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47 Cards in this Set

  • Front
  • Back
What is the most common cause of poisoning death?
carbon monoxide
If patient has hypotension and bradycardia, which drug classes may have caused it? (3)
beta blockers
calcium channel blockers
clonidine
What are the ABCs of poisoning overdose?
airway
breathing
circulation
What are the three ways to alter the kinetics of a poison?
prevent absorption (decontamination)
prevent distribution to target site
enhance elimination
Which is preferred if death is a high risk?
(orogastric lavage/activated charcoal)
orogastric lavage
What is the optimal time frame for orogastric lavage after poisoning?
< 1 hour after exposure
Which is preferred if patient is likely to have adverse effect rleated to a drug?
(orogastric lavage/activated charcoal)
activated charcoal
When will you NOT use charcoal? (2)
hydrocarbons
elementally small (heavy metals, lithium, simple alcohols, caustics) - won't bind charcoal
What is the ratio of activated charcoal to poison?
10:1
Whole bowel irrigation is composed of what?
PEG and electrolytes
Chelators typically have what element? (2)
sulfur or nitrogen
Soft metals bind with what type of chelator?
sulfur donors
gold, silver, mercury, copper I are (soft/hard/borderline) metals
soft
Hard metals bind with what type of chelator?
oxygen seekers
sodium, potassium, calcium, magnesium, aluminum are (soft/hard/borderline) metals
hard
Borderline metals bind with what type of chelator?
nitrogen donors
lead, cadmium, copper 2, arsenic, zinc are (soft/hard/borderline) metals
borderline
Which type of snakes are neurotoxic?
elapidae
Which types of snakes are coagulopathic?
viperidae
Elapid antivenom is mono- or polyvalent?
monovalent
CroFab is mono- or polyvalent?
polyvalent
What is the advantage to using CroFab?
Contains only the Fab portion of the antibody
(Fc portion can elicit allergic reaction)
What antidote is used for digoxin overdose?
DigiFab
What enzyme is responsible for metabolizing alcohols?
alcohol dehydrogenase
What drug is a competitive inhibitor of alcohol dehydrogenase?
fomepizole
Sodium bicarbonate is used as treatment for overdose on what two types of medications?
ASA, TCAs
Treatment of ASA overdose with sodium bicarbonate is a (kinetic/dynamic) mechanism
Kinetic
(enhances elimination by urinary alkalinization and ion trapping)
Treatment of TCA overdose with sodium bicarbonate is a (kinetic/dynamic) mechanism
Dynamic
(alkalinized serum and gives sodium load - increases protein binding and corrects dysrhythmias)
Acetaminophen has what effects on the liver 12 hours after overdose? (2)
rising ALT/AST
increased INR (liver failure)
What is the free radical created in acetaminophen overdose?
NAPQI
What is the treatment for acetaminophen overdose?
N-acetylcysteine
What are the treatments for beta blocker overdose? (2)
epinephrine
glucagon
Which binds unblocked beta receptors coupled to a G-protein that activates adenylyl cyclase to make cAMP?
(epinephrine/glucagon)
epinephrine
Which bypasses the beta receptor and acts directly on the G-protein that activates adenylyl cyclase to convert ATP to cAMP?
(epinephrine/glucagon)
glucagon
What are the treatments for calcium channel blocker overdose? (4)
exogenous calcium
amrinone
epinephrine
insulin
What overdose is amrinone indicated for?
What is its mechanism?
calcium channel blocker toxicity

inhibits PDE from breaking down cAMP (not very effective clinically)
Which treatment is associated with influx of potassium that may also prolong repolarization and allow calcium channels to remain open longer?
(exogenous calcium, amrinone, epinephrine, insulin)
insulin
Which toxin binds to cytochrome A3 in the electron transport chain?
cyanide
What is the major effect of cyanide?
(metabolic/respiratory acidosis/alkalosis)
metabolic acidosis
What are the treatments for cyanide poisoning? (3)
fresh air/oxygen
3 drug kit
cyanocobalamin
What components make up the three drug kit for cyanide poisoning?
amyl nitrite
sodium nitrite
sodium thiosulfate
How does hydroxocobalamin treat cyanide toxicity?
chelates cyanide
What class of drugs give characteristics of "red as a beet, dry as a bone, hot as a hare, blind as a bat, mad as a hatter"?
anticholinergics (Anti-SLUDD)
What are the treatments for anticholinergic overdose? (2)
benzos (first)
physostigmine (reversible cholinesterase inhibitor)
What is the treatment for opiate overdose?
Naloxone (opioid antagonist)
Piloerection in a patient with suspected opioid overdose is indicative of what?
Coingestant preventing them from waking up
What drug is used to avoid intubation (wake you up) from benzodiazepine overdose?
flumenazil