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Pharmacology: Kaplan, Uworld, FA > Toxicology > Flashcards

Toxicology Flashcards

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1
Q

Toxicity of _________ causes
Miosis, salivation, sweats, GI cramps, diarrhea, muscle
twitches → seizures, coma, respiration failure

A

Ach inhibitors

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2
Q

AChE inhibitor toxicity is intervention & antidotes (Rx)

A

Respiratory support; atropine + pralidoxime Rx’s

for irreversible AChE inhibitors

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3
Q

________ toxicity causes ↑ HR, ↑ BP, hyperthermia (hot, dry skin), delirium,
hallucinations, mydriasis

A

Atropine and
muscarinic
blockers

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4
Q

Atropine and
muscarinic
blockers toxicity is Rx via

A

Control cardiovascular symptoms and
hyperthermia + physostigmine (crosses
blood–brain barrier)

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5
Q

______ toxicity sign/symptoms include: Nausea and vomiting, dyspnea with hyperventilation,
mydriasis, vertigo; cardiovascular signs prominent, ↓ BP,
syncope, ↑ HR, arrhythmias

A

Carbon
monoxide
(>10%
carboxyHb)

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6
Q

Rx Carbon
monoxide
(>10%
carboxyHb) toxicity with

A

Hyperbaric O2 and decontamination

humidified 100% O2 okay in mild overdose

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7
Q

_______ toxicity signs/symptoms include: Anxiety/agitation, hyperthermia (warm, sweaty skin),
mydriasis, ↑ HR, ↑ BP, psychosis, seizures

A

CNS stimulants

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8
Q

Rx CNS stimulant toxicity with

A

Control cardiovascular symptoms,
hyperthermia, and seizures— +/– BZs or
antipsychotics

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9
Q

______ toxicity signs/symptoms include: Lethargy, sedation, ↓ HR, ↓ BP, hypoventilation, miosis, coma,
respiration failure

A

Opioid

analgesics

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10
Q

Rx opioid analgesic toxicity with

A

Ventilatory support; naloxone at frequent

intervals

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11
Q

_________ toxicity signs/symptoms includes: Confusion, lethargy, hyperventilation, hyperthermia,
dehydration, hypokalemia, acidosis, seizures, coma

A

Salicylates

(ASA)*

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12
Q

Rx Salicylates

(ASA)* with

A

Correct acidosis and electrolytes: urinary

alkalinization, possible hemodialysis

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13
Q

______, ____ toxicity signs/ symptoms include: Disinhibition (initial), lethargy, ataxia, nystagmus, stupor,
coma, hypothermia, respiratory failure

A

Sedativehypnotics
and
ethanol

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14
Q

Rx Sedativehypnotics
and
ethanol with

A

Ventilatory support: flumazenil if BZs

implicated

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15
Q

toxicity of _________ signs and symptoms include: Agitation, confusion, hallucination, muscle rigidity,
hyperthermia, ↑ HR, ↑ BP, seizures

A

SSRIs

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16
Q

Rx SSRIs with

A

Control hyperthermia and seizures: possible
use of cyproheptadine, antipsychotics, and
BZs

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17
Q

toxicity _______ signs/symptoms include: Mydriasis, hyperthermia (hot, dry skin), 3 Cs (convulsions,
coma, and cardiotoxicity) → arrhythmias

A

Tricyclic

antidepressants

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18
Q

Rx Tricyclic

antidepressants toxicity with

A

Control seizures and hyperthermia, correct

acidosis and possible arrhythmias

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19
Q

the drugs with * indicates *More details in antiinflammatory section

A

Heavy metal poisoning is NEXT

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20
Q

Signs and symptoms of __________ poisoning include: Acute: gastroenteritis, hypotension, metabolic
acidosis, garlic breath, “rice water” stools,
torsades, seizures

Chronic: pallor, skin pigmentation (raindrop
pattern), alopecia, stocking glove neuropathy,
myelosuppression

A

Arsenic (wood preservatives,

pesticides, ant poisons)

