CCB

Question 1

Other that CV and CNS effects , list other physiological system and its expected toxic effects

Answer 1

Metabolic system : hyperglycemia

Question 2

State 2 methods of decontamination and list one indication for each

Answer 2

1-AC activated charcoal ( within 1 hr for ER , and within 4hr if ER )
2- Whole bowel irrigation( if toxic life threatening ingestion of enteric -coated or extended release medications )

Question 3

4 year old , BIB grandmother one hr after witnessed ingestion of 3 tablets of MR diltiazem 240 mg PO
HR 40 , BP 60/40
state the key treatment over the first one hr in ED , PROVIDE ONE POINT OF DETAIL FOR EACH

Answer 3

1- IVF ( 20 ml/kg saline ) ; MAP >65mmhg
2- High dose insulin-euglycemic therapy : 50 ml of 50% glucose IV bolus + rapid short acting insulin 1unit/kg IV
3- IV adrenalin infusion : aim HR >60 bpm
4- IV infusion of 10% Ca chloride : 10 ml , aim for iCa 1.5-2 mmol/L
5- intubation : airway management and hyperventilation.