Toxicology - Pediatric Unintentional Exposures

Question 1

Supportive Care

Answer 1

airway stabilization
early antidote administration, if indicated

Question 2

Lead Antidote

Answer 2

EDTA

Question 3

Levels to Consider

Answer 3

acetaminophen
salicylates
ethanol
iron

Question 4

Activated Charcoal - Dosing

Answer 4

0.5-1 g/kg

Question 5

Acetaminophen - Toxic Dose

Answer 5

> 200 mg/kg PO
60 mg/kg IV

Question 6

NAC - PO Dosing

Answer 6

140 mg/kg load, then
70 mg/kg q4h x 17 doses

Question 7

NAC - IV Dosing

Answer 7

150 mg/kg over 1 hr, then
50 mg/kg over 4 hrs, then
100 mg/kg over 16 hrs

Question 8

Ethylene Glycol - Antidote

Answer 8

ethanol or fomepizole

Question 9

Ethylene Glycol - Management

Answer 9

ADH inhibitor
pyridoxine and thiamine 100 mg/day
supportive care
no GI decontamination (AC does not bind)

Question 10

Methanol - Management

Answer 10

ADH inhibitor
folic acid 1 mg/kg every 4-6 hrs
no GI decontamination (AC does not bind)

Question 11

Household Cleaners - Management

Answer 11

no antidote, no GI decontamination
supportive care only

Question 12

Battery Impaction - Signs & Symptoms

Answer 12

NVD
abdominal pain
refusal to eat or drink
dysphagia

Question 13

Cough & Cold Preparations - Management

Answer 13

activated charcoal
hypertension -> labetalol / nicardipine
arrhythmia -> amiodarone
seizures -> benzodiazepines

Question 14

Fomepizole - Dosing

Answer 14

15 mg/kg load, then
10 mg/kg q12h x 4 doses, then
15 mg/kg q12h until serum level of the toxic alcohol is < 25 mg/dL

Question 15

Ethanol - Dosing (Pediatric)

Answer 15

8 mL/kg over 1 hr load, then
0.8 mL/kg/hr cont infusion until BAC 100-150 mg/dL