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21
Q

Rx toxicity of Arsenic (wood preservatives,

pesticides, ant poisons) with

A

Activated charcoal, dimercaprol (EDT)

Penicillamine or succimer

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22
Q

Signs and symptoms of __________ poisoning include:
Acute (mainly children): severe GI distress →
necrotizing gastroenteritis with hematemesis and
bloody diarrhea, dyspnea, shock, coma

A

Iron (medicinal for anemias

and prenatal supplements)

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23
Q

Rx toxicity of Iron (medicinal for anemias

and prenatal supplements) with

A

Gastric aspiration + carbonate

lavage, deferoxamine IV

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24
Q

Signs and symptoms of __________ poisoning include: Acute: nausea and vomiting, GI distress and pain,
malaise, tremor, tinnitus, paresthesias,
encephalopathy (red or black feces)

Chronic: multisystem effects: anemia (↓ heme
synthesis), neuropathy (wrist drop), nephropathy
(proteinuria, failure), hepatitis, mental retardation
(from pica), ↓ fertility and ↑ stillbirths

A

Lead (tap water, leaded paint
chips, herbal remedies, gas
sniffing, glazed kitchenware,
etc.)

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25
``` Rx toxicity of: Lead (tap water, leaded paint chips, herbal remedies, gas sniffing, glazed kitchenware, etc.) with ```
``` Decontamination—gastric lavage + dimercaprol (severe) or EDTA or succimer (penicillamine if unable to use dimercaprol or succimer) Children: succimer PO ```
26
Signs and symptoms of __________ poisoning include: Acute: vapor inhalation: chest pain, dyspnea, pneumonitis Acute: inorganic salt ingestion: hemorrhagic gastroenteritis, acute tubular necrosis, shock Chronic: organic Hg—CNS effects, ataxia, paresthesias, auditory and visual loss, loosening of teeth
``` Mercury (elemental in instruments); salts used in amalgams, batteries, dyes, electroplating, fireworks, photography ```
27
``` Rx toxicity of: Mercury (elemental in instruments); salts used in amalgams, batteries, dyes, electroplating, fireworks, photography with ```
``` Succimer PO or dimercaprol (IM) Activated charcoal for oral ingestion, then support with succimer PO or dimercaprol (not IV) → causes redistribution of Hg to the CNS →↑neurotoxicity ```
28
NEXT
ANTIDOTES
29
what _____ is used for Rx AChE inhibitors—physostigmine, neostigmine, and pyridostigmine; organophosphates, including insecticides, such as malathion and parathion poisoning
Atropine + pralidoxime (for | irreversible AChE inhibitors)
30
what ____ is used for Rx of Iron and iron salts poisoning
Deferoxamine
31
what____ is used for Rx of Digoxin immune F(ab) poisoning
Digoxin
32
what ____ is used for Rx of Arsenic, gold, mercury, lead; oral succimer for milder lead and mercury toxicity
Dimercaprol (BAL)
33
what ___ is used for Rx of Backup in lead poisoning, then for rarer toxicities (Cd, Cr, Co, Mn, Zn)
EDTA
34
what ___ is used for Rx of Theophylline, beta agonists poisoning
Esmolol
35
what _____ is used for Rx of Methanol or ethylene glycol poisoning
Ethanol, fomepizole
36
what ____ used for RX of Benzodiazepines, zolpidem, zaleplon poisoning
Flumazenil
37
what ____ is used for Rx of Opioid analgesics poisoning
Naloxone
38
what ___ is used for Rx of Carbon monoxide poisoning
Oxygen
39
what ____ is used for Rx of Copper (e.g., Wilson’s disease), iron, lead, mercury poisoning
Penicillamine
40
what ____ is used for Rx of Anticholinergics: atropine, antihistamine, antiparkinsonian—not tricyclics poisoning
Physostigmine
41
what _____ is used for Rx of Heparins poisoning
Protamine
42
what ___ is used for Rx of Warfarin and coumarin poisoning anticoagulants
