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Own peds boards > Poisoning > Flashcards

Poisoning Flashcards

1
Q

Anticholinergic effects

A

(Dry) mydriasis, flushed, increased temp, HR, BP, RR, agitation, hallucinations, delirium

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2
Q

Name some anticholinergics

A

antihistamine, TCA, atropine, antipsychotics, deadly nightshade, jimson weed

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3
Q

Cholinergic effects

A

(Wet) decreased HR, incr/decr BP/RR, confusion, delirium, seizures, coma, miosis, diaphoresis

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4
Q

What dose of acetaminophen is toxic

A

150mg/kg

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5
Q

Rx acetaminophen toxicity

A

activated charcoal and then N-acetylcysteine

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6
Q

Stages of acetaminophen toxicity and time course

A

Stage 1 - nausea, vomiting, anorexia (0-24hr)
Stage 2 - asymptomatic (12-48hr)
Stage 3 - fulminant hepatic failure (2-7days)
Stage 4 - recovery (1-2wks)

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7
Q

Pattern: fixed dilated pupils, visual changes, blindness, pancreatitis

A

methanol

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8
Q

Sx isopropanol

A

gastritis

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9
Q

Sx ethylene glycol

A

renal failure

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10
Q

What is toxic from ethylene glycol and methanol

A

metabolites - glycolate, formate

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11
Q

Rx ethylene glycol and methanol

A

Fomepizate - alcohol dehydrogenase inhigitor
Level >20mg/dL - infuse with ethanol
Level >50mg/dL - hemodialysis

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12
Q

Rx for anticholinergics

A

charcoal and benzos for agitation

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13
Q

Rx b-blockers

A

charcoal, whole bowel irrigation, glucagon, hypoglycemia, hypotension, bradycardia, atropine, milrinone, epinephrine

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14
Q

Rx battery in esophagus

A

emergently remove

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15
Q

Rx battery in stomach and beyong

A

leave in place, reimage in 48hrs, endoscopic removal if accessible at 48hrs

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16
Q

When would you need multiple doses of activated charcoal?

A

for theophylline, phenobarbital, ASA, digoxin

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17
Q

What cathartic can be used

A

Sorbital 1 dose only

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18
Q

When is whole bowel irrigation contra-indicated?

A

Ileus, bowel perforation, bowel obstruction

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19
Q

Rx for organophosphates

A

atropine, pralidoxime

20
Q

Rx for TCA

A

sodium bicarbonate

21
Q

Rx for ethylene glycol

A

fomepizole

22
Q

Rx for isoniazide

A

pyridoxine

23
Q

Rx naloxone

A

narcotics

24
Q

Rx digitalis

A

specific Fab

25
Q

Rx benzo

A

flumazenil

26
Q

Rx acetaminophen

A

N-acetylcysteine

27
Q

Drain openers, rust remover, oven cleaners, toilet bowl cleaners

A

acidic <2

28
Q

Ammonia, bleach, laundry detergents, drain openers

A

alkali

29
Q

Pattern: dyspnea, tachypnea, hypoxemia, cough, wheezing, CNS depression, N/V, abd pain

A

hydrocarbons (glue, gases)

30
Q

Pattern: tinnitus, resp alkalosis (tachypnea), metabolic acidosis, hyperglycemia

A

aspirin

31
Q

What are aspirin doses that are asymptomatic, mild-moderate, sever, fatal

A

asymptomatic - <150mg/kg
mild-moderate 150-300mg/kg
Severe - 300-500mg/kg
Fatal - >500mg/kg

32
Q

Rx aspirin

A

activated charcaol, whole bowel irrigation, rehydration, alkalinization to decrease CNS penetration and enhance excretion

33
Q

Pattern: confusion, coma, cardiac problems

A

TCA

34
Q

Rx TCA toxicity

A

activated charcoal, sodium bicarbonate, seizure treatment, ventricular dysrhythmias, lidocaine or magnesisu, not procainamide

35
Q

Rx for iron toxicity

A

Xray, lavage, whole bowel irrigation

36
Q

Indcation for deferozamine

A 
urine is no longer pink
>100mg/kg Fe++
Iron level >500mcg/dL
Severe gastroenteritis
Iron level 300-500mcg/dL and symptoms
37
Q

Iron dose that is toxic

A

<20mg/kg none
20-60mg/kg mild
>60mg/kg moderate/severe

38
Q

Pattern: WBC >15K, glucose >150 vomiting, diarrhea

A

iron toxicity

39
Q

Dose of NSAID that is toxic

A

> 400mg/kg

40
Q

Pattern: N/V/abdominal pain, GI bleeding, seizures, apnea,metabolic acidosis, renal failure, hepatic failure

A

NSAID toxicity

41
Q

Rx NSAID toxicity

A

charcoal, supportive care

42
Q

Rx single magnet

A

observe

43
Q

Rx multiple magnets

A

endoscopic removal if <12hours

44
Q

Rx for multiple magnets >12hours

A

surgical consult and endoscopy

45
Q

Rx for magnet beyond stomach - symptomatic

A

surgery

46
Q

Rx for magnet beyond stomach - asymptomatic

A

variable

47
Q

Rx organophosphates

A

skin decontaminants, charcoal, atropine, pralidoxime

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