Poisoning MC Flashcards
is activated charcoal used to perfom gastric lavage after poisoning
FALSE
should activated charcoal be given within one to two hours of ingestion of poison?
YES
what is the aim of naloxen admin in an opiate overdose?
Competitive agonist for opioid and opiate drugs. Usually used in patients with opioid poisoning who have significant drowsiness
what is naloxenes half life?
It has a short duration of action (20-90mins) which means you can give rapid infusions as and when needed for the patient.
Patients who have taken an over dose of long acting opioids may need naloxone infusion for 24-48hours.
which drug might be needed to counteract the hypotension seen in beta blockers overdose?
- Glucagon is needed to exert a positive inotropic effect by stimulating adenylate cyclase independently
- Bolus dose of 10mg needed i/v 5-10mins and then needs to be titrated against the patients blood pressure or given as an infusion depending on the response
- The effects can be seen within a few minutes and last up to 15 minutes
- Side effect of nausea indication that the trial dose of glucagon has been given
- Sometimes you might need to also give an anti-emetic due to the risk of hyperglycaemia due to the large dose of glucagon.
what do you give for a paracetamol overdsoe?
- Antidote = N-acetylcysteine (NAC) sold as Parvolex
- Admin within 1st 8 hours is 100% effective
how does NAC work?
- Mode of action = within the first 8-10hrs it works as glutathione donor and this conjugates the toxic paracetamol metabolite
- Usually admin is based on the plasma conc of paracetamol, can be up to 24 hours after ingestion but usually before 12hours is the best
what are the symptoms of diamorphine poisoning?
Severe opioid toxicity produces depression of the respiratory and central nervous systems and pin-point pupils. If untreated the depression of the level of consciousness can lead to deep coma, convulsions and respiratory arrest.
what do you give for a diamoprhine overdose/
Naloxone
The dose of naloxone depends on the circumstances of exposure. Please choose carefully from the following
Consider oral activated charcoal (charcoal dose: 50 g in adults, 1 g/kg in children)
Look for and REMOVE ANY OPIOID-CONTAINING TRANSDERMAL PATCHES
what monitoring do you need to give a patient with diamorphine overdose?
Monitor BP, pulse, respiratory rate, oxygen saturation and conscious level at least hourly for at least 6 hours after exposure or 12 hours if a modified release preparation has been ingested.
what are symptoms of a carbamazepine overdose?
Ataxia, nystagmus, drowsiness, dysarthria and agitation with tachycardia, hypotension, dilated pupils and hyperreflexia.
More severe poisoning leads to coma, respiratory depression and convulsions.
ECG abnormalities similar to those seen in tricyclic antidepressant toxicity may occur and include prolongation of the QRS, QT and PR.
Electrolyte disturbances (including hyponatraemia and hypokalaemia) and abnormal liver function tests may be present.
what do you give for a carbamazepine overdose/
Maintain a clear airway and ensure adequate ventilation.
Cardiac arrest
In the event of cardiac arrest in hospital or witnessed out of hospital cardiac arrest with bystander CPR, resuscitation should be continued for at least 1 hour and only stopped after discussion with a senior clinician
what do you need to monitor after a carbamazepine overdose?
Monitor vital signs and cardiac rhythm; check the capillary blood sugar.
Perform a 12-lead ECG in all patients who require assessment.
what are the symptoms of an ammonia overdose?
Ammonia is corrosive at high concentrations and irritant at low concentrations. In addition, exposure to high concentrations of ammonia gas can cause suffocation. Exposure by any route (ingestion, inhalation, dermal or ocular exposure) may be dangerous; however the most common route of exposure is inhalation.
