Pharmacology Ch59 Poisoned Patient

Front 1

what is the term that denotes the disposition of poisons in the body?

Back 1

Toxicokinetics

Front 2

what is the term that denotes the injurious effects of toxins (ie their pharmacodynamics)?

Back 2

Toxicodynamics

Front 3

hypertension and tachycardia are typically seen in overdoses of these substances?

Back 3

amphetamines, cocaine, and antimuscarinic drugs

Front 4

hypOtension and bradycardia are seen in overdoses of these drugs?

Back 4

calcium channel blockers, Beta Blockers, and sedative hypnotics

Front 5

hypOtension WITH tachycardia occurs with overdoses of these drugs?

Back 5

TCAs, phenothiazines, and theophylline

Front 6

Hyperthermia is most frequently a result of overdose with these drugs?

Back 6

antimuscarinic drugs, the salicylates or sympathomimetics

Front 7

hypOthermia is more likely to occur with toxic overdoses of these drugs?

Back 7

ethanol or other CNS depressants

Front 8

increased respiratory rate is often a feature of overdose with these drugs?

Back 8

CO, salicylates, and other drugs that cause metabolic acidosis or cellular asphyxia

Front 9

these drugs cause respiratory depression, coma, aspiration of gastric contents and other respiratory malfunctions in overdose?

Back 9

Sedative hypnotics and narcotics

Front 10

these drugs cause seizures in overdose which may lead to vomiting and aspiration and to postictal respiratory depression?

Back 10

Cocaine, PCP, TCAs, and theophylline

Front 11

overdoses of these drugs cause dangerous and frequently lethal arrhythmias?

Back 11

TCAs and cardiac glycosides

Front 12

one should give 50% dextrose to any coma patient upon arrival but this must be administered with this substance to avoid Wernicke's syndrome in the suspected alcoholic or malnourished patient?

Back 12

Thiamine

Front 13

the osmolar gap is normally zero, a significant gap is produced by high serum concentrations of intoxicants of Low molecular weight such as....?

Back 13

ethanol, methanol, and ethylene glycol

Front 14

how do you calculate anion gap?

Back 14

(Na+ + K+) -- (HCO3- + Cl-)
difference between the sum of 2 primary cations and the sum of 2 primary anions

Front 15

what is the normal anion gap?

Back 15

12 - 16 mEq/L

Front 16

a significant increase in anion gap occurs in these conditions?

Back 16

Diabetic Ketoacidosis, renal failure, or drug induced metabolic acidosis

Front 17

what are some drugs that may cause an anion gap?

Back 17

cyanide, ethanol, ethylene glycol, ibuprofen, isoniazid, iron, methanol, phenelzine, salicylates, tranylcypromine, valproic acid, & verapamil

Front 18

what are some drugs that cause Hyperkalemia?

Back 18

Beta adrenoreceptors blockers, digitalis, fluoride, lithium, and potassium sparing diuretics

Front 19

drugs associated with hypOkalemia?

Back 19

barium, Beta adrenoceptor Agonists, methylxanthines, most diuretics, toluene

Front 20

OD with these drugs results in delirium, hallucinations, seizures, coma, tachy, hypertension, hyperthermia, mydriasis, dec bowel sounds, urinary retention?

Back 20

Antimuscarinic drugs (eg atropine, some antidepressants and antihistamines, and jimsonweed)

Front 21

OD of these drugs will result in anxiety, agitation, seizures, coma, bradycardia or tachy, pinpoint pupils, salvation, sweating, hyperactive bowel, fasciculations then paralysis?

Back 21

Cholinomimetic drugs (carbamate, organophosphates, inhibitors of acetylcholinesterase)

Front 22

OD -->lethargy, sedation, coma, bradycardia, hypOtension, hypOventilation, pinpoint pupils, cool skin, dec bowel sounds, flaccid muscles?

Back 22

Opioids (eg heroin, morphine, methadone)

Front 23

OD-->confusion, lethargy, coma, seizures, hyperventilation, hyperthermia, dehydration, hypOkalemia, anion gap metabolic acidosis?

Back 23

Salicylates

Front 24

OD-->disinhibition initially, later lethargy, stupor, coma, NYSTAGMUS common, dec muscle tone, hypOthermia, small pupils, hypOtension, and dec bowel sounds in severe OD

Back 24

Sedative hypnotics (barbituates, benzos, ethanol)

Front 25

OD-->agitation, anxiety, serizures, hypertension, tachycardia, arrhythmias, MYDRIASIS, VERTICAL & HORIZONTAL NYSTAGMUS, skin warm and sweaty, hyperthermia, inc muscle tone, possible Rhabdomyolysis?

