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Pharm - ABIM

Toxidromes

QuestionAnswer
What did the patient take if Patient shows up with hypertension, tachycardia, fever, diaphoresis, mydriasis, rhabdomyolysis? What do you treat with? Sympathomimetic intoxication (Cocaine, methamphetamine, pseudoephedrine). Treat with benzodiazepines.
What toxidromes present with fever, tachycardia, hypertension, mydriasis, increased respiratory rate? How can you tell the difference between these toxidromes? Sympathomimetic and anticholinergic. Sympathomimetic has moist skin. Anticholinergic has dry skin.
Which toxidrome presents with low body temperature, bradycardia, hypotension and miosis? How do you tell the difference between the toxidromes? Opioid and cholinergic intoxication. Opioid intoxication has very low respiratory rate. It is a respiratory depressant. Opioid intoxication skin is very dry, whereas cholinergic intoxication has moist skin.
Name some examples of sympathomimetic substances Cocaine, methamphetamines, pseudo ephedrine
Name some examples of anti-cholinergic substances Diphenhydramine, tricyclic antidepressants, pralidoxime (antidote to organophosphate poisoning), atropine , quetiapine
Name some examples of cholinergic substances Nerve agents, physostigmine, organophosphates
Which toxidromes give you miosis? Opioid and cholinergic
Which toxidromes give you dry skin? Opioid and anti-cholinergic
Which toxidromes give you moist skin? Sympathomimetic and cholinergic
Which toxidromes give you mydriasis? Sympathomimetic and anti-cholinergic
Describe the Sympathomimetic toxidrome in relation to temperature, heart rate, blood pressure, respiratory rate, skin, eyes. Sympathomimetic: fever, tachycardia, hypertension, tachypnea, moist skin, dilated pupils
Describe the opioid toxidrome in relation to temperature, heart rate, blood pressure, respiratory rate, skin, eyes. Opioid: decreased temperature, bradycardia, hypotension, significantly depressed respiratory rate, dry skin, miosis.
Describe the anti-cholinergic toxidrome in relation to temperature, heart rate, blood pressure, respiratory rate, skin, eyes. anti-cholinergic: fever, tachycardia, hypertension, tachypnea, dry skin, dilated pupils
Describe the cholinergic toxidrome in relation to temperature, heart rate, blood pressure, respiratory rate, skin, eyes. cholinergic: decreased temperature, bradycardia, hypotension, decreased respiratory rate, moist skin, small pupils. SLUDGE. Salivation, lacrimation, urination, diaphoresis, G.I. motility, Emesis.
When can you use activated charcoal? If patient is within 1 to 2 hours of the time of ingestion, and the patient does not have risk of aspiration.
Created by: christinapham
 

 



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