Specific Toxicity Treatments Quiz

Study Notes

Specific Toxicity Treatments

Acetaminophen: Treatment involves N-acetylcysteine.
AChE inhibitors/organophosphates: Treatment involves atropine followed by pralidoxime.
Antimuscarinic/anticholinergic agents: Treatment includes physostigmine which can cross the blood-brain barrier (BBB) to control hyperthermia.
Arsenic: Treatment involves dimercaprol and succimer.
Benzodiazepines: Treatment involves flumazenil.
Beta-blockers: No specific treatment mentioned.
Carbon monoxide: Treatment involves hyperbaric oxygen (100% O2).
Copper: Treatment includes "penny" cillamine (penicillamine), trientine, or a combination of substances using three copper pennies.
Cyanide: Treatment uses hydroxocobalamin, nitrites, and sodium thiosulfate.
Dabigatran: Treatment is idarucizumab.
Digoxin: Treatment involves digoxin-specific antibody fragments.
Direct Factor Xa inhibitors (e.g., apixaban): Treatment includes andexanet alfa.
Heparin: Treatment involves protamine sulfate.
Iron (Fe): Treatment uses deferoxamine, deferasirox, or deferiprone.
Lead: Treatment involves penicillamine, calcium disodium EDTA, dimercaprol, and succimer.
Mercury: Treatment involves dimercaprol and succimer combined with fomepizole and dialysis.
Methanol/ethylene glycol: Treatment involves fomepizole followed by ethanol and dialysis.
Methemoglobin: Treatment uses methylene blue and vitamin C.
Methotrexate: Treatment uses leucovorin.
Opioids: Treatment involves naloxone.
Salicylates: Treatment isn't explicitly listed but could involve sodium bicarbonate to adjust urine pH.
TCAs: Treatment isn't explicitly listed.
Warfarin: Treatment involves vitamin K (delayed) or prothrombin complex concentrate (PCC) or FFP (immediate effect).

Drug Reactions—Cardiovascular

Coronary vasospasm: Causal agents include cocaine, amphetamines, sumatriptan, and ergot alkaloids.
Cutaneous flushing: Causal agents involve vancomycin, adenosine, niacin, calcium channel blockers, and echinocandins. Vancomycin infusion reactions exhibit widespread erythematous rash; managing involves using diphenhydramine for symptomatic relief.
Dilated cardiomyopathy: Causal agents involve alcohol, anthracyclines, preventing with dexrazoxane and trastuzumab.
Torsades de pointes: This involves agents that prolong the QT interval, including methadone, antiarrhythmics (class IA, III), antibiotics, antipsychotics, antidepressants (TCAs), antiemetics, and antifungals.