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170 Cards in this Set
- Front
- Back
Most important predictor of outcome with acetaminophen toxicity is:
|
4 hour post ingestion level. 150 or greater --> hepatic toxicity. 300 or greater --> severe liver damage
|
|
When should you give n-acetylcysteine?
|
When you know the 4 hour level is >150.
|
|
Toxidrome: tachycardia, nausea, vomiting htn, belly pain, diaphoresis, anorexia, tremulous, mydriasis, tachypnea, fever, delirium, psychosis
|
amphetamines
|
|
Toxidrome: mydriasis, absent sweating, ileus, tachycardia, delirium, disoriented, ataxia, halucinate, psychosis, seizure, coma, resp failure, urinary retention, hyperpyrexia,
|
anticholinergic
|
|
Toxidrome: salivation, lacrimation, emesis, bronchorrea, urination, diarrhea, cramping, seizures, miosis, bradycardia, muscle weakness
|
cholinergic (organophosphates)
|
|
Toxidrome: lethargy, coma, seizures, hypotension, prolonged qrs
|
cyclic antidepressants
|
|
Toxidrome: nausea, hematemesis, shock, hypotension, coma, hyperpyrexia, metaboic acidosis, coma, hepatitis,coma
|
iron
|
|
Toxidrome: rotary nystagmus, dissociative delusions, aggression, coma, seizures
|
phencyclidine
|
|
Toxidrome: tinnitus, tachypnea, confusion, fever, nausea, vomiting, metabolic acidosis
|
salicylates
|
|
Toxidrome: nausea, vomiting, tremors, tachycardia, arrhythmia, hypotension, confusion, seizures
|
theophylline
|
|
What substances do you NOT use activated charcoal for?
|
Cyanide, Alcohol, Lithium, Heavy Metals
|
|
What should you do with a coin in the proximal esophagus?
|
removed by endoscopy
|
|
Most important predictor of outcome with acetaminophen toxicity is:
|
4 hour post ingestion level. 150 or greater --> hepatic toxicity. 300 or greater --> severe liver damage
|
|
When do you give N-acetylcysteine without waiting for a tylenol level?
|
if they took more than 150 mg/kg
|
|
When should you give n-acetylcysteine?
|
When you know the 4 hour level is >150.
|
|
How do you treat a salicylate ingestion?
|
use sodium bicarb to alkalinize the urine. Address hypokalemia and hypoglycemia
|
|
Toxidrome: tachycardia, nausea, vomiting htn, belly pain, diaphoresis, anorexia, tremulous, mydriasis, tachypnea, fever, delirium, psychosis
|
amphetamines
|
|
How do you treat ibuprofen ingestion?
|
supportive care; check a tylenol level
|
|
Toxidrome: mydriasis, absent sweating, ileus, tachycardia, delirium, disoriented, ataxia, halucinate, psychosis, seizure, coma, resp failure, urinary retention, hyperpyrexia,
|
anticholinergic
|
|
Most common electrolyte abnormality with alcohol ingestion?
|
hypoglycemia
|
|
Toxidrome: pinpoint pupils, cyanosis, respiratory depression, bradycardia, hypotension, low temp
|
opiates
|
|
Toxidrome: salivation, lacrimation, emesis, bronchorrea, urination, diarrhea, cramping, seizures, miosis, bradycardia, muscle weakness
|
cholinergic (organophosphates)
|
|
Toxidrome: profuse sweating, tearing, abdominal pan, wheezing
|
organophosphates
|
|
Toxidrome: lethargy, coma, seizures, hypotension, prolonged qrs
|
cyclic antidepressants
|
|
How do you treat opiate toxicity?
|
narcan
|
|
Toxidrome: nausea, hematemesis, shock, hypotension, coma, hyperpyrexia, metaboic acidosis, coma, hepatitis,coma
|
iron
|
|
Toxidrome: rotary nystagmus, dissociative delusions, aggression, coma, seizures
|
phencyclidine
|
|
Toxidrome: violent, anasarca and mydriasis or asymmetric pupils
|
PCP
|
|
How do you treat organophosphate poisoning?
|
atropine
|
|
Toxidrome: tinnitus, tachypnea, confusion, fever, nausea, vomiting, metabolic acidosis
|
salicylates
|
|
Toxidrome: nausea, vomiting, tremors, tachycardia, arrhythmia, hypotension, confusion, seizures
|
theophylline
|
|
What is the mechanismo fo action of organophosphates?
