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toxicology
First Aid toxicology
| Question | Answer |
|---|---|
| acetaminophen OD | N-acetylcysteine (regenerates glutathione) |
| salicylate OD --> resp alk and metab acid | NaHCO3 (alkanize urine), dialysis |
| amphetamine OD (basic) | NH4Cl (acidify urine) |
| AChE inhibitor poisoning, organophosphates | atropine (anti-muscarinic), pralidoxime (regenerates AChE) |
| antimuscarinic / anticholinergic poisoning | physostigmine salicylate |
| atropine OD | physostigmine salicylate |
| beta-blocker OD | glucagon |
| verapamil OD | glucagon |
| digitalis OD | stop digitalis, normalize K+, lidocaine, anti-digitalis Fab fragments, Mg++ |
| iron poisoning | deferoxamine |
| lead poisoning | EDTA, dimercaprol, succimer, penicillamine |
| arsenic, MERcury, gold poisoning | diMERcaprol, succimer |
| copper, aresenic, gold poisoning | pencillamine ("copper pennies") |
| CN poisoning | nitrite, hydroxocobalamin, thiosulfate |
| methemoglobin | methylene blue |
| CO poisoning | 100% O2, hyperbaric O2 |
| methanol, ethylene glycol poisoning | ethanol, dialysis, fomepizole (inhibits EtOH DH) |
| opioid OD | naloxone/naltrexone |
| BZD OD | flumazenil (competitive antag at GABA receptor) |
| TCA OD | NaHCO3 (serum alkalinization) |
| heparin OD | protamine |
| warfarin OD | vit K, fresh frozen plasma (contains vit K factors) |
| tPA, streptokinase OD | aminocaproic acid |
| encephalopathy, erythrocyte basophilic stippling | lead poisoning; treat with EDTA |
| cell death due to peroxidation of membrane lipids, gastric bleeding, metab acid, scarring leading to GI obstruction | iron poisoning; treat with deferoxamine |
| atropine-like SE | TCA |
| coronary vasopasm | cocaine, sumatriptan |
| cutaneous flushing | niacine, Ca++ channel blockers, adenosine, vancomycin |
| DCM | doxorubicin (Adriamycin), daunorubicin |
| torsades des pointes | class IA (quinidine) and class III (sotalol) antiarrhythmics, cisapride (used in GI to increase ACh release --> improve transit time) |
| agranulocytosis | clozapine, carbamazapine, colchicine, PTU, methimazole |
| aplastic anemia | chloramphenicol, benzene, NSAIDs, PTU, methimazole |
| direct Coombs-positive hemolytic anemia | methyldopa |
| gray baby syndrome | chloramphenicol |
| hemolysis in G6PD deficient patients | INH, sulfonamides, primaquine, high dose aspirin, ibuprofen, nitrofurantoin |
| thrombolytic complications | OCPs |
| cough | ACE inhibitors |
| pulmonary fibrosis | bleomycin, busulfan, amiodarone |
| focal to massive hepatic necrosis | halothane, valproic acid, acetaminophen, Amanita phalloides (mushroom) |
| hepatitis | INH |
| pseudomembranous colitis | clindamycin, ampicillin |
| adrenocoritcal insufficiency | glucocorticoid withdrawl (HPA suppression) |
| gynecomastia | spironolactone, digitalis, cimetidine, EtOH, ketoconazole (Some Drugs Cause Awesome Knockers), estrogen, marijuana |
| hot flahes | tamoxifen, clomiphene |
| gingival hyperplasia | phenytoin |
| gout | furosemide, thiazides |
| osteoporosis | corticosteroids, heparin |
| photosensitivity | sulfonamides, amiodarone, tetracycline (SAT for a photo) |
| SLE-like syndromes | hydralazine, phenytoin, INH, methyldopa, procainamide |
| tendonitis, tendon rupture, cartilage damage (in kids) | fluoroquinolones |
| Fanconi's syndrome | expired tetracycline, heavy metal exposure |
| interstitial nephritis | methicillin, NSAIDs |
| hemorrhagic cystitis | cyclophosphamide, ifosfamide; prevent by coadministering with mesna |
| disulfram-like reaction | disulfram, metronidazole, 1st generation sulfonyurea, certain cephalopsporins, procarbazine, some HIV drugs |
| cinchonism (tinnitus, headache, nausea) | quinidine, quinine |
| nephrogenic DI | lithium, demeclocycline |
| seizures | bupropion, imipenim/cilastatin, withdrawl from BZD/EtOH |
| tardive dyskinesia | anti-psychotics |
| nephrotoxicity and neurotoxicity | polymyxins |
| nephrotoxicity and ototoxicity | aminoglycosides, loops, cisplatin, vancomycin |
| induce P450 | BCG PQRS - barbituates, carbamazapine, griseofulvin, phenytoin, quinidine, rifampin, St. John's wort, EtOH |
| inhibit P450 | PICK EGS - proteast inhibitor (HIV), INH, cimetidine, ketoconazole, erythromycin, grapefruit, sulfonamides |
| inhibits EtOH DH | fomeprizole |
| inhibits acetylaldehyde DH | disulfram |
| sulfa drugs | TMP-SMX, sulfasalazine, sulfonyurea, celecoxib (COX-2 inhibitor), furosemide, thiazide |
Created by:
anpham26
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