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Chapter 19: Toxicology

Terms in this set (28)

Toxicology
Study of toxic or poisonous substances.
Poison
any substance whose chemical action can damage body structures or impair body function.
What are some examples of acute and chronic poisoning ?
Overdose on heroin - acute poisoning
years of alcohol abuse - chronic poisoning
Substance abuse
is the misuse of any substance to produce a desired effect (for example, cocaine intoxication).
Overdose
when a patient takes a toxic dose of a drug.
Some chemical compounds will irritate or burn the skin or mucous membranes, resulting in burning or blistering. This patient most likely exposed it self to the poison through what route and why?
Ingesion - the presence of such injuries at the patient's mouth strongly suggest this.
What are some of the sins and symptoms of OPIODS (Heroin, Oxycodone)
Hypoventilation or respiratory arrest
Pinpoint pupils
Sededation or coma
Hypotension
What are some of the sins and symptoms of SYMPATHOMIMETICS
(Epinephrine, albuterol, cocaine, methamphetamine)
Hypertension
Tachycardia
Dilated pupils
Agitation or seizures
Hyperthermia
What are some of the sins and symptoms of SEDATIVE-HYPNOTIC
(Diazepam [valium] , secobarbital [seconal], flunitrazepam [Rohypnol] )
Slurred speech
Sedation or coma
Hypoventilation
Hypotension
What are some of the sins and symptoms of ANTICHOLINERGICS
(atropine, Jimson weed)
Tachycardia
Hyperthermia
Hypertension
Dilated pupils
Dry skin and mucous membranes
Sedation, agitation, seizures, coma, or delirium,
decreased bowel sounds
What are some of the sins and symptoms of CHOLINERGICS
(pilocarpine, nerve gas )
Excess defecation or urination
Muscle fasciculations
Pinpoint pupils
Excess lacrimation or salivation
Airway compromise
Nausea or vomiting
Why is it important to take containers such as pill bottles from the scene with you ?
Containers at the scene can provide critical information. In addition to the name and concentration of the drug, a pill bottle lable may list specific ingredients, the number of pills that were originally in the bottle, the name of the manufactures, and the dose that was prescribed.
Why is it important to examine a patients vomit in the case of acute poisoning ?
In case you see pill fragments. Technically you should collect the vomit to be later analyze by department physician.
Emergency care for a patient who has been poisoned may include actions on your part that range from ________ patients to instituting ______. Most often, you will not be administering a specific antidote because ______?
reassuring an anxious patient
CPR
most poisons do not have one.
What is the most important treatment you can perform for a poisoning?
diluting and/or physically removing the poisonous agent.
What are the four avenues poisons typically enter the body?
Inhalation
Absorption
Ingestion
Injection
Which of the four avenues is most difficult to treat and why?
Injection
you can flush the skin in absorption
give activated charcoal in ingestion
oxygen in inhalation
but there's no way to dilute or remove an injected poison.
Before you proceed with treatment of any poisoning victim what should you do first ?
contact medical control
You've deferred the inhalation poison patient to hazmat specialist who brings the patient back to you. Only thing specialist did was take the victim out to fresh air. Is scene safe what should be done?
The patient's clothing should be removed by the hazmat during extrication because it may contain trapped gases that can be released, exposing you to the toxin. SO YOU CANNOT ADMINISTER EMERGENCY CARE UNTIL THIS STEP HAS BEEN COMPLETED AND THERE IS NO DANGER OF THE POISON CONTAMINATING YOU.
What are some of the characteristics of carbon monixide poisoning?
Odorless and produce severe hypoxia without damaging or even irritating the lungs.
What are some of the characteristics of chlorine gas poisoning ?
Is very irritating to the tissues and causes airway obstruction and pulmonary edema.
What are some of the signs and symptoms of chlorine gas poisoning?
The patient may have burning eyes, sore throat, cough, chest pain, hoarseness, wheezing, respiratory distress, dizziness, confusion, headache, or stridor in severe cases.
May have seizures or AMS.
What are some of the signs and symptoms that a poison was absorbed ?
history of exposure, liquid or powder on a pt's skin, burns, itching, irritation, redness of the skin in light-skinned individuals, or typical odors of the substance.
What is the emergency treatment for a typical contact poisoning ?
1. avoid contaminating yourself or others.
2. While protecting yourself from exposure, remove the irritating or corrosive substance from the patient as rapidly as possible.
3. remove all clothing that has been contaminated with poisons or irritating substnaces, thoroughly brush off any dry chemicals, flush the skin with running watr and then wash the skin with soap and water for at least 20 min.
When is the only time you should not irrigate the contact area with water ?
When a patient has been contaminated with a poison that reacts violently with water, such as PHOSPHORUS OR ELEMENTAL SODIUM.
If syrup of ipecac causes vomiting why is not used to treat patients of ingested poisoning ?
Because if the patient has AMS there's a risk of aspiration and compromision of the airway, so ambulances don't carry it anymore.
What are some of the contraindications of activated charcoal?
ingested acid, an alkali, or ptroleum products, decreased level of consciousness and cannot protect their airway or are unable to swallow.
Tolerance
when over time, a person need routinely increasing amounts of the substance to achieve the desire effect.
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