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First Aid toxicology

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