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38 Cards in this Set
- Front
- Back
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List the Management principles in toxicology
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1. stabilize 2. get data 3. decontaminate 4. decrease absorption of toxin (charcoal) 5. increase elimination of toxin 6. treat w antidote 7. determine appropriate disposition
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treatment for people w/ low blood sugar?
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dextrose
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treatment for people w/opiate poisoining?
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naloxone
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treatment for alchol-induced werickes encephalopathy?
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thiamine
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what happens during seizure? Treatments?
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metabolic demands increase; benzos (pams), propofol, barbituate
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treatment for CO poisioning/hypoxia?
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Oxygen
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unknown toxicity: what do you do?
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S (substrate response to dextrose, oxygen, naloxone, or thiame); H= history; O= observations; R= rule out non-toxic causes w/ EKG and Head CT; T= toxidrome signs and symptoms; E= electrocardiogram
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Diagnostic tests best for evaulating a poisoned patient?
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Electrocardiogram, Lab for-acetominophen, alcohol via osmol gap, arterial blood gas (acidosis, salicyllate poisioning), anion gap, and Radiographs (chipes)
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antidoe for acetominophen
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N-acetylcysteine, which substitutes for hepatic glutathione, most effective after 8 hours to treat hepatic failure
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anion gap basic metabolic panel pneumonic?
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I'll have : SALT on my BUN and SUGAR, to CREATe, BICARBONATE, K
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How to calculate anion gap? Normal? w/ metabolic acidosis
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AnGap=Na-(Cl +HCO3); 8-12; metabolic acid= wide gap w/ low HCO3
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equation fo osm gap?
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Measured osmolarity- calculated osmolarity; (2Na +bun/2.8 +Glc/18 +EtoH/4.6); normal=5-10
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toxins causing osmolar gap?
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alcohols + diuretic= ME DIE = methanol ethanol diuretic isopropanol Ethylene glycol
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treatment for body packers?
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golytely
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role of GI decontamination? (stomach pumping)
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prevent further absorption, increase elimination
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limitations of GI decontamination?
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emetics- seizures, diminished concciousness, caustic ingestions, gastic lavage- only works w/ in 1 hour, diminished conciousness
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drugs that use charcoal?
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teophylline, pheonbarbital, carbamazepine, quinine, dapsone, salicylate
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what is forced diuresis used for?
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lithium
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what is alkaline diuresis used for?
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salicylates, phenobarbitol (K is the key)
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hemodialysis is used for?
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lithium, asa, theophylline, ethylene glycol, methanol
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what do TCAs cause on EKC?
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Wide QRS, R' AVR
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signs for opiote toxidrome?causes? Antidote?
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slow RR, pinpoint pupils; morphine, heroin, ines/enes; naloxene
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signs for cholinergic toxidrome? Causes?Treatmeant?
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Secretions Lacrimation Urination Defecation Gastric Cramping Emesis; caused by organophosphates; atropine, parlidoxime, dizepam (for seizures)
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symptoms for Anticholinergic toxisyndrome? Causes? Treatment>
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hot as hades, red as a beet, dry as a bone, blind as a bat, mad as a hatter; causes by antidepresantes, antihistamines, atropine, plants: physostigmine
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symptoms for sympathomimetic toxidrome? Causes? Treatment?
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tachycardia, hyperthermia, agitated delirium, dilated pupils; cocaine/ampetamines; benzodiazepines
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symptoms for sedative-hypnotic toxidrome?
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body shuts down, decreased tem, bullae; barbiturates/sometimes benzos; no treatment
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symptoms of salicylism? Treatment?
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tinnitus, respiratory alkalosis followed by metabolic ; alkalinize urine w/ NaHCo3 and K
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symptoms for cyclic antidepression syndrome? Causes? Treatment?
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hypotension, tachycardia, wide QRS/QTc, seizure; Amitriptyline, Citolopram, and Venlafaxine; make blood pH basic (hyperventilate/NA bicarb)
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symptoms of serotonin syndrome? Causes? Treatment?
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anxiety, tachycardia, nausea/cramps, neuromuscular, cough medicine; caused by antidepressants; treat w/ cyproheptadine
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symptoms for isoniazid poisining? Causes? Treatment?
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positive ppd test, seizures that don't respond to diazepam; treat w/ pyridoxine (vitamin b6)
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symptoms for toxic alcohol i.e antifreeze??
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wide anion gap
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treatment of methanol toxicity?
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ethanol, fomepizole, folic acid, dialysis over 50
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treatment of ethylene glycol?
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ethanol, fomepizole, thaimine/magneizium, pyridoxine, dialysis over 50
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antidote for cyanide?
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nitrates
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antidotes for cabon monoxide?
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oxygen, hbo
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antidoes for nitrates/nitrites?
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methylene blue
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antidoes for beta-blockers?
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glucagon
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antidotes for Ca cahnnel blockers?
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Calcium, glucagon
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