37 Questions
What is the main reason why the syrup of ipecac has no role in the hospitalized setting?
It is not effective according to literature
Which of the following is NOT a risk associated with gastric lavage?
Cardiac arrest
When is gastric lavage typically indicated for ingestion of highly toxic substances?
Within 60 minutes of hospital arrival
What is the purpose of activated charcoal in drug ingestion cases?
To bind drugs and interfere with absorption
In what timeframe should activated charcoal ideally be administered after drug ingestion?
Within 1 hour
Why should gastric lavage be carefully considered before use in patients?
To prevent aspiration risk
What is one common risk associated with the use of activated charcoal as a treatment?
No reduction in morbidity or mortality
When is multi-dose therapy with activated charcoal considered?
$4$ hours after ingestion of certain drugs
What potential adverse effects are associated with forced diuresis?
Pulmonary edema, volume overload, and hypernatremia
In what situation is urine pH manipulation typically reserved for?
Salicylate poisoning
Why should Diamox be avoided in inducing alkaline diuresis in specific patients?
It can lead to metabolic acidosis exacerbating toxicity of certain drugs
When is hemodialysis indicated in toxicology cases?
When severe electrolyte imbalances are present
What is the potential risk of using alkaline diuresis in drug poisoning cases?
Alkalemia, hypernatremia, and hypokalemia
What is the purpose of urine pH manipulation in the context of salicylate poisoning?
To enhance elimination of salicylates
In what scenario is routine use of alkaline diuresis not recommended?
In salicylate poisoning
What is the most notable clinical triad for opioid toxicity/overdose?
Central nervous system depression, respiratory depression, and miosis
What is the potency comparison between fentanyl and morphine?
Fentanyl is 50-100 times more potent than morphine
Which drug is most notably associated with Noncardiogenic pulmonary edema in opioid overdose cases?
Heroin
What is a common symptom of opioids that can cause transient GI upset?
Decreased gut motility
Which symptom is notably associated with seizures in opioid overdose?
Lethargy
What is the range of symptoms that generalized central nervous system depression from opioids can exhibit?
Lethargy, agitation, paranoia
What has significantly increased overdose deaths according to the text?
Fentanyl mixed with other drugs like heroin and cocaine
'History' is emphasized as a major component for which aspect of opioid diagnosis?
Diagnosis process
What is the purpose of ordering a CMP for further assessment in this case study?
To assess electrolytes, renal and liver function, and glucose
What role does CBC play in the assessment described in the case study?
Providing information about potential side effects of intoxication
Which substances are traditionally assessed in a toxicology screen according to the text?
Opiates, amphetamines, benzodiazepines, cocaine
What do ethanol levels greater than 300 indicate in the clinical setting?
Severe intoxication causing respiratory compromise
Which assessment should be carried out next after evaluating mental status and pupil size based on the text?
Assessing muscle tone
How do labs such as CMP and CBC contribute to ruling out other differential diagnoses in this case study?
By providing information on organ functions and electrolytes
What is a common electrolyte deficiency seen in patients with chronic alcoholism?
Potassium deficiency
What is the approximate number of Americans with Alcohol Use Disorder?
14.4 million
What is the mortality range from delirium tremens despite modern medical management?
5-15%
What information should a provider investigate if a patient is noted to consume alcohol regularly?
History of prior alcohol withdrawal
Alcohol withdrawal is more common in which gender?
Men
In which population is withdrawal typically seen?
Those who abuse alcohol daily for at least 3 months
What is a common vitamin replacement needed for patients with chronic alcoholism?
Vitamin B6 replacement
How many hospital admissions are there annually for problems related to alcohol abuse in the U.S.?
1.2 million
Test your knowledge on ordering labs for further assessment in an emergency department scenario. Learn about the importance of assessing electrolytes, renal and liver function, and glucose levels in patients with suspected ingestion of unknown substances.
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