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49 Cards in this Set
- Front
- Back
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What 2 drugs are given for seizures?
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Benzos
Phenobarb |
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What 4 drugs are given for altered mental status?
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DONT
-Dextrose -Oxygen -Naloxone -Thiamine |
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What should you do for a patient with hyperthermia?
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Sedate
Cool Paralyse |
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What toxidrome is suggested by sedation/coma, pinpoint pupils, and respiratory depression?
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Opioids
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What toxidrome is suggested by large pupils, sweating, htnsive, tachycardia, and agitation?
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Sympathomimetics
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What toxidrome is suggested by DUMBBELS?
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Cholinergics
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What is DUMBBELS?
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Defecation, Urination
Miosis Bronchorrhea, bradycardia Emesis Lacrimation Sweating |
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What is the txmt for cholinergic crisis?
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Atropine
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What toxidrome is suggested by Mydriasis, dry skin, tachy, decreased BS, seizures, and agitated delirium?
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Anticholinergic
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Anticholinergic acronym?
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Blind as a bat, dry as a bone, red as a beet, mad as a hatter, hot as a hare, seizing like a squirrel
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Antidote for Acetaminephin:
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N-acetylcysteine (NAC)
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Antidote for TCA's:
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Bicarbonate
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Antidote for organophosphates:
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Atropine and Pralidoxime
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Antidote for hydroflouric acid:
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Calcium
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Antidote for Cyanide:
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Antidote kit of ASS:
amyl nitrite sodium nitrite sodium thiosulfate |
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Antidote for Iron:
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Deferoxamine
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Antidote for Lead:
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Succimer (DMSA)
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Antidote for Carbon monoxide:
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oxygen (HBO or normobaric)
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Antidote for Sulfonylureas:
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Dextrose, octreotide
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Antidote for digoxin:
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dig-specific antibodies
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Antidote for salicylates:
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Bicarb
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Antidote for Methanol or Ethylene glycol:
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Fomepizole or Ethanol
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Antidote for Opioids:
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naloxone
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Antidote for benzos:
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Flumazenil
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Antidote for snakes and spiders:
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Antivenom!
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3 options for GI decontamination:
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-Ipecac
-Charcoal -Gastric lavage |
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Hoe much does activated charcoal prevent absorption in the GI tract?
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30-50% of substances
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What is the best time to use activated charcoal?
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Within 30-60min
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What are 3 adverse effects of activated charcoal?
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-Persistent emesis
-Aspiration risk -GI obstruction |
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What are 4 relative contraindications to GI Decon with activated charcoal?
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SUCH
-Substances not absorbed by it -Unprotected airway -Corrosives -Hydrocarbons |
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What is the dosing for AC?
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1 gram per kg of person
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What labs should you order for ingestion?
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Chem 7, APAP, ASA
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Why do a chem 7?
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Do look for metabolic acidosis
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What are the causes of an elevated anion gap metabolic acidosis?
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MUDPILESCAT
Methanol, metformin, uremia, dka, paraldehyde, phenformin, iron, INH, lactic acidosis, ethylene glycol, salicylates, sepsis, cellular asphyxiants alcoholic ketoacidosis Tylenol |
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What lab is vs isn't an absolute necessity in all OD patients?
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-Acetaminophen is
-Aspirin isn't |
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Why is it essential to screen for acetaminophen but not aspirin?
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Acetaminophen toxicitiy is asymptomatic early (silent)
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What are 3 signs of TCA toxicity on EKG?
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-Prolonged QRS
-Prolonged R in aVr -Sinus tachycardia |
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What does Digoxin do to the EKG?
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-Scooped t waves
-AV block |
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What does Lithium do to the EKG?
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Inverted t waves
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What do CCB's and BB's show on the ekg?
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-PR prolongation
-AV Block -Bradycardia |
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What drugs cause ischemic changes on ekg?
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-cocaine
-CO -amphetamines |
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should you screen for drugs of abuse in a pt with ingestion?
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No - not shown to change management
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What are 4 techniques for enhancing elimination of drugs?
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WUHM
-Whole bowel irrigation -Urinary alkalinization -Hemodialysis -Multiple dose charcoal |
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What 4 features make a drug "dialyzable"?
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-Small molecules
-Low vol of distrib -Low protein binding -Renally cleared |
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What 4 drugs is dialysis commonly done for?
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SETL
-Saliclyates -Ethylene glycol/methanol -Theophylline -Lithium |
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What is Urinary Alkalinization most often recommended for?
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Salicylates
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What pH is considered alkaline for this?
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>7.5
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For what 5 types of drugs is whole bowel irrigation considered?
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SLIDE
-Sustained relase (verapamil) -Lithium -Iron -Drug packets -Enteric coated drugs |
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REMEMBER: what are the 4 things you should do for ALL suicide attempts?
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-Chem 7
-APAP -EKG -maybe ASA urine drug screens rarely help |
