drug overdoses Flashcards
(24 cards)
beta blocker overdose symptoms
bradycardia
hypotension
heart failure
syncope
beta blocker overdose management
brady - atropine
in resistant cases glucagon used
what drugs can be cleared with haemodialysis
BLAST
Barbiturate
Lithium
Alcohol (inc methanol, ethylene glycol)
Salicylates
Theophyllines
complications of iron overdose
Metabolic acidosis
Erosion of gastric mucosa → GI bleeding
Shock
Hepatotoxicity and coagulopathy
treatment for iron overdose
> 60 mg/lg - whole bowel irrigation if within 4 hours
-desferrioxamine if serum iron >90 or abover 60 + symptomatic or iron on AXR, or in shock/acidosis
what can lithium toxicity be precipitated by
dehydration
renal failure
drugs: diuretics (especially thiazides), ACE inhibitors/angiotensin II receptor blockers, NSAIDs and metronidazole.
what concentration is lithium toxicity
above 1.5 mmol/l
features of lithium toxicity
coarse tremor (a fine tremor is seen in therapeutic levels)
hyperreflexia
acute confusion
polyuria
seizure
coma
managment of lithium toxicity
mild/mod - IV isotonic saline (monitor sodium)
severe - haemodialysis
paracetamol overdose - who can benefit from activated charcoal
those who present within an hour
treatment of paracetamol overdose
acetylcystine infused over 1 hour
adverse effect of acetylcystine
anaphylactoid reaction
- stop IV and start at slower rate
what ABG result does salicylate overdose cause
initially respiratory alkalosis due to stimulation of the respiratory centre
then later the direct acid effects of them with renal failure leads to metabolic acidosis
symptoms of salicylate overdose
hyperventilation (centrally stimulates respiration)
tinnitus
lethargy
sweating, pyrexia*
nausea/vomiting
hyperglycaemia and hypoglycaemia
seizures
coma
treatment of aspirin (salicylate) overdose
ABC
charcoal if within 1 hour
IV sodium bicarb
haemodialysis
indications for haemodialysus in salicylate overdose
serum concentration > 700mg/L
metabolic acidosis resistant to treatment
acute renal failure
pulmonary oedema
seizures
coma
causes of serotonin syndrome
-MOAI
-SSRIs + st John’s wort, and tramadol
-ecstasy
-amphetamines
features of serotonin syndrome
onset within hours
-hyperreflexia
-myoclonus
-rigidity
-hyperthermia
-sweating
-confusion
-dilated pupils
treatment of serotonin syndrome
IV fluids
benzodiazepines
severe - cryoheptadine and chlorpromazine
early features of tricyclic overdose (amitriptyline)
anticholinergic
-dry mouth
-dilated pupils
-agitation
-sinus tachy
-blurred vision
features of severe tricyclic overdose
arrhythmias
seizures
metabolic acidosis
coma
ECG changes for tricyclic overdose
sinus tachy
widening of QRS
prolongation of the QT interval
managment of tricyclic overdose
IV bicarbonate (when widening of QRS or ventricular arrythmia)
