Clinical Toxicology - Poisoned Patients Management
45 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is a primary aim in the management of a poisoned patient?

  • Administer antidotes as the first step
  • Establish the cause of poisoning before treatment
  • Maintain respiration and circulation (correct)
  • Increase the concentration of poison in the system

In clinical toxicology, which of the following is considered a common source of poisoning?

  • Atmospheric pollutants
  • Occupational chemicals
  • Food preservatives
  • Household cleaning products (correct)

Which statement reflects an important strategy in treating poisonings?

  • Focusing solely on the substance involved
  • Restricting all oral intake regardless of the situation
  • Assessing the vital signs and reflexes (correct)
  • Administering activated charcoal immediately

What is the first goal in the treatment of acute poisoning?

<p>Keep the concentration of the poison as low as possible (D)</p> Signup and view all the answers

What should clinicians do regardless of the type of toxin ingested?

<p>Always assume a life-threatening intoxication (C)</p> Signup and view all the answers

Which of the following best describes the focus of clinical toxicology?

<p>Effects of drugs and chemicals on humans (C)</p> Signup and view all the answers

What is the correct approach when managing a poisoned patient?

<p>Manage as if all patients have life-threatening poisoning (A)</p> Signup and view all the answers

What is an essential component of supportive care in poisoning management?

<p>Monitoring the patient's vital signs (A)</p> Signup and view all the answers

What is the primary purpose of risk assessment in the context of acute poisoning?

<p>To predict the patient's likely clinical course and complications (C)</p> Signup and view all the answers

Which of the following aspects is NOT included in the physical examination of a patient suspected of acute poisoning?

<p>Mood and emotional state (D)</p> Signup and view all the answers

What is the first step in a five-step risk assessment for managing acutely poisoned patients?

<p>Identifying the ingested agent(s) (A)</p> Signup and view all the answers

Which method is recommended for preventing further absorption of poison through dermal exposure?

<p>Removing all clothing and washing the skin gently for at least 30 minutes (C)</p> Signup and view all the answers

In the evaluation of acute poisoning cases, which feature is considered in conjunction with the dose and time since ingestion?

<p>Clinical features and progress (B)</p> Signup and view all the answers

Which of the following clinical features should be examined during a neurological assessment?

<p>Pupil size and reflexes (A)</p> Signup and view all the answers

Which option describes a key management goal in cases of poisoning?

<p>Prevention of further poison absorption and enhancement of elimination (D)</p> Signup and view all the answers

What should be assessed to predict the likelihood of significant toxicity in an acutely poisoned patient?

<p>Dose taken calculated in mg/kg body weight (B)</p> Signup and view all the answers

What is the main focus of management in cases of poisoning?

<p>Supportive care and prevention of poison absorption (B)</p> Signup and view all the answers

What is the primary factor contributing to death from poisoning?

<p>Loss of airway-protective reflexes (D)</p> Signup and view all the answers

Which fluid is preferred for intravenous infusion in hypotensive patients?

<p>Normal saline or isotonic solution (A)</p> Signup and view all the answers

What is the first step in the Disability (Neurological) assessment for poisoning victims?

<p>Checking the blood sugar level (D)</p> Signup and view all the answers

What should be considered when evaluating a poisoning victim's temperature?

<p>Possible toxic syndromes associated with hyperthermia (D)</p> Signup and view all the answers

Which vital signs are critical to assess during the circulation evaluation in poison management?

<p>Blood pressure and pulse rate (C)</p> Signup and view all the answers

When dealing with toxic seizures, what is the recommended initial treatment?

<p>IV administration of benzodiazepines (C)</p> Signup and view all the answers

What is the significance of gathering information from sources other than the patient in poisoning cases?

<p>To accurately identify the poison and ingestion details (B)</p> Signup and view all the answers

What is the primary method used to remove solid corrosives in emergency situations?

<p>Removal with forceps (C)</p> Signup and view all the answers

What is the recommended time frame for administering ipecac syrup for inducing vomiting?

<p>Within 30 minutes of ingestion (A)</p> Signup and view all the answers

Which of the following conditions is NOT a contraindication for induction of emesis?