Back 25

Stimulants (amphetamines, cocaine, phencyclidine, PCP)

Front 26

OD-->antimuscarinic effects, the 3 C's of coma, convulsions, cardiac toxicity (QRS prolongation, arrhythmias, and hypotension)?

Back 26

TCAs

Front 27

Toxicity of this agent =mild anorexia, nausea, vomiting, delayed jaundice, hepatic and renal failure?

Back 27

Acetaminophen

Front 28

Toxicity of this agent = renal failure, crystals in urine, anion and osmolar gap, initial CNS excitation, eye exam normal?

Back 28

Antifreeze (ethylene glycol)

Front 29

toxicity = dysphagia, dyarthria, ptosis, opthalmoplegia, muscle weakness, incubation pd 12-36h?

Back 29

Botulism

Front 30

toxicity = bitter almond odor, seizures, coma, abnormal ECG?

Back 30

Cyanide

Front 31

toxicity=coma, metabolic acidosis, retinal hemorrhages?

Back 31

Carbon Monoxide

Front 32

toxicity = distinctive odor, coughing, pulmonary infiltrates?

Back 32

Gasoline

Front 33

toxic features= bloody diarrhea, coma, radiopaque material in gut (seen on Xray), high leukocyte count, hyperglycemia?

Back 33

Iron

Front 34

toxic features=abdominal pain, hypertension, seizures, muscle weakness, metallic taste, anorexia, encephalopathy, delayed motor neuropathy, changes in renal and reproductive function?

Back 34

Lead

Front 35

toxic features=hallucinations, dilated pupils, hypertension?

Back 35

LSD

Front 36

toxic features=acute renal failure, tremor, salivation, gingivitis, colitis, erethism (fits of crying, irrational behavior), nephrotic syndrome?

Back 36

mercury

Front 37

toxic features=rapid respiration, visual symptoms, osmolar gap, severe metabolic acidosis?

Back 37

methanol

Front 38

toxic features=severe nausea and vomiting 8hr after ingestion, delayed hepatic and renal failure?

Back 38

Mushrooms (Amanita phalloides type)

Front 39

toxic features=oropharyngeal burning, headache, vomiting, delayed pulmonary fibrosis and death?

Back 39

Paraquat

Front 40

toxic features=coma with eyes open, horizontal and vertical nystagmus, HYPERACUSIS?

Back 40

PCP

Front 41

toxic features=hallucinations, mydriasis, seizures (these plants contain an atropine like alkaloids)?

Back 41

Nightshade family, Jimsonweed

Front 42

digitalis like poisoning caused by these plants?

Back 42

Oleander and foxglove

Front 43

delayed severe GI distress, seizures, hemolytic anemia, death caused by this plant?

Back 43

predatory bean (rosary pea)

Front 44

cathartics such as this agent may decrease absorption and hasten removal of toxins from the GI tract?

Back 44

Sorbitol

Front 45

antidote for: acetaminophen (best given within 8 to 10h of overdose)?

Back 45

N-Acetylcysteine

Front 46

antidote for: Cholinesterase inhibitors?

Back 46

Atropine

Front 47

antidote for: membrane depressant cardiotoxic drugs (eg: quinidine, TCAs)?

Back 47

Sodium Bicarb

Front 48

antidote for: iron salts?

Back 48

Deferoxamine

Front 49

antidote for: Digoxin and related cardiac glycosides?

Back 49

Digoxin-specific Fab antibodies (Digibind)

Front 50

antidote for: Caffeine, theophylline, metaproterenol?

Back 50

Esmolol

Front 51

antidote for: methanol or ethylene glycol?

Back 51

Ethanol

Front 52

antidote for: benzos or zolpidem?

Back 52

Flumazenil

Front 53

another antidote for: methanol and ethylene glycol other than ethanol?

Back 53

Fomepizole

Front 54

antidote for: beta adrenoceptor blockers?

Back 54

Glucagon

Front 55

antidote for: opioids?

Back 55

Naloxone (Narcan)

Front 56

antidote for: carbon monoxide?

Back 56

Oxygen

Front 57

antidote for: suggested for muscarinic receptor blockers NOT tricylcics?

Back 57

Physostigmine

Front 58

antidote for: organophosphate cholinesterase inhibitors?

Back 58

Pralidoxime (2-PAM)