Asprin And Paracetamol Flashcards
Oil of winter green is also known as…
Methyl salicylate (topical keratolytic)
How can aspirin intoxication occur during treatment?
Overdose of aspirin causes pyrexia which could be mistaken as fever so patient takes even more
MOA of salicylates at therapeutic doses…
Antipyretic, anti-inflammatory, analgesic by inhibiting prostaglandin biosynthesis
Which systems are affected by salicylate toxicity (specific symptoms not written)…
GIT
CNS
kidney
Electrolyte and acid base balance
Hypersensitivity
Salicylism (8th cranial nerve)
Hyperthermia
Hematologic
Fatal dose of salicylate poisoning is…
390mg/kg body weight
Early and late causes of death in salicylate poisoning…
Early: respiratory failure (causing acidosis cuz CO2 not exhaled, opposite to earlier ik :/ ) and cardiac arrhythmia
Late: renal failure and hemorrhage
Investigations for salicylate poisoning…
Blood salicylate levels
LFT & RFT
prothrombin amd bleeding time
Arterial pH, CO2, HCO3 and potassium levels
What is the treatment of salicylate poisoning (just titles)
Supportive ABC
Gastric decontamination
Excretion of poison in blood
Symptomatic treatment
MOA of paracetamol at therapeutic and toxic level
Therapeutic: analgesic and antipyretic (due to central inhibition of prostaglandin) and weak anti-inflammatory (due to weak perilheral prsotaglandin synthesis inhibition)
Toxic: overwhelmes conjugation pathway in liver (main pathway that metabolize paracetamol) and cytochrome p450 pathway (minor) causing liver necrosis
The 4 phases of clinical presentation on paracetamol toxicity includes…
Phase 1(0.5-24hrs): GIT symptoms like nausea, vomitting, malaise, sweating, but normal conciousness level
Phase 2 (24-72hrs): chemical blood changes were there is raised AST, ALT, LDH and bilirubin and also right hypochondrial pain
Phase 3 (72-96hrs): liver failure were there is jaundice, coagulation defects and altered consciousness
Phase 4 (7-10 days): Prognosis were there is recovery or death
Fatal dose of paracetamol is…
15g
Paracetamol has 11 letters and we are 4 brothers LOL
Investigations for paracetamol poisoning include…
Serum levels of paracetamol
LFT & RFT
prothrombin time
Specific antidote for paracetamol poisonong is…
N-acetyl cysteine (NAC)
Treatment of paracitamol poisoning is by…
Supportive ABC
GIT decontamination
Specific antidote
Excretion from blood
Symptomatic
What is the MOA of NAC & dosage?
Increases glutathione availability which helps detoxify in the minor pathway (CYP450)
Enhances conjugation (major pathway)
140mg/kg initial dose
70mg/kg/4hrs for 3 days maintenance dose
