Toxicology For Emergency Medicine

Front 1

name 3 signs of the opioid toxidrome

Back 1

miosis, altered mental status, respiratory depression

Front 2

what is the treatment for opiate toxicity

Back 2

naloxone 0.05-0.1 mg IV with incremental dosing

Front 3

name 4 signs of opiate withdrawal

Back 3

diarrhea, abdominal cramps, piloerection, and yawning. note these are similar to sympathomimetic toxidrome.

Front 4

name 3 signs of sedative/hypnotic toxidrome

Back 4

mental status depression from drowsiness to coma, ataxia and respiratory depression

Front 5

name 3 agents capable of causing sedative/hypnotic toxidrome

Back 5

benzodiazepines, barbiturates, Gamma hydroxybutyrate

Front 6

How is sedative/hypnotic toxidrome treated

Back 6

mainly supportive care, with the exception of flumazenil as a reversal agent for benzodiazepines

Front 7

name 9 different symptoms of the extrapyramidal toxidrome

Back 7

oculogyric crisis, rigidity, torticollis, trismus, dysphagia, dystonia, akathisia, neuroleptic malignant syndrome, chloride dyskinesia

Front 8

name 3 agents capable of causing an extrapyrimadal toxidrome

Back 8

haloperidol, phenothiazine, metoclopramide

Front 9

what is the treatment for an extrapyrimadal toxidrome

Back 9

Benadryl 1-2 mg per kilogram IV every 6 hours; benztropine 0.05 mg per kilogram IV every 12 hours; benzodiazepines

Front 10

name 5 different methods for gastric emptying

Back 10

induced emesis, gastric lavage, activated charcoal, cathartics, whole bowel irrigation

Front 11

name 3 signs of the opioid toxidrome

Back 11

miosis, altered mental status, respiratory depression

Front 12

what is the treatment for opiate toxicity

Back 12

naloxone 0.05-0.1 mg IV with incremental dosing

Front 13

name 4 signs of opiate withdrawal

Back 13

diarrhea, abdominal cramps, piloerection, and yawning. note these are similar to sympathomimetic toxidrome.

Front 14

name 3 signs of sedative/hypnotic toxidrome

Back 14

mental status depression from drowsiness to coma, ataxia and respiratory depression

Front 15

name 3 agents capable of causing sedative/hypnotic toxidrome

Back 15

benzodiazepines, barbiturates, Gamma hydroxybutyrate

Front 16

How is sedative/hypnotic toxidrome treated

Back 16

mainly supportive care, with the exception of flumazenil as a reversal agent for benzodiazepines

Front 17

name 9 different symptoms of the extrapyramidal toxidrome

Back 17

oculogyric crisis, rigidity, torticollis, trismus, dysphagia, dystonia, akathisia, neuroleptic malignant syndrome, chloride dyskinesia

Front 18

name 3 agents capable of causing an extrapyrimadal toxidrome

Back 18

haloperidol, phenothiazine, metoclopramide

Front 19

what is the treatment for an extrapyrimadal toxidrome

Back 19

Benadryl 1-2 mg per kilogram IV every 6 hours; benztropine 0.05 mg per kilogram IV every 12 hours; benzodiazepines

Front 20

name 5 different methods for gastric emptying

Back 20

induced emesis, gastric lavage, activated charcoal, cathartics, whole bowel irrigation

Front 21

what is the current role of ipecac in gastric decontamination

Back 21

minimal. In recent years, the utility of ipecac has been challenged. if he used ipecac is best administered under 30 minutes from time of ingestion. the American Academy of pediatrics no longer recommends families keep ipecac in their homes

Front 22

what are 6 contraindications to ipecac use

Back 22

limited airway protection, vomiting, altered mental status, seizing, age under 6 months, caustic ingestions

Front 23

what is the role of gastric lavage in gastric decontamination

Back 23

used for ingestions occurring within the hour of potentially life threatening calcium channel blockers or TCA

Front 24

what are 4 contra indications to gastric lavage

Back 24

nontoxic or mildly toxic ingestions, caustic ingestions, hydrocarbons, large pills which do not fit through oral gastric tubing

Front 25

what are 4 wayts to prevent aspiration during gastric lavage

Back 25

placing the patient in the left lateral decubitus position, Trendelenburg position, having suction readily available, definitive airway protection through intubation

Front 26

what size tube should be used for gastric lavage

Back 26

36-40 French orogastric

Front 27

what is the mechanism of action of activated charcoal

Back 27

direct absorption of toxin via the large molecular surface area provided by charcoal. Charcoal acts also by "gut dialysis" providing a change in the concentration gradient allowing toxin to flow from the intrahepatic circulation back in to the gut for excretion via charcoal

Front 28

what is the current role that activated charcoal plays in gastric decontamination

Back 28

activated charcoal is more commonly used tool for gastric decontamination. Best if used within one hour of ingestion

Front 29

name 6 toxins not readily resorbed by activated charcoal

Back 29

iron, lithium, heavy metals, hydrocarbons, caustics, alcohols

Front 30

name 5 potential toxins for which multiple dose activated charcoal treatment is appropriate

Back 30

theophylline, sustained release drugs, phenobarbital, salicylates, carbamazepine

Front 31

name 6 toxidromes

Back 31

sympathomimetic, anti-cholinergic, cholinergic, opioid, sedative/hypnotic, extrapyramidal

Front 32

name 10 different symptoms of the sympathomimetic toxidrome

Back 32

tachycardia, hypertension, diaphoresis, dilated pupils, agitation, seizures, altered mental status, hyperthermia, piloerection, cardiac dysrhythmias

Front 33

name 5 different agents capable of causing the sympathomimetic toxidrome

Back 33

cocaine, amphetamines, theophylline, over-the-counter decongestions, caffeine

Front 34

what is the treatment for sympathomimetic toxidrome

Back 34

benzodiazepines, hydration and cooling

Front 35

name 3 mimics of the and have to mimetic toxidrome

Back 35

hypoglycemia, alcohol withdrawal, benzodiazepine withdrawal

Front 36

name 11 different anticholinergic toxidrome symptoms

Back 36

tachycardia, hypertension, flushed but dry skin, dilated pupils, agitation, hyperthermia, hallucinations, seizures, urinary retention, sedation, coma

Front 37

what series of phrases is helpful and remembering the anticholinergic toxidrome

Back 37

mad at a hatter, hot as a hare, dry as a bone, blind is a bat, and red as a beet

Front 38

what are two distinguishing feature between the anticholinergic and sympathomimetic toxidrome

Back 38

there is no diaphoresis in the anticholinergic toxidrome. urinary retention is present with anticholinergic crisis