|
interfere with acetylcholinesterase
|
|
Toxidrome: anorexia, headache, poor appetite, muscle weakness, visual disturbance, nausea, vomiting, fatigue
|
Digoxin toxicity
|
|
What substances do you NOT use activated charcoal for?
|
Cyanide, Alcohol, Lithium, Heavy Metals
|
|
Toxidrome: Anticholinergic symptoms with dysrhythmia
|
Tricyclic antidepressents
|
|
What should you do with a coin in the proximal esophagus?
|
removed by endoscopy
|
|
How do you treat TCA ingestion
|
alkalinize the urine; cardiac monitoring. - no cardiac meds.
|
|
When do you give N-acetylcysteine without waiting for a tylenol level?
|
if they took more than 150 mg/kg
|
|
Toxidrome: depressed sensoriu, bradycardia, hypotension, diaphoresis
|
beta blocker - cardiac monitoring needed.
|
|
How do you treat a salicylate ingestion?
|
use sodium bicarb to alkalinize the urine. Address hypokalemia and hypoglycemia
|
|
Toxidrome: hypoxemia, diffuse bilateral infiltrates, cough, tachypnea, history of choking/gagging
|
hydrocarbon
|
|
How do you treat ibuprofen ingestion?
|
supportive care; check a tylenol level
|
|
Most important predictor of outcome with acetaminophen toxicity is:
|
4 hour post ingestion level. 150 or greater --> hepatic toxicity. 300 or greater --> severe liver damage
|
|
When should you use a hyperbaric chamber for carbon monoxide poison? (when level is greater than. . . and 4 other things )
|
25%, pregnancy, acidsois, cardiac involvement, neuro involvement
|
|
Most common electrolyte abnormality with alcohol ingestion?
|
hypoglycemia
|
|
When should you give n-acetylcysteine?
|
When you know the 4 hour level is >150.
|
|
How do you distinguish cyanide poisoning from carbon monoxide?
|
Carbon monoxide responds to 100% O2 and improves.
|
|
Toxidrome: pinpoint pupils, cyanosis, respiratory depression, bradycardia, hypotension, low temp
|
opiates
|
|
Treatment for cyanide poisoning
|
sodium thiosulfate
|
|
Toxidrome: tachycardia, nausea, vomiting htn, belly pain, diaphoresis, anorexia, tremulous, mydriasis, tachypnea, fever, delirium, psychosis
|
amphetamines
|
|
Toxidrome: profuse sweating, tearing, abdominal pan, wheezing
|
organophosphates
|
|
Most important predictor of outcome with acetaminophen toxicity is:
|
4 hour post ingestion level. 150 or greater --> hepatic toxicity. 300 or greater --> severe liver damage
|
|
Toxidrome: looks drunk, large anon gap, oxalate crystals on UA
|
ethylene glycol
|
|
Toxidrome: mydriasis, absent sweating, ileus, tachycardia, delirium, disoriented, ataxia, halucinate, psychosis, seizure, coma, resp failure, urinary retention, hyperpyrexia,
|
anticholinergic
|
|
How do you treat opiate toxicity?
|
narcan
|
|
How do you treat iron ingestion?
|
Serum iron level 3-5 hours out; >500, use deferoxamine and gastric lavage
|
|
Toxidrome: violent, anasarca and mydriasis or asymmetric pupils
|
PCP
|
|
Toxidrome: salivation, lacrimation, emesis, bronchorrea, urination, diarrhea, cramping, seizures, miosis, bradycardia, muscle weakness
|
cholinergic (organophosphates)
|
|
Toxidrome: lethargy, coma, seizures, hypotension, prolonged qrs
|
cyclic antidepressants
|
|
How do you treat organophosphate poisoning?
|
atropine
|
|
How do you treat methemoglobinemia
|
methylene blue
|
|
When should you give n-acetylcysteine?
|
When you know the 4 hour level is >150.
|
|
Toxidrome: nausea, hematemesis, shock, hypotension, coma, hyperpyrexia, metaboic acidosis, coma, hepatitis,coma
|
iron
|
|
What meds put you at risk for methemoglobenemia
|
dapsone, sulfa, nitrates, teething baby (lidocaine), rasburicase, muscle relaxing gels
|
|
What is the mechanismo fo action of organophosphates?
