Toxicology and Poisoning

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Questions and Answers

What is the primary concern when treating an unresponsive patient who is intoxicated?

Establishing and maintaining an airway (correct)

Performing a neurological exam

Administering naloxone

Establishing an IV line

What is the term for the symptoms of alcohol withdrawal, which typically occur within 12-48 hours?

Delirium tremens (correct)

Hepatitis

Chronic malnutrition

Alcohol intoxication

Which of the following medical conditions is associated with alcoholism?

Uncontrolled diabetes

Pancreatitis

All of the above (correct)

Head trauma

What is the effect of naloxone on opioid overdose?

It reverses the effects of the opioid Signup and view all the answers

What is the primary mechanism of action of opioids?

Binding to receptor sites in the brain and other tissues Signup and view all the answers

What is the indication for administering naloxone?

When the patient has agonal respirations or apnea Signup and view all the answers

Where is lead usually stored in the body?

Teeth and bones Signup and view all the answers

What is the primary treatment for iron exposure?

Provide ABCs and transportation Signup and view all the answers

What is the primary effect of cyanide exposure on the body?

Blocks the utilization of oxygen at the cellular level Signup and view all the answers

What is the primary symptom of costic exposure?

Severe pain in the mouth, throat, and chest Signup and view all the answers

Which type of alcohol is more toxic than ethyl alcohol?

Both A and B Signup and view all the answers

What is the primary consideration when treating multiple patients with similar signs and symptoms at the same scene?

Food poisoning Signup and view all the answers

What is a characteristic of cocaine?

It can cause local anesthesia and CNS stimulation Signup and view all the answers

What is a common effect of marijuana and cannabis compounds?

Distortion of sense of time and space Signup and view all the answers

What is a characteristic of methamphetamine?

It is a low-cost, long-acting drug Signup and view all the answers

What is a potential risk of taking erectile dysfunction medications with nitrates?

Severe hypotension or cardiovascular collapse Signup and view all the answers

What is a characteristic of stimulants?

They increase activity and excitement Signup and view all the answers

What is a potential effect of SSRIs?

Nausea, vomiting, dizziness, tremors, and dilated pupils Signup and view all the answers

What is a characteristic of organophosphates?

They cause anxiety, restlessness, headache, tremors, respiratory depression, and loss of consciousness Signup and view all the answers

What is a common effect of lithium?

Nausea, vomiting, hand tremors, excessive thirst, and slurred speech Signup and view all the answers

What is a common effect of carbon monoxide poisoning?

Headache, nausea, and vomiting Signup and view all the answers

What is a treatment for nerve gas agent poisoning?

All of the above Signup and view all the answers

Study Notes

Here is a summary of the text in detailed bullet points:

• Alcohol is the most widely used drug in the US, and alcoholism is the fourth leading cause of death, often associated with chronic malnutrition, falls, and aggressive behavior.

• Medical problems associated with alcoholism include head trauma, toxic reactions, uncontrolled diabetes, liver damage, hepatitis, cirrhosis, pancreatitis, and increased risk of breast and colorectal cancer.

• If an intoxicated patient is unresponsive, treat them as any other unresponsive patient, establishing and maintaining an airway, and suspecting internal bleeding if they appear in shock.

• Symptoms of alcohol withdrawal, also known as delirium tremens (DTs), usually occur within 12-48 hours and require paramedic backup and administration of benzodiazepines for seizure control.

• Opioids are CNS depressants, including opiates (natural drugs derived from opium) and opioids (synthetic drugs), which produce therapeutic effects by binding to receptor sites in the brain and other tissues.

• Effects of opioids include euphoria, hypotension, respiratory depression, pinpoint pupils, vomiting, constipation, seizures, and cardiac arrest.

• Naloxone (Narcan) is a drug that reverses opioid overdose effects, but may precipitate withdrawal symptoms, and should only be used when the patient has agonal respirations or apnea.

• Stimulants are drugs that increase activity and excitement, including cocaine, amphetamines, and synthetics, which can cause addiction, psychosis, tremors, seizures, and cardiovascular problems.

• Cocaine is a naturally occurring alkaloid that can be absorbed across mucosal membranes, causing local anesthesia and CNS stimulation.

• Amphetamines have legitimate clinical applications, but are highly addictive and can cause agitation, hallucinations, and paranoia.

• Methamphetamine is a low-cost, long-acting drug that can stay in the system for up to 12 hours and is extremely addictive.

• Synthetic drugs, often marketed as bath salts, can cause agitation, hallucinations, and paranoia.

• Marijuana and cannabis compounds are harvested from the Cannabis sativa plant and can cause distorted sense of time and space, euphoria, drowsiness, and increased appetite.

• Spice is a blend of synthetic cannabinoids that can cause psychosis, hallucinations, tachycardia, vomiting, renal problems, and seizures.

