toxicology

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btknipe
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71009
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toxicology
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2011-03-06 15:13:42
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toxicology
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toxicology
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  1. study of the detection, chemistry, pharmacological actions, and antidotes of the toxic substances.
    toxicology
  2. any chemical (drug, poison, or other) that causes adverse effects on an organism that is exposed to it.
    toxin
  3. entry of a substance into the body through the GI tract
    ingestion
  4. entry of a substance into the body through the respiratory tract
    inhalation
  5. entry of a substance into the body directly through the skin or mucous membrane
    surface absorption
  6. phosphorus-containing organic chemicals
    organophosphates
  7. entry of a substance into the body through a break in the skin.
    injection
  8. the process of minimizing toxicity by reducing the amount of toxin obsorbed into the body
    decontamination
  9. removing an ingested poison by repeatedly filling and emptying the stomach with water or saline via a gastric tube.
    gastric lavage, aka pumping the stomach
  10. powder usually premixed with water, that will adsorb (bind) some poisons and help prevent them from being absorbed by the body.
    activated charcoal
  11. administration of polyethylene glycol continuously at 1 to 2 L/hr through a nasogastric tube until the effluent is clear or objects are recovered.
    whole bowel irrigation
  12. substance that will neutralize a specific toxin or counteract its effect on the body
    antidote
  13. a toxic syndrome; a group of typical signs and symptoms consistently associated with exposure to a particular type of toxin
    toxidrome
  14. substance that liberates hydrogen ion (H+) when in solution
    acid
  15. substance that liberates hydroxyl ions (OH-) when in solution; a strong base
    alkali
  16. therapeutic index
    maximum tolerated dose divided minimum curative dose of a drug; the range between curative and toxic dosages
  17. soluble poisonous substance secreted during growth of a bacterium
    exotoxin
  18. an exotoxin that produces GI symptoms and diseases such as food poisoning
    enterotoxin
  19. use of a pharmacological substance for purposes other than medically defined reasons
    substance abuse
  20. compulsive and overwhelming dependence on a drug; an addiction may be physiological dependence or a psychological dependence, or both
    addiction
  21. the need to progessively increase the dose of a drug to reproduce the effect originally achieved by smaller doses.
    tolerance
  22. referring to alcohol or drug withdrawal in which the patient's body reacts severely when deprived of th abused substance.
    withdrawal
  23. poisoning from pharmacological substance in excess of that usually prescribed or that the body can tolerate
    drug overdose
  24. disorder found in habitual and excessive users of alcohol after cessation of drinking for 48 to 72 hours. experience visual, tactile, and auditory disturbances. death can result in severe cases.
    delirium tremens DT's
  25. # number of poisoning that occur annually
    4 million
  26. most common route of toxic exposure
    ingestion
  27. most effective and widely used method of reducing absorption of toxins
    activated charcoal
  28. Amitriptyline
    amoxapine
    clomipramine
    doxepin
    imipramine
    nortripyline
    tricyclic antidepressants
  29. treating bi polar disorder this drug is proven to be most effective
    lithium
  30. most common pit viper
    rattlesnake
  31. because of the presence of neurotoxin, coral snake venom primarily affects _____ tissue
    nervous
  32. most common abused substance in US
    alcohol
  33. What are the 3 principles of decontamination
    • 1. Reduce intake of toxin
    • 2. Reduce absorption of toxin body
    • 3. Enhance elimination of toxin
  34. cathartics such as ___ increase gastric motility, thus shortening the amount of time toxins stay in GI tract.
    sorbitol
  35. whole bowel irrigation involves the administration of ______ through a nasogastric tube
    polyethylene glycol continuously at 1to 2L/hr
  36. activated charcoal does not bind with these
    ingestion of petroleum products or corrosive agents
  37. Why might someone who has been working with industrial solvent like paint thinners look like a CO poisoning patient?
    people exposed to high levels of methylene chloride show S/S of CO poisoning.
  38. often used as industrial solvent is converted to CO int he liver after inhalation
    methylene chloride
  39. 7 pathophysiological effects of CO
    • 1. Limits oxygen transport
    • 2. Inhibits oxygen transfer
    • 3. Causes tissue inflammation
    • 4. Causes reduced cardiac function
    • 5. Increased activation of nitric oxide
    • 6. Causes vasodilation
    • 7. Induces free radical formation
  40. the 2 cyanide treatment kits
    • 1 Lilly or Pasadena cyanide antidote kit
    • 2 Cyanokit - Hydroxocobalamin
  41. 3 things found in Lilly or Pasadena cyanide antidote kit.
    • 1. amyl nitrate ampules
    • 2. sodium nitrate solution
    • 3. sodium thiosulfate solution
  42. preferred antidote where combination of CO/cyanide poisoning is suspected
    Cyanokit - Hydroxocobalamin
  43. how cyanokit works
    combine with the cyanide ion to form cyanocobalamin
  44. nifedipine
    verapamil
    nicardipine
    diltiazem
    amlodipine
    5 common Calcium Channel blockers
  45. calcium channel block poisoning treatment algorhythm
    • 1. evidence of possible ingestion
    • 2. contact poison control center
    • 3. consider gastrointestinal decontamination with activated charcoal (do not induce vomiting.)
