Science Quiz / TCA Toxicity

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Do you know about TCA toxicity?

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HintAnswer
Are TCA's on the one pill can kill list?
Time to peak (range in hours) in both therapeutic and overdose
Vd range in both therapeutic and overdose (L/kg)
Metabolism enzyme class
Half life range (hours)
Protein binding %
Basic drugs bind to this protein
Acidic drugs bind to this protein
TCAs are weak acids or bases?
Ionized or unionized at gastric pH
High or low first pass metabolism?
Therapeutic mechanism of action: TCAs inhibit presynaptic reuptakes of NE and ______
Tertiary amines, like clomipramine, are more potent reuptake inhibitors of ______?
Secondary amines are more potent reuptake ihibitors of ______?
TCAs bind to other receptors at therapeutic and toxic doses? Antagonizing which receptor causes dry mouth, blurry vision, constipation, urinary retention, and increased HR?
Antagonizing which receptor causes vasodilation and dizziness?
Antagonizing which receptor can cause Dysrhythmias, coma, and seizures?
Sodium channel blockade can cause a slowed propagation which manifests as a long QTc, right BBB, and _____?
How many systems are affected?
System 1:
Increased NE and ACh antangonism will cause initial ______?
Increase in blood pressure and heart rate will cause reflex ______?
HintAnswer
What receptor influences hypotension?
Which receptor is responsible for a widened QRS interval?
System 2:
Sodium channel blockade in the CNS can cause which symptom?
When managing the patient's ABC's, is the patient's hypertension and tachycardia supposed to be managed?
Decontamination method of choice
What symptom discourages the use of charcoal?
Drug of choice for seizures?
How to treat hypotension? (3 letters)
Lab to monitor in TCA toxicity three times in the first 6 hours??
Does TCA toxicity correlate with toxicity?
Increased QRS intervals correlate with arrythmias and ______?
QRS over _____msec is significant?
Antidote technique
Antidote chemical
Antidote increases serum pH causing the TCA to (increase/decrease) binding to alpha-glycoprotein?
Increasing serum pH causes TCA to become ionized/unionized and make it less toxic by inhibiting the binding to Na-channels?
Antidote indicated when _____
How many mEq/L in D5W is given to patient, just like the case of salicylates?
What is 1-2X the maintanence rate (mL/hour)?
Titrate serum to pH of ______
Endpoints: When signs and symptoms of toxicity decrease and QRS interval decreases below _____ msec

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