Toxicology Flashcards
Whole bowel irrigation
Need NGT insertion
1:1 nursing
Give 1-2L/hr PEG solution until clear effluent
Used for:
LIMBS
Lithium
Iron
Metals (lead)
Body packers
SR preparations: beta blockers, verapamil, diltiazem, metformin
Also venlafaxine
Contraindications:
Combative/uncooperative patient
Reduced GCS if airway not secured
Haemodynamic instability
MDAC
These people drink charcoal quickly:
Theophylline
Phenobarbitone
Dapsone
Carbamazepine
Quinine
Initial dose 50g then 25g q2hrs
Check for bowel sounds
Dialysable drugs
BLISTMED
Barbiturates
Lithium
Isoniazid
Salicylates
Toxic alcohols/theophylline
Metformin, methanol
Ethylene glycol
Dabigatran
- also carbamazepine, sodium valproate
- aeiou: acidosis, electrolytes, intoxication, overload, uraemia
Na channel blockers
TCAs
Antidepressants: venlafaxine, citalopram
Propranolol
Type 1a antiarrhythmics: procainamide
Type 1c antiarrhythmics: flecainide
Antiepileptics: Carbamazepine
Local anaesthetics: lignocaine, cocaine
Quinine
Sodium valproate/phenytoin don’t usually present with features on overdose
> 100ms risk of seizures
160ms risk of arrhythmias
QT prolonging agents
Antipsychotics: haloperidol, droperidol, quetiapine
Antibiotics: erythromycin
Antidepressants: citalopram, venlafaxine
Antihistamines: loratadine
Hypokalaemia, hypocalcaemia, hypomagnasaemia
Antiarrhythmics: procainamide, flecainide
Sotalol
Quinine/chloroquine
Marine envenomation
Box jellyfish
- cardiovascular collapse
- severe pain and urticarial welts
- remove tentacles and use vinegar
- CPR
- 1 vial antivenom 1:10 with saline over 15 minutes
Irukandji
- delayed symptom onset
- severe pain
- catecholamine surge with hypertension and tachycardia leading to APO and cardiogenic shock
- no role for antivenom
Blue ringed octopus
- ascending flaccid paralysis
- tetrodotoxin
- apply PIB
- may need intubation
Sea snakes
- myotoxicity, nausea, vomiting, neurotoxicity is rare
- PIB
- will need monovalent sea snake antivenom 1:10 with saline over 15 minutes
