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What is the Poison Control Center number?
1-800-222-1222
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What is a toxidrome?
A compound that produces characteristic clinical pictures. (We know exactly what s/s to expect from this specific compound)
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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)
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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
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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
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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)
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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
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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
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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
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Which two main compounds does activated charcoal single dose NOT work for?
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What agents does multi-dose activated charcoal work for?
- Carbamazepine
- Theophylline
- Phenobarbital
- Quinine
- Dapsone
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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)
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Antidote and MOA for acetaminophen poisoning
- N-acetylcysteine
- maintains or restores hepatic concentrations of glutathione
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2 antidotes for cholinesterase inhibitors such as organophosphorous and n-methylcarbamate insecticides
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Antidote for rattlesnakes, cottonmouths, copperheads
Crotalidide antivenin
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Antidote for black widow spider envenomation
Antivenin - Latrodectus mactans
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Antidote for coral snake venom
Antivenin - Micrurus fulvius
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Antidote for CCBs and fluoride and its MOA
- Calcium gluconate and chloride
- Increase intracellular levels of calcium
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Antidote for lead poisoning
Calcium disodium EDTA
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Antidote for internal contamination with plutonium, americum, curium
Calcium trisodium pentetate
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Antidote for cyanide poisoning
Cyanide antidote kit
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Antidote for acute iron poisoning and its MOA
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Antidote for digoxin toxicity and its MOA
- Digoxin immune Fab
- binding
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2 antidotes to methanol or ethylene glycol poisoning (1 MOA)
- 1. ethanol
- 2. fomepizole (inhibits alcohol dehydrogenase)
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Antidote for beta-blocker and CCBs and its MOA
- Glucagon
- Increases production of cyclic AMP - increas intracellular levels of Ca++
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Antidote for methemoglobinemia
methylene blue
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Antidote for opioids and its MOA
- naloxone
- antagonizes opioid receptors
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Antidote for sulfonylurea induced hypoglycemia and its MOA
- octreotide acetate
- lowers insulin levels
- (be careful in diabetics)
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Antidote for anticholinergics and its MOA
- Physostigmine
- cholinesterase inhibitor
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Antidote for radiation poisoning from radioactive iodine
potassium iodide
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Antidote for INH toxicity and its MOA
- pyridoxine hydrochloride
- MOA: replacement fo B6
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Antidote for TCA or salicylate toxicity and its MOA
- Sodium bicarbonate
- increases clearance of acidic medications
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Antidote for BZD toxicity and its MOA
- Flumazenil
- antagonizes BZD receptors
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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)
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