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99 Cards in this Set
- Front
- Back
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Which of the following statements is correct?
– Pethidine is an opioid antagonist – Naloxone is an opioid antagonist – Naltrexone is an opioid antagonist – Phenacetine is an opioid antagonist |
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Which of the following statements is correct?
– Tramadol belongs to strong opioids – Tramadol belongs to nonopioids – Tramadol belongs to weak opioids – Tramadol belongs to inhibitors of reuptake of serotonine a noradrenaline |
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Which of the following statements is correct?
– nausea and vomiting are common adverse effects of opioids – constipation is a common adverse effect of opioids – peptic ulcer is a common adverse effect of opioids – dependence is a common adverse effect of treatment with opioids |
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Which of the following statements is correct?
– Paracetamol (acetaminophen) in overdose produces hepatotoxicity – Paracetamol (acetaminophen) in overdose produces metabolic acidosis – Paracetamol (acetaminophen) in overdose produces liver failure – Paracetamol (acetaminophen) in overdose produces Reye´s syndrome |
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Which of the following statements is correct?
– death in overdose with strong opioids is caused by excessive hypertension – death in overdose with strong opioids is caused by gastrointestinal bleeding – death in overdose with strong opioids is caused by inhibition of respiration – death in overdose with strong opioids can be prevented by naloxone |
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Which of the following statements is correct?
– COX–2 selective NSAIDs have advantage of a rapid onset of analgesic action – COX–2 selective NSAIDs have advantage of a lower risk of gastropathy – COX–2 selective NSAIDs have advantage of a lower risk of bleeding – COX–2 selective NSAIDs have advantage of a lower cardiovascular risk |
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Which of the following statements is correct?
– Ibuprofen produces an irreversible inhibition of platelet cyclooxygenase – Aspirin produces an irreversible inhibition of platelet cyclooxygenase – Diclofenac lacks an antiinflammatory effect – Paracetamol (acetaminophen) lacks an antiinflammatory effect |
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Which of the following statements is correct?
– in patients with painful bony metastases oral morphine may be used – in patients with painful bony metastases a combination of an opioid with a non–steroidal anti–inflammatory drug (NSAID) could be beneficial – opioids do not produce important adverse effects in patients with painful bony metastases – in patients with painful bony metastases carbamazepine may have better analgesic effects than opioids |
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Which of the following statements is correct?
– Opioids are used therapeutically as analgesics – opioids are used therapeutically as antidepressants – opioids are used therapeutically as sedatives – opioids are used therapeutically as anti–diarrheals |
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Which of the following statements is correct?
– Naloxone has a low affinity for mu receptors – Naloxone is effective only by the parenteral route – Naloxone has a significantly longer half–life than morphine – Naloxone acts by competitive inhibition |
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Which of the following statements is correct?
– antiplatelet effect of aspirin is caused by inhibiting the production of prostacycline – antiplatelet effect of aspirin is caused by inhibiting the production of tromboxane – hepatotoxicity caused by paracetamol overdose can be antagonized by acetylcysteine – hepatotoxicity caused by paracetamol overdose can be antagonized by atropine |
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Which of the following statements is correct?
– the risk of gastrointestinal bleeding after NSAIDs is higher in infants – the risk of gastrointestinal bleeding after NSAIDs is higher in diabetes – the risk of gastrointestinal bleeding after NSAIDs is higher in elderly (>65 years) – the risk of gastrointestinal bleeding after NSAIDs is higher in ulcer disease |
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Which of the following statements is correct?
– Aspirin is contraindicated in children with chickenpox or flu symptoms – Aspirin is contraindicated in peptic ulcer disease – Aspirin is the drug of choice for rheumatoid arthritis – Aspirin should be avoided in diabetics |
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Which of the following statements regarding opioid analgesics is correct?
– pain relief provided by opioids increases with age – the combination with paracetamol increases their analgesic efficacy – opioid analgesics should never be given to patients with chronic pain – in acute pain, the risk of inducing opioid–dependence is negligible |
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Which of the following NSAIDs is COX–2 selective?
– celecoxib – ibuprofen – etoricoxib – aspirin |
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Common adverse effects of opioids are:
– nausea and vomiting – constipation – peptic ulcer – thrombocytopenia |
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Which of the folowing drugs inhibits platelet cyclooxygenase?
