Toxicological Emergencies Flashcards

Which antidote is indicated for acetaminophen toxicity in pediatric patients?

Answer: N-acetylcysteine (NAC)

N-acetylcysteine replenishes glutathione stores and prevents hepatotoxicity from acetaminophen overdose.

A 4-year-old presents with miosis, bradycardia, excessive secretions, and bronchospasm after pesticide exposure. Which toxidrome does this represent?

Answer: Cholinergic

Organophosphate and carbamate pesticides inhibit acetylcholinesterase, producing the cholinergic toxidrome (SLUDGE/DUMBELS).

What is the first-line antidote for opioid-induced respiratory depression in a pediatric patient?

Answer: Naloxone

Naloxone is a competitive opioid receptor antagonist that rapidly reverses opioid-induced respiratory depression and sedation.

Which GI decontamination method is MOST appropriate for an alert 2-year-old who ingested an unknown substance 30 minutes ago?

Answer: Activated charcoal

Activated charcoal is most effective when given within 1 hour of ingestion in alert patients who can protect their airway.

A teenager presents with hyperthermia, tachycardia, hypertension, agitation, and dilated pupils. Which toxidrome is most likely?

Answer: Sympathomimetic toxidrome

Sympathomimetic toxidrome from cocaine or amphetamines presents with hyperthermia, tachycardia, hypertension, agitation, and mydriasis.

Which clinical finding best indicates severe acetaminophen hepatotoxicity rather than early ingestion effects?

Answer: Markedly elevated transaminases with coagulopathy

Markedly elevated transaminases combined with coagulopathy signal hepatic injury from acetaminophen-induced NAPQI accumulation.

What is the appropriate dose of activated charcoal for a pediatric patient weighing 20 kg?

Answer: 20 grams

The recommended dose of activated charcoal is 1 g/kg body weight, so a 20 kg child receives 20 grams.