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47 Cards in this Set
- Front
- Back
What is the most common cause of poisoning death?
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carbon monoxide
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If patient has hypotension and bradycardia, which drug classes may have caused it? (3)
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beta blockers
calcium channel blockers clonidine |
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What are the ABCs of poisoning overdose?
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airway
breathing circulation |
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What are the three ways to alter the kinetics of a poison?
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prevent absorption (decontamination)
prevent distribution to target site enhance elimination |
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Which is preferred if death is a high risk?
(orogastric lavage/activated charcoal) |
orogastric lavage
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What is the optimal time frame for orogastric lavage after poisoning?
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< 1 hour after exposure
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Which is preferred if patient is likely to have adverse effect rleated to a drug?
(orogastric lavage/activated charcoal) |
activated charcoal
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When will you NOT use charcoal? (2)
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hydrocarbons
elementally small (heavy metals, lithium, simple alcohols, caustics) - won't bind charcoal |
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What is the ratio of activated charcoal to poison?
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10:1
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Whole bowel irrigation is composed of what?
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PEG and electrolytes
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Chelators typically have what element? (2)
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sulfur or nitrogen
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Soft metals bind with what type of chelator?
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sulfur donors
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gold, silver, mercury, copper I are (soft/hard/borderline) metals
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soft
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Hard metals bind with what type of chelator?
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oxygen seekers
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sodium, potassium, calcium, magnesium, aluminum are (soft/hard/borderline) metals
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hard
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Borderline metals bind with what type of chelator?
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nitrogen donors
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lead, cadmium, copper 2, arsenic, zinc are (soft/hard/borderline) metals
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borderline
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Which type of snakes are neurotoxic?
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elapidae
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Which types of snakes are coagulopathic?
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viperidae
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Elapid antivenom is mono- or polyvalent?
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monovalent
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CroFab is mono- or polyvalent?
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polyvalent
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What is the advantage to using CroFab?
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Contains only the Fab portion of the antibody
(Fc portion can elicit allergic reaction) |
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What antidote is used for digoxin overdose?
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DigiFab
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What enzyme is responsible for metabolizing alcohols?
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alcohol dehydrogenase
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What drug is a competitive inhibitor of alcohol dehydrogenase?
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fomepizole
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Sodium bicarbonate is used as treatment for overdose on what two types of medications?
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ASA, TCAs
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Treatment of ASA overdose with sodium bicarbonate is a (kinetic/dynamic) mechanism
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Kinetic
(enhances elimination by urinary alkalinization and ion trapping) |
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Treatment of TCA overdose with sodium bicarbonate is a (kinetic/dynamic) mechanism
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Dynamic
(alkalinized serum and gives sodium load - increases protein binding and corrects dysrhythmias) |
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Acetaminophen has what effects on the liver 12 hours after overdose? (2)
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rising ALT/AST
increased INR (liver failure) |
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What is the free radical created in acetaminophen overdose?
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NAPQI
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What is the treatment for acetaminophen overdose?
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N-acetylcysteine
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What are the treatments for beta blocker overdose? (2)
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epinephrine
glucagon |
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Which binds unblocked beta receptors coupled to a G-protein that activates adenylyl cyclase to make cAMP?
(epinephrine/glucagon) |
epinephrine
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Which bypasses the beta receptor and acts directly on the G-protein that activates adenylyl cyclase to convert ATP to cAMP?
(epinephrine/glucagon) |
glucagon
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What are the treatments for calcium channel blocker overdose? (4)
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exogenous calcium
amrinone epinephrine insulin |
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What overdose is amrinone indicated for?
What is its mechanism? |
calcium channel blocker toxicity
inhibits PDE from breaking down cAMP (not very effective clinically) |
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Which treatment is associated with influx of potassium that may also prolong repolarization and allow calcium channels to remain open longer?
(exogenous calcium, amrinone, epinephrine, insulin) |
insulin
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Which toxin binds to cytochrome A3 in the electron transport chain?
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cyanide
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What is the major effect of cyanide?
(metabolic/respiratory acidosis/alkalosis) |
metabolic acidosis
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What are the treatments for cyanide poisoning? (3)
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fresh air/oxygen
3 drug kit cyanocobalamin |
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What components make up the three drug kit for cyanide poisoning?
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amyl nitrite
sodium nitrite sodium thiosulfate |
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How does hydroxocobalamin treat cyanide toxicity?
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chelates cyanide
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What class of drugs give characteristics of "red as a beet, dry as a bone, hot as a hare, blind as a bat, mad as a hatter"?
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anticholinergics (Anti-SLUDD)
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What are the treatments for anticholinergic overdose? (2)
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benzos (first)
physostigmine (reversible cholinesterase inhibitor) |
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What is the treatment for opiate overdose?
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Naloxone (opioid antagonist)
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Piloerection in a patient with suspected opioid overdose is indicative of what?
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Coingestant preventing them from waking up
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What drug is used to avoid intubation (wake you up) from benzodiazepine overdose?
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flumenazil
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