toxicology
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| show | exposure to non pharmocological substances
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| show | exposure to drugs (legal or olleagal
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| 70% of poisonings in what age | show 🗑
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| 80% of suicides are | show 🗑
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| routes | show 🗑
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| Ingestion | show 🗑
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| show | corrosive substances (acids/alkalis)-burns to lips tongue,throat
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| show | due to absorption from GI tract, most absorptions occurs in small intestine
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| inhalation absorption occurs | show 🗑
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| Absorption occurs | show 🗑
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| Injected absorbption occurs | show 🗑
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| Gastric Lavage to be done within | show 🗑
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| show | -reduce absorption of toxins -Enhance elimination of toxin-cathartics,whole bowel irrigation
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| show | -most effective in 30 mins of ingestion -effective with ASA,amphetimines,strychnine,dilantin, theophylline and phenobarbitol
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| Cathartic Agent (in charcoal) | show 🗑
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| Emesis involves | show 🗑
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| show | miz with air and distribute freely throughout airway
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| Mists | show 🗑
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| Fumes | show 🗑
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| show | tachyapnea,dyspnea,CP,coughing, STRIDOR 80% occluded, wheezing, rales,rhonchi
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| show | -most common in 13-15yrs seen in 6-8 yrs -AKA-gateway substances -sniffed (from container),huffing(substance placed on cloth),bagging (placed in bag) -dilated pupils,tinnitus,n/v
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| Cyanide | show 🗑
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| Cyanide S/S | show 🗑
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| show | -2 amps of sodium nitrate 3% 300mg -2 vials of sodium Thiosulfate 25% 12.5 iv -Boric acid n or Sodium hydroxide to adjust pH -12 ampules of Amyl Nitrate inhalants USP 5min 0.3 ml
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| show | iron in hemoglobin to trivalent (Fe3+) form called methemoglobin (loves cyanide)= = CN-Met-Hgb/still must be detoxified + Thiosulfate= Thiocyanate. then excreted by kidneys and returned to hemoglobin
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| show | -colorless,odorless,tasteless gas -200-250x >affinity for O2 -forms carboxyhemoglobin -cherry red skin and cyanosis -death from MI n ischemia due to hypoxia -half life in room air is 4-7hrs tx hyperbaric chamber
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| Alkalis cause | show 🗑
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| show | proteins to precipitate, forms dense clots over injured area
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| show | -penetrates deeply like alkaline burn -deactivated by Calcium fluoride -cell fx is disruptes,bones are destroyed -Tx.Mg++/Ca++ or benzethonium chloride,immerse limb in ice water
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| hydrocarbons | show 🗑
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| show | Tofranil,elavil,norpramin,pamelor,amitriptyline -blocks reuptake of NE/serotonin in presynaptic neuron A2 primarily -do not use flumazenil,may cause seizures
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| SSRI's | show 🗑
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| show | Nardil
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| overdose common in ages | show 🗑
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| show | an early sign of toxicity
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| show | breaks down tyramine in liver tyramine increases relase of NE potent vasopressor)
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| show | for bipolar,moves into cells like Na+ but not pumped out easily, changes reuptake of NE causing anti adrenergic effects -tx-control seizures,alkaline urine w.sodium bicarb, osmotic diuresis with mannitol,possible hemodyalisis
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| show | mild-<150 mg/kg mod-severe-150-300 mg/kg Severe->300 mg/kg Fatal ->500 mg/kg
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| show | -Rx analgesic/antipyretic agent -forms a hepatotoxic metabolite if no mngd in 16-24hrs -30 tablets are toxic-Tx mucomist
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| show | -exceeds bodys ability to store, causes disruption of cellular functions,anaerobic metabolism and acidosis -leads to Myocardial depression,venodilation and cerebral edema -corrosive to intestinal mucosa,liver injury -20 mg/kg van be lethatl, CV collaps
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| Iron OD treatment | show 🗑
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| show | kids most common victims-paint chip ingestion -causes brain and nervous system damage -adults exposed thru inhalation
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| show | -only metallic element that is liquid at rm temp,inhalation most common route -accumalates in organs mainly brain n kidneys
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| show | -activated charcoal -lavage
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| show | Bacteria,Virus, toxic chemical
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| Salmonella | show 🗑
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| show | Acute bacterial infection of bowel,resistant to stomach acid,infects colin leading to colitis -diarrhea,fever,abd pain,rectal pain -incubation 1-7 days,lasts 7 days
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| show | toxic Megacolon: severe inflammation causes colon to dilate or stretch, thin colon will eventually tear -diaffhea suddenly stops, abd swells -causes dysentary
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| Botulisim (bacterial) | show 🗑
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| Norwalk Virus (Viral) | show 🗑
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| show | Cylopeptide group (deadly) -contains amanita (cause 90% of deaths) toxic to liver -s/s-excess saliva,tears,sweating,abd cramps,n/v,diarrhea brady.
