toxicity Flashcards
management of lithium toxicity
initial= IV isotonic saline (sodium chloride)
severe = haemodyalisis
management cocaine toxicity
chest pain= GTN + benzodiazepine
hypertension= sodium nitroprusside + benzodiazepine
myadrisis
hypertonia/ hyperreflexia
wide QRS
agitation + psychosis/ hallucination
may be brady or tachycardia
what mat be causing toxicity
cocaine
criteria for liver transplant after paracetamol overdose
Arterial pH < 7.3, 24 hours after ingestion
or all of the following:
prothrombin time > 100 seconds
creatinine > 300 µmol/l
grade III or IV encephalopathy
someone has had a paracetamol overdose and is receiving an IV infusion acetylcysteine
-they begin to vomit + develop urticaria
Anaphylactoid reactions to IV acetylcysteine are generally treated by
-stopping the infusion, then restarting at a slower rate.
features of tricyclic overdose?
Early:
-dry mouth
-dilated pupils
-agitation
-sinus tachycardia
-blurred vision
Severe/ later:
-arrythmias
-seizures
-metabolic acidosis
-coma
ECG tricyclic overdose?
-sinus tachycardia
-widened QRS
-prolonged QT interval
management of tricyclic overdose?
IV bicarbonate= 1st line
may also use IV lipid emulsion
features of salycylate poisoning? (aspirin)
-hyperventilation
-tinnitus
-lethargy
-sweating/ pyrexia
-N+V
-hyperglycaemia + hypoglycaemia
-seizures
-coma
mixed respiratory alkalosis + metabolic acidosis
treatment of salicylate overdose
<1 hour activated charcoal
alkalisation of urine (sodium bicarbonate)
haemodyalisis
-acute renal failure
-pulmonary oedema
-seizures
-coma
-metabolic acidosis resistant to treatment
-serum concnetration >700
what types of overdose is a glucagon injection good for?
BB
CCB
insulin
benzodiazepine overdose management
flumazenil
benzodiazepine overdose signs
-low RR
-blurred vision/ double vision
-confusion/ coma
-tremors
management of an ethylene glycol or methanol poisioning?
fomepizole
when would you consider dyalisis for trycyclic overdose?
never
-it is inneffective at removing tricyclics
treatment for carbon monoxide poisoning?
1st= 100% high flow O2 (target sats 100%)
2nd= hyperbaric oxygen
management BB overdose?
atropine= 1st (for the bradycardia)
if resistent= glucagon
what elecrolyte abnormality is MDMA most associated with
hyponotramia (either due to excessive water consumption whilst taking MDMA or SAIDG)
signs of opioid toxicity
pinpoint pupuls
bradypnoea
altered mental status