<p>Mild intoxication (D)</p> Signup and view all the answers

Under what circumstances is gastric lavage indicated?

<p>When emesis has failed or is contraindicated (D)</p> Signup and view all the answers

Which of the following is an indication for using activated charcoal?

<p>Ingestion within one hour with significant risk of toxicity (C)</p> Signup and view all the answers

What is the adult dosage of activated charcoal?

<p>1 gm/kg (C)</p> Signup and view all the answers

Which agent is NOT bound to activated charcoal?

<p>Opiates (C)</p> Signup and view all the answers

What type of cathartic acts by increasing motility in the gastrointestinal tract?

<p>Irritant cathartics (C)</p> Signup and view all the answers

What is the purpose of using chelating agents in clinical toxicology?

<p>To bind metallic poisons and form soluble compounds (B)</p> Signup and view all the answers

Which method of poison excretion enhancement is particularly beneficial when renal function is impaired?

<p>Peritoneal dialysis (D)</p> Signup and view all the answers

In the context of pharmacological antidotes, what type of antagonism do competitive antagonists primarily involve?

<p>Competing with the agonist for the same receptor site (D)</p> Signup and view all the answers

What is the main principle behind hemodialysis used in poison excretion enhancement?

<p>Separation of toxins using a semipermeable membrane (B)</p> Signup and view all the answers

What type of substances are used in hemoperfusion to aid in toxin clearance?

<p>Charcoal or resin as adsorbent materials (A)</p> Signup and view all the answers

What is the primary goal of Whole Bowel Irrigation (WBI)?

<p>To clean GIT from non-absorbed ingested toxins (D)</p> Signup and view all the answers

Which of the following conditions is a contraindication for performing Whole Bowel Irrigation?

<p>Recent bowel surgery (C)</p> Signup and view all the answers

Which antidote works by interacting with a poison to form a non-toxic complex?

<p>Activated charcoal (A)</p> Signup and view all the answers

Which of the following antidotes competes with the poison for certain receptors?

<p>Naloxone (C)</p> Signup and view all the answers

What type of antidote is N-acetylcysteine classified as?

<p>Chemical antidote (B)</p> Signup and view all the answers

Which of the following is an example of a physical antidote?

<p>Activated charcoal (D)</p> Signup and view all the answers

What is the mechanism of action for Fomepizole as an antidote?

<p>Decreases the conversion of poison into toxic metabolites (D)</p> Signup and view all the answers

Which type of antidote is designed to bypass the effects of a poison?

<p>Physiological antidotes (D)</p> Signup and view all the answers

Flashcards

Clinical Toxicology

The study of how drugs and chemicals affect humans (and other animals), often focusing on poisonings and determining the substance and amount in the body.

Poisoned patient management

All poisoned patients should be treated as potentially life-threatening, even if they seem normal.

Initial approach to poisoning

A routine approach to managing poisoning, regardless of the specific substance ingested.

Common poisoning sources

Poisoning can come from various substances, including household products, pesticides, and prescription/over-the-counter medications.

Signup and view all the flashcards

Treating the Patient

Prioritize treating the patient's symptoms, not just finding and neutralizing the poison immediately.

Signup and view all the flashcards

Supportive therapy

Essential for maintaining respiration and circulation, which are primary concerns during poisoning.

Signup and view all the flashcards

Intoxication Progress

Monitor the vital signs and reflexes to measure and chart the extent of poisoning.

Signup and view all the flashcards

Poison Elimination Goals

Reduce poison concentration by preventing absorption and increasing its elimination, and counteract effects at affected areas if possible.

Signup and view all the flashcards

Acute Poisoning Assessment

A dynamic process requiring ongoing clinical examination and management due to fluctuating patient conditions.

Signup and view all the flashcards

Risk Assessment Steps (Acute)

A 5-step process to predict clinical course, complications, & patient management; includes agent, dose, time, clinical features & progress, and patient factors.

Signup and view all the flashcards

Risk Assessment: Agent

Evaluate the toxicity potential of ingested substances.