|
interfere with acetylcholinesterase
|
|
Toxidrome: tachycardia, nausea, vomiting htn, belly pain, diaphoresis, anorexia, tremulous, mydriasis, tachypnea, fever, delirium, psychosis
|
amphetamines
|
|
Toxidrome: rotary nystagmus, dissociative delusions, aggression, coma, seizures
|
phencyclidine
|
|
Toxidrome: anorexia, headache, poor appetite, muscle weakness, visual disturbance, nausea, vomiting, fatigue
|
Digoxin toxicity
|
|
Toxidrome: Anticholinergic symptoms with dysrhythmia
|
Tricyclic antidepressents
|
|
How do you treat TCA ingestion
|
alkalinize the urine; cardiac monitoring. - no cardiac meds.
|
|
Toxidrome: tinnitus, tachypnea, confusion, fever, nausea, vomiting, metabolic acidosis
|
salicylates
|
|
Toxidrome: mydriasis, absent sweating, ileus, tachycardia, delirium, disoriented, ataxia, halucinate, psychosis, seizure, coma, resp failure, urinary retention, hyperpyrexia,
|
anticholinergic
|
|
Toxidrome: salivation, lacrimation, emesis, bronchorrea, urination, diarrhea, cramping, seizures, miosis, bradycardia, muscle weakness
|
cholinergic (organophosphates)
|
|
Toxidrome: depressed sensoriu, bradycardia, hypotension, diaphoresis
|
beta blocker - cardiac monitoring needed.
|
|
Toxidrome: nausea, vomiting, tremors, tachycardia, arrhythmia, hypotension, confusion, seizures
|
theophylline
|
|
Toxidrome: hypoxemia, diffuse bilateral infiltrates, cough, tachypnea, history of choking/gagging
|
hydrocarbon
|
|
When should you use a hyperbaric chamber for carbon monoxide poison? (when level is greater than. . . and 4 other things )
|
25%, pregnancy, acidsois, cardiac involvement, neuro involvement
|
|
Toxidrome: lethargy, coma, seizures, hypotension, prolonged qrs
|
cyclic antidepressants
|
|
What substances do you NOT use activated charcoal for?
|
Cyanide, Alcohol, Lithium, Heavy Metals
|
|
Toxidrome: nausea, hematemesis, shock, hypotension, coma, hyperpyrexia, metaboic acidosis, coma, hepatitis,coma
|
iron
|
|
What should you do with a coin in the proximal esophagus?
|
removed by endoscopy
|
|
How do you distinguish cyanide poisoning from carbon monoxide?
|
Carbon monoxide responds to 100% O2 and improves.
|
|
Toxidrome: rotary nystagmus, dissociative delusions, aggression, coma, seizures
|
phencyclidine
|
|
When do you give N-acetylcysteine without waiting for a tylenol level?
|
if they took more than 150 mg/kg
|
|
Treatment for cyanide poisoning
|
sodium thiosulfate
|
|
Toxidrome: looks drunk, large anon gap, oxalate crystals on UA
|
ethylene glycol
|
|
How do you treat a salicylate ingestion?
|
use sodium bicarb to alkalinize the urine. Address hypokalemia and hypoglycemia
|
|
How do you treat iron ingestion?
|
Serum iron level 3-5 hours out; >500, use deferoxamine and gastric lavage
|
|
How do you treat ibuprofen ingestion?
|
supportive care; check a tylenol level
|
|
Toxidrome: tinnitus, tachypnea, confusion, fever, nausea, vomiting, metabolic acidosis
|
salicylates
|
|
How do you treat methemoglobinemia
|
methylene blue
|
|
Most common electrolyte abnormality with alcohol ingestion?
|
hypoglycemia
|
|
Toxidrome: nausea, vomiting, tremors, tachycardia, arrhythmia, hypotension, confusion, seizures
|
theophylline
|
|
What substances do you NOT use activated charcoal for?
|
Cyanide, Alcohol, Lithium, Heavy Metals
|
|
Toxidrome: pinpoint pupils, cyanosis, respiratory depression, bradycardia, hypotension, low temp
|
opiates
|
|
What meds put you at risk for methemoglobenemia
|
dapsone, sulfa, nitrates, teething baby (lidocaine), rasburicase, muscle relaxing gels
|
|
What should you do with a coin in the proximal esophagus?
|
removed by endoscopy
|
|
Toxidrome: profuse sweating, tearing, abdominal pan, wheezing
|
organophosphates
|
|
When do you give N-acetylcysteine without waiting for a tylenol level?
