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Questions and Answers
What is the primary mechanism of action of activated charcoal in the gastrointestinal tract?
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?
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?
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?
What is the purpose of using saline cathartics with activated charcoal?
What is a common adverse effect of activated charcoal?
What is a common adverse effect of activated charcoal?
What is the primary advantage of using activated charcoal in the gastrointestinal tract?
What is the primary advantage of using activated charcoal in the gastrointestinal tract?
Which of the following is a potential complication of using repeated doses of cathartics?
Which of the following is a potential complication of using repeated doses of cathartics?
Why is activated charcoal administered as a slurry by mouth or through a lavage tube?
Why is activated charcoal administered as a slurry by mouth or through a lavage tube?
What is the primary mechanism of action of Hydroxocobalamin in treating cyanide poisoning?
What is the primary mechanism of action of Hydroxocobalamin in treating cyanide poisoning?
Which of the following antidotes is used to treat envenomation from Pit Vipers, Crotalidae species of North American snakes?
Which of the following antidotes is used to treat envenomation from Pit Vipers, Crotalidae species of North American snakes?
What is the role of thiosulfate in the treatment of cyanide poisoning?
What is the role of thiosulfate in the treatment of cyanide poisoning?
What is the mechanism of action of Sodium nitrite in treating cyanide poisoning?
What is the mechanism of action of Sodium nitrite in treating cyanide poisoning?
Which of the following antidotes acts as a co-substrate to prevent the formation of toxic metabolites?
Which of the following antidotes acts as a co-substrate to prevent the formation of toxic metabolites?
What is the purpose of administering Anavip in the treatment of envenomation from Pit Vipers, Crotalidae species of North American snakes?
What is the purpose of administering Anavip in the treatment of envenomation from Pit Vipers, Crotalidae species of North American snakes?
What is the result of the administration of Hydroxocobalamin in the treatment of cyanide poisoning?
What is the result of the administration of Hydroxocobalamin in the treatment of cyanide poisoning?
Which of the following antidotes is NOT used to treat envenomation from Pit Vipers, Crotalidae species of North American snakes?
Which of the following antidotes is NOT used to treat envenomation from Pit Vipers, Crotalidae species of North American snakes?
What is a crucial aspect of a comprehensive treatment plan for substance use disorder?
What is a crucial aspect of a comprehensive treatment plan for substance use disorder?
What is the primary goal of the induction phase of medication-assisted therapy?
What is the primary goal of the induction phase of medication-assisted therapy?
What is the primary purpose of stabilization phase in medication-assisted therapy?
What is the primary purpose of stabilization phase in medication-assisted therapy?
What is a characteristic of a patient who is a good candidate for medication-assisted therapy?
What is a characteristic of a patient who is a good candidate for medication-assisted therapy?
What is the primary goal of the maintenance phase of medication-assisted therapy?
What is the primary goal of the maintenance phase of medication-assisted therapy?
What is a common component of a comprehensive treatment plan for substance use disorder?
What is a common component of a comprehensive treatment plan for substance use disorder?
What is a characteristic of a patient who is not a good candidate for medication-assisted therapy?
What is a characteristic of a patient who is not a good candidate for medication-assisted therapy?
What is the primary purpose of medication-assisted therapy?
What is the primary purpose of medication-assisted therapy?
What is the primary mechanism of action of naltrexone in treating opioid use disorder?
What is the primary mechanism of action of naltrexone in treating opioid use disorder?
Which medication is available only through a federally certified opioid treatment program?
Which medication is available only through a federally certified opioid treatment program?
Who can prescribe naltrexone?
Who can prescribe naltrexone?
What is the primary goal of acamprosate treatment for alcohol use disorder?
What is the primary goal of acamprosate treatment for alcohol use disorder?
What is the mechanism of action of acamprosate in treating alcohol use disorder?
What is the mechanism of action of acamprosate in treating alcohol use disorder?
What is the difference between naltrexone and methadone in terms of prescription and dispensing?
What is the difference between naltrexone and methadone in terms of prescription and dispensing?
What is the effect of naltrexone on alcohol use disorder?
What is the effect of naltrexone on alcohol use disorder?
What is the administration route of the extended-release form of naltrexone?
What is the administration route of the extended-release form of naltrexone?
Which of the following strategies is designed to reduce drug abuse?
Which of the following strategies is designed to reduce drug abuse?
What is the primary goal of promoting drug take-back, drop-box, and disposal programs?
What is the primary goal of promoting drug take-back, drop-box, and disposal programs?
Who should be involved in naloxone rescue efforts?
Who should be involved in naloxone rescue efforts?
What is the purpose of prescription drug monitoring programs?
What is the purpose of prescription drug monitoring programs?
What type of threats do health care professionals need to be aware of?
What type of threats do health care professionals need to be aware of?
What is the deliberate use of infectious biological agents to cause illness?
What is the deliberate use of infectious biological agents to cause illness?
Why is it important for health care professionals to have an awareness of biological terrorism?
Why is it important for health care professionals to have an awareness of biological terrorism?
What is the purpose of risk evaluation and mitigation strategies?
What is the purpose of risk evaluation and mitigation strategies?
What is the goal of improved health and behavioral care for substance use disorders?
What is the goal of improved health and behavioral care for substance use disorders?
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.
