Emergency Preparedness Flashcards
Common Symptomatic Treatment for Overdose
- Symptoms
- Agitation
- Bradycardia
- Seizures
- HTN
- Hypoglycemia
- Hypotension
- QRS widening
- Sedations
*
- Symptom management
- Sedatives such as BZDs
- Atropine, inotropes
- BZDs
- IV vasodilators
- Dextrose
- IV fluids, vasopressors
- Sodium Bicarb
- Protection of airway with intubation
What is activated charcoal used for and when is it most effective?
Orally ingested drugs
Most effective when used within one hour of ingestion
What is the dose of activated charcoal?
1g/kg
When is activated charcoal contraindicated?
When the airway is unprotected (pt is unconscious cannot clear their throat and or hold their head upright)
What phase of acetaminophen toxicity occurs longer than 96 hours and the patient recovers or receives a liver transplant?
Phase 4
What phase of acetaminophen toxicity has lab evidence of hepatotoxicity such as elevated INR, AST/ALT and other symptoms have stopped. Happens within 24-48 hours
Phase two 24-48 hours
What happens in phase 1 acetaminophen toxicity?
- Happeneds within 1-24 hours commonly asymptomatic or non-specific symptoms such as nausea and vomiting
What happens in phase 3 acetaminophen toxicity
- Within 48-96 hours fulminant hepatic failure, jaundice, renal failure, death
What is the antidote for APAP overdose and how does it work?
NAC
Increases glutathione which increases GSH and converts NAPQI to mercapturic acid which can safely be excreted.
NAC Treatment
Brand names of Oral and IV
dosing of both
both different
- Cetylev oral: 140 mg/kg x 1 then 70 mg/kg q4h x 17 additional doses
- repeat if emesis occurs within one hour
- Acetadote IV: 150 mg/kg IV over 60 minutes followed by 50 mg/kg IV over 4 hours followed by 100 mg/kg IV over 16 hours
Is naloxone harmful if a patient doesnt have an opioid overdose?
No its not so you should always give it if suspected
Primary treatment for anticholnergic overdose?
Primarily supportive care but rarely physostigmine can be given
Warfarin antidote
Phytonadione: Vit K
Heparin, LMWH
Protamine
Direct thromin inhibitors
`Idarucizumab: Praxbind
Apixaban and Rivaroxaban
Coagulation factor Xa recombinant (Andexxa)
BZD antidote
Flumazenel but caution can cause seizures
Beta blockers
Glucagon
Cyanide: Nitroprusside at high doses/long duration and renal impairment
- Hydroxocobalamin (Cyanokit)
Digoxin
Digoxin Immune Fab (Digifab)
Ethanol
Thiamine B1 to prevent wernickes enceph
Hydrocarbons petroleum products gas
Do not induce vomitting keep NPO due to aspiration risk
Isoniazid
Pyridoxine B6
Iron
Deferoxamine (Desferal)
Organophosphates including insecticides
Atropine and pralidoxime
Methotrexate
Leucovorin, levoleucovorin (Fuslev)
Methemoglobinrmia from something like topical benxocaine
Methylene blue but is contraindicated in patients with G6DP def
Neostigmine
Pralidoxime
Paralytics: rocurronium as an example
Neostigmine methylsulfate (Bloxiverz): Roc, vecuronium, pancuronium
Sugammadex: Bridion: Rocuronium, vecuronium
Salicylates
Sodium bicarb
ADHD med MDMA
BZD
MEthanol
Fomepizole (Antizol)
Animal bites
Black widow
Rabies
Human rabies immune globulin (HyperRAB)
Widow: Ativenin for lactrodectus
Crolidae for rattle snake
