Emergency Preparedness, Toxicology and Antidotes

Question 1

What should be administered if overdose of Bengay is suspected?

Answer 1

Bicarbonate

Question 2

What is the reversal agent of MTX

Answer 2

leucovorin (folinic acid)

Question 3

why is leucovorin used for MTX overdose?

Answer 3

it provides folate rescue

Question 4

what are some symptoms of opioid overdose?

Answer 4

pinpoint pupils, blue lips, shallow breathing, unresponsive to commands

Question 5

What drug class is indicated for stimulant overdose especially in cases of agitation and seizure?

Answer 5

BZDs

Question 6

What is an option if a child has sprayed a household chemical in their eyes and states it’s burning

Answer 6

rinse gently with tap or hose water for 15 minutes then seek medical attention

Question 7

Child resistant container yes or no: monthly pillboxes

Answer 7

no

Question 8

Child resistant container yes or no: flip caps

Answer 8

no

Question 9

Child resistant container yes or no: unit-dose packaging

Answer 9

yes

Question 10

Child resistant container yes or no: card adherence packaging

Answer 10

yes

Question 11

treatment for overdose of isoniazid

Answer 11

pyridoxine (B6)

Question 12

what type of lab abnormality would be expected in a patient with alcohol overdose

Answer 12

increased anion gap

Question 13

MOA of n-acetylcysteine in APAP overdose

Answer 13

increases glutathione to increase conversion of NAPQI to non-toxic substrates

Question 14

Reversal agent for Xarelto

Answer 14

Andexxa

Question 15

what is the rumack-mathew nomogram?

Answer 15

used to plot acetaminophen levels to predict probability of hepatoxicity. If probable or possible, NAC should be administered

Question 16

Digoxin antidote

Answer 16

DigiFab (digoxin immune antibody), Digibind

Question 17

Antidote for iron overdose

Answer 17

defeoxamine (chelating agent)

deferiprone and deferasirox for iron overload in blood transfusions

Question 18

Heparin reversal agent

Answer 18

protamine

Question 19

_____ Should be administered during alcohol intoxication to prevent ______

Answer 19

Thiamine for encephalopathy

Question 20

Glucagon can be used during hypoglycemia due to insulin and oral hypoglycemics but also for overdose of what?

Answer 20

beta blockers!

Question 21

obtunded and QRS complex widening could indicate overdose with ______ so _____ should be used

Answer 21

TCA overdose, use sodium bicarb

Question 22

What is CI in G6PD deficiency

Answer 22

methylene blue

Question 23

MOA of atropine

Answer 23

blocks acetycholine at the muscarinic receptor: treats cholinergic symptoms from organphosphate poisoning or other cholinergic drugs

Question 24

Symptoms that could be possible after contact with an organophosphate pesticide

Answer 24

eye tearing, salivation, vomiting, frequent bowel movements (CHOLINERGIC Symptoms)

Question 25

What to give for a calcium channel blocker overdose (diltiazem)

Answer 25

calcium chloride or calcium glucagon

Question 26

what is a CI for use of activated charcol

Answer 26

unprotected airway

Question 27

What happens during phase 1 of acetaminophen overdose? (1-24 hours post ingestion)

Answer 27

asymptomatic or non-specific symptoms like N/V

Question 28

what symptoms would you see later in APAP overdose (after phase 1)

Answer 28

hepatotoxicity, hepatic failure, renal failure

Question 29

Reversal agent for dabigatran (Pradaxa)

Answer 29

Praxbind or Indarucizumab

Question 30

Antidote for methanol and ethylene glycol overdose

Answer 30

1st line: Fomepizole | 2nd line: ethanol

Question 31

what is the MOA of fomepizole and what is it used to treat

Answer 31

competitive inhibitor of alcohol dehydrogenase which converts ANTIFREEZE to its toxic metabolites

Question 32

What is used for snake bites (rattlesnack and copperheads)

Answer 32

CroFab (crotalidae polyvalent immune antibody)

Question 33

What's an early symptom of nicotine overdose?

Answer 33

abdominal pain, nausea, diaphoresis, tachycardia, tremors

Question 34

what are late symptoms of nicotine overdose?

Answer 34

bradycardia, dyspnea, lethargy, coma, seizures

Question 35

What is used in cyanidetoxicity

Answer 35

hydroxocobalamin (Cyanokit) and Nithiodote (sodium thiosulfate + sodium nitrate)

Question 36

What is dangerous about nitroprusside

Answer 36

can cause cyanide toxicity if renal insufficiency present or prolonged use

Question 37

what type of symptoms would ingestion of belladonna or night shade cause?

Answer 37

anticholinergic: dry skin, flushing, blurry vision, constipation, urinary retention, tachycarida

Question 38

How long after ingestion can activated charcoal be used and considered effective?

Answer 38

1 hour post ingestion