Which drugs are used to acutely control seizures?
Benzodiazopienes
When are whole bowel irrigations used?
Slow absorbed substances to reduce their chance of being absorbed into the blood
What can be done once the substance is absorbed into blood?
Haemodialysis
What is the antedote for paracetamol
N-acetylcysteine
What doesn’t bind to charcoal?
Potassium
Iron
Lead
Lithium
Alcohol
Caustic/Corrosives
Why do people die from tricyclic antidepressants?
Binds to inactive Na channels in the heart to block Na entry - causes wider QRS on ECG
What is the triad of narcotic toxicity?
Small pupil
Hypoventilation
Hypotension
What do anti-cholinergic toxins present?
Fragmentary speech
Dry - decreased SLUD, particularly dry axilla
Tachycardia
Mad as a hatter
Hot as a hare
Blind as a bat
Red as a beet
Dry as a bone
How does sympathomimetic toxicity present?
CNS excitation
Convulsion
What is activated charcoal used for?
Binds to poisons in stomach to deactivate it
How is red back spider bite treated?
Ice
Antivenom
Which substances are amenable to haemodialysis?
L - Lithium
E - Ethylene glycol
T - Theophyline
M- Methanol
S - Salicylates
A - Atenolol
V - Valproic acid
P - Potassium
What do you think of with an increased anion gap?
M - methanol
U - Uremia
D - Diabetic ketoacidosis
P - Paraldehyde
I - Iron, isoniazid
L - Lactic acidosis
E - Ethylene glycol, methanol
S - Salicylate poisoning
What is the pathophysiology of paracetamol toxicity?
The ability of glutathione to metabolise paracetamol is overwhelm and NAPQI is produced - damage
What is the toxic dose of paracetamol?
150/200mg/kg
What is the most common drug overdosed on?
Paracetamol
What are the features of serotonin syndrome?
Agitation
Hyperreflexia
Diaphoresis
Tachycardia
Clonus
Automonic instability
Increase bowel sounds, diarrhoea
How does withdrawal syndrome present?
Diarrhoea
Tachycardia
Piloerection
Hallucination
How is paracetamol overdose managed?
Measure paracetamol levels and treat if it crosses a threshold with N-acetylcysteine therapy
If they present 8-24 hours after ingestion - treat straight away then measure levels
How does acetylcysteine work in paracetamol overdose?
Replaces glutathione
