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TCA Toxicity Quiz Stats

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Hint Answer % Correct
Are TCA's on the one pill can kill list?Yes
100%
Time to peak (range in hours) in both therapeutic and overdose2-8
60%
TCAs are weak acids or bases?bases
60%
Therapeutic mechanism of action: TCAs inhibit presynaptic reuptakes of NE and ______Serotonin
60%
Tertiary amines, like clomipramine, are more potent reuptake inhibitors of ______?serotonin
60%
Secondary amines are more potent reuptake ihibitors of ______?Norepinephrine
60%
TCAs bind to other receptors at therapeutic and toxic doses? Antagonizing which receptor causes dry mouth, blurry vision, constipation, urinary retention, and increased HR?Muscarinic Receptor
60%
Antagonizing which receptor causes vasodilation and dizziness?alpha-1 receptor
60%
How many systems are affected?Two
60%
System 1:Cardiovascular
60%
What receptor influences hypotension?alpha-1
60%
Which receptor is responsible for a widened QRS interval?sodium
60%
System 2:CNS
60%
When managing the patient's ABC's, is the patient's hypertension and tachycardia supposed to be managed?No, because the patient is going to have reflex hypotension and this may cause the patient to crash
60%
Does TCA toxicity correlate with toxicity?No
60%
QRS over _____msec is significant?100
60%
Antidote chemicalSodium Bicarb
60%
Vd range in both therapeutic and overdose (L/kg)15-40
40%
Protein binding %95
40%
Basic drugs bind to this proteinalpha-glycoprotein
40%
Acidic drugs bind to this proteinalbumin
40%
Ionized or unionized at gastric pHionized
40%
Hint Answer % Correct
High or low first pass metabolism?High
40%
Antagonizing which receptor can cause Dysrhythmias, coma, and seizures?Sodium Channel
40%
Increased NE and ACh antangonism will cause initial ______?Tachycardia and Hypertension
40%
Increase in blood pressure and heart rate will cause reflex ______?Hypotension
40%
Decontamination method of choiceGastric lavage
40%
Drug of choice for seizures?Benzodiazepines
40%
Lab to monitor in TCA toxicity three times in the first 6 hours??EKG
40%
Increased QRS intervals correlate with arrythmias and ______?seizures
40%
Antidote techniqueSerum alkalinization
40%
Antidote increases serum pH causing the TCA to (increase/decrease) binding to alpha-glycoprotein?Increase
40%
Increasing serum pH causes TCA to become ionized/unionized and make it less toxic by inhibiting the binding to Na-channels?Unionized
40%
Metabolism enzyme classCYP
20%
Half life range (hours)7-56
20%
Sodium channel blockade can cause a slowed propagation which manifests as a long QTc, right BBB, and _____? Widened QRS
20%
Sodium channel blockade in the CNS can cause which symptom?Seizures
20%
What symptom discourages the use of charcoal?seizures
20%
How to treat hypotension? (3 letters)F/P/P
20%
Antidote indicated when _____QRS>100ms
20%
How many mEq/L in D5W is given to patient, just like the case of salicylates?150
20%
What is 1-2X the maintanence rate (mL/hour)?100-200
20%
Titrate serum to pH of ______7.5-7.55
20%
Endpoints: When signs and symptoms of toxicity decrease and QRS interval decreases below _____ msec100
20%

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Created Jan 12, 2016ReportNominate
Tags:toxicity

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