Emergency Medicine Flashcards
Activated charcoal dose and when to administer
1g/kg for only one dose. (Multiple dose may be considered if patient ingested in some situations). Give within one hour of ingesting overdosed drugs.
Activated charcoal contraindication
when the airway is unprotected. Intestinal obstruction decreased peristalsis, GI tract is not intact.
Acetaminophen 4 phases
Phase 1: (1-24 hours): asymptomatic or non-specific symptoms, such as N/V
Phase 2: (24-48 hours): lab signs of hepatotoxicity. Usually symptoms from phase 1 subside.
Phase 3 (48-96 hours): hepatic failure
Phase 4 (> 96hours): the patient recovers or receives a liver transplant
N-Acetylcysteine (NAC) dose for Tylenol overdose
Oral (Cetylev): 140mg/kg x 1 followed by 70mg/kg every 4 hours x 17 additional doses.
IV (Acetadote IV): 150mg/kg IV over 60 minutes, followed by 50mg/kg IV over 4 hours, followed by 100mg/kg IV over 16 hours.
Anticholinergics overdose symptoms and treatment
Red as a beet (flushing), Dry as bone (dry skin), Blind as a bat (mydriasis, double/blurry vision), Mad as a hatter (AMS, Hot as a hare (fever).
Treatment: Supportive care. Rarely use physostigmine
Warfarin overdose treatment
Phytonadione, Kcentra
Factor Xa inhibitors overdose treatment
Kcentra, Andexxa (Andexxa is only for apixaban and rivaroxaban)
Heparin/LMWH overdose treatment
Protamine
Direct thrombin inhibitor overdose treatment
Idarucizumab
What is phytonadione
vitamin K
Benzodiazepine overdose treatment
Flumazenil
Beta-blocker overdose
Glucagon (if unresponsive to symptomatic treatment), high dose insulin with glucose if glucagon doesn’t work. Lipid emulsion to increase excretion of lipophilic drugs.
CCB overdose treatment
Glucagon, insulin, lipid emulsion, or IV calcium (chloride or gluconate)
Cyanide poisoning treatment
hydroxocobalamin or sodium thiosulfate + sodium nitrite
Digoxin overdose treatment
Digoxin immune Fab (DigiFab)
Ethanol overdose treatment
Thiamine to prevent Wernicke’s encephalopathy
Hydrocarbon poisoning treatment
Do not induce vomiting. Keep the patient NPO. Symptom management
Sulfonylurea-induced hypoglycemia treatment
octreotide
Isoniazid overdose treatment
Pyridoxine (primary tx), benzodiazepines and/or barbiturates.
Iron overdose treatment
Deferoxamine
Organophosphates poisoning treatment (insecticides, nerve gases, etc)
Atropine (to block the effects of ACh) and/or Pralidoxime (reactivates cholinesterase and treats muscle weakness and respiratory muscle paralysis)
Methotrexate overdose treatment
leucovorin or levo-leucovorin
Neostigmine or pyridostigmine overdose treatment
pralidoxime
Nicotine overdose treatment
supportive care (ex. atropine -bradycardia and benzodiazepine -seizure)
paralytics (ex.rocuronium) overdose treatment
neostigmine (helps with roc, vec, and panc) or sugammadex (this one doesn’t help with pancuronium)
Salicylate overdose treatment
Sodium bicarbonate
Stimulant overdose treatment
Supportive care (ex. benzo for seizure/agitation)
Antifreeze (ethylene glycol) or methanol overdose treatment
1st line: fomepizole. 2nd line: ethanol
Tricyclic antidepressant overdose treatment
sodium bicarbonate and supportive care. might need vasopressor to treat hypotension
Valproic acid or topiramate induced hypothermia treatment
Levocarnitine