• Hallucinogens alter sensory perception, including LSD, which affects the senses rather than physiological functions, and PCP, which can cause violent behavior, hallucinations, and superhuman strength.

• Ketamine is a club drug used in combination with other drugs, causing mild inebriation, lethargy, dreamy thoughts, and increased sociability.

• Mescaline is a drug derived from the Pod Cactus, causing profound vomiting, hallucinations, and distortion of time and space.

• Sedatives and hypnotics reduce anxiety and help calm agitated patients, including barbiturates, benzodiazepines, and non-benzodiazepines.

• Anti-ischemic medications, such as beta blockers, calcium channel blockers, and cardiac glycosides, can cause hypotension, weakness, dizziness, confusion, and rhythm disturbances.

• Erectile dysfunction medications, such as Viagra and Cialis, can cause severe hypotension or cardiovascular collapse if taken with nitrates.

• Tricyclic antidepressants carry a high risk of intentional overdose, causing altered mental status, dysrhythmia, dry mouth, blurred vision, and dilated pupils.

• MAOIs (monoamine oxidase inhibitors) can precipitate a hypertensive crisis if taken with certain foods, causing delayed symptoms such as hyperactivity, dysrhythmias, and hypertension.

• SSRIs (selective serotonin reuptake inhibitors) are prescribed for depression, causing nausea, vomiting, dizziness, tremors, and dilated pupils.

• Lithium is used to treat bipolar disorder, causing nausea, vomiting, hand tremors, excessive thirst, and slurred speech.

• Non-steroidal anti-inflammatory drugs (NSAIDs) are popular options for pain relief and anti-inflammatory action, but can cause GI bleeding and kidney dysfunction with chronic use.

• GHB (gamma-hydroxybutyric acid) is a drug associated with sexual assaults, causing CNS depression and amnesia.

• Organophosphates are the major component in many insecticides and nerve gases, causing anxiety, restlessness, headache, tremors, respiratory depression, and loss of consciousness.- Nerve gas agents can be treated with antidotes such as the Duodote kit, Antidote Treatment Nerve Agent Auto Injector, and the Mark 1 kit, which are indicated for known exposure to nerve agents or Organophosphates with manifestation of signs and symptoms.

Removal of the patient from the source of exposure is critical in nerve gas agent poisoning.
Carbon monoxide is a common fatal poisoning produced during incomplete combustion of organic fuels, and is a major contributor to death in house fires.
Carbon monoxide poisoning can be difficult to diagnose in the field due to variable and vague signs and symptoms, including headache, nausea, and vomiting.
Cherry red color of the skin is a late sign of carbon monoxide poisoning.
Treatment in the field involves providing the highest concentration of oxygen possible to displace CO molecules from hemoglobin.
Metals such as lead are a leading cause of chronic metal poisoning, which can significantly hamper intellectual development in children.
Lead absorption usually occurs via the respiratory or GI tract, and is stored in the teeth and bones, with a half-life of 30 years in bone.
Most organic lead exposures occur in occupational settings, with very few treatment options in the field other than identification and provision of transportation.
Iron exposure can cause GI symptoms, systemic toxicity, and metabolic acidosis, and treatment involves providing ABCs and transportation.
Chlorine gas exposure is common due to widespread use of chlorine compounds in the home and occupational settings, and can cause burning sensation in the eyes, nose, and throat, as well as chest tightness, choking, and cyanosis.
Removal of patients from the area of exposure and quick triage are crucial in chlorine gas exposure, with prioritization of patients with breathing problems.
Cyanide exposure can occur due to combustion, industrial exposure, or ingestion of products containing cyanide, and blocks the utilization of oxygen at the cellular level, resulting in cellular suffocation and death.
Cyanide exposure can cause altered mental status, headache, palpitations, and an odor of bitter almonds on the patient's breath, with rapid and labored respirations early on, followed by slow and gasping respirations.
Costic exposure involves strong acids and strong alkalis used in industry, agriculture, and the home, and can cause severe pain in the mouth, throat, and chest, as well as respiratory distress.
Methyl alcohol and ethylene glycol are more toxic than ethyl alcohol and can cause a drunken feeling, followed by severe toxicity, blindness, renal failure, and eventually death.
Hydrocarbons are found in cleaning and polishing agents, glues, spot removers, lighter fluids, paints, and thinners, and can cause life-threatening toxicity and sudden death.
Multiple patients with similar signs and symptoms at the same scene may be considered food poisoning, with treatment involving supportive care.
Few plants are actually poisonous, but some ornamental shrubs and house plants can be toxic, with most plant-related exposures involving children younger than 6 years.

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Description

This quiz covers the effects of various substances on the body, including alcohol, opioids, stimulants, hallucinogens, and other drugs. It also covers poisoning from metals, gases, and other substances, and the treatment of these conditions.