Signup and view all the flashcards

Risk Assessment: Dose

Calculate the ingested dose in mg/kg, predicting toxicity.

Signup and view all the flashcards

Risk Assessment: Time

Determine the likely clinical progression based on ingestion time.

Signup and view all the flashcards

Risk Assessment: Clinical Features

Correlate the patient's symptoms with the ingested dose and time since ingestion.

Signup and view all the flashcards

Prevention of Further Poison Absorption (Dermal)

Remove clothes and gently wash skin with soap and water for at least 30 minutes to prevent further absorption.

Signup and view all the flashcards

Physical Exam (Acute)

Assess vital signs (PR, RR, BP, Temp, O2), neurological status (GCS, pupils, reflexes), skin and other relevant signs to understand poison effects.

Signup and view all the flashcards

Airway Management in Poisoning

Keeping the airway open and removing any obstructions, especially due to flaccid tongue or aspiration, to prevent death from airway blockage.

Signup and view all the flashcards

Respiratory Evaluation in Poisoning

Assess respiratory rate and oxygen saturation, providing supplemental oxygen if needed, especially with elevated breathing.

Signup and view all the flashcards

Circulatory Evaluation in Poisoning

Rapid assessment of vital signs (BP, pulse) and hydration in a poisoned patient. Continuous ECG monitoring, venous access, lab tests and IV fluids are essential.

Signup and view all the flashcards

Neurological Evaluation in Poisoning

Evaluate altered mental status, checking for seizures and if blood sugar <72 mg/dL, treat hypoglycemia by administering dextrose IV.

Signup and view all the flashcards

Temperature Evaluation in Poisoning

Be mindful of potential hyperthermic complications caused by some toxins.

Signup and view all the flashcards

Poison Identification

Identifying the ingested poison is crucial for appropriate management.

Signup and view all the flashcards

Poisoning History

Gather detailed information from sources such as family, friends, and the scene (place, pill bottles) to understand the circumstances and time/amount of ingestion.

Signup and view all the flashcards

Poisoning Management

Supportive care, preventing further poison absorption, enhancing elimination, and using antidotes when appropriate are crucial stages of treatment.

Signup and view all the flashcards

Whole Bowel Irrigation (WBI)

A procedure to remove non-absorbed toxins from the gastrointestinal tract using polyethylene glycol electrolyte solutions.

Signup and view all the flashcards

WBI Indications

Used for toxin ingestion, massive drug intake, sustained-release/enteric-coated drugs, and body packers.

Signup and view all the flashcards

Antidote

A substance that counteracts the toxic effects of a poison.

Signup and view all the flashcards

Antidote Classification (Mechanism)

Antidotes are categorized by how they work: form non-toxic complexes (e.g., chelators), speed up poison breakdown, or block poison effects.

Signup and view all the flashcards

Physical Antidotes

Antidotes that alter a poison's physical properties without chemically changing it. (e.g., adsorption, coating, dissolving).

Signup and view all the flashcards

Chemical Antidotes

Antidotes that chemically neutralize a poison, using oxidation, reduction, or precipitation reactions.

Signup and view all the flashcards

GIT Hemorrhage

Bleeding in the gastrointestinal tract, a contraindication for WBI.

Signup and view all the flashcards

Contraindications for WBI

Conditions making Whole Bowel Irrigation unsuitable (e.g., recent bowel surgery, intestinal obstruction).

Signup and view all the flashcards

Eye Exposure Treatment

Wash conjunctiva (the inner lining of the eye) with running water or normal saline for 20 minutes.

Signup and view all the flashcards

Solid Corrosive Removal

Use forceps to remove solid corrosives from the eye.

Signup and view all the flashcards

GIT Exposure Treatment

Induce emesis, perform gastric lavage, use activated charcoal, and cathartics to prevent absorption and promote elimination.

Signup and view all the flashcards

Ipecac Syrup Use

A safe method to induce vomiting within 30 minutes of ingestion, but no longer routinely used at home.

Signup and view all the flashcards

Emesis Contraindications

Avoid inducing vomiting in cases of convulsions, corrosives, hydrocarbons, coma, or in patients under 6 months of age.

