Gastrointestinal Decontamination Methods
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Questions and Answers

What is the primary mechanism of action of activated charcoal in the gastrointestinal tract?

  • It increases the absorption of poisons in the gastrointestinal tract
  • It reduces the extent of absorption of poisons in the gastrointestinal tract (correct)
  • It promotes the elimination of toxic substances through emesis
  • It converts toxic substances into non-toxic substances
  • What is the recommended dose of activated charcoal for adults?

  • 50-200 g
  • 25-100 g (correct)
  • 25-50 g
  • 10-25 g
  • Which of the following is a contraindication for the use of activated charcoal?

  • Ingestion of acidic substances
  • Ingestion of heavy metals (correct)
  • Presence of patient's bowel sounds
  • Ingestion of sedatives
  • What is the purpose of using saline cathartics with activated charcoal?

    <p>To decrease the gastrointestinal transit time</p> Signup and view all the answers

    What is a common adverse effect of activated charcoal?

    <p>Emesis</p> Signup and view all the answers

    What is the primary advantage of using activated charcoal in the gastrointestinal tract?

    <p>It reduces the absorption of toxic substances</p> Signup and view all the answers

    Which of the following is a potential complication of using repeated doses of cathartics?

    <p>Fluid and electrolyte disturbances</p> Signup and view all the answers

    Why is activated charcoal administered as a slurry by mouth or through a lavage tube?

    <p>To facilitate its adsorption of toxic substances</p> Signup and view all the answers

    What is the primary mechanism of action of Hydroxocobalamin in treating cyanide poisoning?

    <p>It rapidly exchanges its hydroxyl group with free cyanide to produce nontoxic cyanocobalamin</p> Signup and view all the answers

    Which of the following antidotes is used to treat envenomation from Pit Vipers, Crotalidae species of North American snakes?

    <p>Ovine IgG Fab fragments</p> Signup and view all the answers

    What is the role of thiosulfate in the treatment of cyanide poisoning?

    <p>It forms thiocyanate, which is excreted in the urine</p> Signup and view all the answers

    What is the mechanism of action of Sodium nitrite in treating cyanide poisoning?

    <p>It oxidizes hemoglobin to form methemoglobin to bind cyanide</p> Signup and view all the answers

    Which of the following antidotes acts as a co-substrate to prevent the formation of toxic metabolites?

    <p>None of the above</p> Signup and view all the answers

    What is the purpose of administering Anavip in the treatment of envenomation from Pit Vipers, Crotalidae species of North American snakes?

    <p>To bind and neutralize venom toxins</p> Signup and view all the answers

    What is the result of the administration of Hydroxocobalamin in the treatment of cyanide poisoning?

    <p>The production of nontoxic cyanocobalamin that is eliminated in the urine</p> Signup and view all the answers

    Which of the following antidotes is NOT used to treat envenomation from Pit Vipers, Crotalidae species of North American snakes?

    <p>Hydroxocobalamin</p> Signup and view all the answers

    What is a crucial aspect of a comprehensive treatment plan for substance use disorder?

    <p>Screening, assessment, and diagnosis of substance use disorder</p> Signup and view all the answers

    What is the primary goal of the induction phase of medication-assisted therapy?

    <p>To abstain from using the problem substance for 12 to 24 hours</p> Signup and view all the answers

    What is the primary purpose of stabilization phase in medication-assisted therapy?

    <p>To adjust the dose of the MAT drug based on the patient's response</p> Signup and view all the answers

    What is a characteristic of a patient who is a good candidate for medication-assisted therapy?

    <p>Is motivated to adhere to a treatment plan</p> Signup and view all the answers

    What is the primary goal of the maintenance phase of medication-assisted therapy?

    <p>To stabilize the patient on a steady dose of the MAT drug</p> Signup and view all the answers

    What is a common component of a comprehensive treatment plan for substance use disorder?

    <p>Psychosocial support and counseling</p> Signup and view all the answers

    What is a characteristic of a patient who is not a good candidate for medication-assisted therapy?

    <p>Has a contraindication to the MAT drug</p> Signup and view all the answers

    What is the primary purpose of medication-assisted therapy?

    <p>To support a patient's recovery from substance use disorder</p> Signup and view all the answers

    What is the primary mechanism of action of naltrexone in treating opioid use disorder?

    <p>Blocking the actions of opioids</p> Signup and view all the answers

    Which medication is available only through a federally certified opioid treatment program?

    <p>Methadone</p> Signup and view all the answers

    Who can prescribe naltrexone?

    <p>Any licensed prescriber</p> Signup and view all the answers

    What is the primary goal of acamprosate treatment for alcohol use disorder?

    <p>Achieving complete abstinence from alcohol</p> Signup and view all the answers

    What is the mechanism of action of acamprosate in treating alcohol use disorder?