– aspirin – tramadol – ibuprofen – warfarin |
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Endogenous cortisol secretion:
– is lowest after awakening in the morning – is lowest at the evening and during the first half of the night – is highest after awakening in the morning – is highest at the evening and during the first half of the night |
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Systemic long–lasting glucocorticoid therapy:
– is never used in rheumatoid diseases – only the lowest doses are always used in this therapy – starts with rather high doses which are gradually reduced – functional failure of adrenal glands can be caused also using the lowest–dose maintenance therapy |
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Systemic long–lasting glucocorticoid therapy:
– is used only in very serious mostly autoimmune diseases with direct life threats – is commonly and broadly used in rheumatoid disease treatment – is mainly used in regular 6–8– hour intervals – the dose–regimen based on the endogenous cortisol secretion is mainly used |
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For lowering of systemic long–lasting glucocorticoid therapy–adverse effects:
– “pulse therapy” can be used – short–lasting corticosteroids are used in lowest effective doses – long–lasting corticosteroids are used in lowest effective doses – corticosteroids should be quickly removed as soon as after the remission reaching |
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Among short–lasting corticoids belong:
– prednison – methylprednisolon – dexamethazon – betamethazon |
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Systemic long–lasting therapy:
– with dexamethazon should be terminated by transferring to the short–lasting corticoid – with prednison should be terminated by transferring to the short–lasting corticoid – with dexamethazon should be terminated by gradual dose reduction – with prednison should be terminated by gradual dose reduction |
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In rheumatology the systemic glucocorticoid application is often use e.g.:
– in systemic lupus erythematodes – in rheumatoid arthritis with extraarticular lesions – in golf or tennis knee pain – in tendovaginitis |
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For local glucocorticoid therapy are used mainly:
– water–insoluble derivates (corticoid esters) – methylprednisolon acetate and betamethason dipropionate – hydrocortison and cortisol – fludrocortison acetate |
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Glucocorticoid intraarticular application is used:
– in primary immunopathological induced inflammatory joint lesions – in septic arthritis – always in strictly aseptic conditions – preventively in suspected joint cavity infection |
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In local therapy corticosteroids are applied:
– subcutaneously in the painful area – in direct injection into the soft tissue – into the tendon covering in tendovaginitis – directly into the tendon tissue in tendovaginitis |
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Mark frequent adverse effects of systemic long–lasting glucocorticoid treatment:
– higher predisposition to infectious diseases – osteoporosis – emaciation, anorexia – sedation, somnolence |
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Mark what can be used to prevent rather rapidly evolving tolerance and to reduce kidney failure:
– continuous uninterrupted low–doses application of glucocorticoids – so–called “diurnal” glucocorticoid application – with daily dose applied during morning or at latest midday – so–called “intermittent” type of application – where the drug is applied for 3–4 subsequent days followed by 2–3 days pause – so–called called “diurnal” glucocorticoid application – with daily dose applied during afternoon and evening |
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One–large–dose of glucocorticoid (e.g. methylprednisolon infusion) is used:
– in polytrauma a trauma – in prevention of septic and toxic shock development – in osteoporosis treatment – in peptic ulcer treatment |
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Mark the corticoid with long–lasting effect (with T1/2 = at least 12–36 hours):
– methylprednisolon – dexamethazon – hydrokortison – betamethazon |
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High doses short–lasting treatment (not exceeding 48 hours) with glucocorticoids is used:
– in anaphylactic shock, in snake bite – in status asthmaticus, in brain oedema – to prevent thrombus formation – in peptic ulcer treatment |
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High doses short–lasting treatment (not exceeding 48 hours) with glucocorticoids:
– does have practically no risks – can induce ventricle dysrhythmia complications – can induce in diabetics hyperglycaemia and hyperglycaemic coma – can induce in diabetics hypoglycaemic coma |
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Mark the glucocorticoid sequence, where the drugs are in order from the least effective to the most effective:
– dexamethazon – hydrocortizon – methylprednisolon – hydrocortizon – methylprednizolon – dexamethazon – methylprednisolon – prednisolon – dexamethazon – hydrocortizon – prednisolon – dexamethazon |
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Central muscle–relaxant drugs are:
