OTC Killers
Toxidromes
The really bad apples
The Natural World
Recreational Misadventures
100
The minimum amount of time after acetaminophen overdose that an acetaminophen level should be obtained.
What is 4 hours?
100
euphoria, bradypnea, miosis, coma
What is opioid toxidrome?
100
The treatment for symptomatic sodium nitrite ingestion.
What is Methylene blue?
100
The only state in the continental US without any native venomous snakes.
What is Maine?
100
This commonly prescribed medication for depression and smoking cessation is occasionally abused due to its amphetamine-like properties in overdose.
What is bupropion?
200
The ideal amount of time within which NAC is administered after acetaminophen overdose.
What is 8 hours?
200
A key sign that helps differentiate between antimuscarinic and sympathomimetic poisonings.
What is diaphoresis?
200
The medication that should be given to a patient that was in a fire at a plastics factory and has hypotension, altered mental status and lactate >8.
What is Hydroxocobalamin?
200
The expected symptoms after consuming this plant.
What is dry mucous membranes, tachycardia, dilated pupils, urinary retention, altered mental status.
200
The substance that is frequently found in pills (oxycodone, alprazolam etc) that a are purchased on the street.
What is fentanyl?
300
The first salicylate-specific symptom after aspirin poisoning (ie not nausea/vomiting).
Bonus: the ASA level at which this occurs
What is tinnitus?
What is approximately 30 mg/dL
300
coma/depressed mental status, normal-mildly decreased respirations, dilated but reactive pupils
What is sedative/hypnotic toxidrome?
*depending on the sedative/hypnotic you may see more respiratory effects. Benzos alone should NOT cause respiratory depression.
300
The common medication you should ask patient if they take anytime you see an unexpectedly very high lactate.
What is Metformin?
300
The treatment for a patient that is seizing after ingesting this mushroom:
What is a GABA agonist + 5gm pyridoxine?
300
The OTC medication a patient may take in excess to try to treat opioid withdrawal that can cause QTC prolongation and torsades in overdose.
What is Loperamide?
400
Medication that can be used off label for extremely large acetaminophen overdoses to decrease the metabolism to NAPQI.
What is fomepizole?
400
The first medication that should be given after a patient presents with salivation, urination, bradycardia, bronchorrhea.
What is Atropine?
400
The compound used in airbags as a precursor to nitrogen gas. It causes severe metabolic acidosis, multisystem organ failure and death without an antidote if ingested.
What is Sodium Azide?
400
The treatment for cardiotoxicity from consuming large amounts of this plant
What are digoxin-specific antibody fragments?
400
The use of very large amounts of this common recreational drug can cause sodium channel blockade, QRS prolongation and ventricular dysrhythmias.
What is cocaine?
500
Indications for hemodialysis in salicylate poisoned patient (List at least two).
ASA >100 mg/dL
ASA >90 mg/dL with renal impairment
ASA >90 mg/dL despite adequate alkalinization
End organ dysfunction: Altered mental status or new hypoxemia
Chronic ASA poisoning with level >60 mg/dL
500
A bodybuilder has been taking a compound that is banned for human consumption to increase fat burning. Today he took a higher dose because he has a competition coming up. He presents to the ED with nausea, vomiting, tachycardia, diaphoresis and a temperature of 42C. You notice his mucous membranes are yellow. Name the compund he ingested
2,4-Dinitrophenol (uncoupler)
Treatment: active cooling, prayers.
500
The indications for antivenom after a bite by this US snake.
What are swelling spreading past one major or two minor joints OR significant lab abnormalities (thrombocytopenia, low fibrinogen, high D dimer)?
500
The opioids that cause seizure in overdose. (Name 2)
Tramadol, meperidine (Demerol)