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| Food posioning onsets | show 🗑
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| Poisonis plants onset | show 🗑
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| show | Wasps,bees,hornets, fire ant
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| show | occurs 10-14 days after sting fever,malaise,HA,urticaria,polarthiritis
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| show | -local tissue necrosis -dark,dry spots-violin mark on back, unaware of bite, becomes ischemic and ulcerates
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| Brown recluse S/S | show 🗑
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| show | orange red hourglass,black abdomen,very potent venom, causes excessive neurotransmitter release-severity influenced by age,weight,gen health
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| Black Widow S/S | show 🗑
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| show | constricting band 3/4-1.5 inches wide, occlude lymphatic flow only, cool compress,venom stored at bulb tail -Only Bark scopion is fatal-pain occurs 3hrs post bite
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| Scorpion Venoms effects | show 🗑
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| show | Rattlesnakes, cottonmouths, and copperheads -distinct pit between eye and nostril
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| Vipers venom | show 🗑
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| show | -do not allow to walk, do not apply cold compress,give pain meds anything PO, or suction venom,. -restrict movement, keep limb below heart, immobilize, most deaths occur 6-30hrs , 90% within 1st 48hrs
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| show | red and black bands, red on yellow kill a fellow-hangs on and chews-venom is neuro toxic, blacks ACH receptor sites, no necrosis or edema-CNS S/s, causes respiratory and skeletal muscle paralyisis w/in 12-24 hrs
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| show | resembles a coral snake, red on black venom lack
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| Marine animals | show 🗑
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| show | Venomous stinging cells-hollow threadlike tube, serves as a hypodermic needle, contains venom
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| Jellyfish | show 🗑
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| show | bottom dwellers, flower like appearance, razor sharp exoskeleton
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| show | rince with sea water, fresh water is bad, flush with alcohol(isopropyl), baking soda, meat tenderizer, remove with forceps,immobilize
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| Starfish | show 🗑
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| Sea cucumber | show 🗑
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| show | sting produces laceration 15-20 cm long, localized and systemic reaction. TX-irrigation w/fresh water, remove stinger, immerse in hot water
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| show | removal of drug causes adverse physical reactions
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| Psychological dependence | show 🗑
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| show | must use more to get desired effect
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| show | CNS depressants, cause respiratory distress S/S= PINPOINT pupils
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| Sedative hypnotics | show 🗑
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| show | benzedrine, dexedrine, cocaine, ritalin (S/S=DILATED pupils, SNS afects) TX: treat dysryhthmias, Valium 5-10 for seizures, Haldol for hyperactivity)
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| Drug ingestion OD | show 🗑
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| Cocaine | show 🗑
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| show | PCP and LSD,MDMA, weed,srooms-Dilated pupils-TX-valium and haldol
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| Rohypnol-potent benzo | show 🗑
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| show | most abused drug-absorbed in intestines in 30-120 mins, inhibits ADH=increaseddiuresis TX: chemstrips, 25 gm og D50, 100 mg thiamine
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| 3 dependence factors | show 🗑
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| Alcohol Dependence | show 🗑
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| Organophosphates | show 🗑
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| Methanol tx: | show 🗑
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| show | wood alcohol, GAS lin Antifreeze,no more toxic than ethanol but metabolites are extremely toxic-10-15 ml of 40% solution can cause death, (4cc can cause blindness)-liver converts alcohol to formaldehyde n in mins to formic acid=metabolic acidosis,
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| Methanol " | show 🗑
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| Ethylene Glycol | show 🗑
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| Ethylene S/S | show 🗑
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| " | show 🗑
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