Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
11 Cards in this Set
- Front
- Back
|
Acute toxicity presents as... (type of patient, findings)
|
younger patient in a suicide attempt, HYPERkalemic
|
|
|
Chronic toxicity presents as...
|
older patient, HYPOkalemic; often just started new med that decreased excretion or have worsening renal failure
|
|
|
Don't bother getting a level before ___ hours
|
6, because that's how long it needs to equilibrate, but If symptomatic before this, treat even without a level
|
|
|
Presentation of acute toxicity
|
first 3 hours - GI upset
after that, bradycardia, PVCs (anything but tachycardias, because AV node is completely blocked) |
|
|
Presentation of chronic toxicity
|
same cardiac side-effects, but non-cardiac side-effects seen more commonly than in acute: headache, altered MS, sz, decreased appetite
|
|
|
Levels in chronic toxicity
|
not useful, because they represent the serum levels and it's tissue levels you're interested in
|
|
|
Indications for FAb
|
Level>10 ng/dL (acute) or 4 (chronic)
K>5 Ventricular arrhythmias hemodynamic instability |
|
|
What about Calcium?
|
Even if HyperK+, don't give because it can theoretically drive up intracellular Ca to the point of causing "stone heart"
|
|
|
What else can you use to treat bradycardia?
|
Atropine, since Dig acts centrally by increasing vagal tone
|
|
|
Fab dose
|
Dig level x wt/100 = # of vials
But if don't have level, use 10 for acute and 5 for chronic |
|
|
Pacing and cardioversion?
|
Avoid if possible, because myocardium is already irritable, so can cause malignant arrhythmia
|