– tetrazepam and tizanidine – tolperison and bromazepam – tinidazole and tolperisone – thiocolchicoside and tolperisone |
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Choose the correct theses about peripheral muscle–relaxant drugs:
– most commonly used during general anaesthesia – suitable for long–term treatment of back pain – suitable for short–term treatment of back pain – effect of some of them is similar to curare |
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Mechanism of action of central muscle–relaxant drugs can be:
– stimulation of serotonergic receptors – inhibition of GABA–ergic transmission – induction of hyperpolarization – agonism of alpha–2 receptors |
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Common adverse effects of central muscle–relaxant drugs are:
– somnolence – sedation – agitation – hallucinations |
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Choose the correct theses about tizanidine:
– it is an agonist of imidazoline receptors – it is an antagonist of imidazoline receptors – it is a central muscle–relaxant drug – it is an agonist alpha–2 receptors |
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Choose the correct theses about tolperisone:
– it possesses anti–inflammatory effects – it increases the activity of motor neurons in ventral spinal cord – it is a central muscle–relaxant drug – it blocks voltage–gated calcium ion channels in afferent pathways of pain pathway |
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Diazepam acts as:
– a central myorelaxans – a peripheral myorelaxans – a spasmolytic agent – an anticonvulsant drug |
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Choose the correct theses about central myorelaxans:
– most commonly used during general anaesthesia – are suitable for long–term treatment of back pain – are suitable for short–term treatment – are suitable for treatment of muscle spasms |
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Choose the correct theses about antagonism of effects of benzodiazepines:
– an antidote is fluticasone – an antidote is flumazenile – it is based on inhibition of excessive stimulation of GABA – an antidote is formoterol |
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Choose the correct theses:
– peripheral myoerelaxans are divided to depolarizing and non–depolarizing – central myoerelaxans are divided to depolarizing and non–depolarizing – into the group of central myorelaxans belongs diazepam – into the group of central myorelaxans belong suxamethonium |
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Choose the correct theses:
– a depolarizing central myorelaxans is tetrazepam – a hyperpolarizating central myorelaxans is tetrazepam – a depolarizing peripheral myorelaxans is tetrazepam – a hyperpolarizating central myorelaxans is diazepam |
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Choose the correct theses:
– the effect of central myorelaxans can be abolished by neostigmine – the effect of depolarizing myorelaxans can be abolished by neostigmine – the effect of non–depolarizing myorelaxans can be abolished by neostigmine – the effect of some central myorelaxans can be abolished by flumazenile |
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Choose the correct theses:
– depolarizing myorelaxans competitively block cholinergic receptors – non–depolarizing myorelaxans competitively block cholinergic receptors – by acting of depolarizing myorelaxans is induced an action potential – by acting of non–depolarizing myorelaxans is induced an action potential |
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Choose the correct theses about suxamethonium:
– its effect can be abolished by neostigmine – it belongs to central myorelaxans – it causes induction of action potential – it has rapid onset and short–term of action |
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Choose the correct theses about dantrolen:
– it belongs to central myorelaxans – it belongs to peripheral myorelaxans – it increases the intracytoplasmic concentration of calcium – it is used in the treatment of malignant hyperthermia |
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Choose the correct theses about tubocurarine:
– it is a peripheral myorelaxans – it induces depolarization – its effect can be abolished by administration of cholinesterase inhibitors – it belongs to central myorelaxans |
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Choose the correct theses about pancuronium and atracurium:
– they belong to non–depolarizing central myorelaxans – their effect can be abolished by so called "recurarization" – they competitively block cholinergic receptors without formation of action potential – their antidote is for example neostigmine |
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Propofol:
– is a dissociative intravenous anaesthetic – can be used for conscious sedation (for short–lasting interventions) – causes respiratory depression – is an associative inhalational anaesthetic |
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Local anaesthetics:
– cannot be used intra–articularly – some local anaesthetics can be used as antiarrhythmics – some local anaesthetics can be used as cardiotonics – can be favourably used together with epinephrine for infiltrative application (into the tissue) |
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Thiopental:
