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Medicine (MD/DO)
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USMLE Step 1
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Pharmacology
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Toxicities & Antidotes

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Pharmacology | Medicine (MD/DO) School Study Aid

Toxicities & Antidotes
37 Picmonics to Learn | 1 hr 3 mins
Benzodiazepine Intoxication Assessment
Drowsiness
Confusion
Respiratory Depression
Hypotension
Coma
Treatment
Flumazenil (Romazicon)
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2 mins
Benzodiazepine Antidote
Antidote
Flumazenil
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40 secs
Warfarin Antidotes
Antidotes
Vitamin K
Fresh Frozen Plasma
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59 secs
Alteplase
Mechanism
Tissue Plasminogen Activator
Indications
Thrombosis
Side Effects
Bleeding
Contraindications
Intracranial Hemorrhage
Internal Hemorrhaging
Considerations
Minimize Bleeding
Monitor for Shock
Antidote
Aminocaproic Acid
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2 mins
Acetylcholinesterase Inhibitor Poisoning
DUMBBELSS
Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Emesis
Lacrimation
Salivation
Sweating
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2 mins
Acetylcholinesterase Inhibitor Antidote
Antidote
Atropine
Pralidoxime
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1 min
Acetaminophen Antidote
Antidote
N-Acetylcysteine
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33 secs
Aspirin Poisoning (Salicylism) Assessment
Early Symptoms
Nausea and Vomiting
Tinnitus
Confusion
Hyperventilation
Respiratory Alkalosis
Late Symptoms
Metabolic Acidosis
Coma
Hyperthermia
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1 min
Atropine
Indications
Blocks DUMBBeLSS
Bradycardia
Side Effects
Skin Flushing
Increased Temperature
Dry Mouth
Cycloplegia
Disorientation
Mydriasis
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1 min
Antimuscarinic Antidote
Antidote
Physostigmine Salicylate
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44 secs
Amphetamines Intoxication Assessment
Euphoria
Insomnia
Mydriasis
Diaphoresis
Hypertension
Tachycardia
Paranoia
Anxiety
Anorexia
Seizures
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2 mins
Amphetamine Antidote
Antidote
Ammonium Chloride (NH4Cl)
Acidify Urine
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34 secs
Beta Blocker Antidote
Antidote
Glucagon
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29 secs
Arsenic, Gold and Copper Antidotes
Toxic Metals
Arsenic
Gold
Copper
Antidotes
Penicillamine
Dimercaprol (BAL)
Succimer
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2 mins
Iron Antidote
Antidote
DeFEroxamine
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23 secs
Opioid Antidote
Antidote
Naloxone
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29 secs
Tricyclic Antidepressant (TCA) Antidote
Antidote
Sodium Bicarbonate (NaHCO3)
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27 secs
Lead Antidotes
Antidotes
Dimercaprol
CaEDTA
Succimer
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39 secs
Acute Digoxin Toxicity
Clinical Symptoms
Hyperkalemia
Cholinergic (Nausea, Vomiting, Diarrhea)
Blurry Yellow Green Vision with Halo of Light
Arrhythmia
Bradycardia
EKG Changes
Prolonged PR interval
Decreased QT
Scooping on EKG
T Wave Inversion
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2 mins
Digoxin Toxicity Treatment
Activated Charcoal
Slowly Normalize K+
Digibind (Anti-Digoxin Fab)
Magnesium Sulfate
Lidocaine
Cardiac Pacing
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2 mins
Activated Charcoal (Actidose)
Mechanism
Binds to Toxins
Indications
Ingested Poison
Side Effects
Black Stool
GI Distress
Considerations
Give As Soon As Possible
Via Mouth or NG Tube
Gastric Lavage
Do Not Administer with Antidotes
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2 mins
Substance Use Disorder Assessment (Formerly Substance Abuse Assessment)
Changes in Mood
Poor Hygiene
Odd Sleep Patterns
Frequent Injuries
Relationship or Job Difficulty
Poor Performance
Anorexia OR Weight Loss
Social Isolation
Financial Problems
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2 mins
Marijuana Intoxication Assessment
Euphoria
Slowed Reaction Time
Conjunctival Injection
Increased Appetite
Anxiety
Social Withdrawal