Acute: Fresh plasma Chronic: Vitamin K
43
what ____ is used for Rx of Nonspecific: all oral poisonings except Fe, CN, Li, solvents, mineral acids, or corrosives poisonings
Activated charcoal
44
NEXT
NATURAL MEDICINALS
45
“______” medicinals are available without prescription and are considered to be nutritional supplements rather than drugs
Natural
46
_______products are marketed without FDA review of safety and efficacy, and there are no requirements governing the purity or the chemical identities of constituents.
Herbal (botanic)
47
______ is Clinically used for ↓ Cold symptoms by ↑ ILs and TNF
Echinacea
48
Side effects of Echinacea include
GI distress, dizziness, headache
49
Side effects of Echinacea are?
GI distress, dizziness, headache
50
______ is Clinically used for Hyperlipidemias, cancer (evidence is weak) works via Inhibits HMG-CoA reductase and ACE
Garlic
51
Side effect of garlic are?
Allergies, hypotension, antiplatelet actions; use | caution when used with anticoagulants
52
``` ______ is Clinically used for Intermittent claudication; Alzheimer disease (evidence is weak) works via Antioxidant, free radical scavenger, ↑ NO ```
Gingko
53
side effects of Gingko are?
Anxiety, GI distress, insomnia, antiplatelet actions; use caution when used with anticoagulants
54
``` ______ is Clinically used for Possible ↑ in mental and physical performance (evidence is weak) via Unknown mechanism ```
Ginseng
55
side effects of Ginseng are?
Insomnia, nervousness, hypertension, mastalgia, | vaginal bleeding
56
______ is Clinically used for Symptomatic treatment of BPH; works via 5α-reductase inhibitor and androgen receptor antagonist
Saw palmetto
57
side effects of Saw palmetto are?
GI pain, decreased libido, headache, hypertension
58
____________ is Androgen precursor advocated for treatment of AIDS (↑CD4 in women), Alzheimer disease and “aging,” diabetes, hypercholesterolemia, and SLE (↓in symptoms and “flare-ups” in women)
Dehydroepiandrosterone | DHEA
59
side effects of Dehydroepiandrosterone | (DHEA) are?
``` Women: androgenization and concern regarding CV disease and breast cancer Men: feminization in young and concern in elderly regarding BPH and cancer ```
60
_______ is a Serotonin metabolite used for “jet-lag” and sleep disorders
Melatonin
61
side effects of Melatonin
Drowsiness, sedation, headache | Contraindicated in pregnancy, in women trying to conceive ↓LH), and in nursing mothers (↓prolactin
62
Chronic poisoning with ______ will result in a multitude of effects including inhibition of heme synthesis and accumulation of δ-aminolevulinate in the plasma
lead
63
Arsenic poisoning is associated | with _______ breath and changes in ________ pigmentation
Garlic; skin
64
________ causes auditory and visual loss and loosening of the teeth, while inhaled mercury vapor can cause interstitial pneumonitis and neurological effects.
Organic mercury
65
_______ chelates iron and is the antidote in iron | poisoning
Deferoxamine
66
______ is useful for a variety of metals including lead, arsenic, and mercury.
Dimercaprol
67
______ is a back-up in lead poisoning.
EDTA
68
_______ is useful in copper poisoning, and succimer is | preferred for lead poisoning in kids.
Penicillamine
69
snake poisoning leads to coagulation & CNS @ Nn receptor Rx with____?
giver fresh plasma to stop bleeding
70
Rx phenytoin (class IB anti-arrhythmic) toxicity (cadriotoxicity)
Sodium bicarbonate
71
Amphetamines toxicity Rx___?
to Rx symptoms give: Beta-blockers | to excrete out in urine give: ascorbic acid
72
NSAID toxicity Rx with___?
sodium bicarbonate
73
mushroom posioning aka muscarnic posioning Rx with__?
atropine

Pharmacology: Kaplan, Uworld, FA (9 decks)

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