– is a local anaesthetic – can be used for rectal sedation (especially in children) – can be used also in acute cerebral hypertension by cerebral edema – doesn’t cause breath depression, on the contrary it acts as bronchodilatans |
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Lidocaine belongs to:
– general anaesthetics – local anaesthetics – spasmolytics – antiarrhythmics |
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Mark the drug combination used for analgosedation in clinical practise (including catastrophe medicine):
– fentanyl with aminophenazone – ketamin with midazolam – fentanyl with s midazolam – fentanyl with suxamethonium |
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Mark effects of atropine used in general anaesthesia premedication:
– atropine causes bronchodilatation – atropine reduces heart rate – atropine reduces gastrointestinal secretions – atropine causes peripheral vasoconstriction |
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Local anaesthetics:
– can be mutually combined within the same drug group – are commonly combined with vasodilators – are used in lower doses, when applied into soft and hyperaemic tissues or in higher pH – are used in lower doses, when applied into inflammatory tissue |
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Ketamin:
– is an associative general anaesthetic – is an effective analgesic advantageously used in bone and muscular pain, in burns – causes respiratory depression, cannot be used in asthma – does not cause respiratory depression, it is a bronchodilator |
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Lidocaine:
– is used in a pressor response to tracheal intubation (i.v. bolus) – in topical application induces strong, fast, only several minutes lasting local anaesthetic effect – in topical application induces strong, fast, 1–2 hours lasting local anaesthetic effect – can be used as antiarrhythmic in bradycardia |
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Thiopental:
– inhibits respiratory center, can cause bronchospams – increases blood pressure – increase intracranial pressure – has a short–lasting effect (lasting for about 10min when i.v. applied) |
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Fentanyl:
– can be used for general anaesthesia induction – can be used in injection, transdermal and buccal drug form – has long.lasting massive effect – is about 5times stronger analgesic as sufentanil |
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Inhalation general anaesthetics
– are e.g. propofol a etomidat – cause associative general aneasthesia – cannot be used for sedation or self–service analgesia – are e.g. isoflurane and sevoflurane |
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Trimecaine:
– is an antiarytmic – combination with bupivacaine speeds and prolongs its effect – combination with suxamethonium shortens and lowers its effect – cannot be used for epidural anaesthesia |
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Among relatively frequent adverse effects of halothane belongs:
– malignant hyperthermia – heart rate disturbances (especially tachycardia) – depression of respiratory centre – hypertension |
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Mark the correct answer:
– ropivacaine and mepivacaine cause weak vasocontriction – local anaesthetics have aminoester or aminoamide molecular structure – local anaesthetics are structurally close to cocaine and that´s why most of them have certain risk of dependency provoking – local anaesthetics are weak acids |
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Mark the correct answer:
– articaine is very important local anaesthetic in stomatology – bupivacaine or levobupivacaine are local anesthetics with long–lasting effect used in epidural anaesthesia – trimecaine, lidocaine and articaine are aminoester local anaesthetics – procaine is aminoamide local anaesthetic |
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Aminoester local anaesthetics:
– are more widely used than aminoamide local anaesthetics – are synthetic cocaine derivates – have higher risks of allergic adverse effects in comparison to aminoamide local anaesthetics – have lower interaction risks than aminoamide local anaesthetics |
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Sympathomimetics given in acute care are applied:
– in one initial dose (bolus) followed by maintenance infusion – in one initial dose (bolus) followed by oral application – in the course of the cardiopulmonary resuscitation intra–bronchially – in the course of the cardiopulmonary resuscitation subcutaneously |
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Sympathomimetics with dominant β1 adrenergic effect:
– are vasoconstrictors – do not increase the heart metabolic demands – have positive inotropic effect – can increase the heart arrhythmia risks |
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Sympathomimetics with dominant β2 adrenergic effect:
– are vasodilators – are vasoconstrictors – have positive inotropic effect – are bronchodilators |
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Sympathomimetics with dominant α adrenergic effect:
– are vasoconstrictors – are convenient in shock therapy – are vasodilators – are predominantly bronchodilators |
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Mark typical adrenaline (epinephrine) characteristics:
