Antidotes

Question 1

Benzodiazepines

Answer 1

Flumazenil

Question 2

Beta blocker

Answer 2

Atropine (antimuscarinic - inhibits parasympathetic NS) up to 3mg IV

Or glucagon + glucose

Question 3

Cyanide

Answer 3

100% O2
GI decontamination

Moderate: sodium nitrate/sodium thiosulfate
Or dicolbalt edetate then glucose
Or hydroxycobalamin
(Binds cyanide)

Question 4

Carbon monoxide

Answer 4

Remove source
100% O2 unti; COHb <10%
Anticipate cerebral oedema with mannitol
Consider hyperbaric O2

Question 5

Digoxin

Answer 5

Correct hypokalaemia

Inactivate with Digoxin-specific antibody fragments

Question 6

Iron

Answer 6

Desferrioxamine

Question 7

Oral anticoags

Answer 7

Vitamin K slow IV

Pro-thrombin complex concentrate or FFP

Question 8

Opiates

Answer 8

Naloxone 0.4-2mg IV

Question 9

Organophosphate insecticides

Answer 9

Atropine IV 2mg every 10min

Question 10

Aspirin

Answer 10

Correct dehydration
ECG
Bloods: paracetamol & salicylate lvls, glucose, U&E, LFT, INR, ABG, HCO3, FBC
Urine: pH, consider catheter to monitor UO
Correct acidosis (e.g, sodium bicarb)
Consider Dialysis

Question 11

Paracetamol

Answer 11

GI decontamination presenting <4h
Activated charcoal 1g/kg (max 50g)
Bloods: glucose, U&E, LFT, INR, ABG, FBC, HCO3, blood paracetamol lvl
If <10-12h post OD & plasma paracetamol above threshold: N-acetyl cycteine
If >8-24h & suspect large OD: start N-acetylcycteine, stopping if below treatment line