|
if they took more than 150 mg/kg
|
|
How do you treat opiate toxicity?
|
narcan
|
|
How do you treat a salicylate ingestion?
|
use sodium bicarb to alkalinize the urine. Address hypokalemia and hypoglycemia
|
|
Toxidrome: violent, anasarca and mydriasis or asymmetric pupils
|
PCP
|
|
How do you treat ibuprofen ingestion?
|
supportive care; check a tylenol level
|
|
How do you treat organophosphate poisoning?
|
atropine
|
|
What is the mechanismo fo action of organophosphates?
|
interfere with acetylcholinesterase
|
|
Most common electrolyte abnormality with alcohol ingestion?
|
hypoglycemia
|
|
Toxidrome: pinpoint pupils, cyanosis, respiratory depression, bradycardia, hypotension, low temp
|
opiates
|
|
Toxidrome: anorexia, headache, poor appetite, muscle weakness, visual disturbance, nausea, vomiting, fatigue
|
Digoxin toxicity
|
|
Toxidrome: profuse sweating, tearing, abdominal pan, wheezing
|
organophosphates
|
|
Toxidrome: Anticholinergic symptoms with dysrhythmia
|
Tricyclic antidepressents
|
|
How do you treat TCA ingestion
|
alkalinize the urine; cardiac monitoring. - no cardiac meds.
|
|
How do you treat opiate toxicity?
|
narcan
|
|
Toxidrome: depressed sensoriu, bradycardia, hypotension, diaphoresis
|
beta blocker - cardiac monitoring needed.
|
|
Toxidrome: violent, anasarca and mydriasis or asymmetric pupils
|
PCP
|
|
Toxidrome: hypoxemia, diffuse bilateral infiltrates, cough, tachypnea, history of choking/gagging
|
hydrocarbon
|
|
How do you treat organophosphate poisoning?
|
atropine
|
|
When should you use a hyperbaric chamber for carbon monoxide poison? (when level is greater than. . . and 4 other things )
|
25%, pregnancy, acidsois, cardiac involvement, neuro involvement
|
|
What is the mechanismo fo action of organophosphates?
|
interfere with acetylcholinesterase
|
|
Most important predictor of outcome with acetaminophen toxicity is:
|
4 hour post ingestion level. 150 or greater --> hepatic toxicity. 300 or greater --> severe liver damage
|
|
How do you distinguish cyanide poisoning from carbon monoxide?
|
Carbon monoxide responds to 100% O2 and improves.
|
|
Toxidrome: anorexia, headache, poor appetite, muscle weakness, visual disturbance, nausea, vomiting, fatigue
|
Digoxin toxicity
|
|
When should you give n-acetylcysteine?
|
When you know the 4 hour level is >150.
|
|
Treatment for cyanide poisoning
|
sodium thiosulfate
|
|
Toxidrome: Anticholinergic symptoms with dysrhythmia
|
Tricyclic antidepressents
|
|
Toxidrome: tachycardia, nausea, vomiting htn, belly pain, diaphoresis, anorexia, tremulous, mydriasis, tachypnea, fever, delirium, psychosis
|
amphetamines
|
|
Toxidrome: looks drunk, large anon gap, oxalate crystals on UA
|
ethylene glycol
|
|
How do you treat TCA ingestion
|
alkalinize the urine; cardiac monitoring. - no cardiac meds.
|
|
Toxidrome: mydriasis, absent sweating, ileus, tachycardia, delirium, disoriented, ataxia, halucinate, psychosis, seizure, coma, resp failure, urinary retention, hyperpyrexia,
|
anticholinergic
|
|
How do you treat iron ingestion?
|
Serum iron level 3-5 hours out; >500, use deferoxamine and gastric lavage
|
|
Toxidrome: depressed sensoriu, bradycardia, hypotension, diaphoresis
|
beta blocker - cardiac monitoring needed.
