Term
| What typically makes a drug a poison |
|
Definition
|
|
Term
| What is a common mechanism of toxicity as the dose increases? |
|
Definition
| loss of receptor selectivity |
|
|
Term
| What are the methods use for gut decontamination and which are effective |
|
Definition
Gastric lavage
Charcoal
Cathartics: increase defecation
Ipecacs
Whole Bowel irrigation - May be effective |
|
|
Term
| Contraindications to gastric lavage |
|
Definition
Loss of consciousness
Risk of Hemorrage or Perforation
Carrosives
Hydrocarbons |
|
|
Term
| Contraindications to Activated Charcoal |
|
Definition
Hydrocarbons, Alcohol, pesticides
Fe, Li, CN
Corrosives
Unprotected Airway |
|
|
Term
| What two evacutation techniques should not be combined in treating toxicity |
|
Definition
| Whole Bowel Irrigation and Activated Charcoal |
|
|
Term
| If a drug has a large volume of distribution, when would you typically see toxicity |
|
Definition
| Only acute overdose after long-term use |
|
|
Term
| When can toxicity be suggested by blood levels, but the patient did not ingest abnormal amounts |
|
Definition
| if drug has a large Volume of distribution and it was ingested recently |
|
|
Term
| When would an elder patient show signs of lead toxicity if the exposure was years earlier |
|
Definition
| High Bone Turn-over: pagets, hyperparathyroid |
|
|
Term
| What zone of the acinus does acetomenophen affect and what can be used to prevent liver damage |
|
Definition
|
|
Term
| What is used to combate ethylene gycol and methanol toxicity |
|
Definition
|
|
Term
| What are the mechanisms to increase the elimination of toxins from the blood? |
|
Definition
Alkalizing the blood: Sodium bicarb
Hemodyalisis
|
|
|
Term
| What substances can be eliminated by hemodialysis |
|
Definition
Small
Polar
Low volume of distribution
Low protein binding capacity |
|
|
Term
| What is the toxidrome of Opiods and what is used to treat it |
|
Definition
Miosis
Coma
Respiratory depression
Bradycardia
Decreased bowel sounds
Tx: Naloxone, Naltrexone, of Nalmefene |
|
|
Term
| What is the toxidrome of cholinergics and how is it treated |
|
Definition
Diarrhea
Urination
Miosis
Bradycardia
Bronchoconstriction
Emesis
Lacrimation
Sweating
Salivation
Tx: Pralidoxime(2-PAM)
|
|
|
Term
| Overdose of what drugs is most likely to cause the anti-cholinergic toxidrome |
|
Definition
Tricyclic antidepressants
Anti-Histamines
Not mentioned: Typical antipsychs, and NMJ blockers |
|
|
Term
| What is the toxidrome of Anti-cholinergics and what is used to treat it |
|
Definition
Psychosis(mad as a hatter)
Blindness(blind as a bat)
Flushing(red as a Beet)
Fever(hot as a hare)
Decreased lacrimation, salivation, hidrosis(dry as a bone)
Tachycardia(tacky as a leisure suit)
Tx: Pysostigmine |
|
|
Term
| What is the sympathetic toxidrome and how is it treated? |
|
Definition
CNS excitation
Tach, Hypertension
Hyperthermia, Sweating
Tx: Benzos
Phentolamine
Ca-block |
|
|
Term
| How do you differentiate anti-cholinergic and sympathetic toxicities |
|
Definition
| Sympathetics: Increased Sweating, increased BP |
|
|
Term
| What is used to combat benzo toxicity |
|
Definition
|
|
Term
| Contraindications to Flumazenil and off-label uses |
|
Definition
Seizuregenic meds: theophylline, Carbamazepine, chloral hydrate
Seizure history
Prolonged benzo use
TCA
Off label: Ethanol tox
Hepatic Encephalopathy |
|
|
Term
when is N-acetyl cysteine used
What are the adverse effects
When is it given IV |
|
Definition
Acetomenophen tox
Hypersensitivity
IV: pregnant, vomiting, hepatic failure |
|
|
Term
| How is digoxin toxicity treated? |
|
Definition
|
|
Term
Major signs of lead poisoning
Pathophys in kids
How is it treated |
|
Definition
Encephalopathy
Neurological deficits
Nephopathy
Anemia
GI Pain
Blue/Black line in Gums
Kids: Premature synaptic pruning
Tx: Chelation Agents |
|
|
Term
| Complications of activated charcoal? |
|
Definition
Vomiting
Aspiration complications |
|
|
Term
| When is multi-dose activated charcoal used? |
|
Definition
Extended Release
Delayed Gastric Emptying
Significant Enterohepatic circulation |
|
|
Term
| What areas of the body does polyethylene glycol damage? |
|
Definition
Renal
CNS
Causes Acidosis |
|
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