Toxicology

Question 1

What is the poison control center phone number?

Answer 1

1-800-222-1222

Question 2

The American Association of Poison Control Centers (AAPCC) is associated with the ___

a. prescription drug monitoring programs
b. national poison data system

Answer 2

b. national poison data system

Question 3

Classic toxidrome?

SACOS

Answer 3

S - sympathomimetics
A - anticholinergics
C - cholinergics
O - opioids
S - sedative hypnotic

Question 4

Consider treating sympathomimetic toxidrome with what class of meds?

Answer 4

benzos

Question 5

3 drugs that can cause sympathomimetic toxidrome?

Answer 5

caffeine
cocaine
amphetamines

Question 6

signs of cholinergic toxidrome?

SLUDGE

Answer 6

S - salivation
L - lacrimation
U - urination
D - diarrhea
G - gastrointestinal distress
E - emesis

Question 7

Cholinergic toxidrome is caused by ___ ACh

a. too much
b. deficit of

Answer 7

a. too much

Common causes:
cholinesterase inhibitors
nerve gases, pesticides

Question 8

Cholinergic toxidrome causes ___ pupils

a. pinpoint
b. dilated

Answer 8

a. pinpoint

Question 9

Sympathomimetic toxidrome causes __ pupils

a. pinpoint
b. dilated

Answer 9

b. dilated

Question 10

Cholinergic toxidrome:

Muscarinic effects?

Answer 10

• diarrhea
• urination
• miosis
• BBB (bradycardia, bronchorrhea, bronchospasm)
• emesis
• lacrimation
• salivation

Question 11

Cholinergic toxidrome:

nicotinic effects?

Answer 11

• mydriasis
• tachycardia
• weakness
• HTN
• fasciculations

Question 12

___ is a nicotinic effect

a. miosis
b. mydriasis

Answer 12

b. mydriasis

Question 13

___ is a muscarinic effect

a. miosis
b. mydriasis

Answer 13

a. miosis

Question 14

What Tx for anticholinergic toxidrome induces cholinergic effects?

Answer 14

physostigmine

Question 15

What class of drugs is used to Tx anticholinergic toxidrome?

Answer 15

benzos

Question 16

opioid toxidrome causes __ pupils

a. miosis
b. mydriasis

Answer 16

a. miosis

pin point pupils

Question 17

Opioid toxidrome causes __ blood pressure

a. increased
b. decreased

Answer 17

b. decreased

Question 18

General approach followed by poison control centers for any AE or other poisoning?

RADAR

Answer 18

R - recognition
A - assessment
D - definitive Dx
A - advice
R - reporting

Question 19

___ causes QTc prolongation

a. TCAs
b. antidepressants
c. non DHB CCBs

select all that apply

Answer 19

a, b

Question 20

___ causes PR prolongation

a. TCAs
b. antidepressants
c. non DHB CCBs

select all that apply

Answer 20

c. non DHB CCBs

Question 21

MOA of activated charcoal?

Answer 21

prevents absorption of xenobiotics

Question 22

Activated charcoal is pharmacologically inert and unabsorbed.

a. true
b. false

Answer 22

a. true

Question 23

activated charcoal adsorbs xenobiotics that are in the dissolved liquid phase via indirect contact

a. true
b. false

Answer 23

b. false

via DIRECT contact

Question 24

Poor candidates for activated charcoal?

PHAILS

Answer 24

P - pesticides
H - hydrocarbons
A - acids/alkali
I - iron
L - lithium
S - solvents

Question 25

activated charcoal is typically not recommended if it has been more than __ to __ hours since ingestion of the poison

Answer 25

1, 2

Question 26

Single dose activated charcoal dose?

Answer 26

1g/kg of body weight

Question 27

Activated charcoal is more effective with a single dose of evacuant a. true b. false

Answer 27

b. false AC alone is comparably effective to AC plus a single dose of evacuant

Question 28

whole bowel irrigation is achieved through administration of large amounts of osmotically balanced ___ solution

Answer 28

PEG electrolyte lavage

Question 29

Whole bowel irrigation is indicated for immediate release pharmaceuticals. a. true b. false

Answer 29

b. false Primarily indicated for: - sustained release or delayed release - metals - xenobiotics with very slow absorptive phases

Question 30

Sodium bicarb __ to __ mEq/kg rapid initial infusion is used to increase the urinary pH to 7 to 8

Answer 30

1, 2 only works for xenobiotics that are acidic only works for drugs that are predominantly renally eliminated

Question 31

___ may occur after administration of hypertonic sodium bicarb a. hypernatremia b. hyponatremia

Answer 31

a. hypernatremia

Question 32

Bicarbonaturia is associated with urinary potassium ___ a. losses b. excess

Answer 32

a. losses

Question 33

Blockage of sodium channels can be detected by observing what?

Answer 33

prolonges QRS interval

Question 34

Hemodialysis is a suitable method of xenobiotic removal with Vd < __ L/kg

Answer 34

1 ``` Low Vd < 1L/kg single compartment PK low protein binding MW < 5000 Daltons water soluble ```

Question 35

___ is an established effective Tx method of local anesthetic induced cardiovascular collapse

Answer 35

intravenous lipid emulsion acts as a lipid sink and traps lipophilic drugs and draws them away from target tissues, especially the heart and brain

Question 36

Intravenous lipid emulsion: Most case reports use __ % liposomal emulsion continuous infusion at a rate of __ mL/kg/hr

Answer 36

0.5