

Antipsychotic OD class drugs ?

``` Haloperidol Chlorpromazine Thioridazine Clozapine Olanzapine Risperidone Aripiprazole ```

Amphetamine overdose class drugs ?

Adderall Ritalin Cocaine

if they are bleeding out ?

give them FFP, GI bleed on coumadin especially if they are in shock

SSRI OD H and P ?

Hyperreflexia/ myoclonus Hyperthermia **clonus**

Anticholinergic OD typical patient tx. ?

Activated charcoal Admit if significant presentation

Theophylline OD: Labs ?

Theophylline level Hypokalemia Metabolic acidosis Hyperglycemia

Amphetamine overdose tx. ?

Mostly monitoring Consider benzodiazepines (Lorazepam, Valium) - depress everything down

Tricyclic antidepressant OD: H and P : Serious toxicity is almost always seen within 6 hours ?

coma, cardiac conduction delays, supraventricular tachycardia, hypotension, respiratory depression, premature ventricular beats, ventricular tachycardia, and seizures.

Tricyclic antidepressant OD: Tx. : cardiac conduction delay ?

sodium bicarbonate

Phenobarbital OD: H and P ?

Respiratory depression Hypotension Hypothermia

Phenobarbital OD: Labs ?

phenobarbital levels

Valproate OD: Labs ?

Valproic acid levels Ammonia elevated Liver enzyme elevation Hypoglycemia Hypocalcemia Hypernatremia Hypophosphatemia

Anticholinergic OD: Severe delirium tx. ?

Physostigmine - acetlychoinesterase inhibitor

Antipsychotic OD: Consider treatments ?

Dantrolene Amantadine Electroconvulsive therapy

SSRI OD tx ?

Primarily supportive IV fluids

Antipsychotic OD: EKG findings ?

QT prolongation

Long acting class drug benzo ?

Clonazepam Diazepam

Muscarinic toxidrome ?

Organophosphates

MAOI OD Tx. ?

ICU admission and careful monitoring

Phenytoin OD: Tx. ?

IV fluids Charcoal Observe/admit

Tricyclic antidepressant OD: Tx. : seizure ?

benzo, phenobarbital

Valproate OD: Tx. consider?

Naloxone I-caritine Hemodialysis

``` Stage 3 (day 3-4) hx. and PE ? ```

Nausea/vomiting reoccur Jaundice Altered mental status Anuria

Opioid-like manifestations: coma, miosis, decreased respirations ?

Clonidine

Antipsychotic OD Hx and PE ?

Fever >38°C (100.4°F) Lead pipe muscle rigidity Change in mental status Tachycardia ``` Hypertension or hypotension Tachypnea or hypoxia Diaphoresis or sialorrhea Tremor Incontinence ```

Anticholinergic OD class drugs ?

Antihistamines (diphenhydramine) SSRI (fluoxetine) Tricyclic antidepressants (amitriptyline) Atropine Skeletal muscle relaxants (cyclobenzaprine)

MAOI OD: Toxic symptoms delayed ____ hours

6-12

Antipsychotic OD: if QT >500ms tx. ?

Magnesium sulfate

Clonidine OD: H and P ?

Bradycardia Hypotension Miosis Decreased respirations

CCB OD typical ?

activated charcoal IV fluids

Profound metabolic acidosis and elevated lactate level ?

Cyanide

CCB OD second line ?

Epi

``` Stage 3 (day 3-4) - failure findings ? ```

Hepatic failure Metabolic acidosis Coagulopathy Renal failure Pancreatitis

if it is high and they are bleeding a little bit ?

``` Stage 1 (first 24 hours) hx. and PE ? ```

N and V

Which has liver damage, lithium of valproate OD ?

Valproate OD

``` Stage 4 (after day 5) hx. and PE ? ```

Clinical improvement OR Multi-organ failure

Digoxin MOA ?

blocks the Na/K pump (repolarization, brings it back to the state) bring NA in and K out but this allows that not to work

Anticholinergic OD: Hyperthermia, agitation tx. ?

Lorazepam

Opiaite OD h and P ?

Bradycardia Bradypnea Pinpoint pupils Hypothermia Bowel sounds decrease Dry skin everything decrease really like benzos

Tricyclic antidepressant OD: Labs ?

EKG-- sinus tachycardia, right axis deviation, and prolongation of the PR, QRS, and QT intervals

Which has marked hyperglycemia, BB OD or CCB OD ?

CCB OD

3rd most common prescription poisoning death ?

Carbamazepine OD: Tx. ?

IV fluids Charcoal Hemodialysis

Calcium channel blocker overdose class drugs ?

Amlodipine Verapamil Diltiazem

Carbamazepine OD: H and P ?

Anticholinergic toxidrome Coma respiratory failure Seizure

``` Stage 2 (day 2-3) hx. and PE ? ```

Nausea/vomiting improvement Abdominal pain Hepatic tenderness

Intermediate acting class drug benzo ?

Lorazepam Temazepam

Short acting class drug benzo ?

Alprazolam Midazolam

Benzo Hx. and PE ?

``` Bradycardia Bradypnea Somnolence Dizziness slurred speech Confusion Ataxia incoordination ``` **everything is slowing down PUPILS ARE UNCHANGED!**

Elevated level on digoxin immunoassay, and hyperkalemia ?

Dig.

CCB OD consider ?

Glucagon Insulin/glucose therapy

Valproate OD: H and P ?

Respiratory Depression Hypotension altered mental status

Antipsychotic overdose aka ?

Neuroleptic malignant syndrome

Amphetamine (Sympathomimetic) overdose hx and PE ?

``` Agitation Mydriasis - dilated Diaphoresis Tachycardia Tachypnea Hypertension possibly hyperthermia ``` **everything is increased here **

BB tx if brady ?

Atropine Cardiac pacing

Lithium OD Tx. ?

IV NL saline sodium polystyrene Severe = hemodialysis

Digoxin OD considerations ?

Atropine Cardiac pacing

``` Stage 4 (after day 5) findings ? ```

Improvement OR Worsening

Wide-complex bradycardia ?

Class IC antiarrhythmic drugs (propafenone)

``` Stage 2 (day 2-3) findings ? ```

Liver enzyme elevations Bilirubin elevated PT/INR elevated

``` Stage 1 (first 24 hours) findings ? ```

Potassium low - cause Vomiting out acid

SSRI overdose ?

Serotonin syndrome

Antipsychotic OD: if intubation tx. ?

Nondepolarizing paralytic (rocuronium) DO NOT USE succinylcholine

Anticholinergic overdose pneumonic ?

Dry as a bone Red as a beet Hot as a hare Blind as a bat Mad as a hatter Stuffed as a pipe

ASA OD ABG ?

metabolic acidosis first then respiratory alkalosis

Which has kidney and thyroid damage, Lithium or valproate OD ?

Lithium

Theophylline OD: Tx. ?

IV fluids Charcoal Consider observation

Phenytoin OD: H and P ?

Vertical, bidirectional, or alternating nystagmus Sedation Ataxia Later - Ophthalmoplegia - Apnea **this one slows things down and they get crazy eye movements**

Antipsychotic OD: If ventricular arrhythmia tx. ?

Sodium bicarbonate

Tricyclic antidepressant OD: medications contraindicated ?

``` all class Ia and Ic antiarrhythmic agents, ``` β-blockers, calcium channel blockers class III antiarrhythmic agents **do not give them things to slow them down more like BB and CCB**

Toxicology Flashcards

(96 cards)