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Emergency Medicine | Medicine (MD/DO) School Study Aid


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Toxicology
46 Picmonics to Learn | 1 hr 17 mins

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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
Acetaminophen
Indications
Fever
Pain
Mechanism of Action
Reversibly inhibits COX
Acts primarily in CNS
Side Effect
Hepatic Necrosis
N-acetylcysteine Antidote
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51 secs
Acetaminophen Antidote
Antidote
N-Acetylcysteine
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33 secs
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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59 secs
Indirect Cholinomimetics
Acetylcholinesterase Inhibitors
Doesn't Cross BBB
Edrophonium
Myasthenia Gravis (Diagnosis)
Pyridostigmine and Neostigmine
Myasthenia Gravis (Tx)
Ileus
Crosses BBB
Physostigmine
Atropine Overdose
Glaucoma
Donepezil
Alzheimer's
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2 mins
Antimuscarinic Antidote
Antidote
Physostigmine Salicylate
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44 secs
Atropine
Indications
Blocks DUMBBeLSS
Bradycardia
Side Effects
Skin Flushing
Increased Temperature
Dry Mouth
Cycloplegia
Disorientation
Mydriasis
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1 min
Anticholinergics
B.O.AT.S Acronym
Benztropine
Parkinson's Disease
Oxybutynin
Decrease bladder spasms
Atropine
Mydriasis and Cycloplegia
Scopolamine
Motion Sickness
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1 min
Arsenic, Gold and Copper Antidotes
Toxic Metals
Arsenic
Gold
Copper
Antidotes
Penicillamine
Dimercaprol (BAL)
Succimer
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2 mins
Systemic Effects of Beta-Blockers
Respiratory
Bronchoconstriction
Metabolic
Decreased Insulin
Decreased Glycolysis and Lipolysis
Eye
Reduces Intraocular Pressure
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1 min
Beta Blocker Antidote
Antidote
Glucagon
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28 secs
Barbiturates
Barb- Drug Names
Indications
Seizure Treatment
Anesthesia Induction
Mechanism of Action
Increased Duration of Cl- Channel Opening
Decrease Neuron Firing
Side Effects
Sedation
Cardiovascular and Respiratory Depression
CNS Depression
P450 inducer
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2 mins
Phenobarbital (Barbiturates)
Mechanism
Barbiturate
Indications
Seizures
Side Effects
Ataxia
Paradoxical Excitement
Fatigue/Drowsiness
Considerations
Monitor Plasma Levels
High Potential for Abuse
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1 min
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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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
Iron (Ferrous Sulfate)
Mechanism
Ferrous Salts
Indications
Anemia
Side Effects
GI Distress
Nausea and Vomiting
Dark Stools
Considerations
Take Between Meals
Liquid can Stain Teeth
Keep out of Reach from Children
Caution with GI Disorders
Avoid Antacids
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2 mins
Iron Antidote
Antidote
DeFEroxamine
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22 secs
Lead Antidotes
Antidotes
Penicillamine
Dimercaprol
CaEDTA
Succimer
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58 secs
Anion Gap Metabolic Acidosis
Pathophysiology
Increased Anion Gap
MUDPILES
Methanol
Uremia
Diabetic Ketoacidosis (DKA)
Propylene Glycol
Isoniazid or Iron
Lactic Acid
Ethylene Glycol
Salicylates
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1 min
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
Tricyclic Antidepressant (TCA) Antidote
Antidote
Sodium Bicarbonate (NaHCO3)
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26 secs
Theophylline
Indications
Asthma
Mechanism
Inhibits Phosphodiesterase
Increases cAMP
Side Effects
Cardiotoxicity
Neurotoxicity
Blocks Adenosine Action
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53 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
Warfarin
Mechanism of Action
Interferes with Vitamin K-dependent Clotting Factors
Extrinsic Pathway
Bridge with Heparin
Indications
Chronic Anticoagulation
Side Effects
Bleeding
Necrosis
Cytochrome P450
Contraindications
Pregnancy
Antidote
FFP + Vitamin K
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2 mins
Warfarin Antidotes
Antidotes
Vitamin K
Fresh Frozen Plasma
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58 secs
ACE Inhibitor Toxicity
CAPTOPRIL Mnemonic
Cough
Angioedema
Potassium Changes (Hyperkalemia)
Taste Change
Hypotension
Pregnancy Changes
Rash
Increased Renin
Lower Angiotensin II
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2 mins
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
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
Opioid Antidote
Antidote
Naloxone
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28 secs
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
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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2 mins
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
Amphetamines Intoxication Assessment
Euphoria
Insomnia
Mydriasis
Diaphoresis
Hypertension
Tachycardia
Paranoia
Anxiety
Anorexia
Seizures
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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
Phencyclidine (PCP) Intoxication Assessment
Violent Behavior
Motor Issues
Nystagmus
Increased Pain Tolerance
Tachycardia
Delirium
Psychosis
Seizures
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2 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
Ethanol Metabolism
Characteristics
Zero Order Elimination
Pathway
Ethanol
Alcohol Dehydrogenase
Produces NADH
Acetaldehyde
Acetaldehyde Dehydrogenase
Produces NADH
Acetate
Thiokinase
Acetyl-CoA
Drugs
Fomepizole
Disulfiram
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3 mins
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
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

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