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54 Cards in this Set
- Front
- Back
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What are the most common ingestants in the US
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Analgesics
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List some analgesics
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APAP, salicylates, NSAIDS
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What are the most common fatal overdose drugs in the US
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Sedatives, hypnotics, antipsychotics
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What is the most common cause of drug-induced seizures? Some less common causes?
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Most common - Alcohol
Less common - Cocaine, MDA, INH |
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What does black widow venom cause
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Enhanced ACh release
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List the toxins/toxicants that inhibit ACh release
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Pit viper and coral snake venom, also botulinum toxin
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Thallium (and radiation) causes what
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Alopecia (hair loss)
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Miosis (pinpoint pupils) is caused by what toxins/toxicants
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Opioids/Opiates, and organophosphate insecticides
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Mydriasis (dilated pupils) is caused by what toxins/toxicants
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Anticholinergics, cocaine, amphetamines
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Bradycardia can be caused by what
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a) Calcium channel antagonist overdose
b) Beta-blocker overdose c) Organophosphate insecticides |
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Tachycardia can be caused by what toxins/toxicants
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Amphetamines, Cocaine, Tricyclic antidepressants
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Trycyclic antidepressants exert toxicity by what mechanism(s)
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Poison Na+ channels causing wide QRS (delayed depolarization)
Poison K+ channels leading to QTc prolongation (prolonged repolarization) |
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Describe the main points of use and safety for activated charcoal
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No randomized control trial to confirm that AC is more effective than nothing
DO NOT give to unconscious patient not capable of protecting their own airway |
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How does one calculate anion gap
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(Na - (Cl + CO2))
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What is the normal anion gap
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<14
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How is osmolar gap calculated
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Measured value - (2Na + BUN/2.8 + BS/18)
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What are the major and minor modes of metabolism for acetaminophen (APAP)? Which forms toxic metabolites
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Mostly by glucuronidation and sulfonation
Minor by CYP2E1 - Forms toxic metabolites |
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What do salicylate do in regards to the mechanism of toxicity
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Uncouple oxidative phosphorylation
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How does sodium bicarbonate function to treat a salicylate overdose
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Alkalinizes urine promoting ion trapping in renal tubule
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Are salicylates dialyzable
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Yes, low molecular weight and Vd is low
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What is the antidote for iron overdose
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Deferroxamine
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What is/are the possible side effects of chronic deferroxamine use
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Yersinia sepsis or mucormycosis infection
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What are two possible toxins/drugs that can lead to neural tube defects (are teratogenic)
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Carbemazepine and valproic acid
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Carbemazepine and valproic acid can cause what
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Neural Tube Defects (teratogenic)
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How does digoxin function in toxicity
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Poisons Na/K ATPase leading to HYPERkalemia
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What is the antidote to digoxin
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Fab antibody
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Beta-blocker overdose can cause what
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Bradycardia, hypotension, and low blood glucose
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What is the treatment for a beta-blocker overdose? How?
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Glucagon - bypasses beta receptor to increase cyclic AMP
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Psychostimulants (ie amphetamine) lacking OH group on phenyl ring results in what
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Resistance to metabolism by COMT
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Describe the toxicity of methanol
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Conversion of methanol by ADH to formic acid which is toxic
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How can methanol toxicity be treated
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ADH inhibition by fomepizole (4-methyl pyrazole)
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Describe the toxicity of ethylene glycol
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Conversion of ethylene glycol by ADH to glycolic acid which is toxic
ALSO oxalic acid metabolite combines with calcium to form calcium oxalate crystals = HYPOCALCEMIA |
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How can ethyene glycol toxicity be treated
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ADH inhibition by fomepizole (4-methyl pyrazole)
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What does isopropanol cause
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KETOSIS
NOT metaboic acidosis |
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Aspiration pneumonitis are a risk of consuming
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Aliphatic hydrocarbons
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Aliphatic hydrocarbons are associated with what risk
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Aspiration pneumonitis
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Aromatic hydrocarbons (ie benzene) is associated with what risk
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Leukemia
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Solvents like toluene are associated with developing what
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Distal renal tubular acidosis and brain atrophy
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Carbon monoxide causes what
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Hypoxia
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How are snakebites treated
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Fab antivenin (CroFab)
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What does brown recluse venom cause
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Dermonecrosis
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What is important to know about lionfish venom
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It is heat labile
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What does ciguatera poisoning cause
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Reversal of cold-hot temperature sensation
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Cyclopeptide species mushrooms with amanitin function to cause poisoning by what mechanism
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Inhibition of RNA polymerase II
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Pathogens most associated with food poisoning are
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Staph, campylobacter, salmonella, and E coli O157:H7
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E coli O157:H7 is associated with what
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Hemolytic uremic syndrome caused by verotoxin
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Botulism is/has
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a) Descending paralysis
b) Inhibition of ACh release c) Specific EMG findings (Small brief, abundant motor unit action potentials after repetitive stimulation |
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Isoniazid (and hydrazine found in Gyromitra mushrooms) do what in terms of toxicity
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Inhibition of pyridoxine formation and therefore GABA
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What is the antidote for methemoglobinemia
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Methylene blue, doesn't work for G6PD
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What is the APAP mechanism of toxicity? How is it treated/reversed
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Forms NAPQI via CYP2E1 and detoxified endogenously by scavenger glutathione and therapeutic antidote N-acetylcytesine (NAC)
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How is the estimated blood level for a drug (based on osmolar gap) calculated
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Estimated blood level = (Osmolar gap x Molecular Weight)/10
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What is "A MUD PILE CAT"
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(Causes of anion gap acidosis)
Alcohol Methanol Uremia Diabetic ketoacidosis Paraldehyde, phenol Iron, Isoniazid, inborn errors of metabolism Lactic acidosis Ethylene glycol, diethylene glycol Carbon monoxide, cyanide Aspirin Toluene |
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What are the symptoms of Neuroleptic Malignant Syndrome (NMS)
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FALTER
Fever Autonomic instability Leukocytosis Tremor Elevated enzymes Rigidity of muscles |
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Serotonin toxicity can be caused by what drug combinations
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Paroxetine and meperidine
SSRI and dexometorphan |
