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28 Cards in this Set
- Front
- Back
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Define toxicokinetics
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The determination and quantification of the time course of absorption, distribution, biotransformation, and excretion of chemical
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Some drugs with large volumes of distribution?
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antidepressants and antimalarials
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Some drugs with low volumes of distribution?
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lithium, phenytoin, salicylates
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Urinary alkalinization does what?
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increases renal elimination of weak acids
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What happens in salicylate or phenytoin OD?
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capacity of the liver to metabolize drugs is exceeded, and elimination changes from first-order (constant half life) to zero-order (variable half life) kinetics
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toxicodynamics
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denotes the injurious effects of toxins
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Symptoms of OD with amphetamines, cocaine, and antimuscarinics?
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HTN and tachycardia
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Symptoms of OD with calcium channel blockers, B blockers, and sedative hypnotics?
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hypotension with bradycardia
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Symptoms of OD with tricyclic antidepressants, phenothiazines, and theophylline?
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hypotension with tachycardia
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Hyperthermia in OD of?
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antimuscarinicis, salicylates, sympathomimetics
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Hypothermia with OD of?
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ethanol and other CNS depressants
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Increased respiratory rate in OD of?
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CO, salicylates, other drugs that cause metabolic acidosis or cellular asphyxia
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OD of sedative-hypnotics and opioids
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respiratory depression, coma, aspiration of gastric contents, other respiratory malfunctions
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OD of cocaine, PCP, tricyclic antidepressants, and theophylline
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seizures, vomiting and aspiration of gastric contents, postictal respiratory depression
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OD of what causes fatal arrhythmias
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tricyclic antidepressants and cardiac glycosides
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Drugs causing direct liver and kidney damage
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Amanita phalloides mushrooms, acetaminophen, some inhalands and some heavy metals
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Steps to managing the poisoned patient?
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maintenance of vital functions, ID of toxic substance, decontamination procedures, enhancement of elimination, and sometimes a specific antidote
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ABCDs
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Airway, Breathing, Circulation, Dextrose or Decontamination
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Osmolar gap?
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the difference between the measured serum osmolarity and the osmolarity predicted by measured serum concentrations of sodium glucose and BUN; gap is normally 0; significant gap produced by high serum concentration of intoxicants of low molecular weight (ethanol, methanol, ethylene glycol)
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Anion gap?
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the difference between the sum of the measured serum concetrations of the 2 primary cations, Na and K, and the sum of the measured serum concentrations of the 2 primary anions, Cl and HCO3-
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Normal anion gap?
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12-16 mEq/L
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Causes of increase in anion gap?
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diabetic ketoacidosis, renal failure, drug-induced metabolic acidosis
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Drugs that cause an anion gap?
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cyanide, ethanol, ethylene glycol, ibuprofen, isoniazid, iron, methanol, phenelzine, salicylates, tranylcypromine, valproic acid, verapamil
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Drugs that cause hyperkalemia?
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B-adrenoceptor blockers, digitalis, fluoride, lithium, potassium-sparing diuretics
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Drugs that cause hypokalemia?
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barium, B-adrenoceptor agonists, methylxanthines, diruetics, toluene
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Methods of decontamination
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removal and washing of clothes, activated charcoal, gastric lavage, syrup of ipecac, whole bowel irrigation, cathartics
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Activated charcoal in OD of what drugs?
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amitriptyline, barbiturates, carbamazepine, digitalis glycosides, phenycyclidine, propoxyphene, theophylline, tricyclic antidepressants, valproic acid
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hemodialysis?
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exrtracorporeal circulation procedure in which a patient's blood is pumped thru a column containing semipermeable membrane that allows the removal of many toxic compounds
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