    <p>Restoring the balance of neuronal excitation and inhibition</p> Signup and view all the answers

    What is the difference between naltrexone and methadone in terms of prescription and dispensing?

    <p>Methadone is only available through a certified opioid treatment program</p> Signup and view all the answers

    What is the effect of naltrexone on alcohol use disorder?

    <p>It reduces the rewarding, pleasurable effects of alcohol</p> Signup and view all the answers

    What is the administration route of the extended-release form of naltrexone?

    <p>Intramuscular injection</p> Signup and view all the answers

    Which of the following strategies is designed to reduce drug abuse?

    <p>Innovative drug products with deterrents to abuse</p> Signup and view all the answers

    What is the primary goal of promoting drug take-back, drop-box, and disposal programs?

    <p>To reduce deaths from drug overdose</p> Signup and view all the answers

    Who should be involved in naloxone rescue efforts?

    <p>Family, friends, active bystanders, emergency medical services, and police</p> Signup and view all the answers

    What is the purpose of prescription drug monitoring programs?

    <p>To identify patients at high risk for overdose</p> Signup and view all the answers

    What type of threats do health care professionals need to be aware of?

    <p>Biological, chemical, explosive, and radiological threats</p> Signup and view all the answers

    What is the deliberate use of infectious biological agents to cause illness?

    <p>Biolerrorism</p> Signup and view all the answers

    Why is it important for health care professionals to have an awareness of biological terrorism?

    <p>To appreciate epidemiologic clues of a biological terrorism event</p> Signup and view all the answers

    What is the purpose of risk evaluation and mitigation strategies?

    <p>To reduce the risk of opioid overdose</p> Signup and view all the answers

    What is the goal of improved health and behavioral care for substance use disorders?

    <p>To provide effective treatment for substance use disorders</p> Signup and view all the answers

    Study Notes

    Gastrointestinal Decontamination

    • Activated charcoal is used to adsorb poisons in the gastrointestinal tract and reduce absorption.
    • It is administered as a slurry by mouth in alert patients or through a lavage tube as a single dose.
    • Dosage: Children: 25-50 g, Adults: 25-100 g.
    • Contraindications: ingestion of aliphatic hydrocarbons and caustics, absence of patient's bowel sounds, ingestion of heavy metals or simple alcohols.

    Antivenin

    • Antivenin (antivenom) is used to treat envenomation from pit vipers (Crotalinae) native to North America.
    • Examples: ovine IgG Fab fragments (Crotalidae), Crotalidoe immune F(ab'), equine (Anavip).

    Cyanide Antidote

    • Hydroxocobalamin (Cyanokit) is an antidote for cyanide poisoning.
    • It rapidly exchanges its hydroxyl group with free cyanide to produce nontoxic, stable cyanocobalamin (vitamin B12).

    Detoxifying Substance

    • Sodium nitrite is a cyanide antidote that oxidizes hemoglobin to methemoglobin, which binds cyanide.
    • Thiosulfate is administered to form thiocyanate, which is excreted in the urine.

    Enzymatic System Detoxification

    • Antidotes act as co-substrates or prevent formation of toxic metabolites, enhancing detoxification by increasing activity or inhibiting activity.

    Medication-Assisted Therapies

    • Medication-assisted therapy (MAT) is used for substance use disorders.
    • Phases of treatment: induction, stabilization, and maintenance.
    • Examples: methadone, naltrexone, and acamprosate.

    Methadone

    • Can be prescribed only by authorized physicians and dispensed through a federally certified opioid treatment program (methadone clinic).

    Naltrexone

    • Opioid receptor antagonist that blocks the actions of opioids and reduces craving.
    • Available as a tablet (ReVia, Depade) and in an IM injectable extended-release form (Vivitrol).
    • Can be prescribed by any licensed prescriber.

    Acamprosate

    • FDA approved for the treatment of alcohol use disorder.
    • Mechanism of action: restores the balance of neuronal excitation and inhibition compromised from chronic alcohol use.

    Substance Use Disorder Treatment

    • Comprehensive treatment plan includes: screening, assessment, diagnosis, individual counseling, acute detoxification, residential and outpatient rehabilitation programs, and support groups.
    • Approaches to reduce deaths from drug overdose: drug take-back programs, naloxone rescue, co-prescriptions for naloxone, innovative drug products with deterrents to abuse, and prescription drug monitoring programs.

    Terrorism and Disaster Preparedness

    • Biological threats: bioterrorism is the deliberate use of infectious biological agents to cause illness.
    • Healthcare professionals should be aware of the potential for biological terrorism and appreciate epidemiologic clues of a chemical or biological terrorism event.

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    Description

    Learn about the recommended methods and drugs used to decontaminate the gastrointestinal tract, including activated charcoal and its indications and dosage. Understand how these agents work to adsorb poisons and reduce absorption.

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