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2010-12-08 17:50:52

Therapeutics Week 15 - Intro to Toxicology
Show Answers:

  1. What is the Poison Control Center number?
  2. What is a toxidrome?
    A compound that produces characteristic clinical pictures. (We know exactly what s/s to expect from this specific compound)
  3. Effects of sympathomimetics on BP, HR, Temp, Eyes, Mental Status, and other
    • BP up
    • HR up
    • Temp slightly up
    • Eyes - mydriasis
    • Mental status - hyperalert
    • Other - increased reflexes, tremor

    (e.g. meth, sudafed)
  4. Effects of Anticholinergics on BP, HR, Temp, Eyes, Mental Status, and other
    • BP up slightly or no change
    • HR up
    • Temp up
    • Eyes- mydriasis
    • Mental Status - altered
    • Bowel sounds decreased
  5. Effects of Cholinergics on BP, HR, Temp, Eyes, Mental Status, and other
    • BP down slightly or no change
    • HR down
    • Temp no change
    • Eyes - miosis
    • Mental status altered
    • Increased bronchial sounds
    • Increased bowel sounds
  6. Effects of opioids on BP, HR, Temp, Eyes, Mental Status, and other
    • BP down
    • HR down
    • Temp down
    • Eyes - miosis
    • LOC decreased
    • Decreased bowel sounds
    • Lungs - late rales

    (demerol doesn't cause small pupils)
  7. Effects of sedative-hypnotics on BP, HR, Temp, Eyes, Mental Status, and other
    • BP down
    • HR down
    • Temp down
    • Eyes - miosis (can cause mydriasis)
    • Resp rate down
    • Peristalsis decreased
    • Hyporeflexia
  8. Who should not receive ipecac?
    • Pts with no gag reflex, unconscious, comatose, expected to become non-responsive within the next 30 min, children, elderly, pregnant, debilitated, history of seizures
    • Not for corrosive agents
  9. Limitations/complications of gastric lavage
    • Ingestion within past hour only
    • Not for hydrocarbons or corrosive agents
    • Aspiration
    • Mechanical injury to esophagus and/or stomach
    • Fluid and electrolyte imbalance
    • Acid/base disorders
  10. Which two main compounds does activated charcoal single dose NOT work for?
    • Iron
    • Lithium
  11. What agents does multi-dose activated charcoal work for?
    • Carbamazepine
    • Theophylline
    • Phenobarbital
    • Quinine
    • Dapsone
  12. Which meds is hemodialysis useful for?
    • Methanol
    • Ethylene glycol
    • Salicylates
    • Ethanol (usually don't dialyze)
    • Theophylline (usually don't dialyze)
    • Lithium (dialyze if pt is > 4 with chronic use, > 6 with acute exposure, or if 2.5 - 4 if symptomatic)
  13. Antidote and MOA for acetaminophen poisoning
    • N-acetylcysteine
    • maintains or restores hepatic concentrations of glutathione
  14. 2 antidotes for cholinesterase inhibitors such as organophosphorous and n-methylcarbamate insecticides
    • atropine
    • pralidoxime
  15. Antidote for rattlesnakes, cottonmouths, copperheads
    Crotalidide antivenin
  16. Antidote for black widow spider envenomation
    Antivenin - Latrodectus mactans
  17. Antidote for coral snake venom
    Antivenin - Micrurus fulvius
  18. Antidote for CCBs and fluoride and its MOA
    • Calcium gluconate and chloride
    • Increase intracellular levels of calcium
  19. Antidote for lead poisoning
    Calcium disodium EDTA
  20. Antidote for internal contamination with plutonium, americum, curium
    Calcium trisodium pentetate
  21. Antidote for cyanide poisoning
    Cyanide antidote kit
  22. Antidote for acute iron poisoning and its MOA
    • Deferoxamine
    • chelation
  23. Antidote for digoxin toxicity and its MOA
    • Digoxin immune Fab
    • binding
  24. 2 antidotes to methanol or ethylene glycol poisoning (1 MOA)
    • 1. ethanol
    • 2. fomepizole (inhibits alcohol dehydrogenase)
  25. Antidote for beta-blocker and CCBs and its MOA
    • Glucagon
    • Increases production of cyclic AMP - increas intracellular levels of Ca++
  26. Antidote for methemoglobinemia
    methylene blue
  27. Antidote for opioids and its MOA
    • naloxone
    • antagonizes opioid receptors
  28. Antidote for sulfonylurea induced hypoglycemia and its MOA
    • octreotide acetate
    • lowers insulin levels
    • (be careful in diabetics)
  29. Antidote for anticholinergics and its MOA
    • Physostigmine
    • cholinesterase inhibitor
  30. Antidote for radiation poisoning from radioactive iodine
    potassium iodide
  31. Antidote for INH toxicity and its MOA
    • pyridoxine hydrochloride
    • MOA: replacement fo B6
  32. Antidote for TCA or salicylate toxicity and its MOA
    • Sodium bicarbonate
    • increases clearance of acidic medications
  33. Antidote for BZD toxicity and its MOA
    • Flumazenil
    • antagonizes BZD receptors
  34. Pharmacokinetic changes that may occur in toxicity
    • Decreased rate of absorption, distribution, metabolism, elimination
    • Activation of other elimination pathways
    • Saturated first-pass effect (so there is more active drug)
    • Saturated binding sites (concentrations and elimination affected)