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Pre-reg > Chapter 16- Emergency Poisoning > Flashcards

Chapter 16- Emergency Poisoning Flashcards

1
Q

What drug overdose is repeated doses of activated charcoal given?

A 
Carbamazepine 
Dapsone 
Phenobarbital 
Quinine 
Theophylline
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2
Q

What’s aspirin overdose treated with

A

Activated charcoal

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3
Q

What’s opioid overdose treated with

A

Repeated doses of Naloxone (short half life)

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4
Q

What’s paracetamol overdose treated with

A

Acetylcysteine

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5
Q

What is used in lidocaine toxicity?

A

Intralipid

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6
Q

What is used for benzodiazepine toxicity?

A

Flumazenil

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7
Q

What is used for digoxin toxicity?

A

Digoxin-specific antibody

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8
Q

What is used for heparin toxicity?

A

Protamine sulphate

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9
Q

What is used for opioid toxicity?

A

Naloxone

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10
Q

What is used for paracetamol toxicity?

A

Acetylcysteine

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11
Q

What is the MHRA advice surrounding the use of acetylcysteine?

A

Reminder for possible need to continue treatment even after the recommended 3 dose regimen over 21 hours
This is on an individual patient case-by-case basis

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12
Q

What two places can you find information on poisoning?

A

ToxbaseUK National Poisons Information Service

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13
Q

Within how much time of poisoning should activated charcoal ideally be taken?

A

Within 1 hour

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14
Q

Activated charcoal should not be used in the poisoning of what substances?

A

Petroleum distillates, corrosive substances, alcohols, malathion, cyanides and metal salts including iron and lithium salts

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15
Q

What is the treatment of choice for severe aspirin poisoning?

A

Haemodialysis

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16
Q

In opioid poisoning, are the patient’s pupils pinpoint or dilated?

A

Pinpoint

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17
Q

What is the disadvantage of naloxone administration in opioid poisoning?

A

Has a shorter duration of action of many opioids so may require repeated doses Can however be given via continuous infusion

18
Q

When would you consider the use of activated charcoal in paracetamol overdose?

A

If paracetamol in excess of 150 mg/kg is thought to have been ingested within the previous hour.

19
Q

In what situations would you give acetylcysteine in paracetamol overdose?

A
  • If on the treatment line on the paracetamol overdose graph-Who present 8–24 hours after taking an acute overdose of more than 150 mg/kg of paracetamol- Staggered overdose if ingested more than 150mg/kg, if patient’s risk of toxicity is uncertain- Patients with features of hepatic injury, jaundice
20
Q

When is a paracetamol overdose classed as staggered?

A

If they have taken a toxic dose over more than 1 hour

21
Q

The paracetamol treatment graph is unrelieable in what kind of overdose?

A

Staggered

22
Q

What is the dosing regimen for acetylcysteine in paracetamol overdose?

A

1st infusion for 1 hour 150mg/kg
2nd infusion for 4 hours 50mg/kg
3rd infusion for 16 hours 100mg/kg

23
Q

Does TCA overdose result in dilated or pinpoint pupils?

A

Dilated

24
Q

What is used to treat bradycardia in acute overdose of beta blockers?

A

Atropine

25
Q

What lithium level is associated with serious toxicity?

A

> 2 May need treatment with haemodialysis

26
Q

Oxygen should be administered to patients with what types of poisoning?

A

Cyanide, Carbon monoxide

27
Q

Sodium thiosulphate is used for what type of poisoning?

A

Cyanide

28
Q

How do you treat convulsions caused by overdose/poisoning?

A

If over 5 minutes in duration must give IV Diazepam or Lorazepam. If IV not available give buccal midazolam or rectal diazepam.

29
Q

How can you treat toxicity from carbamazepine, phenobarbital, quinine, theophylline or dapsone?

A

Repeated doses of charcoal

30
Q

Symptoms of aspirin poisoning?

A

Hyperventilating, tinnitus, deafness, sweating.

31
Q

How do you treat aspirin and antidepressant poisoning?

A

Treat using charcoal and sodium bicarbonate to increase the urinary excretion (make sure to correct the K+ concentration before)

32
Q

Symptoms of paracetamol poisoning?

A

Nausea and vomiting

33
Q

What is used to treat benzodiazepine overdose?

A

Flumazenil

34
Q

What is used to treat a betablocker overdose?

A

Atropine IV (reverses bradycardia)

35
Q

What is used to treat calcium channel blocker overdose? (HINT-4)

A

Charcoal, calcium chloride, calcium gluconate, atropine (for bradycardia)

36
Q

How do you treat iron poisoning?

A

Desferrioxamine mesilate (deferoxamine)

37
Q

Signs of theophylline toxicity?

A

Agitation, tachycardia, hyperglycemia, hypokalaemia

38
Q

How do you treat theophylline toxicity?

A

Repeated doses of activated charcoal, manage hypokalaemia with IV KCL, short acting beta blocker e.g esmolol for severe tachycardia

39
Q

How do you treat heparin toxicity?

A

Protamine sulphate IV

40
Q

What is more likely to occur in poisoning, hypertension or hypotension?

A

HypotensionTreat by elevating foot of bed and giving IV sodium chloride or a colloid to increase plasma volume.

41
Q

If someone is having a convulsion as a result of an overdose/ poisoning, what can be done?

A

Leave if under 5 minsIV diazepam or lorazepam (NB benzo’s should NOT be given by IM route)If IV not available:Buccal midazolam (not licensed for adults or children unfer 3 months)Rectal diazepam

42
Q

Somebody has been stung by a bee and has had a severe anaphylactic reaction to it. How should this be managed?

A

EpipenIM adrenaline/ epinephrine

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