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30 Cards in this Set
- Front
- Back
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All patients with altered mental status mus immediatetly receive which 4 things
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Oxygen, naloxone, thiamine and glucose
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What are the two most helpful vital signs in assesing poisoning
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Pulse rate and pupillary size
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substances causing Nystagmus
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Alcohol, Barbiturates, phenytoin, carbamazepine
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Substances that have a garlic odor in poisoned patients
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DMSO, Arsenic, organophosphates, phosphorus, thallium
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Drugs that have a bitter almond odor in poisoned patients
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Cyanide, apricot pits
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Substances that cause bulous lesions
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Barbituates, CO
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How do you calculate anion gap
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AG = Na - (HCO3 + Cl)
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What is the normal anion gap
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12 +/- 4 mEq/L
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Causes of High Anion gap
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MUDPILES -- Methanol, Uremia, Diabetes, Paraldehyde/phenformin, Iron/isoniazid, Lactate (cocaine), Ethelyne glycol, Salicylates
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Causes of decreased anion gap
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Lithium and bromide
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Toxins hat increase osmolal gap
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methanol, ethanol, isopropanol, theylene glycol, acetone, osmotic diuretics. Normal osmolal gap does NOT exclude toxic alcohol ingestion
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Is the toxicoligy screen more sensitive or specific
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Has good specificity but poor sensitivity
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what will serum drug screens test for
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Salicylates, acetaminophen, ethanol, TCA, Benzos and barbs
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What is the function of cathartics and what are some of the commonly used ones
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causing added osmotic load to gut. Allows rapid removal of charcoal/drug from body. Mg citrate/sulfate and Sorbitol are the most common used. Sorbitol is the most rapid
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What are some of the things that charcoal cannot bind
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Metal like iron and lithium, alcohols
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What is the function of whole bowel irrigation and what is used to do this
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originally for pre bowel surgery. Used in cases of poisoning with lithium/iron not absorbed by charcoal, body packers, ingestion of foreign objects like bags with cocaine. WBI is carried out by POLYETHYLENE GLYCOL
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Acid trapping can be used for which drugs
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Basic drugs -- PCP and amphetamines. High risk due to myoglobinuric renal failure
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Antidote for HF acid
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Calcium
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Chelator of Lead, cadmium, copper and zinc
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EDTA
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chelator of Iron/aluminum
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Deferoxamine
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Chelator of arsenic, lead, gold, inorganic Hg
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Dimercaprol (BAL)
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chelator of Lead and mercury
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Dimercaptosuccinic acid (DMSA)
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What is the antidote for drugs causing methemoglobinemia
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Methylene blue
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What is the antidote for heparin poisoning
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Protamine and Vit K
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What are some of the irritants of inhalation syndrome
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Phosgene, Chlorine and Ammonia
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What would you suspect in a group of people with small pupils, sweating and secretions, difficulty breathing, NVD
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Organophosphate poisoning
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What would you suspect is early NVD, headache, dizzy, followed by collabpse and severe metabolic ACIDOSIS
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Cyanide. Possibly Hydrogen sulfide
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What would you suspect with groups of people with blistering rashes
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Mustards. Acid/alkaline corrosives
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what if present with palpitations, dizziness, passing out and chest pain
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Myocardial syndrome -- halogenated and aromatic hydrocarbons
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What if people with blue skin, headaches and difficulty breathing
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Hematologic syndrome -- oxidants, Methemoglobinemia
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