Poisonings Flashcards


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created 1 year ago by taniaharper
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1

5 basic principles in treating a poisoning

supportive care-ABCs, discontinue exposure, decontaminate patient, prevent absorption, enhance elimination/reverse effects

2

How to prevent absorption

puking, pumping, pulverized powder, purging

3

How do induce vomiting

syrup of ipecac, apomorphine, copper sulfate, NaCl, raw eggs/dry mustard, mild soap, H2O2 (hydrogen peroxide)

4

Agents to increase transit time (cathartics-purging drugs)

  • mag sulfate, sodium sulfate, mineral oil/castor oil,
  • sorbitol (1 gm/kg up to 50 gm/dose)

5

Clinical indications for toxicity to sympathomimetic drugs

HR (fast), BP (high), cardiac rhythm (sinus tachycardia), RR (normal to high), temperature (normal to high), eyes (dilated pupils), skin (normal), secretions (normal)

6

Sympathomimetic drugs

cocaine, amphetamines, caffeine, PCP, MDMA

7

Clinical indications for toxicity to anticholinergic drugs

HR (fast), BP (high), cardiac rhythm (fast), RR (normal to high), temperature (high), eyes (dilated), skin (dry), secretions (dry)

8

MOA of anticholinergic drugs

  • blocks ACh at muscarinic receptors
  • blocks PNS

9

MOA of cholinergic drugs

inhibits acetylcholinesterase

10

Too much cholinergic activity can cause (DUMBELLS)

diarrhea, urination, miosis(constricted pupils)/,muscle weakness, bronchorrhea, bronchospasms, bradycardia, emesis, salvation/sweating

11

Nicotinic cholinergic activity effects

mydriasis, tachycardia, weakness, hypertension, fasciculations

12

Treatment of cholinergic toxicity

high dose Atropine until dry

13

Primary anticholinergic offenders that cause toxicity (pesticides)

organophosphates, carbamates

14

Primary hallmark of sedative-hypnotics toxicity

sedation

15

Sedative-hypnotics antidote

Flumazenil (rarely used because of seizure activity)

16

Treatment for opioid toxicity

Naloxone (mu antagonism)

17

Hallmark findings of opioid toxicity

CNS depression, respiratory depression, miotic pupils

18

Serotonin syndrome is associated with ____ and characterized by ____

use of psych meds (SSRIs, TCAs), cognitive, autonomic, neuromuscular effects

19

Clinical effects of serotonin syndrome

(my hyper dog is the dumbest animal around here)

muscle rigidity, myoclonus, hyperreflexia, dilated pupils, irritability, tremors, diarrhea, altered mental status, agitation, hyperthermia

20

Treatment of serotonin syndrome

d/c offending agent, intubation/ventilatory support, bzd/sedation, cyproheptadine (antidote) w/ 5HT1A antagonist-only administered PO, if altered, not good choice

21

Most common toxic agents

cough and colds, analgesics, vitamins, topicals

22

Most lethal toxins

carbon monoxide, acetaminophen, CCBs, antidepressants

23

Risk factors for toxicity

curiosity, mobility, supervision, storage, recent use, CRC's