CEN TOXICOLOGY QUESTIONS
- ANS-
#1 drug used in suicide overdose - ANS-tricyclic antidepressants
0PIATES CLINICAL PRESENTATION - ANS-Pinpoint pupils Respiratory depression
Bradycardia Hypotension Hypothermia Pulmonary edema Seizures
Acetaminophen Toxicity - Antidote - ANS-N-acetylcysteine (NAC)
Glutathione precursor and glutathione substitute
Increases substrate supply for the non-toxic sulfate conjugation pathway
Available as oral and IV form
Extremely effective if initiated within 8 hours
Standard of care to treat patients up to 24 hours
ACIDIC OD NBM - ANS-NBM: Nothing by mouth
Agents that Affect Pupil Size
Miosis [SMALL PUPILS] (COPS) - ANS-Cholinergics ;rest & digest], Clonidine
Opiates, organophosphates
Phenothiazines, pilocarpine
Sedative-hypnotics, SAH
MydriASis (A3S)
Antihistamines, Antidepressants, Atropine
Sympathomimetics
alkaline OD - ANS-Gastric emptying and activated charcoal are contraindicated. Perforation is
treated surgically.
anticholinergic COCAINE TREATMENT - ANS-CNS sedation Labetolol Treat hyperthermia
?Parlodel or desipramine
1
anticholinergic over dose examples - ANS-Atropine
antihistamines [benadryl]
TCAs Tricyclic antidepressants (Amitriptyline)
Cyclobenzapine (muscle relaxant)
ANTICHOLINERGIC: ATROPINE TREATMENT - ANS-Physostigmine
Gut decontamination Supportive care
Anticholinergics [not producing fluids/blood to heart, lungs and brain] syndrome
(antihistamines, bronchodilators, cyclic antidepressants, SLEEP AIDS) - ANS-Hot as a hare
(hyperthermia)
Red as a beet (flushed)
Dry as a bone [ANHYDROSIS (dry skin, urinary retention)
Blind as a bat (mydriasis)
Mad as a hatter (hallucinations, delirium, myoclonic jerking)
, The antidote for anticholinergic toxicity is physostigmine salicylate. Physostigmine is the only
reversible acetylcholinesterase inhibitor capable of directly antagonizing the CNS manifestations
of anticholinergic toxicity; it is an uncharged tertiary amine that efficiently crosses the
blood-brain barrier
Antidote for Iron toxicity - ANS-deferoxamine - iron chelator
"de":removal "fer" iron "ox": amino
GIVE MEDICINE UNTIL URINE IS CLEAR
Antihyperglycemics ARE Sulfonylurea AGENTS - ANS-Sulfonylurea agents are widely used as
therapy for hyperglycemia in type 2 diabetes mellitus
[glipizide, glyburide and glimepiride]
Antihyperglycemics/Sulfonylurea OD Antidote - ANS-Octreotide [tiny dose of 50mcg]
[80 mg/bolus if used for GI Bleed]
Antimuscarinic (e.g. Atropine) is an antidote for: - ANS-organophosphate and carbamate
insecticides, nerve agents, some poison mushrooms
aspirin overdose antidote
Aspirin is a derivative of salicylic [salt] acid - and is also known as acetylsalicylic acid. -
ANS-salicylate poisoning
Sodium bicarbonate is given in a significant aspirin overdose (salicylate level greater than 35
mg/dL 6 hours after ingestion) regardless of the serum pH, as it enhances elimination of aspirin
in the urine. It is given until a urine pH between 7.5 and 8.0 is achieved.
BAC Def - ANS-For example, a BAC of 0.1% is one part alcohol per 1,000 parts blood. Though
it doesn't sound like much, this level of alcohol in the body can cause serious side effects. Two
to three drinks in an hour, depending on body weight, age, gender, and other factors, increases
BAC to 0.1%.
BAL - ANS-blood alcohol level
BENZODIAZIPINES CLINICAL PRESENTATION - ANS-Respiratory depression Drowsiness
Coma
BENZODIAZIPINES TREATMENT - ANS-Flumazenil
beta blocker is an antidote for - ANS-theophylline
CaChannel Blocker [-pine] & BETA blockers [-olol] Antidote - ANS-insulin along with glucose
supplementation
high-dose insulin has been established as an effective therapy for calcium channel blocker
overdose with cardiogenic shock
Carbon Monoxide Poisoning - ANS-Most common cause of death by poisoning Symptoms vary:
Mild: HA, mild dyspnea Mod: HA, dizziness, N/V,dyspnea, irritability Severe: Coma, seizures,
CV collapse
cholinergic cells that use which neurotransmitter - ANS-Referring to cells that use acetylcholine
as their synaptic transmitter.
