Toxicology/Chemical Abuse

Question 1

self-directed use of drugs for non-therapeutic purposes that does not comply w/ social norms

Answer 1

abuse

Question 2

indiscriminate use of drugs

- done at random or without careful judgment

Answer 2

misuse

Question 3

types of dependency

Answer 3

1. physical

2. psychological

Question 4

unpleasant s/s occur when drug is stopped

Answer 4

physical dependency

Question 5

feelings of satisfaction & pleasure from taking drug

Answer 5

psychological dependency

Question 6

> drug dosage to experience same effect formerly produced from taking drug

Answer 6

tolerance

Question 7

set of behavioral & physiological symptoms that accompany the withdrawal of a drug

Answer 7

withdrawal syndrome

Question 8

4 reasons why someone becomes dependent or addicted to chemicals

Answer 8

1. alter mood or perception
2. produce unusual sensations
3. > users perceived ability to function in society
4. alleviate pain

Question 9

any substance that in small amounts can cause death or serious bodily harm by chemical action

Answer 9

poison

Question 10

any agent to counteract a poison

Answer 10

antidote

Question 11

how do poisons affect the body

Answer 11

by interfering with cellular processes in a manner which ultimately interferes w/ respirations or circulatory processes

Question 12

ways poisons interfere with cellular processes in the body

- carbon monoxide

Answer 12

combine with hemoglobin so that the body cannot use oxygen

Question 13

ways poisons interfere with cellular processes in the body

- cyanide

Answer 13

interfere w/ enzymes which enable cell to use oxygen

Question 14

ways poisons interfere with cellular processes in the body

- curare

Answer 14

depress (slow down) CNS, affect muscle tissue which supports respirations

Question 15

ways poisons interfere with cellular processes in the body

- rat poison (for example)

Answer 15

alters pH of blood, causes massive bleeding

Question 16

Types of poisonings

Answer 16

• accidental
• suicidal
• criminal
• industrial
• food

Question 17

non-intentional, typically children

Answer 17

accidental poisonings

Question 18

intent to harm, overdose

Answer 18

suicidal poisonings

Question 19

poisonings that are planned to harm

Answer 19

criminal poisonings

Question 20

work, environmental poisonings

Answer 20

industrial poisonings

Question 21

most common type of poisonings

Answer 21

food poisoning

Question 22

sources of poisonings based on age

- children under 10

Answer 22

plants, soaps, detergents, cleaners, vitamins, OTC products

Question 23

sources of poisonings based on age

- teenagers (10-17)

Answer 23

carbon monoxide, abuse of alcohol, drugs or both, inhalers

Question 24

sources of poisonings based on age

- Young adults (18-21)

Answer 24

antidepressants, heroin, cocaine, alcohol

Question 25

sources of poisonings based on age | - adults (over 21)

Answer 25

antidepressants, anti-anxiety, codeine, cocaine

Question 26

prevention strategies for poisonings of children

Answer 26

* Keep meds in their proper containers * Use childproof caps * Keep meds out of reach of children * Do not treat meds lightly or as candy (Mr. Yuk) * Read labels and do not mix products * Have emergency numbers handy * Use toxic chemicals in well vented areas * Destroy unused or old meds/chemicals * Identify houseplants

Question 27

steps to the assessment of poisonings

Answer 27

1. identify what was taken 2. gather baseline information: name, age, weight, address, phone #, VS 3. identify major organs involved: CNS, cardiopulmonary, renal 4. identify how much was taken and how long ago: describe substance ingredients, odor breath, burns on tongue or mouth

Question 28

sources of information for poisonings

Answer 28

- Poison Control Center - Emergency Department at Hospital - Pharmacy - CDC - PDR or any drug reference book

Question 29

treatment of poisonings is focused around?

Answer 29

• Supporting vital functions • Offering first aid, manage complications • Prevention of further absorption • Removal or elimination of poison • Use of specific antidotes Note: Look at what the poison does to the body; treat the person not the poison.

Question 30

interventions for inhaled substances

Answer 30

fresh air

Question 31

interventions for poison that come in contact with the skin

Answer 31

- speed & shower - flood w/ water 2-3'' - remove clothes - wash soap & water

Question 32

interventions for poisons that come in contact with the eyes

Answer 32

- rapid irrigation copious warm water 15" - do not use eye drops - hold eye open - remove contact lenses

Question 33

interventions for systemic overdoses of poisoning

Answer 33

- induce vomitus (2 ways) * emesis: naturally occurring vomitus * syrup of Ipecac: directly stimulates the vomiting center and irritates the gastric mucosa - gastric lavage: irrigation of gastric contents

Question 34

Nursing Interventions for inducing vomitus and gastric lavage

Answer 34

Ensure proper positioning to prevent aspiration of gastric contents

Question 35

contraindications to syrup of ipecac/gastric lavage (5)

Answer 35

1) More than 1 hour has elapsed since ingestion 2) Under 1 year 3) Comatose or convulsing 4) Absent gag or cough reflex 5) Ingestion of sharp objects, CNS poisons, acids, petroleum distillates (gas, kerosene, etc.)

Question 36

inactivation of poison | - chemical antidotes

Answer 36

MOM, milk, egg whites, Na bicarb, activated charcoal

Question 37

agent which absorbs substances and prevents intestinal absorption (most common chemical antidote)

Answer 37

activated charcoal

Question 38

proper way to administer activated charcoal

Answer 38

- do not administer immediately following Ipecac syrup (wait at least 30 min) - must contain sorbitol - give magnesium citrate (laxative) afterwards

Question 39

systemic antidote used for opioids

Answer 39

narcan

Question 40

systemic antidote used for benzodiazepines

Answer 40

ramazicon

Question 41

systemic antidote used for digoxin toxicity

Answer 41

digibind

Question 42

systemic antidote used for coumadin & heparin toxicity

Answer 42

vitamin K

Question 43

systematic antidote used for tylenol overdose

Answer 43

mucomyst

Question 44

how to hasten elimination

Answer 44

forced diuresis, dialysis, change of pH of urine