Paranoid Delusions
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2 mins
Alcohol Use Disorder Assessment (Formerly Alcohol Abuse Assessment)
Intoxication
CNS Depression
Withdrawal
Wernicke-Korsakoff Syndrome
Medical Complications
GI Distress
Cardiomyopathy
Pancreatitis
Cirrhosis
Immunosuppression
Sexual Dysfunction
Considerations
Screening (Assessments)
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3 mins
Alcohol Use Disorder Interventions (Formerly Alcohol Abuse Interventions)
Withdrawal
Reduce Environmental Stimuli
Antianxiety Medications
Vitamin Supplements
Seizure Precautions
Suicide Precautions
Fever
Considerations
Identify Support Systems
Group Therapy
Disulfiram
Naltrexone
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2 mins
Cocaine Intoxication Assessment
Euphoria
Delusions
Mydriasis
Hallucinations
Agitation
Hypertension
Arrhythmias
Hyperthermia
Seizures
Nasal Septum Perforation
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2 mins
LSD Intoxication Assessment
Psychosis
Perceptual Distortion
Visual Hallucinations
Paranoia
Depersonalization
Anxiety
Tachycardia
Flashbacks
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2 mins
Phencyclidine (PCP) Intoxication Assessment
Violent Behavior
Motor Issues
Nystagmus
Increased Pain Tolerance
Tachycardia
Delirium
Seizures
Psychosis
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2 mins
Opioid Use Disorder and Withdrawal Assessment (Formerly Opioid Abuse and Withdrawal Assessment)
Abuse Assessment
Euphoria
Miosis
CNS Depression
Abuse Withdrawal
Yawning
Gooseflesh
Sweating
Rhinorrhea
Kicking Movements
Consideration
Naloxone
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1 min
Naloxone (Narcan)
Mechanism
Competitive Opioid Receptor Antagonist
Indications
Opioid Induced CNS Depression
Side Effects
Severe Nausea and Vomiting
Excitable State
Opioid Withdrawal Symptoms
Considerations
Repeated Dosing Often Required
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1 min
MDMA (Ecstasy) Toxicity: Management
Airway Management
Management of Hypertension
Benzodiazapines
Nitroprusside
Activated Charcoal if Within One Hour of Ingestion
Ice Bath if Hyperthermic
Cyproheptadine if Serotonin Syndrome
Fluid Restriction for Hyponatremia
Hypertonic Saline if Hyponatremia + Altered Mental Status
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4 mins
Cyanide Poisoning Diagnosis and Treatment
Lab Findings
Lactic Acidosis
Elevated Venous PO2
Check Carboxyhemoglobin
Management
Sodium Nitrate PLUS Sodium Thiosulfate
Methemoglobinemia
OR Hydroxocobalamin (First Line)
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4 mins
Cyanide Poisoning: Pathophysiology and Clinical Manifestation
Pathophysiology
Inhibits Complex IV of Oxidative Phosphorylation
Forces Cells Into Anaerobic Metabolism
Presentation
Exposure to Fire Fumes
Industrial Exposure
Headache and Confusion
Arrhythmias
"Cherry Red" Skin
Almond Breath/Taste
Acute Renal Failure
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4 mins
MDMA (Ecstasy) Toxicity: Mechanism and Clinical Findings
Mechanism
Sympathomimetic
Increases Release and Blocks Reuptake of Catecholamines
Clinical Presentation
Euphoria
Increased Alertness
Extreme Hyponatremia Leading to Altered Mental Status
Acute Liver Injury
Serotonin Syndrome
Rhabdomyolysis
Hypertensive Urgency/Emergency
Arrhythmia
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5 mins
Substance Use Disorder
Diagnostic Criteria
2 or More Symptoms For 1 year
Tolerance
Withdrawal Symptoms
Cravings
Using More Than Intended
Inability to Cut Down
Time-Consuming Substance Acquisition
Impaired Functioning at Work
Reduced Recreational Activities
Dangerous Activities
Continued Use
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2 mins
Long-acting Benzodiazepines
Drug Names
Lorazepam
Diazepam
Clonazepam
Chlordiazepoxide
Indications
Insomnia
Anxiety
Seizures
Eclampsia
Alcohol Withdrawal
Considerations
Half-life > 24 Hours
Dependence
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3 mins
Methemoglobinemia Diagnosis and Management
Clinical Features
Cyanosis
Respiratory Distress
Headache
Lethargy
Diagnosis
"Chocolate-colored Blood"
Decreased Oxygen Saturation
Normal Partial Pressure of Arterial O2 (PaO2)
Management
Identify Triggers
Methylene Blue
Vitamin C
Exchange Transfusion
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3 mins

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