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22 Cards in this Set
- Front
- Back
LD50
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-the dose at which 50% pf ppl die
-used for acute exposure |
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Common poisons (5)
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Drugs
Organic solvents (gas, paint thinner, & adhesives) Pesticides Heavy metals Gases & inhaled particulates |
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Principle 1
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Every chemical is a potential poison
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Principle 2
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Type & Amount
-What is the LD50 |
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Principle 3
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Acute vs chronic exposure
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Tx strategy for acute poisoning
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1. Maintain vital fnxs-ABCDextrose
2. Hx, exam, & labs 3. Prevent further absorption 4. Antidote 5. Increase elimination |
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Drugs/methods that decrease absorption of poisons (4)
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Ipecac
Activated charcoal (w/in 30-60 min of ingestion) Gastric lavage Polyethylene glycol |
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ipecac
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MoA: irritates gastric mucosa to induce V
Ind: unintentional ingestion Cont: corrosives, hydrocarbons, caustics S/E: D & drowsiness |
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Activated charcoal
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MoA: absorbes substances preventing the body from doing so
Cont: Fe+, lithium, K+, caustics, hydrocarbons,alcohol, cyanide S/E: dark stools, aspiration pneumonia, GI obstruction |
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Gastric lavage
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Ind: recent ingestion, patent airway
Cont: corrosives, hydrocarbons, caustics |
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What role does Polyethylene glycol play in OD?
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MoA: bowel irritation hastens passage through GI tract
Ind: sustained release drugs, Fe+, foreign bodies, drug packets |
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Antidote for organophosphate poisoning
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Atropine
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Antidote for heavy metals
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Dimercaprol
MoA: chelation Ind: arsenic, lead, gold Cont: Fe+, cadmium, selenium, silver, uranium Mon: creatinine |
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Antidote for Acetaminophen
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N-acetylcysteine
MoA: replenishes glutathione (required for metabolism of acetaminophen) A/E: bronchospasm, cough, N/V |
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Antidote for benzodiazapines
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Flumazenil
MoA: antagonizes benzodiazapine receptors Cont: tricyclic anti-depressant OD, BZD dependence A/E: SZ, N/V, agitation |
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Antidote for Digoxin
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Digoxin immune Fab
MoA: Ab binds digoxin Ind: current Dig usage + V dysrhythmias, bradycardia, hyperkalemia, or toad licking Mon: skin sensitivity test A/E: hypokalemia |
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Antidote for Methanol/Ethylene glycol
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Fomepizole
*Do not use w/ EtOH MoA: interferes at alcohol dehydrogenase level A/E: mild AST/ALT elevation, eosinophilia Mon: poison levels, pH, LFTs, CBC |
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Antidote for Lead & Mercury poisoning
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Dimercaptosuccinic acid (DMSA)
MoA: chelates lead, mercury cations |
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Antidote for Opioids
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Nalaxone
MoA: opioid receptor agonist A/E: opioid withdrawl |
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Antidote for Nerve agent, organophosphate insecticide, or anticholinesterase OD
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Pralidoxime (2-PAM)
*Give Atropine 1st for organophosphate poisoning MoA: reactivates cholinesterase A/E: cholinergic Sx Mon: creatinine |
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When to use forced diuresis
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Salicylate OD
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EtOH OD
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Tx: supportive; administer thiamine if low blood glucose
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