Shared Flashcard Set

Details

Toxicology
Antidotes and lists
27
Medical
Professional
04/02/2013

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Cards

Term
ABCDE toxicology
Definition
Airway patent
breathing
circulatory/bleeding
disabled neurologically
exposed to chemicals or cold
Term
AVPU toxicology
Definition
Alert
Voice response
Pain Response
No response
Term
DONT cocktail
Definition
Coma cocktail
Dextrose
Oxygen
naloxone
thiamine
Term
QRS >120 ms toxicology
Definition
organic pyrophosphate herbicides
Term
Gastroelimination
Definition
Activated charcoal (10X weight injested) preferred.

Additional methods:
Gastro lavage = trauma during tubation
vomiting = aspiration pneumonitis

Poorly absorbed to charcoal: Fe and Li

really concerned: Ca/B blockers and tricyclic antidepressants
Term
spontaneous emesis toxicology
Definition
aspirin, acetaminophen, ibuprofen, pheophylline
Term
Forced alkyline diuresis complications
Definition
PE, alkalemia, hypokalemia,

consider hemodyialsis
for cholorohexyphosphate herbicide
Term
Antidote Acetominophen
Definition
N-acetyl cystein
Term
Opioid antidote ER
Definition
Naloxone
Term
Benzo antidote
Definition
fluazenil
Term
methylene glycol antidote
Definition
OLD: Et-OH
New: fomepizol
Term
snake venom antidote
Definition
crotalidae polyvalent immune fab
Term
digitalis antidote
Definition
fab fragments
Term
CO poisening signs and symptoms
Definition
Pinkish --> cherry red skin discoloration

target = brain/heart with delayed neurological problems (3-21 days later)

hyperbaric O2 efficacy still debated
Term
SO in air problems
Definition
H2SO3 formation with mucous contact causes irritation/bronco-constriction/asthma response

Tx = support
Term
Nitrogen Oxides toxicology
Definition
Farm Silage

Pulmonary edema, irritate
eyes,nose,throat

Tx = support
Term
Ozone toxicology
Definition
Low concentrations: cough, decrease pulmonary compliance

high: pulmonary edema, thickening terminal bronchioles, bronchitis

Tx = support
Term
Dimercaprol
Definition
acute arsenic and inorganic mercury
poisoning chelator

combo with EDTA for Pb poisening

no reversal neural Hg symptoms
not recommended Fe/Cd poisening

AE: tachycardia, HyperT, nausea/vomit, increased prothrombin time
Term
Succimer
Definition
Oral dimercaprol chelator used for Pb poisening.

Must monitor Hb/Fe/Liver enzymes

adverse: GI upset, arrhythmia, hepatotoxic, rash
Term
Ca-EDTA
Definition
Chelator used to treat Pb poisening
if blood over 70 add dimercaprol as well

AE: arrythmia, ECG delta, hypoT, CNS (fever and fatique)
Term
Deferoximine toxicology
Definition
Fe chelator for acute toxicity

High doses associated with acute respiratory distress, skin flushing, hypotension.

Prolonged = auditory/visual effects and suseptibility to yersinia

ascorbic acid may enhance adverse effects
Term
Arsenic toxicology
Definition
Released during buring coal, moonshine (from H20 source), pressure treated wood, traditional medicines

Binds to sulfhydral groups to interfere with enzymes, gluconeo, and glutathione

Rice-water stool = buzz word!
hypo/hyper pigmented and cancerous skin
(check x-ray, skin, liver biopsy)

antidote: dimercaprol
Term
Lead toxicology
Definition
Battery manufactor, paints

Inactivates gamma-aminolevulinic acid dehydrase necessary for synthesis of heme and interferes with calcium (bone and nerves)

Acute: abdominal effects, neuro changes, joint pain, nephropathy
Chronic: miscarriage

X-ray: BURTON LINE >70
Term
Mercury Toxicology
Definition
1. fish and plant water, thimersol vaccine (rare)

2. Interacts sulfhydral groups, inhibits enzymes, and alters cell permiability

Inhale: pneumonitis/P. edema
ingest: hemorragic GI issues and renal failure

TRIAD: TREMOR, PSYCHIATRIC, GINGIVOSTOMATOSIS
(may constrict visual fields with methylmercury)

CNS and KIDNEY

penicillamine, succimer, DIMERCAPEROL
Term
Fe toxicology
Definition
Produces ROS --> Gi pain, acidosis, multisystem organ failure

hepatoxicity and bowel obstruction (from scars)... whole bowel irrigation method of choice
Term
Ethanol
Methanol
Ethylene glycol
Definition
Ethanol --> acetaldehyde --> Acetic acid
Methanol --> formic acid/formaldehyde
Glycol --> oxalic acid --> nephrosis


May cause respiratory failure and alcoholic ketoacidosis (MeOH,glycol>ethanol>isopropanol)
SWEET BREATH

Methanol in paint causes blindness
glycol = kidney stones and profound gap, give bicarb!
Term
DMAA
Definition
stimulant in bodybuilding supplement may cause heart attacks
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