– remarkable immediate vasoconstriction – positive inotropic and vasodilation effects (it is an inovasodilator) – β1,2 sympathomimetic effects – positive inotropic and vasoconstriction effects (it is an inovasoconstrictor) |
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Mark typical noradrenalin (norepinephrine) characteristics:
– vasodilation effect – positive inotropic and vasoconstriction effects (it is an inovasoconstrictor) – β1,2 sympathomimetic effects without the α adrenergic effects – β1 sympathomimetic with medium α sympathomimetic effect |
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Mark typical dobutamine characteristics:
– dominant α adrenergic effect (it is a vasoconstrictor) – dominant β1 adrenergic effect (inotropic effect) – dobutamine is conveniently used in acute heart failure treatment in combination with dopamine (which improves renal perfusion) – dobutamine is conveniently used in shock therapy in combination with dopamine (which potentiates vasoconstriction) |
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Mark typical levosimendan characteristics:
– inotropic effect due to the increased sensitivity of tropine T to calcium – dominant α adrenergic effect (it is a vasoconstrictor) – high risk of serious arrhythmias by increased calcium sarcoplasmatic concentration in cardiomyocytes – levosimendan is conveniently used in acute heart failure treatment as alteration to β sympathomimetics in chronic beta–blockers treatment |
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Fibrinolytic drugs:
– are non–selective (working through plasmin activation) and selective (which act directly on the thrombus) – are in–direct (working through antithrombin activation) and direct (which act on catalytic site of thrombin) – use of streptokinase is accompanied by remarkable risks of allergic reaction and hypotension – use of alteplase is accompanied by remarkable risks of allergic reaction and symptomatic hypotension |
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Direct thrombin inhibitor anticoagulatives (anticoagulants):
– are e.g. rivaroxaban and apixaban (called “xabans”) – is e.g. dabigatran (called “agatran”) – are conveniently used for thromboembolic prophylaxis in patients with renal failure – can be applied orally even in patients early after surgery |
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Direct factor–Xa inhibitor anticoagulatives (anticoagulants):
– are e.g. rivaroxaban a apixaban (called “xabans”) – is e.g. dabigatran (called “agatran”) – are conveniently used for thromboembolic prophylaxis in patients with renal failure – can be applied orally even in patients early after surgery |
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Dabigatran:
– inhibits coagulation after antithrombin activation – directly inhibits the catalytic site of thrombin – is comparably effective as well as safe in comparison with warfarin in the thromboembolytic prophylaxis – can be applied orally, has renal excretion and low risks of drug interactions |
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Rivaroxaban:
– directly inhibits the catalytic site of factor Xa – inhibits coagulation after antithrombin activation which blocks the factor Xa effect – can be applied orally, its effect is well predictable without necessary effect monitoring and with low risks of drug – its effect can be terminated by protamine sulfate |
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Apixaban:
– directly inhibits the catalytic site of factor Xa – inhibits coagulation after antithrombin activation which blocks the factor Xa effect – can be applied orally and intravenously, its effect is well predictable without necessary effect monitoring and with low risks of drug – its effect can be terminated by indirect factor Xa inhibitors |
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In comparison with warfarin, the indirect thrombin or factor Xa inhibitors have:
– faster onset of action – higher risks of drug interactions – well predictable effect without necessary effect monitoring – the possibility of effect termination by protamine sulfate |
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Further poison (toxic substance) absorption can be prevented:
– through emesis induction (in oral intoxications) – by giving absorbing substances (Carbo medicinalis) – by forced diuresis – by haemodialysis |
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Mark SPECIFIC antidotes used in poisoning (intoxication) treatment:
– naloxone – magnesium sulphate (10% solution) or sorbitol (40% solution) – alcohol (ethanol) – Carbo medicinalis |
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In salicylate or barbiturate intoxication (=slight acids):
– slight urine acidification can speed up their elimination (using i.v. bolus of 1mmol acetic acid) – slight urine alkalization can speed up their elimination (using i.v. bolus of 1mmol sodium bicarbonate) – haemoperfusion can be used for their elimination – a specific antidotum can be used |
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In organophosphate intoxication (insecticides – DDT, chemical weapons etc.):
– the patient has typically dry mouth, mydriasis, increased heart rate and body temperature – a specific antidotum can be used – atropine – only sympthomatic and non–specific treatment can be used (no specific antidotum) – the patient has typically signs of cholinomimetic/parasympathomimetic overdose |