Cholinergic Drug toxicity
antidote - ANS-2-PAM
Atropine
Cholinergics {see, spit, pee, shit] pathway - ANS-muscuric and nicotinic receptors that use
acetylcholine neurotransmitters
- ANS-
#1 drug used in suicide overdose - ANS-tricyclic antidepressants
0PIATES CLINICAL PRESENTATION - ANS-Pinpoint pupils Respiratory depression
Bradycardia Hypotension Hypothermia Pulmonary edema Seizures
Acetaminophen Toxicity - Antidote - ANS-N-acetylcysteine (NAC)
Glutathione precursor and glutathione substitute
Increases substrate supply for the non-toxic sulfate conjugation pathway
Available as oral and IV form
Extremely effective if initiated within 8 hours
Standard of care to treat patients up to 24 hours
ACIDIC OD NBM - ANS-NBM: Nothing by mouth
Agents that Affect Pupil Size
Miosis [SMALL PUPILS] (COPS) - ANS-Cholinergics ;rest & digest], Clonidine
Opiates, organophosphates
Phenothiazines, pilocarpine
Sedative-hypnotics, SAH
MydriASis (A3S)
Antihistamines, Antidepressants, Atropine
Sympathomimetics
alkaline OD - ANS-Gastric emptying and activated charcoal are contraindicated. Perforation is
treated surgically.
anticholinergic COCAINE TREATMENT - ANS-CNS sedation Labetolol Treat hyperthermia
?Parlodel or desipramine
1
anticholinergic over dose examples - ANS-Atropine
antihistamines [benadryl]
TCAs Tricyclic antidepressants (Amitriptyline)
Cyclobenzapine (muscle relaxant)
ANTICHOLINERGIC: ATROPINE TREATMENT - ANS-Physostigmine
Gut decontamination Supportive care
Anticholinergics [not producing fluids/blood to heart, lungs and brain] syndrome
(antihistamines, bronchodilators, cyclic antidepressants, SLEEP AIDS) - ANS-Hot as a hare
(hyperthermia)
Red as a beet (flushed)
Dry as a bone [ANHYDROSIS (dry skin, urinary retention)
Blind as a bat (mydriasis)
Mad as a hatter (hallucinations, delirium, myoclonic jerking)
, The antidote for anticholinergic toxicity is physostigmine salicylate. Physostigmine is the only
reversible acetylcholinesterase inhibitor capable of directly antagonizing the CNS manifestations
of anticholinergic toxicity; it is an uncharged tertiary amine that efficiently crosses the
blood-brain barrier
Antidote for Iron toxicity - ANS-deferoxamine - iron chelator
"de":removal "fer" iron "ox": amino
GIVE MEDICINE UNTIL URINE IS CLEAR
Antihyperglycemics ARE Sulfonylurea AGENTS - ANS-Sulfonylurea agents are widely used as
therapy for hyperglycemia in type 2 diabetes mellitus
[glipizide, glyburide and glimepiride]
Antihyperglycemics/Sulfonylurea OD Antidote - ANS-Octreotide [tiny dose of 50mcg]
[80 mg/bolus if used for GI Bleed]
Antimuscarinic (e.g. Atropine) is an antidote for: - ANS-organophosphate and carbamate
insecticides, nerve agents, some poison mushrooms
aspirin overdose antidote
Aspirin is a derivative of salicylic [salt] acid - and is also known as acetylsalicylic acid. -
ANS-salicylate poisoning
Sodium bicarbonate is given in a significant aspirin overdose (salicylate level greater than 35
mg/dL 6 hours after ingestion) regardless of the serum pH, as it enhances elimination of aspirin
in the urine. It is given until a urine pH between 7.5 and 8.0 is achieved.
BAC Def - ANS-For example, a BAC of 0.1% is one part alcohol per 1,000 parts blood. Though
it doesn't sound like much, this level of alcohol in the body can cause serious side effects. Two
to three drinks in an hour, depending on body weight, age, gender, and other factors, increases
BAC to 0.1%.
BAL - ANS-blood alcohol level
BENZODIAZIPINES CLINICAL PRESENTATION - ANS-Respiratory depression Drowsiness
Coma
BENZODIAZIPINES TREATMENT - ANS-Flumazenil
beta blocker is an antidote for - ANS-theophylline
CaChannel Blocker [-pine] & BETA blockers [-olol] Antidote - ANS-insulin along with glucose
supplementation
high-dose insulin has been established as an effective therapy for calcium channel blocker
overdose with cardiogenic shock
Carbon Monoxide Poisoning - ANS-Most common cause of death by poisoning Symptoms vary:
Mild: HA, mild dyspnea Mod: HA, dizziness, N/V,dyspnea, irritability Severe: Coma, seizures,
CV collapse
cholinergic cells that use which neurotransmitter - ANS-Referring to cells that use acetylcholine
as their synaptic transmitter.
Cholinergic Drug toxicity
antidote - ANS-2-PAM
Atropine
Cholinergics {see, spit, pee, shit] pathway - ANS-muscuric and nicotinic receptors that use
acetylcholine neurotransmitters
