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Questions and Answers
What is a primary indication for administering Naloxone?
What is a primary indication for administering Naloxone?
Which of the following is NOT a sign or symptom of CNS depressants?
Which of the following is NOT a sign or symptom of CNS depressants?
What can be a side effect of administering Naloxone?
What can be a side effect of administering Naloxone?
Which substance is classified as a hallucinogen?
Which substance is classified as a hallucinogen?
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Which signs and symptoms are most characteristic of CNS stimulants?
Which signs and symptoms are most characteristic of CNS stimulants?
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What is the definition of poisoning?
What is the definition of poisoning?
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Which of the following is a common antidote for carbon monoxide poisoning?
Which of the following is a common antidote for carbon monoxide poisoning?
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What route of exposure is the most common type of poisoning?
What route of exposure is the most common type of poisoning?
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What action does activated charcoal perform in cases of poison ingestion?
What action does activated charcoal perform in cases of poison ingestion?
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Which of the following is a sign or symptom of poisoning via ingestion?
Which of the following is a sign or symptom of poisoning via ingestion?
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When is activated charcoal indicated for use?
When is activated charcoal indicated for use?
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What are the common contraindications for administering activated charcoal?
What are the common contraindications for administering activated charcoal?
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Which route of exposure provides the most rapid onset of signs and symptoms in poisoning cases?
Which route of exposure provides the most rapid onset of signs and symptoms in poisoning cases?
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What is a common symptom associated with carbon monoxide poisoning?
What is a common symptom associated with carbon monoxide poisoning?
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Which of the following symptoms is NOT associated with drug withdrawal?
Which of the following symptoms is NOT associated with drug withdrawal?
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Which stage of drug withdrawal can result in seizures?
Which stage of drug withdrawal can result in seizures?
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What does SLUDGEM refer to in pesticide exposure?
What does SLUDGEM refer to in pesticide exposure?
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Which drug is NOT derived from opium?
Which drug is NOT derived from opium?
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What is a sign of pesticide exposure according to the SLUDGEM acronym?
What is a sign of pesticide exposure according to the SLUDGEM acronym?
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What is the primary reason for the pink coloration of the skin in carbon monoxide poisoning?
What is the primary reason for the pink coloration of the skin in carbon monoxide poisoning?
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Which of the following is NOT a typical sign of drug overdose?
Which of the following is NOT a typical sign of drug overdose?
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Study Notes
Poisoning & Toxicology
- Poisoning is defined as any substance that impairs health or death by its chemical action when ingested, absorbed or inhaled.
- Toxicology is the study of toxins, antidotes, and the effects of toxins on the body.
- An antidote is a substance that counteracts or neutralizes the effects of a poison.
- Common antidotes include:
- Carbon monoxide poisoning: Oxygen
- Opiate overdose: Naloxone (Narcan)
- Ingestions: Activated charcoal
Routes Of Exposure
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Ingestion is the most common route of exposure.
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Ingestion occurs when a substance is swallowed.
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The substance is absorbed in the GI tract and has a slower onset.
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Important questions include: What was taken? How much was taken? When was it taken?
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Signs/symptoms include:
- Swelling or burns around the mouth.
- Nausea, vomiting, diarrhea.
- Altered mental status (ALOC).
- Abdominal pain.
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Activated charcoal is an antidote for ingested poisons.
- Trade names: Actidose, Actidose-aqua.
- Indications: Ingestions within one hour of ingestion
- Contraindications: Inability to swallow, altered mental status, acids or alkalis, cyanide.
- Dosage: 1 gm/kg
- Adults: Generally 30-100g
- Children: Generally 12.5-25g
- Actions: It adsorbs poisons in the stomach before entering the bloodstream.
- Side effects: Vomiting - repeat dose if patient vomits. Black stools.
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Inhalation occurs when a poison is breathed in.
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Inhalation has the most rapid onset.
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Signs/symptoms include:
- Difficulty breathing or chest pain.
- Airway or breathing sounds.
- Neurological issues.
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Injection occurs when a poison enters the bloodstream.
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Common injected poisons are bites and stings and drugs.
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Signs/symptoms include:
- Injection site swelling.
- Euphoria.
- Nausea, vomiting.
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Absorption occurs when a poison enters through the skin or mucous membranes.
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Skin related signs/symptoms include:
- Burns.
- Rashes.
- Blisters.
Carbon Monoxide Poisoning
- Colorless, tasteless, odorless gas.
- Sources of incomplete combustion:
- Furnaces
- Water heaters
- Gas stoves
- Fire places
- Car exhaust
- Carbon monoxide bonds to red blood cells with a higher affinity than hemoglobin, which prevents hemoglobin from binding to red blood cells. This leads to hypoxia, but the skin will appear pink due to the red blood cells being fully saturated.
- Signs/symptoms:
- Headache.
- Nausea.
- Confusion.
- Cherry red lips/skin (late sign)
Pesticide Exposure / SLUDGEM
- Includes insecticides and nerve agents.
- Acronym SLUDGEM describes the symptoms:
- Salivation
- Lacrimation
- Urination
- Defecation
- GI upset
- Emesis
- Miosis
Drugs & Alcohol
- Drug abuse: Self administration of drugs or medications not approved by medical or social norms.
- Overdose: Poisoning by drugs or alcohol.
- Withdrawal: Period of abstinence from a drug the body is accustomed to.
- Tolerance: Larger doses are needed to achieve the same effect.
Drug & Alcohol Withdrawals
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Stage One:
- 8 hours from last drink.
- Nausea, insomnia, sweating, tremors.
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Stage Two:
- 8-72 hours from last drink.
- Worsening symptoms.
- Hallucinations begin.
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Stage Three:
- 48 hours plus from last drink.
- Same signs/symptoms as Stage two.
- Seizures possible.
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Stage Four:
- Delirium Tremens (DTs) - Medical emergency, life-threatening.
- Loss of memory, hallucinations, fevers, sweating, insomnia, confusion, psychosis.
Opioids
- Drugs derived from opium or synthetics.
- Examples include: Heroin, Fentanyl, Morphine, Vicoden/Hydrocodone, Percocet/Oxycontin/Oxycodone, Dilaudid.
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Signs/symptoms of overdose:
- Respiratory depression or arrest.
- Pinpoint pupils.
- Hypotension.
Naloxone / Narcan (Opioid Antagonist)
- Indications: Suspected opioid overdose with respiratory depression of less than 12 or respiratory arrest.
- Actions: It binds to opioid receptor sites and reverses respiratory depression.
- Side effects: Possible acute withdrawal.
- Dosage: 2 mg intranasally, 1 mg in each nostril.
CNS Stimulants
- Examples: Cocaine, crack, meth, PCP, diet pills, MDMA/ecstasy.
- Stimulate the central nervous system.
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Signs/symptoms:
- Excitable, nervous.
- Hypertension.
- Dilated pupils.
- Tachycardia.
CNS Depressants
- Examples: Alcohol, Benzodiazepines (Xanax/Alprozolam, Ativan, Valium).
- Depress the central nervous system.
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Signs/symptoms:
- Euphoria.
- Drowsiness.
- Dilated pupils.
- Sluggishness.
- Bradypnea.
Hallucinogens
- Examples: LSD, PCP, Bath Salts, MDMA.
-
Signs/symptoms:
- Anxiety.
- Paranoia.
- Violent behavior.
- Hallucinations.
- Dilated pupils.
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Description
This quiz covers essential concepts about poisoning and toxicology including definitions, common antidotes, and routes of exposure. Understand how toxins impact health and the importance of recognizing symptoms. Test your knowledge on the effects of different substances and the role of antidotes.
