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Session 3 Pharm- 7
Pharm -7- toxicology
| Question | Answer |
|---|---|
| You have just finished tx a patient for a drug overdose and they are now stable what do you need to monitor them for now | rebound and clinical toxicity |
| What are some common intentional poisonings | acetaminophen, benzos, opiods, and sedative |
| What are some common unintentional poisonings | opioids, cocaine, heroin, acetaminophen, benzos |
| What is the toxic metabolite of acetaminophen | N-acetyl-para-benzoquinoneimine NAPQI |
| What reacts with NAPQI (toxic metabolite of acetaminophen) to deactivate it | Glutathione (GSH) |
| What does NAPQI (toxic metabolite of acetaminophen) attack | causes hepatotoxicity and damage to renal tubular cells |
| What are the two things you can administer in an acetaminophen overdose to help tx the pt | activated charcoal if recent overdose and N-acetylcystein (NAC) a precurson of glutathione |
| what profound S/E can occur from acetaminophen overdose | liver injury, metabloic acidosis, hypoglycemia, renal failure, and pancreatitis |
| patient has wernicke-korsakoff syndrome what have they likely abused | alcohol EtOH |
| Why should women avoid ethanol during pregnancy | it can cause fetal alcohol syndrome marked by mental retardation, growth deficiencies, microcephaly, underdevlopment of midface region |
| You want to encourage your patient to stop drinking EtOH so you prescribe the a drug that will make drinking very unpleasant what did you prescribe them and what is it's MOA | Disulfiram- inhibits acetaldehyde dehydrogenase |
| You need to treat the withdrawal symptoms of a Pt who has just entered your alcohol detox clinic what med will you prescribe to help them if they are delerious and seizing | benzo |
| What drug can you prescribe an EtOH withdrawal pt who is suffering sx of tremors | low dose beta blocker Propranolol to control tremors and reduce heart rate and B/P |
| Pt has succesfuly finished detox for EtOH and you want to help keep them clean what drug can you prescribe that lowers the activity of receptors for glutamate that helps with maintenace of abstienence | Acamprosate |
| What is a major complication of ethylene glycol intoxication that you can detect in the urine | calcium oxalate crystalluria |
| What is the antidote for ethylene glycol or methanol intoxication | Fomepizole if they have a lot of money or Ethanol (lesser of two evils) |
| What are the s/sx of organophosphate poisoning | Diaphoresis, Diarrhea, Urination, Myosis, Bradycardia, Excitation, Lacrimation, Sweating, Salivation |
| What is the MOA of organophosphates as a poison (parathion, malathion) | They are irreversible acetylcholinesterase inhibitors |
| What are the antidotes for organophospahte poisoning | atropine-competitive inhibition of acetylcholine actions at muscarinic receptors and Pralidoxime (2-PAM) breaks the covalent bond between organophosphate and acetylchoinesterase |
| What are the s/sx that a pt will have if they overdosed on an anticholinergic | dry as bone, red as a beet, hot as a pistol, blind as a bat, mad as a hatter |
| What is the antidote fore a pt who overdosed on anticholinergic | Physostigmine |
| What are some common anticholinergics that pt overdose on | Benztropine, antihistamines, phenothiazines, jimson weed, Mushrooms (amanita muscaria) |
| What is the tx for lead poisoning | tx seizures with benzos, cortiocsteroids to reduce intracranial pressure, whole bowel irrigation and chealtion with EDTA and Dimecaprol |
| What is the tx for arsenic poisoning | dimecaprol if given promptly |
| What has your pt been poisoned with if they present with garlic breath and rice water stools | Arsenic |
| What can you give for a pt who has overdosed on Iron | deferoxamine mesylate |
| What is the antidote for cyanide poisoning | Nitrite |
| What would you give to treat withdrawal of opiates | methadone or buprenorphine (subutex) |
| What is the date rape drug | flunitrazepam |
| What is the antidote for benzodiazepine toxication | flumazenil |
| Pt has tea colored urine what have they likely overdosed on | cocaine |
| what is the bad metabolite formed when pt combines cocaine with alcohol | cocaethylene |
| what is the antidote for snake bites | crotaline polyvalent fab |
Created by:
smaxsmith
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