104 Suicide and Self harm Flashcards
Which disease is L-DOPA used to treat?
Parkinsons
Which OD is N-acetylcystein used to treat?
Paracetamol poisoning
What is the MOA of N-acetylcystein?
- Maintains/restores hepatic concentrations of glutathione by producing its precursor - cystein
- required to inactivate the metabolite of paracetamol which is hepatotoxic.
What dose of paracetamol produces hepatotoxicity?
150mg/kg in 1 hour
What investigation is used to determine the degree of paracetamol poisoning?
Plasma-paracetamol concentraton
When should initiation of N-acetylcystein commence?
- when plasma paracetamol concentration is above treatment line on the graph
- when 8-24 hours have elapsed post OD of 150mg/kg
- after a staggered OD
Which groups are the most likely to commit suicide?
- Women 16-24 yrs
- Middle aged men
Which OD is this?
- hypertonia
- hyperreflexia and extensor plantar response
- myoclonus
- myadriasis
- sinus tachy
What is the antidote
TCAs
Use sodium bicarbonate - raises the BP and narrows QRS complex. Affects the protein binding of the drug
Which OD is naloxone used to treat? What is the risk here?
Opiate OD. Short half life so risk of re-sedation –> must observe pts.
Which OD is flumazenil used to treat? What is the risk here?
- OD of benzos.
- Also used as an anti fitting medication so pt may start fitting when reversing OD
Which OD is methionine used to treat?
Paracetamol OD - 2nd line
What are the symptoms of CO poisoning?
(5 listed)
- headache
- nausea
- vertigo
- subjective weakness
- altered level of consciousness
How does CO produce cellular poisoning?
Binds to cytochrome A3 and P450 –> inhibits cellular respiration
What investigations should be performed when considering CO poisoning?
- carboxyhaemoglobin measurement
- ABG
- ECG
- U&E
- CXR
Give 10015 high flow O2 until asymptomatic and SOHb is <10%
What is somatisation?
Psychological causes of physical illness
Name the 4 categories of Durkheim’s theory of social integration
- alturisting
- fantalistic
- egotistic
- anomic
Name the 4 methods of decontamination following poisoning (3 aren’t routinely done)
- forced emesis
- gastric lavage
- catharsis
- activated charcoal
What are the 3 methods of advanced elimination when treating poisoning?
- urine alkalination
- haemodialysis
- haemoperfusion
Which method of advanced elimination is useful in eliminating:
- Theophyline
- carbamazepine
Haemoperfusion
What is the treatment for OD of TCAs?
Bicarbonate
What is diclobalt used to treat?
Cyanide poisoning
Which OD show the following:
- anorexia
- N&V
- abdo pain
- jaundice/encephalopathy
- renal failure
Paracetamol
Which OD shows the following:
- tachycardia
- hyperthermia
- delerium
- agitation
- myadriasis
MDMA
Which OD shows the following:
- coma
- hypotonia
- hyperreflexia
- extensor/absent plantar response
Benzo’s
