Overdose Flashcards

1
Q

Presentation of aspirin overdose

A

Tinnitus, nausea and vomiting, fever, confusion

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2
Q

Signs of aspirin overdose

A

Tachycardia, fever, initial respiratory alkalosis then later by metabolic acidosis

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3
Q

Diagnosis of aspirin overdose

A

VBG looking for acid base imbalance and salicyclate levels

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4
Q

Management of aspirin overdose

A

IV fluids, sodium bicarbonate, potassium chloride.
Dialysis

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5
Q

Aim of management in aspirin overdose

A

Maintain good kidney function and to alkalise thhe urine to increase salicyclate excretion

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6
Q

Complications of aspirin overdose

A

Renal function decline, chest XR showing pulmonary oedema, CT head if signs of cerebral oedema

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7
Q

Symptoms of digoxin poisoning

A

Dizziness, nausea and vomiting, palpitations, visual haloes, yellow/green colour disturbance, confusion

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8
Q

Signs of digoxin poisoning

A

Bradycardia typically without hypotension, Hyperkalaemia

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9
Q

What is the active component in anti-freeze

A

Ethylene glycol

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10
Q

Early features of ethylene glycol poisoning

A

Apparent intoxication, nausea and vomiting, haematemesis, seizures, ataxia, opthalmoplegia, papilloedema, pulmonary oedema, raised anion gap metabolic acidosis

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11
Q

Later features of ethylene glycol poisoning

A

Acute tubular necrosis, hypocalcaemia, hyperkalaemia, hypomagnesaemia

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12
Q

Management of ethylene glycol if acute presentation

A

Gastric lavage or NG aspiration if <1 hour since ingestion

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13
Q

Management of ethylene glycol overdose

A

Fomepizole which prevents metabolism. Alcohol if unavailable, haemofilatration in severe cases

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14
Q

Management of digoxin overdose

A

Immediate digoxin level, IV fluids, correct electrolyte abnormality, continuous cardiac monitoring

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15
Q

When is digibind given in digoxin poisoning

A

If levels >15 after 6 hours
If levels >10 within 6 hours
If symptomatic

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16
Q

Symptoms of paracetemol overdose

A

None, nausea and vomiting, loin pain, abdominal pain, coma

17
Q

Signs of paracetemol overdose

A

Haematuria, proteinuria, jaundice, severe metabolic acidosis

18
Q

Management of paracetemol overdose

A

N-acetylcysteine (NAC)

19
Q

What is a complication of NAC treatment

A

Can cause analphylactoid reaction which are not true reactions,but managed by stopping the infusion temporarily and restarting at lower rate

20
Q

Which groups of patients is there an increased risk of toxicity from paracetemol in

A

Long term enzyme inducers, regular alcohol excess, pre-existing liver disease, glutathione-deplete states - eating disorders, malnutrition, HIV

21
Q

Signs of TCA overdose

A

Drowsiness, arrhythmias, seizures, vomiting, headache, flushing, dilated pupils, confusion

22
Q

Investigations into TCA overdose

A

FBC and VBG (acidosis)
ECG showing QT prolongation

23
Q

Management of TCA overdose

A

Supportive, ITU, RRT

24
Q

Features of benzodiazepine toxicity

A

Lethargy, ataxia, slurred speech, coma, respiratory depression

25
Q

Features of beta blocker overdose

A

Bradycardia, hypotension, mild hypoglycaemia, mild hyperkalaemia

26
Q

Features of cyanide poisoning

A

Nausea and vomiting, rapid loss of consciousness, apnoea, seizures, cardiac arrest

27
Q

Featurse of opioid overdose

A

Pinpoint pupils, confusion, respiratory depression, cyanosis is severe

28
Q

Features of phenothiazine / proclorpromazine overdose

A

Dystonia, sedation, dry mouth, hyperthermia, dysrhythmias

28
Q

Features of phenothiazine / proclorpromazine overdose

A

Dystonia, sedation, dry mouth, hyperthermia, dysrhythmias

28
Q

Features of phenothiazine / proclorpromazine overdose

A

Dystonia, sedation, dry mouth, hyperthermia, dysrhythmias

28
Q

Features of phenothiazine / proclorpromazine overdose

A

Dystonia, sedation, dry mouth, hyperthermia, dysrhythmias

28
Q

Features of phenothiazine / proclorpromazine overdose

A

Dystonia, sedation, dry mouth, hyperthermia, dysrhythmias

29
Q

Features of phenothiazine / proclorpromazine overdose

A

Dystonia, sedation, dry mouth, hyperthermia, dysrhythmias

30
Q

Features of phenothiazine / proclorpromazine overdose

A

Dystonia, sedation, dry mouth, hyperthermia, dysrhythmias

31
Q

Featurs of organophosphate overdose

A

Salivation
Lacrimation
Urination
Diarrhoea
Small pupils, fasciculations, bradycardia

32
Q

Features of MDMA (ecstasy overdose)

A

Agitation, tachycardia, hyperthermia, acute renal failure, hypo/hypertension, mydriasis