Intro to Toxicology

When is dextrose given

Pt with depressed consciousness give 50%, 50 mL IV for adults, 25% 2 ml/kg for children

When is thiamine given

Pt with Wernicke encephalopathy

When is naloxone given

Pt with respiratory depression → can cause opioid withdrawal

When is flumazenil given

Coma caused by BDZ

Anticholinergic syndrome symptom mneumonic

Mad as a hatter, red as a beet, blind as a bat, hot as a hare, dry as a bone

Anticholinergic syndrome symptoms

Increased Temp, HR, RR, BP; dilated pupil, dry skin, delirium/psychosis/paranoia

What is SLUDGE, Killer B’s

Cholinergic muscarinic receptor symptoms: Salivation, lacrimation, urination, diarrhea, GI upset, emesis + bronchorrhea, bronchospasm and bradycardia

When would orogastric lavage be done

<1hr ingestion of life threatening toxin with no effective treatment once absorbed

When is activated charcoal used

Ingestion within previous hour of toxic substance that is absorbed by charcoal

When is whole bowel irrigation with polyethylene glycol used

Metal ingestion, ingestion of sustained release or enteric coated tablets

What is enhanced elimination

Type of detox; urine alkalization, forced diuresis, activated charcoal, hemodialysis etc

Acetaminophen antidote

N acetylcysteine

Anticholinergic antidote

Physostigmine

Benzodiazepine antidote

Flumazenil

Cholinesterase inhibitor antidote

Atropine

Subdisciplines of forensic toxicology

Post mortem, behavioral/human performance, forensic drug testing

What is post mortem toxicology

Establish the toxin that causes death

What is Human Performance Toxicology

How do alcohol and drugs effect behavior