Signup and view all the flashcards

Gastric Lavage Use

A hospital procedure used when emesis fails or is contraindicated, best within 4-6 hours of ingestion.

Signup and view all the flashcards

Activated Charcoal Use

Binds to various drugs and chemicals, preventing absorption in the GI tract. Best within 1 hour of ingestion.

Signup and view all the flashcards

Activated Charcoal Contraindications

Avoid use with oral antidotes, seizures, coma, corrosive ingestion, or substances not bound by charcoal, including hydrocarbons, alcohols and corrosives.

Signup and view all the flashcards

Physiological Antidotes

Substances that counteract the effects of a poison by opposing its action on the body.

Signup and view all the flashcards

Chelating Agents

Substances that bind to metallic poisons, forming compounds that are more easily excreted from the body.

Signup and view all the flashcards

Forced Diuresis

A method of enhancing poison excretion by increasing urine production.

Signup and view all the flashcards

Dialysis

A method of removing poisons from the blood, using a semi-permeable membrane.

Signup and view all the flashcards

Hemodialysis

A type of dialysis that uses a machine to filter the blood.

Signup and view all the flashcards

Study Notes

Clinical Toxicology - Initial Evaluation & Management of Poisoned Patients

  • Clinical toxicology focuses on the effects of drugs and chemicals on humans and other animals, specifically drug overdoses and poisonings. It involves determining the substance and its amount in the body.
  • Clinical toxicology overlaps with other fields like biochemistry, pharmacology, and pathology.
  • All poisoned patients should be managed as if they have a life-threatening intoxication, even if they appear normal.
  • The initial approach to a poisoned patient should be the same, regardless of the ingested toxin. This approach is termed routine poison management.
  • Common poisonings include exposures to household cleaning products, pesticides, and most importantly prescription and over-the-counter medications.
  • Crucial strategies include promptly treating the patient (not the poison), establishing supportive therapy for respiration and circulation, and meticulously tracking vital signs and reflexes to assess intoxication progress.

Approach to the Poisoned Patient (ABCDEs)

  • Airway: Keep airways patent and remove any obstructions. Loss of airway reflexes is a major cause of death. Potential obstructions include flaccid tongue, or aspiration of gastric contents.
  • Breathing: Evaluate respiratory rate and oxygen saturation. If no monitor is available but the patient has a high respiratory rate, supplemental oxygen should be considered.
  • Circulation: Quickly assess vital signs (blood pressure, pulse rate, rhythm) and hydration status. Secure venous access. Draw blood for routine tests. Begin intravenous fluids, using normal saline or another isotonic solution if the patient is hypotensive.
  • Disability (Neurological): Evaluate level of consciousness. If the patient has seizures, check blood sugar. If the blood sugar is less than 72 mg/dL, administer 50 mL of 50% dextrose intravenously. Treat toxic seizures with IV benzodiazepines; refractory seizures may need barbiturates.
  • Exposure (temperature): Consider toxic syndromes associated with hyperthermia, as high drug levels can elevate body temperature significantly.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

Clinical Toxicology Lecture 1 PDF

Description

This quiz covers the essential aspects of clinical toxicology, focusing on the initial evaluation and management of poisoned patients. Learn about the crucial strategies employed in managing various poisonings, including support for vital functions and the routine approach to care.

More Like This

Introduction to Clinical Toxicology
38 questions

Introduction to Clinical Toxicology

CleanestGoblin8066 avatar
CleanestGoblin8066
Clinical Toxicology Overview
80 questions

Clinical Toxicology Overview

EntrancedAstronomy avatar
EntrancedAstronomy
Clinical Toxicology Evaluation & Management
45 questions

Clinical Toxicology Evaluation & Management

EntrancedAstronomy avatar
EntrancedAstronomy
Clinical Toxicology: Initial Evaluation & Management
45 questions

Clinical Toxicology: Initial Evaluation & Management

EntrancedAstronomy avatar
EntrancedAstronomy
Use Quizgecko on...
Browser
Open
Browser
Browser