Emergency Preparedness Flashcards

1
Q

Common Symptomatic Treatment for Overdose

  • Symptoms
  • Agitation
  • Bradycardia
  • Seizures
  • HTN
  • Hypoglycemia
  • Hypotension
  • QRS widening
  • Sedations
    *
A
  • Symptom management
  • Sedatives such as BZDs
  • Atropine, inotropes
  • BZDs
  • IV vasodilators
  • Dextrose
  • IV fluids, vasopressors
  • Sodium Bicarb
  • Protection of airway with intubation
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2
Q

What is activated charcoal used for and when is it most effective?

A

Orally ingested drugs

Most effective when used within one hour of ingestion

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3
Q

What is the dose of activated charcoal?

A

1g/kg

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4
Q

When is activated charcoal contraindicated?

A

When the airway is unprotected (pt is unconscious cannot clear their throat and or hold their head upright)

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5
Q

What phase of acetaminophen toxicity occurs longer than 96 hours and the patient recovers or receives a liver transplant?

A

Phase 4

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6
Q

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

A

Phase two 24-48 hours

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7
Q

What happens in phase 1 acetaminophen toxicity?

A
  • Happeneds within 1-24 hours commonly asymptomatic or non-specific symptoms such as nausea and vomiting
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8
Q

What happens in phase 3 acetaminophen toxicity

A
  • Within 48-96 hours fulminant hepatic failure, jaundice, renal failure, death
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9
Q

What is the antidote for APAP overdose and how does it work?

A

NAC

Increases glutathione which increases GSH and converts NAPQI to mercapturic acid which can safely be excreted.

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10
Q

NAC Treatment

Brand names of Oral and IV

dosing of both

both different

A
  • 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
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11
Q

Is naloxone harmful if a patient doesnt have an opioid overdose?

A

No its not so you should always give it if suspected

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12
Q

Primary treatment for anticholnergic overdose?

A

Primarily supportive care but rarely physostigmine can be given

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13
Q

Warfarin antidote

A

Phytonadione: Vit K

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14
Q

Heparin, LMWH

A

Protamine

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15
Q

Direct thromin inhibitors

A

`Idarucizumab: Praxbind

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16
Q

Apixaban and Rivaroxaban

A

Coagulation factor Xa recombinant (Andexxa)

17
Q

BZD antidote

A

Flumazenel but caution can cause seizures

18
Q

Beta blockers

A

Glucagon

19
Q

Cyanide: Nitroprusside at high doses/long duration and renal impairment

A
  • Hydroxocobalamin (Cyanokit)
20
Q

Digoxin

A

Digoxin Immune Fab (Digifab)

21
Q

Ethanol

A

Thiamine B1 to prevent wernickes enceph

22
Q

Hydrocarbons petroleum products gas

A

Do not induce vomitting keep NPO due to aspiration risk

23
Q

Isoniazid

A

Pyridoxine B6

24
Q

Iron

A

Deferoxamine (Desferal)

25
Q

Organophosphates including insecticides

A

Atropine and pralidoxime

26
Q

Methotrexate

A

Leucovorin, levoleucovorin (Fuslev)

27
Q

Methemoglobinrmia from something like topical benxocaine

A

Methylene blue but is contraindicated in patients with G6DP def

28
Q

Neostigmine

A

Pralidoxime

29
Q

Paralytics: rocurronium as an example

A

Neostigmine methylsulfate (Bloxiverz): Roc, vecuronium, pancuronium

Sugammadex: Bridion: Rocuronium, vecuronium

30
Q

Salicylates

A

Sodium bicarb

31
Q

ADHD med MDMA

A

BZD

32
Q

MEthanol

A

Fomepizole (Antizol)

33
Q

Animal bites

Black widow

A

Rabies

Human rabies immune globulin (HyperRAB)

Widow: Ativenin for lactrodectus

Crolidae for rattle snake