    • 4. place monitors
    • 5. obtain IV
    • 6. if hypotensive consider fluid bolus
    • - then consider calcium, glucagon, and/or epinephrine If not hypotensive transport and monitor
  46. acebutolol
    atenolol
    bisoprolol
    metoprolol
    nadolol
    5 common beta blockers
  47. beta blocker poisoning treatment algorithym
    • 1. Evidence of beta blocker ingestion
    • 2. Contact poison control center
    • 3. consider gastrointestinal decontamination with activated charcoal (do not induce vomiting.)
    • 4. place monitors
    • 5. obtain IV access
    • 6. if hypotensive consider fluid bolus
    • - then consider glucagon
    • -if not hypo tension, transport and monitor
  48. Amitripyline
    Clomipramine
    Doxepin
    Imipramine
    trimipramine
    5 common tricyclic antidepressants
  49. tricyclic antidepressants poisoning algorithym
    • 1. Evidence of possible tricyclic antidepressant ingestion
    • 2. Contact poison control center
    • 3. Consider gastrointestinal decontamination with activated charcoal. Do not induce emesis.
    • 4. Place monitors
    • 5. Obtain IV access
    • 6. If hypotensive consider fluid bolus and check 12 lead
    • -if QRS greater than 100 msec then consider sodium bicarbonate therapy
    • If not hyptensive transport and monitor
  50. treatment for Aspirin overdoes
    • 1. Evidence of possible salicylate ingestion
    • 2. Contact poison control center
    • 3. Consider gastrointestinal decontamination with activated charcoal. Do not induce emesis.
    • 4. Place monitors
    • 5. Obtain IV access
    • 6. Transport and monitor
  51. Acetaminophen treatment algorythym (tylenol)
    • 1. Evidence of possible ingestion
    • 2. Contact poison control center
    • 3. Consider gastrointestinal decontamination with activated charcoal. Do not induce emesis.
    • 4. Place monitor
    • 5. Obtain IV access
    • 6. Place patient in left lateral decubitus or supine position
  52. treatment for pit viper bites
    • - keep patient supine
    • - immobilize the limb with a splint
    • - maintain the extremity in a neutral position
    • - apply high flow high concentration oxygen
    • - start IV with crystalloid fluid
    • - transport patient to emergency department for management which may include administration of antivenin
    • - do not apply ice pack, Freon spray to wound
    • - do not apply arterial tourniquet
    • - do not apply electrical stimulation from any device in an attempt to retard or reverse venom spread
  53. Treatment for coral snake bites
    • - wash wound with copious amounts of water
    • - apply a compression bandage and keep the extremity at the level of the heart
    • - immobilize the limb with a splint
    • - start an IV using crystalloid fluid
    • - transport patient to emergency department for management which may include administration of antivenin
    • - do not apply ice pack, Freon spray to wound
    • - do not incise the wound- do not apply electrical stimulation from any device in an attempt to retard or reverse venom spre
  54. 3 examples of barbituates
    • thiopental
    • phenobarbital
    • primidone
  55. 4 examples of amhpetamines
    • benzedrine
    • dexedrine
    • ritalin
    • speed
  56. drug class of STP, mescaline, psilocybin, PCP
    hallucinogen
  57. drug with S/S of lethargy, slurred speech, coma, emotional lability, hypotension, respiratory depression
    barbituate
  58. drug with S/S of euphoria, hyperactivity, dilated pupils, psychosis, anxiety, hypertension, tachycardia, dysrhythmias, seizures, chest pain
    cocaine
  59. durg with S/S of
    CNS depression, constricted pupils, respiratory depression, hypotension, bradycardia, coma, pulmonary edema, death
    narcotics
  60. drug with S/S of euphoria, dry mouth, dilated pupils, altered sensation
    Marijuana
  61. drug with S/S of exhilaration, hyperactivity, dilated pupils, hypertension, psychosis, seizures
    Amphetamines
  62. drug with S/S of psychosis, nausea, dilated pupils, rambling speech, headache, dizziness, distortion of sensory, suggestibility
    Hallucinogens
  63. drug with S/S of
    hypotension, slurred speech, respiratory, shock, bradycardia, seizures
    Sedatives
  64. drug with S/S of altered mental status, slurred speech, dysrhythmias, coma
    Benzodiazepines
  65. some S/S of alcohol withdrawal syndrom
    • tachycardic, HTN, orthostatic hypotension,
    • - hallucinations
  66. antidote for acetaminophen overdose
    N-acetylcysteine
  67. helps to reduce the effects of benzos
    Romazicon (FLUMAZENIL)
  68. toxicity of Acetaminophen and aspirin
    150mg/kg

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