Toxicology Exam I

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Author:
Rx2013
ID:
66541
Filename:
Toxicology Exam I
Updated:
2011-02-15 17:55:19
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Clinical toxicology
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clinical toxicolgoy
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  1. Causes deformation of limbs
    thalidomide
  2. Accound for most serious/fatal poisoning
    suicide attempts
  3. % ICU admission and % psych admissions due to poison
    • 5% ICU
    • 30% psych
  4. Key points of diagnosis
    • history
    • physical exam
    • laboratory values
  5. Initial focus on the exam
    • vital signs
    • cardiopulmonary assessment
    • neurologic assessment
  6. Consumption of acids leads to
    coagulation necrosis
  7. consumption of bases leads to
    liquifaction necrosis
  8. Elevated ALT is a sign of
    liver damage
  9. Elevated lactate dehydrogenase is a sign of
    heart attack
  10. Guidelines for management of acute poisoning
    • airway management
    • breathing management
    • circulation management
    • (ABC)
  11. Activated charcoal
    • treatment of choice for most ingestions
    • most effective when given w/in the 1st hour
  12. Contraindications to activated charcoal
    • pt with altered conscious state
    • ethanol/glycols
    • alkalis
    • acids
    • petrolum distilates
  13. Examples of drugs that have specific antidotes
    • Benzodiazepines
    • alcohol
    • methamphetamines
  14. Alkali poisons result in
    • liquifaction necrosis
    • significant GI ulceration
  15. Alkaline poisons
    • drain cleaners
    • oven cleaners
    • dishwashing liquids/powders
    • detergents
    • ammonia
    • portland cement
  16. Liquid alkali producst are more likely to cause_____ than powders
    esophageal burns
  17. Antihistamine poisoning
    • cough and cold preperations
    • paracetamol may be in products
  18. Psychostimulants
    • dexamphetamine
    • methylphenidate
  19. Recreational drugs
    • amphetamine
    • cocaine
    • ecstacy
  20. Assesment of antihistamine poisoning (symptoms present)
    • drowsiness
    • restlessness
    • tachycardia
    • palpitations
    • hypertension
  21. Ephedrine may cause
    • hypertensive crisis
    • cerebral hemorrhage
  22. Poisoning with slow release products
    • beware of delayed onset of poisoning
    • pt may require repeated doses of activated charcoal
  23. Asymptomatic antihistamine poisoning
    does not require treatment if dose is <3x the normal daily dose
  24. Symptomatic antihistamine poisoning
    charcoal 1g/kg unless altered conscious state
  25. Symptoms of benzodiazepine poisoning
    • CNS depression
    • drowsiness
    • coma
    • respiratory depression
    • hypotension
  26. Management of BZD overdose
    • charcoal is not usually beneficial
    • flumazenil is antidote
    • depresssion state = call EMS
  27. Ethanol poisoning fatality occurs with blood levels ____ or breath level of _____.
    • >86.8 mmol/L
    • >0.4
  28. Highest ethanol containing product
    • mehtylated spirits (95%)
    • does not contain methanol
  29. Symptoms of EtOH poisoning
    • n/v
    • abd. pain
    • hypoglycemia
  30. Ethanol poisoning management
    • charcoal is no benefit
    • check bg in younger children
  31. Petroleum distillates
    gases/oils/fuels/white spirit
  32. Main complication with petroleum distillate poisoning
    • aspiration pneumonitis
    • risk of aspiration during vomiting outweighs any benefit from removal of the substance
    • CNS toxicity may be evident
  33. Symptoms of petroleum distillate poison
    • coughing
    • choking
    • respiratory distress
  34. management of petroleum distillate poisoning
    charcoal is contraindicated
  35. Salicylate poisoning may result from
    • aspirin
    • oil of wintergreen
  36. symptoms of salicylate poisoning
    • tinnitus
    • vomiting
    • hyperventilation
    • respiratory alkalosis
  37. Patients requiring treatment for salicylate poisoning
    • acute ingestion 150mg/kg
    • all symptomatic pt
    • ingestion of unknown qty
  38. Labs for salicylate poisoning
    • initial serum salicylate then q2h if symptomatic or extended release product was injested
    • urea
    • electrolytes
    • creatinine
    • acid/base
    • glucose
  39. Management of salicylate poisoning
    symptomatic pt require urgent medical assesment

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