Drug overdose and antidoes to toxicity

Question 1

pt is found comatose near empty bottle of blue substance. Lab findings positive for high anion gap metabolic acidosis with an osmolar gap. Physical exam shows blindness. What should be given to treat this toxicity?

Answer 1

Use fomepizole or alcohol for methanol posining or dialysis

Add Folic acid for methanol poisoning

Question 2

industrial worker with rapid onset SOB, dizzyness, palpations and flushed skin after exposure to chemical fumes. Pt has tachypnea, tachycardia, narrowing of venous-arterial O2 gradient, and reddish discoloration of the skin without cyanosis. what antidotes could be given?

Answer 2

inhaled amyl nitrite
hydroxycobalumin or
sodium thiosulphate

for cyanide toxicity

Question 3

what is the MOA for amyl nitrite?

Answer 3

oxidises ferrous (2+) iron present in hobglobin to ferric (3+) iron, which generates methimoglibin and INCREASES affinity of hemoglobin for cyanide. This causes sequestering of cyanide in the blood and decreases binding and inhibition of cytochrome C in tissues.

Question 4

without antidote what serious symptoms are likely to develop in pt with cyanide poisining?

Answer 4

seizures and cardiovascular collapse

Question 5

What are the mechanisms for treatment of cyanide poisoning with hydroxycobalumin and sodium thiosulphate?

Answer 5

bind cyanide and form easily excreted water soluble metabolites

Question 6

what is the treatment for acute lead poisoning from ingestion?

Answer 6

chelation therapy with dimercaprol or edetate disodium calcium (CaNa2EDTA)

Question 7

What’s the mechanism for N-acetylcysteine used for aceteminophen OD?

Answer 7

regeneration of glutatione