|
|
Toxidrome: salivation, lacrimation, emesis, bronchorrea, urination, diarrhea, cramping, seizures, miosis, bradycardia, muscle weakness
|
cholinergic (organophosphates)
|
|
How do you treat methemoglobinemia
|
methylene blue
|
|
Toxidrome: hypoxemia, diffuse bilateral infiltrates, cough, tachypnea, history of choking/gagging
|
hydrocarbon
|
|
Toxidrome: lethargy, coma, seizures, hypotension, prolonged qrs
|
cyclic antidepressants
|
|
Toxidrome: nausea, hematemesis, shock, hypotension, coma, hyperpyrexia, metaboic acidosis, coma, hepatitis,coma
|
iron
|
|
When should you use a hyperbaric chamber for carbon monoxide poison? (when level is greater than. . . and 4 other things )
|
25%, pregnancy, acidsois, cardiac involvement, neuro involvement
|
|
What meds put you at risk for methemoglobenemia
|
dapsone, sulfa, nitrates, teething baby (lidocaine), rasburicase, muscle relaxing gels
|
|
How do you distinguish cyanide poisoning from carbon monoxide?
|
Carbon monoxide responds to 100% O2 and improves.
|
|
Toxidrome: rotary nystagmus, dissociative delusions, aggression, coma, seizures
|
phencyclidine
|
|
Toxidrome: tinnitus, tachypnea, confusion, fever, nausea, vomiting, metabolic acidosis
|
salicylates
|
|
Treatment for cyanide poisoning
|
sodium thiosulfate
|
|
Toxidrome: nausea, vomiting, tremors, tachycardia, arrhythmia, hypotension, confusion, seizures
|
theophylline
|
|
Toxidrome: looks drunk, large anon gap, oxalate crystals on UA
|
ethylene glycol
|
|
What substances do you NOT use activated charcoal for?
|
Cyanide, Alcohol, Lithium, Heavy Metals
|
|
How do you treat iron ingestion?
|
Serum iron level 3-5 hours out; >500, use deferoxamine and gastric lavage
|
|
How do you treat methemoglobinemia
|
methylene blue
|
|
What should you do with a coin in the proximal esophagus?
|
removed by endoscopy
|
|
When do you give N-acetylcysteine without waiting for a tylenol level?
|
if they took more than 150 mg/kg
|
|
What meds put you at risk for methemoglobenemia
|
dapsone, sulfa, nitrates, teething baby (lidocaine), rasburicase, muscle relaxing gels
|
|
How do you treat a salicylate ingestion?
|
use sodium bicarb to alkalinize the urine. Address hypokalemia and hypoglycemia
|
|
How do you treat ibuprofen ingestion?
|
supportive care; check a tylenol level
|
|
Most common electrolyte abnormality with alcohol ingestion?
|
hypoglycemia
|
|
Toxidrome: pinpoint pupils, cyanosis, respiratory depression, bradycardia, hypotension, low temp
|
opiates
|
|
Toxidrome: profuse sweating, tearing, abdominal pan, wheezing
|
organophosphates
|
|
How do you treat opiate toxicity?
|
narcan
|
|
Toxidrome: violent, anasarca and mydriasis or asymmetric pupils
|
PCP
|
|
How do you treat organophosphate poisoning?
|
atropine
|
|
What is the mechanismo fo action of organophosphates?
|
interfere with acetylcholinesterase
|
|
Toxidrome: anorexia, headache, poor appetite, muscle weakness, visual disturbance, nausea, vomiting, fatigue
|
Digoxin toxicity
|
|
Toxidrome: Anticholinergic symptoms with dysrhythmia
|
Tricyclic antidepressents
|
|
How do you treat TCA ingestion
|
alkalinize the urine; cardiac monitoring. - no cardiac meds.
|
|
Toxidrome: depressed sensoriu, bradycardia, hypotension, diaphoresis
|
beta blocker - cardiac monitoring needed.
|
|
Toxidrome: hypoxemia, diffuse bilateral infiltrates, cough, tachypnea, history of choking/gagging
|
hydrocarbon
|
|
When should you use a hyperbaric chamber for carbon monoxide poison? (when level is greater than. . . and 4 other things )
|
25%, pregnancy, acidsois, cardiac involvement, neuro involvement
|
|
How do you distinguish cyanide poisoning from carbon monoxide?
|
Carbon monoxide responds to 100% O2 and improves.
|
|
Treatment for cyanide poisoning
|
sodium thiosulfate
|
|
Toxidrome: looks drunk, large anon gap, oxalate crystals on UA
|
ethylene glycol
|
|
How do you treat iron ingestion?
|
Serum iron level 3-5 hours out; >500, use deferoxamine and gastric lavage
|
|
How do you treat methemoglobinemia
|
methylene blue
|
|
What meds put you at risk for methemoglobenemia
|
dapsone, sulfa, nitrates, teething baby (lidocaine), rasburicase, muscle relaxing gels
|