Toxidromes
Patient with bradypnea, hypopnea, bradycardia, depressed mental status, miosis
What is the Opioid toxidrome
3y/o patient ingests an unknown amount of father's diabetes medication. They present with hypoglycemia that is recurrent despite glucose.
What is Octreotide?
Reduces pancreatic insulin release (via calcium channel blockade)
The hymenoptera species causes the most envenomation deaths per year in the US. These creatures are included in this class. (name 1)
What are bees, wasps/yellow jackets/hornets, or ants
N-acetylcysteine is used to treat toxicity and prevent liver failure from overdosage of this medication
What is acetaminophen
This reversal agent can be used for respiratory depression / apnea seen in benzodiazepine use/overdose
What is flumazenil
Patient with hypertension, tachycardia, agitation, dilated pupils, diaphoresis
What is the Sympathomimetic Toxidrome
OR
Hallucinogenic (Serotonergic) Toxidrome
Patient presents with status epilepticus refractory to standard therapy. Grandmother is taking an antibiotic medication after having a positive PPD 2 weeks ago
What is Vitamin B6 or pyridoxime (Isoniazid toxicity)
Patient was in the garage, felt something 'bite' his finger when reaching behing a box. 1 hour later, he experiences diffuse muscle cramping, abdominal pain, tachycardia. What is he suffering from?
What is Black Widow Spider envenomation (latrodectism)
Methanol ingestion causes toxicity to this part of the body (as well as causing a gap-acidosis)
What is retinal and CNS toxicity?
This flowering plant that grows well in the Inland Empire causes a classic Anticholinergic Toxidrome
What is Jimson Weed
Patient with hypertension, tachycardia, agitation, dilated pupils, urinary retention, dry skin
What is Anticholinergic Toxidrome
Patient presents with somnolence, Kussmaul breathing, and progressive gap acidemia, after ingestion of a liquid from his garage
What is EtOH and fomepizole (4-MP) (ethylene glycol [antifreeze], methanol [windshield wiper fluid], or diethylene glycol [brake fluid] ingestion)
These symptoms are expected after Centruroides sculpturatus envenomation
What are autonomic dysfunction, paresthesias, seizures, cranial nerve abnormalities, and classic roving rotary eye movements?
(Bark scorpion sting)
In caustic ingestions, severe and life-threatening esophageal injuries are more likely with acidic or alkali materials?
What are alkali materials
This is the reversal agent for Heparin
What is Protamine Sulfate
Patient with bradycardia or tachycardia, miosis, incontinence, diarrhea, hypersalivation, bronchorrhea
What is the Cholinergic Toxidrome
Patient intentionally overdoses on her Amitryptiline, and presents with depressed mental status, seizures, hypotension and QRS widening on EKG
What is Sodium Bicarbonate
When stung by a jellyfish in Florida, the best way to deactivate the nematocysts that are imbedded into the skin is by using: cold water, fresh water, urine, or vinegar?
What is Vinegar (acetic acid)
Yellow and white oleander is poisonous when ingested. Patients can exhibit life-threatening cardiac toxicity. What is the antidote/treatment?
What is Digoxin Fab Fragments (Digibind)
High dosages of this medication may be needed in cases of refractory calcium channel blocker overdose to treat and prevent ongoing bradyarrhythmias and hypotension. (not glucagon, pressors, or calcium)
What is Insulin
Patient presents with miosis, sedation, bradycardia, hypertension followed by hypotension, resistant to naloxone
What are the Alpha-2 agonists (Clonidine, guanfacine, xyalzine, dexmedetomidine, medetomidine...)
Patient who was treated with Dapsone for a brown recluse spider bite in Mexico now presents with severe generalized cyanosis. Pulse oximetry is 85% and does not correct with oxygen, arterial blood is a chocolate brown color when a-line is placed.
What is Methylene Blue (Methemoglobinemia from Dapsone ingestion)
Crofab antivenom is used to treat Crotalid snake envenomations and is now widely available at most hospitals. These snakes are included in the Crofab antivenom.
What are:
Crotalus atrox (western diamondback rattlesnake)
Crotalus adamanteus (Eastern diamondback rattlesnake)
Crotalus scutulatus (Mojave rattlesnake), and
Agkistrodon piscivorus (cottonmouth or water moccasin)
Patient appears intoxicated, has a fruity smelling breath. Labs show non-anion gap acidosis but elevated serum osmolar gap. Patient ingested this
What is Isopropyl Alcohol
Patient develops fever 106F, tachycardia, altered mentation, muscular rigidity and blood pressure lability. He was taking Paroxetine (Paxil), then was given a cough medication containing dextromethorphan. Name the antidotes for this syndrome.
What is Cyproheptadine (for the boards) and Benzodiazepines, cooling, and paralysis (for real life)