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22 Cards in this Set

  • Front
  • Back
LD50
-the dose at which 50% pf ppl die
-used for acute exposure
Common poisons (5)
Drugs
Organic solvents (gas, paint thinner, & adhesives)
Pesticides
Heavy metals
Gases & inhaled particulates
Principle 1
Every chemical is a potential poison
Principle 2
Type & Amount
-What is the LD50
Principle 3
Acute vs chronic exposure
Tx strategy for acute poisoning
1. Maintain vital fnxs-ABCDextrose
2. Hx, exam, & labs
3. Prevent further absorption
4. Antidote
5. Increase elimination
Drugs/methods that decrease absorption of poisons (4)
Ipecac
Activated charcoal (w/in 30-60 min of ingestion)
Gastric lavage
Polyethylene glycol
ipecac
MoA: irritates gastric mucosa to induce V
Ind: unintentional ingestion
Cont: corrosives, hydrocarbons, caustics
S/E: D & drowsiness
Activated charcoal
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
Gastric lavage
Ind: recent ingestion, patent airway
Cont: corrosives, hydrocarbons, caustics
What role does Polyethylene glycol play in OD?
MoA: bowel irritation hastens passage through GI tract
Ind: sustained release drugs, Fe+, foreign bodies, drug packets
Antidote for organophosphate poisoning
Atropine
Antidote for heavy metals
Dimercaprol

MoA: chelation
Ind: arsenic, lead, gold
Cont: Fe+, cadmium, selenium, silver, uranium
Mon: creatinine
Antidote for Acetaminophen
N-acetylcysteine

MoA: replenishes glutathione (required for metabolism of acetaminophen)
A/E: bronchospasm, cough, N/V
Antidote for benzodiazapines
Flumazenil

MoA: antagonizes benzodiazapine receptors
Cont: tricyclic anti-depressant OD, BZD dependence
A/E: SZ, N/V, agitation
Antidote for Digoxin
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
Antidote for Methanol/Ethylene glycol
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
Antidote for Lead & Mercury poisoning
Dimercaptosuccinic acid (DMSA)

MoA: chelates lead, mercury cations
Antidote for Opioids
Nalaxone

MoA: opioid receptor agonist
A/E: opioid withdrawl
Antidote for Nerve agent, organophosphate insecticide, or anticholinesterase OD
Pralidoxime (2-PAM)

*Give Atropine 1st for organophosphate poisoning
MoA: reactivates cholinesterase
A/E: cholinergic Sx
Mon: creatinine
When to use forced diuresis
Salicylate OD
EtOH OD
Tx: supportive; administer thiamine if low blood glucose