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Forced diuresis:
– does mean, that certain amount of patients full blood is removed and replaced with another full blood – represents a convenient and safe detoxification method especially in cardiac patients or in changed ion or acid–base balance – is used for speed up elimination of toxic substance in the intoxicated patient – is achieved by increased hydration (oral or intravenous) and oral or i.v. diuretic administration |
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Haemodialysis:
– represents one of the most effective mode of toxic substance elimination – does mean, that certain amount of patients full blood is removed and replaced with another full blood – is well effective in long–lasting barbiturates, methanol, lithium or toadstool intoxications – cannot be used in remarkable acido–basic disbalances (e.g. acidosis) |
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A little school boy – has dry, warm scarlet skin, fever, dry mucosa (mouth, eyes), mydriasis, tachycardia, he is confused (intermittent coma):
– it is presumably organophosphates poisoning (e.g. DDT field spraying) – it is presumably poisoning with atropin or scopolamin containing plants (Atropa belladonna, Datura stramonium etc.) – atropin can be used as a specific antidotum in this poisoning/overdose – physostigmin (=ACHEI) can be used as a specific antidotum in this poisoning/overdose |
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A young man in coma, shows gasping breath, bradycardia, hypotension, remarkable unresponsive miosis, syringe marks on the body:
– it is presumably opioid overdose – it is presumably benzodiazepine overdose – flumazenil can be used as a specific antidotum in this poisoning – naloxone can be used as a specific antidotum in this poisoning |
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In remarkable benzodiazepine overdose/intoxication (deep CNS depressor effect and strong muscle–relaxation) besides common precautions:
– naloxon can be used for deep central depressor effect reduction – acetylcystein (ACC) can be used as a specific antidotum – flumazenil can be used as a specific antidotum – naloxone can be used as a specific antidotum |
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Paracetamol (acetaminophen):
– cannot be overdosed, it is very safe, broadly used freely sold drug – if needed, it is used repeatedly in minimum 4h intervals between doses, maximum 4g daily (eight 500mg tablets) – if needed, it is used repeatedly in minimum 8 h intervals between doses, maximum 10g daily (twenty 500mg tablets) – in children under 12 years age the maximum daily dose is 2,6 g (60 mg/kg) |
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Paracetamol (acetaminophen) intoxication:
– is practically out of the question, it very safe freely sold drug – atropine can be used as a specific antidotum – can cause serious liver damage – acetylcysteine can be used as a specific antidotum |
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Naloxone:
– is a partial agonist of opioid receptors – has short–lasting effect (dose dependently 30–maximum 60 minuts) – can be used for central depressor effect reduction in ethanol intoxication – can be used as a specific antidotum in paracetamol (acetaminophen) overdose |
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Digoxin overdose/intoxication:
– characterise nausea, vomiting, restlessness, faintness, convulsions, tachycardia till serious arrhythmias, changed colour vision – characterise sedation, bradycardia, musclerelaxation, remarkable miosis – potassium supply is part of the overdose therapy – there is no specific antidotum at the disposal for digoxin overdose therapy |
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Acute intoxication with amphetamine derivates (methamphetamine = pervitin, MDMA etc.):
– amphetamine derivates in their pure form (without admixtures or dash) have practically no risks of rhabdomyolysis or disseminative intravascular coagulation – characterise cardiovascular system stimulation central stimulation, hyperactivity, mydriasis, sweating, hyperthermia, sometimes hallucinations – intoxication therapy is only symptomatic, no specific antidotum is at the disposal – methamphetamine (pervitin) intoxication is not life dangerous |
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Mark correct thesis:
– atropine can be used as a specific antidotum in toadstool (Amanita muscarina) intoxication – physostigmine can be used as a specific antidotum in organophosphates (DDT) poisoning – atropine can be used as a specific antidotum in consumption of part of plants – Atropa belladonna or Datura stramonium – alcohol (ethanol) can be used as a specific antidotum in methanol consumption/overdose |
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In alcohol (ethanol) intoxication:
– a serious intoxication (blood alcohol over 3.0 promille) characterise central excitation, cardiovascular stimulation, sweating, hyperthermia – a serious intoxication (blood alcohol over 3.0 promille) characterise deep sedation, somnolence, ataxia, even coma, respiratory depression, hypothermia, frequently hypoglycaemia – clomethiazol or tiaprid can be used for pacification of aggressive alcohol intoxicated patient – atropine can be used for central depressor effect reduction |
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