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24 Cards in this Set
- Front
- Back
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3 conditions that respond rapidly to anidotes
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o Hypoxia → O2
o Hypoglycemia → glucose, glucagon o Heroin (opiates) → Narcan (+ support ventilation) |
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Dry
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anticholinergics(psychotic), antihistamines
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WET
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sympathomimetics( psychotic), cholinergics
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Goal pH for the eyes?
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7.3-7.5 (test with pH strip)
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3 GI decontamination options?
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• Remove from gut: ipecac, gastric lavage
• Bind within the gut: charcoal • Flush through the gut: cathartics, GoLYTELY |
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Ipecac CI
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• AMS (can’t protect airway)
• Actively vomiting • Caustic ingestion (burns going down, burns coming up!) • Hydrocarbons (heavy particles, can get into lungs) |
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Ipecac complications
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• Aspiration
• Mallory-Weiss tear • Intractable vomiting |
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activated charcoal dose
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1-2 g/kg
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Charcoal CI
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• Caustic ingestion
• Aspiration risk (AMS) • Poisons it will not adsorb: PHAILS |
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Charcoal PHAILS
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o Pesticides
o Hydrocarbons o Acids/Alkalis o Iron o Lithium/lead o Solvents |
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tube used on gastric lavage
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36-40F
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What is given in whole bowel irrigation
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polyethylene glycol solutions to speed up the transit of substances
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What life threatening ingestions is HD indcated for (I STUMBLE)
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• Isopropanol
• Salicylates • Theophylline/caffeine • Uremia • Methanol • Barbiturates and Beta-blockers • Lithium • Ethylene glycol and an electrolyte – K+ |
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Hemoperfusion is the addition of a charcoal filter to dialysis?
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Indications: theophylline, Amanita mushrooms
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What is concept of urine alkinization
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weak acids are converted to stronger ions so that they can’t be reabsorbed by the kidney tubules and instead are eliminated in the urine
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Dose and solution given for urine alkinization
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1-2 mEq/kg bolus of NaHCO3
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urine alkinization serum and blood pH goal
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• Urinary pH of 7.5-8.0
• Serum pH of < 7.5-7.55 |
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Urinary alkinization SE and cause
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volume overload,
hypokalemia-Due to the H for K exchange – H is coming out of the cells and K is going in → hypokalemia |
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Complications of forced diuresis
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cerebral edema, pulmonary edema
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enterohepatic dialysis theory
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some absorbed drugs are excreted in the bile; multi-dose charcoal provides a 2nd chance for it to bind
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What are drugs that will enter circulation in large doses warrenting enterohepatic dialysis
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o Carbamazepine
o Dapsone o Phenobarb o Quinine o Theophylline o Salicylates |
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What do cathartics such as sorbitol do
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oReduces transit time for the toxin, but is only theoretically beneficial (data are ambivalent)
oMay effect electrolytes (diarrhea → electrolyte disturbance) |
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CI to cathartics
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•< 5 y.o.
•Renal failure •Caustic ingestion •Took something that will cause diarrhea on its own |
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What drugs can you get serum levels for
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acetaminophen, salicylates, ethanol, lithium, digoxin, anti-seizure meds, theophylline, lead, carbon monoxide, methemoglobinemia
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