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First Aid toxicology

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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